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Per- and polyfiuoroalkyl substances (PFAS) on paper packaging resist water and oil to effectively contain food and beverages. However, previous studies have established correlations between PFAS and several diseases including COVID-19, cancers, and obesity. The goal of this collaborative research between the Philippines and Singapore is to set a baseline for PFAS levels in local packaging with the intended outcome of further increasing awareness on these contaminants in Southeast Asia, providing a starting point for migration experiments and risk assessments on PFAS in commercially-available food contact materials and articles, and initiating policy developments on these substances in the Philippines. In this study, 15 different types of PFAS were analyzed in selected paper packaging used by major quick service restaurants (QSRs) in Metro Manila. Using liquid chromatography-mass spectrometry (LC-MS), PFAS was detected in 100% of the samples with a total PFAS concentration range of 8.20-97.7 ng PFAS/100 cm². The highest amount of PFAS compound measured across all samples was PF-3,7-DMOA (89.8 ng/100 cm²). PFAS compounds regulated in European packaging such as PFHpA, PFOA, PFNA and PFDA were also detected in all samples but at trace levels. Paper wrappers for rice and small burgers were found to have the highest total PFAS of 97.7 ng PFAS/100 cm². This value translates to approximately 65.1 ng F/100 cm² which is way below 10,000 ng F/100 cm², the currently existing limit for PFAS in packaging set by the Danish Ministry of Environment and Food. While each packaging may be deemed safe compared to regulation, the compounded effects brought by use of multiple packaging, and high frequency and long-term exposures require further investigation. [ABSTRACT FROM AUTHOR]

Background: There is increasing interest in using verbal autopsy to produce nationally representative populationlevel estimates of causes of death. However, the burden of processing a large quantity of surveys collected with paper and pencil has been a barrier to scaling up verbal autopsy surveillance. Direct electronic data capture has been used in other large-scale surveys and can be used in verbal autopsy as well, to reduce time and cost of going from collected data to actionable information. Methods: We collected verbal autopsy interviews using paper and pencil and using electronic tablets at two sites, and measured the cost and time required to process the surveys for analysis. From these cost and time data, we extrapolated costs associated with conducting large-scale surveillance with verbal autopsy. Results: We found that the median time between data collection and data entry for surveys collected on paper and pencil was approximately 3 months. For surveys collected on electronic tablets, this was less than 2 days. For small-scale surveys, we found that the upfront costs of purchasing electronic tablets was the primary cost and resulted in a higher total cost. For large-scale surveys, the costs associated with data entry exceeded the cost of the tablets, so electronic data capture provides both a quicker and cheaper method of data collection. Conclusions: As countries increase verbal autopsy surveillance, it is important to consider the best way to design sustainable systems for data collection. Electronic data capture has the potential to greatly reduce the time and costs associated with data collection. For long-term, large-scale surveillance required by national vital statistical systems, electronic data capture reduces costs and allows data to be available sooner. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

Purpose: Informed by health activism (Zoller, 2005), the purpose of this paper is to explore the communicative processes of organizations working with women migrants in countries of destination. In particular, it explored the definitions of and explanations for health of organizations, their solutions to disease and illness, as well as, the methods and tactics they use to communicate health. Design/methodology/approach: It employed qualitative approach specifically in-depth interviews with leaders or core members of not-for-profit and faith-based organizations working with Filipina migrants in Japan. Field notes from participant observations in formal meetings and informal gatherings were likewise used as data sources. Findings: While organizations also recognized physical and spiritual health, they placed strong emphasis on mental well-being. Other than translation service, pastoral care, and shelter, coordinating with other not-for-profit and faith-based organizations, international centers, and governments was solution for addressing illness and disease. Together with face-to-face, digital media were used as method and tactic to communicate within and outside organizations. It likewise found that the organizations included were inclusive such that they also worked with other Filipinos in Japan. Originality/value: This paper contributed to migration health literature by discussing the central role of organizations for mental well-being activism, favorable consequences of coordination among organizations to promote access to quality healthcare and information and dual characterization of digital media for organizing publics. Overall, it is one of the few to explore the ways into which organizations communicatively challenge health structures in countries of destination. [ABSTRACT FROM AUTHOR]

Purpose Drawing insights from the culture-centered approach (Dutta-Bergman, 2004; Dutta, 2007), the purpose of this paper is to explore the meanings of, experiences with, and information sources for antibiotics among at-risk yet understudied populations in urban and economic margins in the Global South.Design/methodology/approach Given the exploratory purpose of this paper, it used qualitative approach specifically focus group discussions with mothers, guardians and female senior citizens from Manila, Philippines.Findings Antibiotics had multiple meanings – from purposes and modes of acquisition to side-effects. Experiences with antibiotics were not only tied to financial difficulties, but also in administering antibiotics to children or wards and managing side-effects. Furthermore, medical doctors were the most accessed and preferred sources of antibiotics-related information.Originality/value To date, this paper is one of the few to argue that knowing the conditions into which antibiotics are situated in the Global South is critical for strengthening global public health campaigns and policies against antimicrobial resistance a and reducing global health inequity. [ABSTRACT FROM AUTHOR]

Background: Existing research on health equity falls short of identifying a comprehensive set of indicators for measurement across health systems. Health systems in the ASEAN region, in particular, lack a standardised framework to assess health equity. This paper proposes a comprehensive framework to measure health equity in the ASEAN region and highlights current gaps in data availability according to its indicator components. Methods: A comprehensive literature review was undertaken to map out a core set of indicators to evaluate health equity at the health system level. Secondary data collection was subsequently conducted to assess current data availability for ASEAN states in key global health databases, national health accounts, and policy documents. Results: A robust framework to measure health equity was developed comprising 195 indicators across Health System Inputs and Processes, Outputs, Outcomes, and Contextual Factors. Total indicator data availability equated to 72.9% (1423/1950). Across the ASEAN region, the Inputs and Processes sub-component of Health Financing had complete data availability for all indicators (160/160, 100%), while Access to Essential Medicine had the least data available (6/30, 20%). Under Outputs and Outcomes, Coverage of Selected Interventions (161/270, 59.63%) and Population Health (350/350, 100%) respectively had the most data available, while other indicator sub-components had little to none (≤ 38%). 72.145% (384/530) of data is available for all Contextual Factors. Out of the 10 ASEAN countries, the Philippines had the highest data availability overall at 77.44% (151/195), while Brunei Darussalam and Vietnam had the lowest data availability at 67.18% (131/195). Conclusions: The data availability gaps highlighted in this study underscore the need for a standardised framework to guide data collection and benchmarking of health equity in ASEAN. There is a need to prioritise regular data collection for overlooked indicator areas and in countries with low levels of data availability. The application of this indicator framework and resulting data availability analysis could be conducted beyond ASEAN to enable cross-regional benchmarking of health equity. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Rural Medicine (Wolters Kluwer India Pvt Ltd) is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Deictic pronouns refer directly to the extralinguistic world (as in Stop her!), while anaphoric pronouns refer to elements introduced in discourse (as in My best friend is Mary. John adores her.). The distinction is central to linguistic theory and may be central also for understanding aphasia. This paper compares the production of deictic and anaphoric pronouns in fluent aphasia and non-fluent aphasia. It does so both for English and for Tagalog, which allows extensive omission of pronominal arguments. For both languages, the results show a dissociation between deictic and anaphoric pronouns. Non-fluent aphasic speech displays a lower proportion of anaphoric pronouns to non-pronouns than non-brain-damaged speech, while the proportion of deictic pronouns to non-pronouns is either not different (Tagalog) or higher (English). In contrast, fluent aphasic speech displays a higher proportion of deictic pronouns to non-pronouns, while the proportion of anaphoric pronouns is either not different (Tagalog) or lower (English). [ABSTRACT FROM AUTHOR]

Pharmaceutical sector corruption undermines patient access to medicines by diverting public funds for private gain and exacerbating health inequities. This paper presents an analysis of UN Convention Against Corruption (UNCAC) compliance in seven countries and examines how full UNCAC adoption may reduce corruption risks within four key pharmaceutical decision-making points: product approval, formulary selection, procurement, and dispensing. Countries were selected based on their participation in the Medicines Transparency Alliance and the WHO Good Governance for Medicines Programme. Each country’s domestic anti-corruption laws and policies were catalogued and analysed to evaluate their implementation of select UNCAC Articles relevant to the pharmaceutical sector. Countries displayed high compliance with UNCAC provisions on procurement and the recognition of most public sector corruption offences. However, several countries do not penalise private sector bribery or provide statutory protection to whistleblowers or witnesses in corruption proceedings, suggesting that private sector pharmaceutical dispensing may be a decision-making point particularly vulnerable to corruption. Fully implementing the UNCAC is a meaningful first step that countries can take reduce pharmaceutical sector corruption. However, without broader commitment to cultures of transparency and institutional integrity, corruption legislation alone is likely insufficient to ensure long-term, sustainable pharmaceutical sector good governance. [ABSTRACT FROM AUTHOR]

Background: A growing number of older adults require complex care, but coordination among professionals to provide comprehensive and high-quality care is perceived to be inadequate. Opportunities to gain the knowledge and skills important for interprofessional collaboration in the context of geriatric care are limited, particularly for those already in the workforce. A short-term training programme in interprofessional collaboration for health and social care workers in the Philippines was designed and pilot tested. The programme was devised following a review of the literature about geriatric care education and group interviews about training needs. The objectives of this paper are to introduce the training programme and to evaluate its influence on attitudes and readiness to collaborate among participants using both quantitative and qualitative methodologies.Methods: A total of 42 community health workers and 40 health institution workers participated in the training in July 2019. Quantitative indicators were used to evaluate attitudes towards and readiness for collaboration before and after the training. Content analysis was performed of responses to open-ended questions asking participants to evaluate the training. A convergent parallel mixed-methods design was applied to determine the patterns of similarities or differences between the quantitative and qualitative data.Results: Significant improvements were seen in scores on the Attitudes Towards Health Care Teams Scale among community health (P < 0.001) and health institution (P < 0.001) staff after the training. Scenario-based case studies allowed participants to work in groups to practise collaboration across professional and institutional boundaries; the case studies fostered greater collaboration and continuity of care. Exposure to other professionals during the training led to a deeper understanding of current practices among health and social care workers. Use of the scenario-based case studies followed by task-based discussion in groups was successful in engaging care professionals to provide patient-centred care.Conclusions: This pilot test of in-service training in interprofessional collaboration in geriatric care improved community and health institution workers' attitudes towards such collaboration. A 3-day training attended by health and social care workers from diverse healthcare settings resulted in recommendations to enhance collaboration when caring for older adults in their current work settings. [ABSTRACT FROM AUTHOR]

Summary: Social workers are expected to challenge the exclusion and oppression of marginalised populations which requires the critical interrogation of prejudicial views, discriminatory attitudes, and oppressive practices. In this regard, social work practitioners need to be vigilant of their own attitudes toward the people they serve. This is relevant to social work practice with sexual minorities. This paper presents the results of a mixed-methods study informed by a critical theoretical frame that explored Vietnamese social work practitioners' attitudes toward sexual minorities. The findings presented in this article were drawn from a survey of 292 social work practitioners based in Hanoi, Vietnam and 12 semi-structured interviews with volunteers recruited from the pool of survey participants. Findings: The findings suggest that practitioners who participated in this study held relatively positive attitudes toward people who identify as lesbian or gay. However, those who had what could be considered moderate to positive attitudes were not necessarily free from prejudicial and discriminatory views, particularly when it came to certain matters such as those relating to their own families and work with young children. Applications: The discussion of the findings illustrate the relevance of the broader social context to Vietnamese social work practitioners' attitudes toward sexual minorities. It highlights the potent influence of dominant ideologies in shaping prejudicial views and attitudes and points to the need for practice at a broader level targeting Vietnamese society and culture as a whole. [ABSTRACT FROM AUTHOR]

Dengue is a global health issue and is also regarded as one of the major public health concerns in the Philippines. Presented in this paper is the application of a geographic information system (GIS) in mapping dengue cases in Baguio City. A descriptive research design was utilized and mapped dengue cases were reconciled with environmental correlates such as land cover, housing information (independent, mixed, or interconnected), hydrology (water bodies and canals), urbanization level (urban or rural), elevation, soil, and land surface temperature. Moreover, demographic factors and practices were utilized for further analysis. Results show that interconnected housing, urbanization, land surface temperature, hydrology, and population density are predictors of dengue cases in Baguio City with the predictive power of 0.3810 (strong), 0.3426 (strong), 0.2509 (medium), 0.1675 (medium), and 0.1323 (medium), respectively. In the context of dengue, several data gaps in health information systems exist. Although the Manual of Procedures for the Philippine Integrated Disease Surveillance and Response (PIDSR) published by the Department of Health (DOH) of 2014 provides a detailed guide in the management and surveillance of communicable disease, the use of GIS was noted to be unspecified. Using GIS provides the possibility of harmonizing several data sets to better inform policymakers. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco industry documents reveal companies' knowledge of a similar young adult market across countries in terms of attitudes and lifestyle aspirations. Some tobacco companies, therefore, use similar marketing approaches across different jurisdictions. We examined young adults' perceptions of flavored cigarette packs, including those containing flavor capsules, in Mexico and the Philippines. METHODS We conducted a secondary analysis of five focus groups held in Mexico and four in the Philippines with young adults who smoke (aged 18-24 years), separated by gender, in which participants interacted with cigarette packs purchased locally. Transcribed and translated data were thematically analyzed and compared between countries. RESULTS Three major themes were identified: 1) Flavor capsules cigarettes are recognizable via pack design through imagery on the pack that is understood to signify capsules; 2) Colors signal flavor and make the pack attractive; and 3) Young adults who smoke identify the target audience for these products as young people and those who are beginning to smoke. CONCLUSIONS Young adults who smoke in Mexico and the Philippines interpreted flavored cigarette pack design similarly and thought that young people are the main audience for these products. This suggests a successful marketing approach creating shared perceptions of flavored cigarette packs in different world regions. It is likely that similar tactics are used in other countries around the world. Therefore, jurisdictions might use evidence from other jurisdictions to support the implementation of evidence-based tobacco control policies. These findings also support the implementation of plain and standardized packaging and flavor bans that would also limit product innovation such as capsules. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the quality of social relationships of older Filipino church members by determining their perceptions of support and non-support in their social network.Design/methodology/approach A qualitative research approach with semi-structured interviews was utilized. A purposive sample of six Filipino older adults (ages 60-89) were invited and agreed to participate in the study.Findings The themes found in the study confirmed the types of support outlined in social convoy theory. Several unique nuances in the types of support and non-support between the interactions of older adult Filipinos with people very close to them, somewhat close to them, and merely acquainted with them were identified. The themes of support include instrumental support, emotional care, social connectedness, and companionship during engagement in activities. Themes characterising lack of support include disrespect and lack of understanding, constraining one’s actions, helplessness in responding to the other’s needs, non-dependability and non-reliability, difficulty in maintaining social connections, making it difficult to play a desired or expected role.Research limitations/implications The study’s limitations are the small sample size, the quality of support explored only through nominating two members of each level of closeness in the older adults’ social convoy, sample size adequacy to reach data saturation, and the lack of data on support reciprocity that may influence the respondents’ perceptions of support and non-support.Practical implications The findings of the paper point to possible interventions to improve social support for the older population. The road map for those interested in developing interventions should also put some emphasis on older adults’ needs in their continued societal engagement. Interventions may involve facilitating role transitions and providing social support systems attuned to the needs of the elderly.Social implications The authors speculate that this lack of support experienced by the older adults relates to the loss of societal roles, especially as this relates to their identity, meaning, and changes in social interactions within their communities. It is therefore important that interventions be planned to provide structures for older adults’ transitions in their re-engagement in society and into the work-force, thereby reducing this sense of role ambiguity and providing them with more positive identities in their communities.Originality/value The results suggest another form of support distinct from the emotional and instrumental support elaborated in previous work. This support is identified as companionship from within the social network that allows older adults to sustain engagement in meaningful activities. The study’s results further suggest a lack of clarity in societal roles, i.e. a sense of role ambiguity, which older adults may experience in the transitioning from adulthood to later adulthood. [ABSTRACT FROM AUTHOR]

Aim: This paper addresses the question of how social accountability is conceptualised by staff, students and community members associated with four medical schools aspiring to be socially accountable in two countries. Methods: Using a multiple case study approach this research explored how contextual issues have influenced social accountability at four medical schools: two in Australia and two in the Philippines. This paper reports on how research participants understood social accountability. Seventy-five participants were interviewed including staff, students, health sector representatives and community members. Field notes were taken and a documentary analysis was completed. Results: Overall there were three common understandings. Socially accountable medical education was about meeting workforce, community and health needs. Social accountability was also determined by the nature and content of programs the school implemented or how it operated. Finally, social accountability was deemed a personal responsibility. The broad consensus masked the divergent perspectives people held within each school. Conclusion: The assumption that social accountability is universally understood could not be confirmed from these data. To strengthen social accountability it is useful to learn from these institutions’ experiences to contribute to the development of the theory and practice of activities within socially accountable medical schools. [ABSTRACT FROM PUBLISHER]

Building on the premises of Positive Psychology, this undertaking conducted a pilot study of the designed 14-session Positive Psychology Intervention (PPI) program established based on the character strengths and virtues (CSV) of persons who use drugs (PWUDs) to assess its usefulness, delivery details, and impacts. Conducted in one of the biggest Drug Abuse Treatment and Rehabilitation Center in the Philippines, 24 PWUDs were randomly selected by the program staff to participate in its pilot run while securing all necessary ethical guidelines and requirements. Via within-subjects pretest-posttest experimental design, the especially adapted and developed tools were used to assess the PWUDs' progress as they were facilitated by the said program. Results yielded significant improvements in the PWUDs' mental wellbeing (M = 1.29, SD = 0.35; t (21) = 9.30, P <.00001), life satisfaction (M = 1.82, SD = 0.24; t (21) = 9.89, P <.00001), and psychological functioning (M = 1.65, SD = 0.19; t (21) = 8.58, P <.00001). Moreover, the PWUDs regarded the designed PPI program very highly and experienced it with positive outcomes, especially for their CSVs. Further improvement of the said program centers around proper time allotment, number of participants in the program sessions, appropriate activities per session, including specific ice breaker games, activity materials needed, and the proper sequencing of each session. These data are used to improve the PPI program structures and components. Pertinent conclusions about the gathered data were drawn, and relevant recommendations were also thereby provided. [ABSTRACT FROM AUTHOR]

Copyright of Counseling Psychologist is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Achieving appropriate wheelchair provision at a national level is complex, requiring regulations, funding and policies established through governments. Understanding wheelchair provision within different countries is key. This paper describes the process used to support the development of wheelchair service strategic plans in Romania and the Philippines. It considers the influences, meaning, challenges and developments when producing strategic priorities within two different contexts. Methods: The International Society of Wheelchair Professionals (ISWP) sponsored affiliates Motivation Foundation Romania and the Philippine Society of Wheelchair Philippine Society of Wheelchair Professionals (PSWP), to conduct organizational ethnographic mixed method stakeholder centred studies, to develop robust strategic plans. An affiliate coordinator for wheelchair provision in less resourced settings supported this process. Results: Diversity between the two-affiliate sites was evident, influencing value placed within both societies towards equality and participation. Common components to address included: advocacy; wheelchair service infrastructure; capacity building; education; training and research. Research process facilitation supported by affiliate coordinator is important. Conclusion: Understanding contextual dimensions, which sharp a countries wheelchair service, is essential. Member states should take action by conducting in-country wheelchair sector analysis, to create wheelchair provision strategies for sustainable development, to meet personal posture and mobility needs, primary for daily living, as a basic human right. Understanding the complexity of providing appropriate wheelchairs within different countries is essential to meet the diverse needs of citizens. Conducting situational analysis of the wheelchair sector involving key stakeholders in the process is important to understand different perspectives and develop strategic priorities towards sustainable development. Producing context specific wheelchair sector reports and strategic plans strengthens the evidence base when informing governments regarding the importance of developing sustainable wheelchair provision infrastructures. The affiliate coordinator role is important to support affiliates to produce robust documentation that clearly and objectively outlines the wheelchair sector issues and plans, to provide solutions. [ABSTRACT FROM AUTHOR]

The main objective of the paper is to critically examine and document the living conditions of the Internally Displaced Persons (IDPs) from Marawi City. Forcibly displaced more than a year ago due to armed conflict, these IDPs managed to find their way to an unoccupied building in the outskirt of Iligan City, Lanao del Norte Province, Philippines. Results show their range of main concerns such as the supply of electricity and water, health services and medicines and more importantly, food. Disruptions on children's schooling and most especially the discontinuation of their parents' livelihood were also documented. The community is waiting for their "turn" to access better temporary shelters provided by the government. The study utilized key informant interview (KII) among 10 household heads (from among the 75 families living in the building). Their narratives reveal several coping strategies amidst insufficient government assistance and community feeling of isolation, the most glaring of those, is the dependency to social network, capitalizing on the social ties with relatives and friends for assistance. The IDPs admitted however that the same assistance is not enough. Additionally, the reduction of food consumption and selling of food relief packs remain unsustainable in coping with their destitute condition. Moreover, the article also touches on the consequence of their displacement context on socio-familial dynamics. [ABSTRACT FROM AUTHOR]

Aim To explore how and why mobile instant messaging applications are used by Filipino nurses as part of their work. Methods Guided by the uses and gratifications theory, in-depth interviews with 20 staff nurses working in 9 hospitals (ie, 4 private and 5 public hospitals) in the Philippines were conducted in July 2015. Interview data were analysed through a phenomenological perspective to thematic analysis. Results Results show that mobile instant messaging applications such as Facebook Messenger and Viber were mostly used by staff nurses and these were accessed using their own smartphones. Thematic analysis indicates that they were used to meet staff nurses' need for information exchange, socialization, and catharsis. Moreover, user interactions vary depending on members within a chat group. For instance, communication via mobile instant messaging applications are much formal when superiors are included in a chat group. Conclusion In general, the results show that mobile instant messaging applications are routinely used by Filipino staff nurses not only for clinical purposes (ie, information exchange) but also for non-clinical purposes (ie, socialization and catharsis). This paper ends with several practical and theoretical implications including future research directions. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cultural competence is significant in addressing the health needs of vulnerable populations. This study conducted psychometric testing of a cultural competency instrument in the Philippines. Methods: Brislin's translation and a cross-sectional online design were used. Exploratory factor analysis (EFA) with varimax rotation examined construct validity of the 23-item scale among 157 adult LGBTQ+ residents. The scale revealed overall reliability (α =.85) including two subscales (α =.87, α =.81, and α =.61). The EFA yielded three theoretical factorial solutions. Conclusion: The Filipino version of the instrument demonstrated reliability and validity. Measuring clients' perceptions of provider and organizational cultural competency can improve the utilization of healthcare in Filipino LGBTQ+ communities. Future research will examine the dimensional structures of the instrument among expanded LGBTQ+ communities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is impacting individuals and society's physical and mental health. Despite the lack of any definite and effective therapeutic regimen, public health measures such as quarantine and isolation have been instituted to contain this pandemic. However, these mitigating measures have also raised issues regarding isolated patients' mental and psychological well-being. Several stakeholders were engaged in this approach, including the university, the local health office, the tertiary hospital, and the local communities. This intervention addresses concerns regarding the health status of isolated individuals due to COVID-19 infection, making the program available to anyone who agrees to participate. This was done through telehealth services delivered via phone calls and SMS. The university provided technical support and telehealth manpower through medical students. The local health unit manages the isolation facilities, while the referral hospital offers specialty care for isolated patients through teleconsultation. Finally, the local community is the one that reintegrates discharged patients into their communities. Three hundred forty-four (344) participants were provided seven sessions on telehealth education and tracking of their COVID-19 prescribed practices and mental health. The mean age of the patients was 37 years; half were females, and 15% had comorbidities. Regarding their mental health status, the level of depression dropped from 6% to 1% (p<0.0001), the level of anxiety dropped from 12% to 2% (p<0.0001), and the level of stress dropped from 3% to 0% (p<0.0001) from the first day of admission to 2 weeks after discharge. Moreover, a general trend of statistically significant increase in various practices was noted: wearing face masks, physical distancing, disinfecting frequently held objects, hand hygiene, and self-monitoring for COVID-19 symptoms. Those with progressing symptoms of COVID-19 were referred immediately to the referral hospital. There were also no reports of complications of co-morbidities during their stay in the isolation facilities or social isolation upon community reintegration. The study concludes that telehealth services have the potential to address many challenges in providing continuous healthcare services to isolated patients until they are reintegrated into their community. Furthermore, a whole-of-society approach is necessary to provide holistic care to patients affected by the pandemic. [ABSTRACT FROM AUTHOR]

Aims: To determine which stressor has the highest occurrence and what stressors are related to nurse outcomes, such as job satisfaction, perceived quality of care, and turnover intention. Background: Numerous stressors have been identified in nursing practice, but it is unclear if specific stressors are related to nurse outcomes. Design The study used a cross‐sectional and descriptive‐correlational research design. Methods: In July and August 2017, survey data were collected from 427 staff nurses employed in a large tertiary‐level private hospital in Metro Manila, Philippines. The Nursing Stress Scale was used to measure stress frequency. Structural equation modelling was used to determine the relationship of stressors and nurse outcomes. Results: Exploratory and confirmatory factor analyses indicate nine Nursing Stress Scale factors. Workload is the most frequent stressor. Moreover, workload was negatively related to job satisfaction and perceived quality of care. Workload and conflict with nurses were positively related to turnover intention. Conclusions: The Nursing Stress Scale has a different factor structure based on a survey of nurses in the Philippines. Only workload and conflict with nurses were related to specific nurse outcomes. Nurse managers should identify and mitigate stressors experienced by nurses since these can lead to turnover and poor quality of care. SUMMARY STATEMENT: What is already known about this topic? Nursing is one of the most stressful health care occupations.Stress is related to job satisfaction, perceived quality of care, and turnover intention.The Nursing Stress Scale is a widely used tool to measure stress in nursing practice. What this paper adds? Stress due to too many non‐bedside nursing tasks is the highest reported item level stressor.Among several stressors, only workload was related to job satisfaction, perceived quality of care, and turnover intention.Instead of the original seven‐factor model, results of factor analyses suggest that the Nursing Stress Scale fits a nine‐factor model. The implications of this paper: Nurse managers should mitigate stressors experienced by nurses to improve job satisfaction.One way to reduce nurse turnover could be to reduce nurses' workload.The quality of care provided to patients by nurses may improve by reducing workload. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco use is a major public health problem in the Philippines. Menthol flavored and flavor capsule cigarettes are independently associated with increased smoking initiation and appeal to youth and young adults. Packaging is an important tobacco marketing tool. We describe cigarette packs sold in the Philippines market and describe products' flavor and capsule inclusion. METHODS Tobacco packs were systematically collected in the Philippines in 2016 and categorized as non-flavored non-capsule, menthol non-capsule, menthol capsule, and non-menthol capsule. Structural elements (e.g. pack type, shape) and graphic components (e.g. imagery, descriptors, color) of the packs were compared. RESULTS Menthol capsule packs were significantly more likely to be hard packs than menthol non-capsule. Menthol packs were more likely to be colored green than non-flavored packs. Non-menthol capsule packs were more likely to display the term 'fresh' than non-capsule packs. Capsule packs were more likely to display technological appeals than non-capsule packs. CONCLUSIONS Menthol and flavor capsule cigarettes are packaged differently (most notably, in terms of color and technological appeals) than non-menthol and non- capsule packs. Packaging and labeling policy should take this into consideration. [ABSTRACT FROM AUTHOR]

In Southeast Asia, the increasing availability of commercially produced complementary foods (CPCF), including dry or instant cereals (CPCF cereals), has been noted, however, concerns exist around their nutrient profile and labelling practices. This 2021 study assessed the nutrient composition, labelling practices, and micronutrient content of CPCF cereals sold in the capital cities of seven Southeast Asian countries: Phnom Penh (Cambodia), Jakarta (Indonesia), Manila (Philippines), Bangkok (Thailand), Vientiane (Lao PDR), Hanoi (Vietnam), and Kuala Lumpur (Malaysia). The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older infants and young children. Micronutrient content of fortified CPCF cereals was assessed against fortification levels specified in the Codex Alimentarius guideline for formulated complementary foods. Of the 484 products assessed, 184 (38.0%) met all nutrient composition requirements. Around one‐third of CPCF cereals contained added sugars and/or sweeteners (37.2%) and high levels of sodium (28.9%). None of the CPCF cereals met all labelling requirements, primarily due to the presence of inappropriate claims on the labels. Most fortified CPCF cereals contained adequate amounts of critical micronutrients, such as calcium, iron, zinc, vitamin A, and vitamin D. However, rates of fortification varied across the seven countries, and almost a third (30.8%) of CPCF cereals were not fortified with any micronutrients. To support the appropriate promotion of CPCF in the region, Southeast Asian countries need to strengthen and enforce national binding legal measures, including national standards for the composition, labelling, and fortification of CPCF cereals. Key messages: Despite most commercially produced complementary foods (CPCF) cereals available in Southeast Asia met the majority of nutrient composition requirements, a considerable number of products contained added sugars/sweeteners (37.2%) and high levels of sodium (28.9%). Regulations that prohibit the use of added sugars/sweeteners and establish an upper limit for sodium in CPCF cereals are a policy priority in the region.None of the 484 CPCF cereals studied met all labelling requirements. Inappropriate claims were the most common. Three‐quarters of the products failed to meet labelling requirements on the protection and promotion of breastfeeding. National regulations on labelling must be strengthened and enforced to protect against inappropriate marketing of CPCF.Approximately two‐thirds or more of fortified CPCF cereals contained adequate amounts of micronutrients critical for older infants and young children (IYC), such as calcium, iron, zinc, vitamin A and vitamin D. Nonetheless, the fortification of CPCF cereals varied greatly by country, and almost a third (30.8%) of CPCF cereals were not fortified with any micronutrients. This is a missed opportunity to provide essential micronutrients to older IYC in contexts where nutrient‐poor diets are common. Future policies that stipulate mandatory minimum micronutrient levels for CPCF cereals are recommended for the region. [ABSTRACT FROM AUTHOR]

The complementary feeding period is a critical stage of child development when micronutrient needs are high and challenging to meet. Understanding if specific micronutrient gaps exist during this period is critical for effective programming. A Comprehensive Nutrient Gap Assessment (CONGA) was conducted in seven countries in Southeast Asia to estimate gaps in micronutrients commonly lacking in the diets of children aged 6–23 months and to establish the certainty of available evidence for each identified gap. Sixty‐eight evidence sources were identified during this analysis, and 310 micronutrient‐specific data points were identified across all seven countries. Data points varied in recency, representativeness and evidence type. The CONGA methodology enabled the estimation of a gap burden rating for each micronutrient in each country, as well as a rating of their evidence certainty. Micronutrient gaps were identified in vitamin D, zinc and iron and a potential gap was identified in calcium during the complementary feeding period in the region. Evidence relevant to intake and deficiency of folate, vitamin B12, thiamine, niacin, vitamin C and vitamin B6 was limited across the region. Proven strategies to address these gaps include increasing the availability and consumption of nutrient‐dense foods, micronutrient supplementation, large‐scale fortification of staple foods and condiments and point‐of‐use fortification through multiple micronutrient powders and fortified speciality foods. More recent data on micronutrient availability, intake and deficiency is urgently needed in Southeast Asia. Key messages: Older infants and young children aged 6–23 months experience micronutrient gaps during the complementary feeding period in Southeast Asia. Synthesis of evidence compiled across seven countries in the region identified gaps in vitamin D, zinc and iron and a potential gap in calcium during this critical period.National nutrition policies and programmes should consider multiple strategies to address these micronutrient gaps.Over half of the data points relevant to nutrient deficiency and intake compiled from the seven countries are over a decade old. More recent data on micronutrient availability, intake and deficiency is urgently needed in Southeast Asia. [ABSTRACT FROM AUTHOR]

Purpose: Researchers have observed a rise in mental health issues among university students over the course of the pandemic, in part due to the closure of schools and public spaces for wellness. Thus, the purpose of this study is to explore how students creatively reassemble their self-care practices through different objects and spaces within their homes to care for their mental health. Methods: Photo-elicitation interviews were conducted with ten (10) female university students from the Philippines. Photographs and interview transcripts were analysed through map-making practices and an iterative process of crafting assemblages and their cofunctionings. Results: The work-home assemblage was identified as the site of self-care, delineated by boundary-making and place-making practices and the creation of time spaces. The two major cofunctionings of the work-home assemblage were (a) caring for the self as fostering different relationalities with the self, and (b) caring for the self as copresencing with human and nonhuman others. Conclusion: Findings demonstrate the importance of material and spatial relationalities in facilitating caring relational encounters with the self. Theoretical and practical implications include attuning to the existing material and spatial resources in one's environment and integrating them into one's practices of caring for the self. [ABSTRACT FROM AUTHOR]

Background: Many low- and-middle-income countries are disproportionately burdened by cervical cancer, resulting in high morbidity and mortality. HPV-DNA testing coupled with treatment with thermal ablation is a recommended screening and precancer treatment strategy, but not enough is known about how this can be effectively implemented in the context of integrated services. The (Scale Up Cervical Cancer Elimination by Secondary prevention Strategy, (SUCCESS) project is conducting a study to understand this approach, integrated into existing women's health services in Burkina Faso, Cote d'Ivoire, Guatemala, and the Philippines (2020–2024). Methods: A hybrid effectiveness-implementation type III mixed-methods observational study design is used to assess feasibility, acceptability, and costs of integrated service delivery in 10 sites per country, selected considering urban/rural location, facility level, onsite/offsite laboratories, and health services type. In each country, a sample size of 2227 women aged 25–49 years will be enrolled with about 20% being women living with HIV. The primary outcome is proportion of HPV positive women completing precancer treatment, if eligible, within three months of screening. Data collection and analysis includes; facility and client exit surveys, key informant and client interviews, registries and project records extractions, and costing data analysis. Analysis includes descriptive statistics, context description, thematic analysis, and document analysis. Quantitative analyses will be stratified by participant's HIV status. Discussion: Recruitment of study participants started in April 2022 (Burkina Faso and Côte d'Ivoire) and August 2022 (Guatemala and the Philippines). Enrolment targets for women screened, client exit, in-depth and key informant interviews conducted were reached in Burkina Faso and Cote d'Ivoire in November 2022. Guatemala and Philippines are expected to complete enrolment by June 2023. Follow-up of study Participants 12-months post-treatment is ongoing and is expected to be completed for all countries by August 2024. In LMICs, integrating cervical cancer secondary prevention services into other health services will likely require specific rather than incidental recruitment of women for screening. Reconfiguration of laboratory infrastructure and planning for sample management must be made well in advance to meet induced demand for screening. Trail Registration ClinicalTrials.Gov ID: NCT05133661 (24/11/2021). Plain English Summary: Low- and middle-income countries bear a disproportionate burden of cervical cancer deaths and suffering from a disease that is preventable and treatable. Unitaid is funding and working collaboratively with the governments of Burkina Faso, Côte d'Ivoire, Guatemala, and the Philippines to implement Scale Up Cervical Cancer Elimination with Secondary prevention Strategy (SUCCESS) project. Significant advancements on cervical cancer management have been made in last four decades. However, the optimal approaches to translating available evidence into actionable screening and treatment implementation strategies in the context of mass-screening programmes is uncertain. SUCCESS project aims to generate evidence on how to deliver cervical cancer services in a way that promotes human papilloma virus (HPV) screening using newer diagnostic and treatment technologies available. This mixed methods study aims to contribute to the evidence on how HPV testing and treatment can be done in manner that is acceptable and feasible in the context of integrated service delivery. Quantitative and qualitative data will be collected over a period of 24 months (2022–2024) across the four countries. In each country, 2227 women aged 25–49 years will be enrolled and screened for HPV, with 20% of them being women living with HIV. In this study, HPV positive will be retested 12-months after initial screening and/or treatment. The findings of the study will add to the body of literature especially from low- and middle-income countries how to implement promising strategies for scaling up cervical cancer screening and treatment coverage. [ABSTRACT FROM AUTHOR]

Background: The Philippines has enacted maternity protection policies, such as the 105-Day Expanded Maternity Leave Law and the Expanded Breastfeeding Promotion Act of 2009, to protect, promote, and support breastfeeding. This study aimed to review the content and implementation of maternity protection policies in the Philippines and assess their role in enabling recommended breastfeeding practices. It also identified bottlenecks to successful implementation from the perspectives of mothers and their partners, employers, and authorities from the government and non-government organizations involved in developing, implementing, monitoring, and enforcing maternity protection policies. Methods: This study employed a desk review of policies, guidelines, and related documents on maternity protection, and in-depth interviews. Of the 87 in-depth interviews, there were 12 employed pregnant women, 29 mothers of infants, 15 partners of the mothers, 12 employers and 19 key informants from the government and non-government organizations. Respondents for the in-depth interviews were from the Greater Manila Area and were recruited using purposive snowball sampling. Data were collected from December 2020 to April 2021. Results: The study shows that maternity protection policies in the Philippines are mostly aligned with the maternity protection standards set by the International Labour Organization. However, their role in improving breastfeeding practices is limited because: (1) not all working women have access to maternity protection entitlements; (2) the duration of maternity leave entitlements is inconsistent with the World Health Organization's recommended duration of exclusive breastfeeding; (3) there are gaps in policy implementation including: a lack of monitoring systems to measure the availability, functionality, and usage of lactation spaces; limited workplace support for breastfeeding; poor communication of maternity and paternity entitlements; and limited breastfeeding advocacy and promotion; and (4) there is limited integration between maternity protection and breastfeeding promotion interventions. Conclusions: There is a need to (1) strengthen communication about and promotion of maternity and paternity entitlements for mothers, fathers and employers, (2) improve monitoring and enforcement mechanisms to ensure utilization of entitlements among mothers, (3) develop modalities to extend the coverage of maternity entitlements to the informal sector, (4) fully cover paid leave entitlements from social insurance or public funding sources in line with International Labour Organization recommendations, and (5) revisit the limitations on the coverage of paternity entitlement. [ABSTRACT FROM AUTHOR]

Background Increased emphasis has been given to the practice of evidence-based medicine (EBM) worldwide. Access to quality health information is essential to the practice of EBM in developing countries. Objectives To understand the information needs and sources of information of physicians from low- and middle-income countries ( LMICs). Methods Medical doctors and students participated in an 18-question online or paper study. Results Of the 156 respondents from six LMICs, 146 (94%) came from the Philippines. Eighty-eight per cent encountered at least one clinical question daily, while 58% were very likely to search for answers. A basic mobile phone was the most used device at home (94%) and at work (82%). More than half had Internet connectivity at home (62%) and just under half at work (46%). In decreasing order, short messaging services ( SMS), email, instant messaging and multimedia messaging services ( MMS) were the most commonly used messaging tools at home and at work. The primary source for medication questions was a formulary, but for diagnostic dilemmas, colleagues were consulted first. Pub Med use was high for therapy and management questions. Conclusion The use of health information from the Internet through mobile devices may be increasing. Access to health information was higher at home than at work. These results may be useful when planning resources for healthcare givers in resource-poor settings. [ABSTRACT FROM AUTHOR]

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O'BRIEN T and ACKROYD S. Nursing Inquiry 2012; 19: 39-50 Understanding the recruitment and retention of overseas nurses: realist case study research in National Health Service Hospitals in the UK This paper illustrates one of the possible applications of critical realist ideas to the analysis of health services, in the use of comparative case study research design, to elucidate the causal social processes underlying events. In the research reported here, a comparative research design was used as a basis for improving our understanding of the processes involved in the assimilation of overseas nurses (OSN) into the salient long-term workforce of the National Health Service (NHS) hospitals in the UK. The work brought to light the salient experiences of overseas nurses during their initial work in the NHS hospitals, and these were used as a basis for developing an account of the general mechanisms typically underlying the recruitment and assimilation at work. The authors conclude that successful assimilation is often hindered by the presence of occupational closure mechanisms, by which home nurses effectively excluded recruits from participation and promotion; these mechanisms, which articulate with everyday racism, threaten successful assimilation for obvious reasons. If the treatment recruits receive does not lead to withdrawal, it is because they typically have very strong economic motives to continue despite unfavourable and sometimes inhumane treatment. Thus, the research offered substantial reasons why recruitment policies should be reviewed by policy-makers. [ABSTRACT FROM AUTHOR]

Aims: The nutrition and dietetics service in Philippine public hospitals was implemented by the Department of Health in 2016 to standardise the daily allowance and nutritional content of inpatient meals. Five years later, it is timely for the Department of Health to assess the quality of inpatient meals and mandated nutrition processes in areas such as staffing, food service, and outcomes monitoring. Methods: A mixed‐method sequential explanatory design was employed using (1) quantitative assessment through a facility survey (n = 193 hospitals) and (2) qualitative exploration of quantitative results through 6 focus group discussions (n = 36 hospitals). Results: Philippine public hospitals were unequipped with the inputs necessary to implement processes that produce high‐quality meals for patients. The hospitals were unable to comply with the required minimum meal allowance (51%), nutritional content of meals (40%), and food service standards. Moreover, they had insufficient human resources and inefficient food procurement practices. Conclusions: The quality of nutrition care and inpatient meals in Philippine public hospitals, who serve mostly people on low incomes, is a neglected problem in the Philippines. Moving forward, a systems approach involving the Department of Health, its regional offices, and hospital management is necessary to equip Philippine public hospitals with the inputs and structures necessary to provide high‐quality nutrition care and inpatient meals that will facilitate patient recovery and overall patient health. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to describe the work-related quality of life (WRQOL) among nurses and explore its association with performance evaluation ratings. Methods: A cross-sectional design was utilized measuring the WRQOL scale and the previous performance appraisal rating. Multistage sampling approach was utilized with nurses stratified based on their position and then systematically random sampled based on their unit assignment. Results: One hundred and eighty-two nurses were included. About half reported a high quality of work life (101; 55.5%). Low scores were noted on the subscale working conditions (100; 54.9%), low to average responses for home-work interface (109; 59.9%), control at work (100; 54.9%), and stress at work (90; 49.5%). A higher proportion of nurses reported positive responses toward the areas of general well-being (113; 62.1%) and job-career satisfaction (112; 61.5%), than in the other subscales. There were notable differences between WRQOL ratings: (1) Head nurses had the highest perceived quality of work life, followed by nurse supervisors and charge nurses (F = 6.1, P < 0.01) and (2) Nurses in the pay-patient services reported lower quality of working life, while those in office and outpatient services had more positive scores (F = 4.6, P < 0.01). Conclusion: Only more than half of the nurses reported a high quality of work life, some of its dimensions, particularly job and career satisfaction and working conditions, appeared to vary in the perceived degree across years in service, work hours, and position. The assessment of the quality of work life may serve as an important tool to address staff burnout, absenteeism and other issues that affect job performance among health-care professionals. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore 232 service providers' and policymakers' experiences of supporting children's well-being during the pandemic, across sectors, in 22 countries – including Kenya, the Philippines, South Africa, India, Scotland, Sweden, Canada and the USA, in the last quarter of 2020. Design/methodology/approach: A smartphone survey delivered via a custom-built app containing mostly open-ended questions was used. Respondents were recruited via professional networks, newsletters and social media. Qualitative content analysis was used. Findings: The findings reveal numerous system-level challenges to supporting children's well-being, particularly virus containment measures, resource deficiencies and inadequate governance and stakeholder coordination. Those challenges compounded preexisting inequalities and poorly affected the quality, effectiveness and reach of services. As a result, children's rights to an adequate standard of living; protection from violence; education; play; and right to be heard were impinged upon. Concurrently, the findings illustrate a range of adaptive and innovative practices in humanitarian and subsistence support; child protection; capacity-building; advocacy; digitalisation; and psychosocial and educational support. Respondents identified several priority areas – increasing service capacity and equity; expanding technology use; mobilising cross-sectoral partnerships; involving children in decision-making; and ensuring more effective child protection mechanisms. Practical implications: This study seeks to inform resilience-enabling policies and practices that foster equity, child and community empowerment and organisational resilience and innovation, particularly in anticipation of future crises. Originality/value: Using a novel approach to gather in-the-moment insights remotely, this study offers a unique international and multi-sectoral perspective, particularly from low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Information on fortifiable food consumption is essential to design, monitor and evaluate fortification programmes, yet detailed methods like 24‐h recalls (24HRs) that provide such data are rarely conducted. Simplified questionnaire‐based methods exist but their validity compared with 24HRs has not been shown. We compared two simplified methods (i.e., a household food acquisition and purchase questionnaire [FAPQ] and a 7‐day semiquantitative food frequency questionnaire [SQ‐FFQ]) against 24HRs for estimating fortifiable food consumption. We assessed the consumption of fortifiable wheat flour and oil using a FAPQ and, for wheat flour only, a 7‐day SQ‐FFQ and compared the results against 24HRs. The participants included children 12−18 months (n = 123) and their mothers 18−49 years selected for a study assessing child vitamin A intake and status in Mandaluyong City, Philippines. For fortifiable wheat flour, the FAPQ estimated considerably lower mean intakes compared to 24HRs for children and mothers (2.2 vs. 14.1 g/day and 5.1 vs. 42.3 g/day, respectively), while the SQ‐FFQ estimated slightly higher mean intakes (15.7 vs. 14.1 g/day and 51.5 vs. 42.3 g/day, respectively). For fortifiable oil, the FAPQ estimated considerably higher mean intakes compared to 24HRs for children and mothers (4.6 vs. 1.8 g/day and 12.5 vs. 6.1 g/day, respectively). The SQ‐FFQ, but not the FAPQ, generated useful information on fortifiable food consumption that can inform fortification programme design and monitoring decisions in the absence of more detailed individual‐level data. Potential adaptations to improve the FAPQ, such as additional questions on foods prepared away from home and usage patterns, merit further research. Key messages: Fortifiable (i.e., industrially processed) food consumption data are essential to design, monitor and evaluate fortification programmes, yet 24‐h recalls (24HRs) that provide such data are rarely conducted.Simplified methods, such as targeted food acquisition and purchase questionnaires (FAPQs) and semiquantitative food frequency questionnaires (SQ‐FFQs), exist but their validity compared to 24HRs has not been shown.Among Filipino children 12−18 months and their mothers, the SQ‐FFQ generated useful information on fortifiable wheat flour consumption while the FAPQ systematically underestimated wheat flour and overestimated oil.Further research could strengthen the FAPQ to better capture foods prepared away from home and usage patterns. [ABSTRACT FROM AUTHOR]

Patient-centered care (PCC) is the prevailing model of care globally. However, most research on PCC has been conducted in Westernized countries or has focused on only two facets of PCC: decision-making and information exchange. Our study examined how culture influences patients' preferences for five facets of PCC, including communication, decision-making, empathy, individualized focus, and relationship. Participants (N = 2071) from Hong Kong, the Philippines, Australia, and the U.S.A. completed an online survey assessing their preferences for exchange of information, autonomy in decision-making, expression and validation of their emotions, focus on them as an individual, and the doctor-patient relationship. Participants from all four countries had similar preferences for empathy and shared decision-making. For other facets of PCC, participants in the Philippines and Australia expressed somewhat similar preferences, as did those in the U.S.A. and Hong Kong, challenging East–West stereotypes. Participants in the Philippines placed greater value on relationships, whereas Australians valued more autonomy. Participants in Hong Kong more commonly preferred doctor-directed care, with less importance placed on the relationship. Responses from U.S.A. participants were surprising, as they ranked the need for individualized care and two-way flow of information as least important. Empathy, information exchange, and shared decision-making are values shared across countries, while preferences for how the information is shared, and the importance of the doctor-patient relationship differ. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traffic enforcers are vulnerable to work accidents, injuries, and illnesses because they are commonly exposed to ergonomic risk factors while performing their tasks. OBJECTIVE: The purpose of this study is to determine the effects of environmental risk factors and postural risk factor to the prevalence of musculoskeletal disorders (MSDs) among traffic enforcers in Manila City, Philippines using binary logistic regression analysis. METHODS: A total of 120 participants were included in the study. The Nordic Musculoskeletal Questionnaire (NMQ) and Rapid Entire Body Assessment (REBA) were utilized. In addition, several devices such as a noise dosimeter, digital air thermometer, and IAQ sensors were also utilized to measure the environmental exposure of enforcers during their work shift. RESULTS: The prevalence of MSDs among traffic enforcers was high, with 71% of the respondents reporting symptoms of MSDs in more than one part of the body for the past 7 days. The body part that has highest prevalence was upper back, followed by lower back, and legs/ankles. Logistic regression analysis revealed that awkward work posture (OR = 4.61, 95% CI = 2.17, 9.83), noise exposure (OR = 1.42, 95% CI = 1.11, 1.82), heat exposure (OR = 0.53, 95% CI = 0.85, 1.05), and pollution exposure (OR = 0.94, 95% CI = 0.85, 1.05) were significant contributors for the prevalence of MSDs among traffic enforcers in Manila City. CONCLUSION: The prevalence of MSDs among traffic enforcers is caused by their work posture and exposure to psychosocial factors such as noise, heat, and poor air quality. Thus, to minimize the risk of MSDs, it is suggested to provide administrative controls, such as job rotation or shifting, and introduce frequent rest breaks. It is also recommended to provide enforcers with appropriate personal protective equipment, such as cooling vests, noise-canceling earplugs and N95 facemasks. This would help in uplifting musculoskeletal health for traffic enforcers and other workers in a similar field. [ABSTRACT FROM AUTHOR]

Child maltreatment is a serious problem affecting millions of children. Research on self-reporting of child maltreatment has shown a difference in reporting between caregivers and children. Increased understanding of this has implications for further evaluations of parenting programmes and assessment of violence and maltreatment. The purpose of this study was to explore caregiver-child reporting discrepancies on child maltreatment and emotional health before and after piloting of the International Child Development Program (ICDP) in the Philippines. Data was collected from caregivers and their children before and after caregiver participation in ICDP. Participants were selected from the Pantawid Pamilyang Pilipino Program in Leyte by Save the Children. Caregivers and children completed a questionnaire with some adapted items from the Conflict Tactics Scale Parent–Child version (CTSPC), some relevant complementary items on psychological aggression and items from the emotional problems subscale from the Strength and Difficulties Questionnaire (SDQ). Matching items, subscales and total count scores were compared using paired t-tests in STATA 14. Forty-six caregivers and 43 children aged from 5–13 years participated at baseline, and 44 caregivers and 42 children at endline. At baseline, children reported significantly more maltreatment than their caregivers. The groups reported similarly at baseline and endline on the items from the subscale on emotional problems. Both children and caregivers had lower scores on our harsh discipline scale at endline, indicating improved parenting strategies after the intervention. These results indicate a difference in reporting of child maltreatment between caregivers and children, with higher rates reported by the children before the intervention, but not after. This is important because it illustrates child and caregiver perspectives on maltreatment, and how they can differ. As such, our findings point towards a positive effect of ICDP on parenting. [ABSTRACT FROM AUTHOR]

Objectives: Evidence for affordable and pragmatic programmes to address the burden of untreated tooth decay in children in low‐ and middle‐income settings is limited. This study aimed to (1) assess the effect of a government‐run, school‐based daily group toothbrushing programme compared to standard school‐based oral health education on the incidence of dental caries and odontogenic infections in Filipino children over a period of 3 years; and (2) assess the additional preventive effect of on‐demand oral urgent treatment (OUT) and weekly fluoride gel application. Methods: A cluster‐randomized trial was conducted in Camiguin, Philippines. Schools in three regions were randomly assigned to one of three intervention groups: The Essential Health Care Programme (EHCP), which includes daily toothbrushing with fluoride toothpaste; EHCP plus twice‐yearly access to on‐demand urgent oral treatment (EHCP + OUT) and EHCP plus weekly application of high‐concentrated fluoride gel (EHCP + Fluoride). Schools in a nearby province with a similar child population were selected as external concurrent control group. Clinical oral examinations were performed by calibrated dentists from a random sample of 682 seven‐year‐old students who were examined at baseline and over the following 3 years. Outcome variables were the number of decayed primary teeth, the number of decayed, missing and filled permanent teeth (DMFT) and surfaces (DMFS), and the number of permanent teeth with pulpal involvement, ulcerations, fistula or abscess (PUFA). Data were analysed using multilevel mixed‐effects negative binomial regression. Results: Three years after implementation, increments in dental caries and odontogenic infections in permanent teeth did not significantly differ between the EHCP and control group, yet the incidence of DMFT was lower by 22% in children receiving EHCP. Compared to controls, children receiving EHCP + Fluoride had a significantly lower increment of DMFT, DMFS and PUFA by 40%, 40% and 47%, respectively. Children receiving EHCP + OUT had lower incidence rates of DMFT and DMFS than control children by 23% and 28%, respectively. A lower incidence rate was also found for PUFA, but the effect was not statistically significant. Conclusions: Findings suggest that the weekly application of fluoride gel and urgent oral treatment, in addition to daily school‐based toothbrushing with fluoride toothpaste, are realistic and effective strategies to lower the burden of dental caries in Filipino children. Implementation challenges may explain why no substantial caries‐preventive benefits were demonstrated for school‐based toothbrushing only. Intervention compliance should be considered in future programme implementation and evaluation research. [ABSTRACT FROM AUTHOR]

Summary: There is a void in the health promotion literature concerning the role of health insurance. This study offers a comparative analysis of employee health insurance in the United States and the Philippines. As the first study of its kind, it examines insurance as an instrument of health promotion policy for improving population health and reducing healthcare costs. The following questions guide this study: (i) How has insurance coverage of employee healthcare in these two countries evolved and changed over time, and why? (ii) What factors incentivize payers (employers and insurers) to incorporate health promotion into their health plans, even if health promotion does not fall within the traditional ambit of insurance? and (iii) How does health promotion through the insurance vehicle operate cost-efficiently and within the Global Health Promotion framework of the World Health Organization (WHO)? US and Philippine public-use datasets were gathered and disaggregated to address these questions. The Affordable Care Act (ACA) in the US and universal healthcare legislation leading to the Universal Healthcare Act (UHC) in the Philippines initiated major paradigmatic shifts in insurance coverage. Health literacy, behavioral change and social equity are objectives pursued in both countries by mandating and/or nudging payers to offer health screenings, wellness and fitness programs and primary preventive and diagnostic services. By providing a means to finance access to promotive health and encourage individual responsibility for risk prevention ('healthism'), insurance influences social attitudes about health. However, our findings indicate that outcomes and relative success vary depending on a country's insurance environment, its regulation and the economic, political and socio-cultural forces that affect or shape it (e.g. private markets vs. multi-payer system). Contextual realities also drive incentives and rewards to payers and users of promotive health benefits against the backdrop of financial risk or exposure. [ABSTRACT FROM AUTHOR]

Background: Migrant domestic workers are vulnerable to physical and mental health problems given the many challenges they experience while working abroad. Using network analysis, this study examined the structure of depression, cardiometabolic health indicators (BMI, waist-hip ratio (WHR), blood pressure, and heart rate), bone mass, and perceived health status in this population. The network model allowed for an examination of central symptoms or symptoms with the most direct connections with other symptoms; bridge symptoms, or symptoms that link two or more communities; and edges, or relationships among symptoms. Method: Cross-sectional data were gathered from 1375 Filipino domestic workers in Macao (SAR), China. Data from a subsample of 510 participants who met a cutoff indicating depression were analyzed. Anthropometric measurements and surveys were used to collect data, which was analyzed using R statistical software. Results: Results showed four community clusters: three communities consisted of at least two depression symptoms each and the fourth community included physical health indicators. Strong edges were formed between BMI-bone mass, psychomotor-concentration, BMI-WHR, and sad mood-anhedonia. The node with the highest expected influence was BMI. There were three bridges: worthlessness, psychomotor difficulties, and concentration difficulties. Conclusion: The link between depression, cardiometabolic indicators, bone mass, and poor perceived health reinforces the need to address multimorbidity within migrant populations. Health promotion interventions that address mental and physical health may improve the health of this population. [ABSTRACT FROM AUTHOR]

Background: The rate of international migration for the primary purpose of employment has increased exponentially in recent decades. A significant proportion of this global movement takes place across East and Southeast Asia as workers move on a temporary basis from lower-middle-income home countries such as Indonesia, the Philippines, Thailand and Vietnam to high-income host destinations including Hong Kong and Singapore. Relatively little is known about the unique and long-term health needs of this heterogeneous group of people. This systematic review presents an analysis of recent research into the experiences and perceptions of health of temporary migrant workers in the East and Southeast Asian regions. Methods: Five electronic databases CINAHL Complete (via EbscoHost), EMBASE (including Medline), PsycINFO (via ProQuest), PubMed and Web of Science, were systematically searched for qualitative or mixed methods, peer-reviewed literature published in print or online between January 2010 and December 2020. Quality of the studies was assessed using the Critical Appraisal Checklist for Qualitative Research published by the Joanna Briggs Institute. Findings from the included articles were extracted and synthesised using qualitative thematic analysis. Results: Eight articles were included in the review. Findings from this review indicate that multiple dimensions of workers' health is impacted by the processes of temporary migration. In addition, the research reviewed indicated that migrant workers used various strategies and mechanisms to attempt to address their health-related issues and to take better care of themselves. Such agentic practices could help them manage and maintain their health and wellbeing across physical, psychological and spiritual dimensions within the structural constraints of their employment. Conclusions: Limited published research has focused on the health perceptions and needs of temporary migrant workers in East and Southeast Asia. The studies included in this review focused on female migrant domestic workers in Hong Kong, Singapore, and the Philippines. These studies provide valuable insights but do not reflect the heterogeneity of migrants moving within these regions. The findings of this systematic review highlight that temporary migrant workers experience high and sustained levels of stress and are exposed to certain health risks which may compromise long-term health outcomes. These workers demonstrate knowledge and skills in managing their own health. This suggests that strength-based approaches to health promotion interventions may be effective in optimising their health over time. These findings are relevant to policy makers and non-government organisations supporting migrant workers. [ABSTRACT FROM AUTHOR]

Service workers are expected to maintain high‐quality service delivery despite customer mistreatment—the poor‐quality treatment of service workers by customers—which can be demeaning and threatening to self‐esteem. Although service work is increasingly delivered by middle‐aged and older workers, very little is known about how employees across the age range navigate abuse from customers on the job. Does advancing age help or hinder service performance in reaction to customer mistreatment? Drawing on strength and vulnerability integration theory, we proposed that age paradoxically both helps and hinders performance after customer mistreatment, albeit at different stages. We tested our proposed model in a two‐sample field investigation of service workers and their supervisors using a time‐lagged, dyadic design. Results showed that age heightens the experience of self‐esteem threat but, nevertheless, dampens reactions to self‐esteem threat, leading to divergent effects on performance at different stages. Implications for age and service work, as well as aging and the sense of self, are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about Filipino American women's (FAW) sexual and reproductive health (SRH). The purpose of this study was to examine the SRH knowledge, attitudes, and self-efficacy among young adult FAW. Method: This was a qualitative, descriptive interpretive design. Four focus group interviews and one individual interview were conducted. Purposive sampling was used for this study. Inclusion criteria were female, Filipino American, between the ages 18 and 24 years old, and be able to understand and speak English. Results: Twelve participants (n = 12) were recruited. Three themes emerged from this study: (a) sources of SRH information; (b) influence of cultural values, religion, and intergenerational factors; and (c) facilitators of and barriers to women's health services. Discussion: Themes emerged from the content analysis identifying SRH disparities within the Filipino American community, which may inform future interventions and research on this topic. [ABSTRACT FROM AUTHOR]

The Centers for Disease Control and Prevention works to eliminate tuberculosis (TB) disease by finding and treating cases of TB disease and expanding latent tuberculosis infection (LTBI) testing and treatment to prevent TB disease. Approximately 70% of reported TB cases in the United States occur among non-U.S.–born persons. We conducted 15 focus groups with U.S. residents born in the six most common countries of birth among non-U.S.–born TB patients: Mexico, the Philippines, India, Vietnam, China and Guatemala. Participants reacted to 39 messages on LTBI and TB disease risk factors, the Bacille Calmette-Guérin (BCG) vaccine, and LTBI testing and treatment. There was low awareness of LTBI, the TB blood test, and how the TB blood test is not affected by prior BCG vaccination. Several participants thought TB disease is contracted by sharing kitchenware. Some felt negatively targeted when presented with information about countries where TB disease is more common than the U.S. Findings highlight the need for communication aimed at increasing LTBI testing and treatment to include messages framed in ways that will be resonant and actionable to populations at risk. Focus groups revealed LTBI misconceptions which highlight areas for targeted education to decrease TB stigma and increase LTBI testing and treatment. [ABSTRACT FROM AUTHOR]

Prolonged implementation of lockdowns during the coronavirus disease 2019 (COVID‐19) pandemic has resulted in older adults living alone in social isolation. The purpose of the study was to describe the meaning of the experience of Filipino older adults, who are living alone and using social media technologies during the COVID‐19 pandemic. Eight participants who met the inclusion criteria were interviewed using the snowball selection technique. Transcribed interviews were read while also listening to the recorded interviews and highlighting significant words, phrases, and statements. An iterative process of analysis using van Manen's phenomenological approach identified thematic structures and categories revealing life‐worlds of corporeality, relationality, temporality, spatiality, and materiality. The five general essences of flourishing, communicating, struggling, journeying and empowering, described the meaning of living alone and using social media technologies among older adults during the pandemic. The experience was expressed as "flourishing despite struggling to communicate, while journeying and empowering oneself and others." Older adults in isolation struggled to communicate with others however, with social technologies opportunities were opened for them in securing needed food, safety and security, maintaining their health, and their social connectedness. Despite the physical isolation and living arrangements during the pandemic, the use of social media technologies sustained older persons' well‐being. [ABSTRACT FROM AUTHOR]

Purpose: Although cerebrovascular accident is a leading cause of mortality in the Philippines, there has never been a national survey of stroke client descriptors and rehabilitation practices. This paper reports on data from the audit of stroke care for inpatients in hospitals serviced by physiatrists. Method: Audit was done of the medical records of stroke clients admitted to hospitals with rehabilitation units. Performance indicators for timely referral to rehabilitation were applied. Results: A total of 1683 records were audited. The majority of clients had cerebral infarct followed by cerebral haemorrhage. The median length of stay was 7 days; stay was lengthier for haemorrhagic strokes. Only 54.1% of the clients were referred to rehabilitation, with a median delay of 3 days between admission and referral to rehabilitation. 25.4% of the clients had early referral to rehabilitation. 39.2% of the 1397 clients were referred to rehabilitation earlier than 2 days before discharge. Conclusion: This Filipino study provides valuable information on stroke types and prevalence, demographics and rehabilitation practices. Despite the prevalence of post-stroke rehabilitation, it has been underutilised in the management of stroke. [ABSTRACT FROM AUTHOR]

Background: Many unrepresented stories of Filipino transgender migrant workers in Japan are significant in Filipino trans women's struggle for visibility. Aim: This study aims to explore how migration and gender performance influence the gender affirmation of Filipino trans women or transpinay entertainers in Japan. Method: This study draws on a qualitative approach using grounded theory to collect data between 2012 and 2018 through participant observations and semi-structured interviews in Manila, Cebu, and Japan. Through snowball sampling and ties with the LGBTQ community, 14 participants shared their narratives that revolved around their background, gender identity, visa and job application process, entertainment work, and relationships before, during, and after migration. Results: The transpinays' migration experience is influential in their gender affirmation as in Japan and upon their return to the Philippines. The transpinay entertainers migrate to Japan is not solely for economic reasons; they also seek sexual emancipation. Before moving to Japan, they negotiate their gender identity to pass the auditions and apply for an entertainer visa. During their migration, doing and undoing gender is woven into their lives with their intersecting subordinate identities as a Filipino transgender woman and a migrant worker, resulting into an intersectional invisibility. Their entertainer profile as a Filipino transgender woman is an embodiment of gendered performances and ethnicity. Transpinay entertainers returned several times or chose to stay in Japan because they were marginalized in their home country. Conclusion: The transpinay entertainers provide a significant case for highlighting the temporal aspect of their gender performance and migration experience, in which their commitment toward entertainment work transforms over time. The migration experience in Japan indicates a positive outcome in their gender affirmation that does not necessarily lead to gender confirmation surgery. [ABSTRACT FROM AUTHOR]

Drawing upon the conservation of resources theory, we developed and tested a moderated mediation model linking domestic intimate partner aggression ( IPA) to job performance and career advancement. Our model posits that the indirect relationship between IPA and career advancement via in-role performance and organizational citizenship behaviors ( OCBs) is moderated by perceived organizational support ( POS). Overall, multisource and multiwave data obtained from two independent samples of employed women from the Philippines supported our predictions. Specifically, results suggest that: (1) IPA was negatively associated with supervisor-rated in-role performance and OCBs; (2) there was a stronger negative relationship between IPA and in-role performance and OCBs for employees with low as opposed to those with high levels of POS; and (3) the conditional indirect effects of IPA in predicting supervisor-rated promotability and actual promotion via in-role performance and OCBs were stronger under conditions of low as opposed to high POS. Implications for theory and practice are discussed. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]