Five-year (2015-2019) follow-up study of 6,526 cases of medical repatriation of Filipino seafarers.

BACKGROUND: There is a limited number of studies on the medical repatriation of seafarers. The aim of the study was to follow up on the previous 2010-2014 study using data from 2015-2019 to evaluate the epidemiology of medical repatriation among Filipino seafarers. MATERIALS AND METHODS: Data from medical repatriation records of Filipino seafarers from January 2015 to December 2019 were collected from various claims departments of different manning agencies in Manila, Philippines. RESULTS: Data from a total of 6,526 medical repatriation cases and 464,418 deployments in a 5-year period resulted in a medical repatriation rate calculated at 1.4%. We used the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) to determine the most common causes of repatriation. We found that these were musculoskeletal disorders, gastrointestinal problems, and traumatic injuries. The distribution of the specific illnesses per organ system is presented. CONCLUSIONS: Filipinos continue to represent the most numerous group of seafarers in the world. The continued profiling of health issues should lead to better health protocols and controlling medical costs. It should also lead to better prioritisation of health protection and care on board ships. Within the present 10-year database of medical repatriations coinciding with the implementation of Maritime Convention Labour Convention 2006, there is a compelling need to compare the two data sets to have an objective evaluation of the convention's projected goals.

Policy-driven mathematical modeling for COVID-19 pandemic response in the Philippines.

Around the world, disease surveillance and mathematical modeling have been vital tools for government responses to the COVID-19 pandemic. In the face of a volatile crisis, modeling efforts have had to evolve over time in proposing policies for pandemic interventions. In this paper, we document how mathematical modeling contributed to guiding the trajectory of pandemic policies in the Philippines. We present the mathematical specifications of the FASSSTER COVID-19 compartmental model at the core of the FASSSTER platform, the scenario-based disease modeling and analytics toolkit used in the Philippines. We trace how evolving epidemiological analysis at the national, regional, and provincial levels guided government actions; and conversely, how emergent policy questions prompted subsequent model development and analysis. At various stages of the pandemic, simulated outputs of the FASSSTER model strongly correlated with empirically observed case trajectories (r=94%-99%, p<.001). Model simulations were subsequently utilized to predict the outcomes of proposed interventions, including the calibration of community quarantine levels alongside improvements to healthcare system capacity. This study shows how the FASSSTER model enabled the implementation of a phased approach toward gradually expanding economic activity while limiting the spread of COVID-19. This work points to the importance of locally contextualized, flexible, and responsive mathematical modeling, as applied to pandemic intelligence and for data-driven policy-making in general.

Usability testing of the Philippine Electronic National Newborn Hearing Screening Registry (ENNHSR).

PURPOSE AND OBJECTIVES: The study determined the usability of the online and offline versions of the Philippine Electronic National Newborn Hearing Screening Registry (ENNHSR) as well as user perspectives and satisfaction on the training modules and the online and offline systems. The steps in creating the systems, training modules, and evaluation of the user training manual and video training modules, accuracy and time and motion studies on data entry as well as determination of user perspectives and satisfaction were the specific objectives. METHODOLOGY: With the combined efforts of the staff of Newborn Hearing Screening Reference Center (NHSRC), Philippine National Ear Institute (PNEI) and the National Telehealth Center (NTHC) of the National Institutes of Health UP Manila, the development of the online and offline versions of the ENNHSR took six (6) months from January 2021 to June 2021 to complete. Creation of the user manual and training modules took three (3) months from July 2021 to September 2021. The pilot of the systems was carried out in 2 Zoom Conferencing sessions with the participation of 28 existing certified newborn hearing center users with different roles, backgrounds, demographics from all over the Philippines. Written evaluation as well as focused group discussions on the training modules and the database were conducted during the sessions. Effectivity of the training modules was determined using a 10-point learning check. The time and accuracies in encoding each data field per user were also determined. RESULTS: All 28 participants were able to attend and actively participate in the required Zoom Conferencing sessions as well as submit the 2 evaluation surveys for the training modules and the ENNHSR. During the learning check 93% or 26 out of 28 passed. The surgical intervention module took the longest time to encode while the fastest module to complete was for speech therapy. The average mean time to complete all modules was 3382 s or around 57 min while the time range was between 32 and 104 min. A screener would need 18 min while an implant programmer who is a clinical audiologist would need 52 min to enter data. The accuracy in encoding patient data was 92% while hearing screening results was 88.64%. The system usability scale (SUS) score of ENNHSR was computed at 75.5 which was the average of individual SUS scores, falling within grade B or 74.1 to 77.1 as its corresponding numerical score range in percentile. Most of the participants noted that it was easy to find patient data, results and that it was streamlined with easy to track information. CONCLUSIONS AND RECOMMENDATIONS: Data gathering and analysis both play important roles in health management, policy implementation and quality assurance. We were able to uncover areas where the system performed well - effectively, efficiently, and with satisfaction. We realize that all the possible problems cannot be detected with a small number of participants and variety in information. This testing will serve as both a means to record or benchmark current usability, but also to identify areas where improvements must be made.

Nursing Informatics Research Trends: Findings from an International Survey.

This follow-up survey on trends in Nursing Informatics (NI) was conducted by the International Medical Informatics Association (IMIA) Student and Emerging Professionals (SEP) group as a cross-sectional study in 2019. There were 455 responses from 24 countries. Based on the findings NI research is evolving rapidly. Current ten most common trends include: clinical quality measures, clinical decision support, big data, artificial intelligence, care coordination, education and competencies, patient safety, mobile health, description of nursing practices and evaluation of patient outcomes. The findings help support the efforts to efficiently use resources in the promotion of health care activities, to support the development of informatics education and to grow NI as a profession.

Understanding COVID-19 dynamics and the effects of interventions in the Philippines: A mathematical modelling study.

BACKGROUND: COVID-19 initially caused less severe outbreaks in many low- and middle-income countries (LMIC) compared with many high-income countries, possibly because of differing demographics, socioeconomics, surveillance, and policy responses. Here, we investigate the role of multiple factors on COVID-19 dynamics in the Philippines, a LMIC that has had a relatively severe COVID-19 outbreak. METHODS: We applied an age-structured compartmental model that incorporated time-varying mobility, testing, and personal protective behaviors (through a "Minimum Health Standards" policy, MHS) to represent the first wave of the Philippines COVID-19 epidemic nationally and for three highly affected regions (Calabarzon, Central Visayas, and the National Capital Region). We estimated effects of control measures, key epidemiological parameters, and interventions. FINDINGS: Population age structure, contact rates, mobility, testing, and MHS were sufficient to explain the Philippines epidemic based on the good fit between modelled and reported cases, hospitalisations, and deaths. The model indicated that MHS reduced the probability of transmission per contact by 13-27%. The February 2021 case detection rate was estimated at ~8%, population recovered at ~9%, and scenario projections indicated high sensitivity to MHS adherence. INTERPRETATION: COVID-19 dynamics in the Philippines are driven by age, contact structure, mobility, and MHS adherence. Continued compliance with low-cost MHS should help the Philippines control the epidemic until vaccines are widely distributed, but disease resurgence may be occurring due to a combination of low population immunity and detection rates and new variants of concern.

Repatriation rates in Filipino seafarers: a five-year study of 6,759 cases.

BACKGROUND: Studies on medical repatriation of seafarers due to illnesses and injuries have been limited. The aim of the study was to describe the epidemiology of medical repatriation among Filipino seafarers. MATERIALS AND METHODS: We performed a retrospective analysis of records from January 2010 to December 2014 of medical repatriations of Filipino seafarers from the claims and legal departments of different manning agencies in Manila, Philippines. RESULTS: We analysed data from a total of 6,759 medical repatriation cases in a 5-year period, representing 174 shipping companies and 2,256 vessels. The total number of seafarers deployed from the manning agencies where we obtained data was 388,963 with the rate of medical repatriations calculated at 1.7%. We used the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) to determine the most common causes of repatriation. We found that these were injuries (trauma), musculoskeletal disorders, gastrointestinal problems, and genitourinary illnesses. We also conducted an analysis of the most common clinical problems per organ system. CONCLUSIONS: Filipinos represent the most numerous group of seafarers in the world. Profiling their health issues may help in optimising current protocols, implementing health surveillance programs, and formulating health policies for seafaring personnel. In addition, our study results may help physicians performing pre-employment medical examinations to identify and manage conditions that are at a high risk of medical repatriation.