University of Manila

Introduction: Spatial analysis of industrial environmental performance data is necessary for optimizing industrial sites, mitigating environmental risks, enhancing environmental performance, minimizing adverse effects, and promoting industrial sustainability. This study aims to map the environmental performance of industry and its effect on water quality and the incidence of diarrhea in East Java Province, Indonesia. Methods: This research was observational and used secondary data. The population and sample of this study were all 38 districts and cities in East Java Province. The study was conducted from June to September 2025. This study utilized the Global Positioning System (GPS) to collect data, namely coordinate points based on the addresses of industries or companies in East Java. Coordinates were colored blue, green, or red according to the industrial environmental performance rating (PROPER). The data analysis in this study used linear regression and a spatial autocorrelation approach in ArcGIS. Results and Discussion: The data of performance in environmental management of companies for 2022–2023 for regencies or cities in East Java showed that the industries included in the PROPER assessment were mostly from Sidoarjo, Pasuruan, and Gresik. The red PROPER ratings were most prevalent in Gresik, Sidoarjo, and Surabaya, while the blue PROPER ratings were most prevalent in Pasuruan, Sidoarjo, and Gresik. Conclusion: There is a spatial effect on the distribution of the number of red proper in East Java province. And a significant correlation was found between the red PROPER rating and the number of diarrhea cases per district/city in East Java province.

ruise ship employees often work long, exhausting hours in physically demanding environments, yet they have limited access to proper healthcare. While the cruise industry prioritizes passenger comfort and safety, far less attention has been given to the health needs of the crew. This research explores whether onboard physical therapy (PT) services could address the growing problem of musculoskeletal disorders (MSDs) among cruise ship workers. A quantitative survey was conducted among 208 employees using structured questionnaires to assess the frequency and severity of musculoskeletal pain, work-related health concerns, and the availability of medical support on board. Descriptive statistics were used to analyze the responses. Results revealed a strikingly high incidence of MSDs. Lower back pain was the most common complaint (80.77%), followed closely by shoulder pain (77.88%). Many crew members (72.12%) reported working 10 or more hours each day, and 63.94% noted that their lower back pain worsened during work. Although more than two-thirds (66.7%) had been advised by physicians to undergo physical therapy, no onboard PT services were available to them. These findings highlight a clear and urgent need for accessible physical therapy on cruise ships. Long working hours, repetitive tasks, and poor ergonomics contribute significantly to MSDs, ultimately reducing worker productivity and increasing absenteeism. Implementing PT services could improve crew well-being, reduce injury rates, and support more efficient ship operations. Future studies should explore cost-effective strategies for integrating physical therapy into onboard health systems to better support the workforce that keeps the cruise industry running.

Childhood-onset systemic lupus erythematosus (cSLE) is a severe autoimmune disorder with diverse multisystem manifestations; neuropsychiatric involvement is an uncommon initial feature. Herpes simplex virus (HSV) encephalitis, although rare, is a potentially life-threatening infection that primarily affects immunocompromised individuals, including those with SLE. Cases where HSV encephalitis precedes SLE diagnosis are exceedingly rare. We present a 14-year-old Filipino female with autoimmune thyroiditis who developed acute behavioral changes after a mild febrile illness. Cranial MRI revealed an acute right frontotemporoparietal infarct; laboratory workup showed bicytopenia and nephrotic-range proteinuria. Positive HSV-1 IgG supported a diagnosis of HSV encephalitis, and empiric acyclovir was initiated. Strongly positive antinuclear antibodies met the entry criterion of the 2019 European League Against Rheumatism /American College of Rheumatology (EULAR/ACR) criteria, with the mucocutaneous, hematologic, and renal domains fulfilled. Her course was complicated by severe hypertension, Class III lupus nephritis, and persistent lupus anticoagulant positivity with cerebral infarction, confirming secondary antiphospholipid antibody syndrome. This case illustrates the layered pathology of infection, inflammation, and thrombosis, where an infectious trigger unmasked an autoimmune process and vascular complications. The interplay between HSV neurotropism and immune dysregulation may have predisposed her to neuroinflammation and systemic autoimmunity. Early multidisciplinary intervention was pivotal to recovery. Further studies are needed to clarify viral-autoimmune interactions in pediatric SLE.

IntroductionMental health literacy is essential for the recognition, management, and prevention of mental disorders among school-aged children. However, few studies have examined the implementation status of school-based mental health literacy in Asian countries. This study aims to compare the approaches taken by the Philippines, Indonesia, and Japan in managing school-based mental health literacy through curriculum-related policies.MethodsThe collected documents of this study analyzed both policies (formulated from 2000 to 2023) and curricula (from grade 1 to grade 12) that were adapted to the deductive content analysis methods. Policies were analyzed using the policy triangle framework (Walt and Gilson in Health Policy Plan 9:353–370, 1994) and mapped using the review points (Margaretha et al. in Front Psychiatry 14:1126767, 2023). Curricula were analyzed using the definition of mental health literacy (Jorm in Am Psychol 67:231–243, 2012). This study focused on mental health laws and policies in the Philippines, Indonesia, and Japan, highlighting their success in addressing the needs of adults and school-aged children. By considering each country’s unique socio-cultural contexts and basic educational approaches, this study identified diverse strategies and methodologies in addressing mental health challenges. Using a common analytic framework, this study collected and analyzed policies and curricula on mental health literacy from the three countries (Philippines, 22; Indonesia, 9; and Japan, 6). The basic education curricula developed by their respective Ministries of Education were used.ResultsThis study highlights two key findings on school-based mental health literacy. First, mental health literacy is incorporated into health and physical education in Japan, health, values education and homeroom guidance in the Philippines, and religious education in Indonesia. Second, while the Philippines and Indonesia implement mental health education based on established policies, Japan lacks a core mental health literacy policy but has developed and implemented related curricula through its course of study guidelines. The curriculum analysis identified a specific challenge: a lack of “first aid skills to support others who are developing a mental disorder or are in a mental health crisis”.ConclusionsThis study revealed the partial implementation of mental health literacy education in the Philippines, Indonesia, and Japan. The Philippines offers a nearly comprehensive curriculum on mental health literacy (grades 1–12), Japan incorporates it into health education (grades 5–10), and Indonesia integrates it into religious education (grades 1–12). While the Philippines and Indonesia align with mental health policies, Japan relies on its national curriculum without a core policy. A key challenge was indicated involving teachers, guidance counselors, or school health personnel as key actors to support students with mental disorders or those potentially at risk, as well as to handle emergency cases of mental disorders in schools. Recommendations include systematic monitoring of the implementation of school-based mental health policies, collaboration with UN agencies to align with international standards while incorporating culturally tailored strategies for each country.

We differentiate the impact of extreme weather shocks on the welfare of the formal and informal sectors by utilizing nationally representative household survey data from the Philippines. We deviated from the typical measure of extreme tails of normalized rainfall values using normal distribution and instead used a novel measure of extreme rainfall from satellite-derived data. We estimate the vulnerability of households using an endogenous switching regression model to account for the heterogeneity in the decision to be in either sector. We find evidence that households’ welfare is adversely affected by extreme rainfall days, but the negative impact is bigger on the welfare of the formal sector. Households in the formal sector have higher incomes and thus have more to lose. However, the adverse impact on informal households may be irreversible given their weak capability to recover and their limited ability to smooth out consumption even during years considered normal. The negative effects of experiencing extreme rainfall three years ago linger. Thus, vulnerable households in the formal sector can potentially slide down to poverty, and those in the informal sector go deeper into poverty when hit by extreme weather events.

BackgroundThe Emergency Department (ED) is a primary source of healthcare services for patients with non-urgent conditions in the Philippines. The adaptation of physician group practice (GP) in the ED has gained popularity in the country due to its potential advantage to patient management and physicians compared to independent consultancy (IC). This study aimed to determine the impacts of GP in a non-urgent ED setting in terms of operations, quality of care, and service satisfaction compared to IC.MethodsHistorical data collection focusing on operations, service costs, patient outcomes, and satisfaction was performed between 2021 and 2022 at a tertiary for-profit private hospital in Metro Manila, Philippines. In addition, patient surveys on demographics, perception, ED accessibility, and descriptive satisfaction ratings were also administered in 2023 (n = 310). These aspects were compared between patients managed by GP and IC quantitatively using univariate descriptive statistics, Mann-Whitney U tests, and ANCOVA to compare operational metrics, financial data, and patient outcomes. Qualitative data from patient surveys were analyzed using a sequential-explanatory approach.ResultsOur analysis of the historical data showed high rates of positive outcomes for non-urgent ED patients in both GP and IC. Total (PhP587,812 vs. PhP379,699; p < 0.001) and per patient (PhP1,801 vs. PhP554; p < 0.001) operational costs were higher for the GPs. However, GPs incurred shorter mean length of stay (165.5 vs. 214.2 min; p < 0.001). There appears to be no difference in service satisfaction and overall patient outcomes between patients managed by GP or IC, although patients of GP physicians assessed the level of care of the ED to be higher (5 vs. 4; p-value = 0.019). In the quantitative and qualitative ratings, most patients provided positive citations on ED service quality, staff, structure, system, physician competency and compassion.ConclusionsWhile GPs were associated with higher operational costs, they improved the ED efficiency and perceived quality of care without compromising patient outcomes. These findings support GP as a viable alternative model for improving ED operations. However, more research is needed to examine its long-term impacts.

This study aimed to analyze the estimated suicide trends among males in the Association of Southeast Asian Nations (ASEAN) countries from year 2000 to 2019 and their relationship with unemployment rates. Age-standardized suicide rate and unemployment data of 10 ASEAN countries (Brunei, Cambodia, Indonesia, Lao People's Democratic Republic, Malaysia, Myanmar, the Philippines, Singapore, Thailand, Vietnam) were analyzed using Joinpoint regression. Results showed that ASEAN countries (except the Philippines and Myanmar) recorded an increase or a plateau in the decline of age-standardized suicide rates in males during the second half of the 2010s. This was in contrast with global trends for males, which has been steadily decreasing. Unemployment was significantly associated with suicide rates. Our study found generally increasing or plateauing suicide trends in ASEAN countries between years 2013 and 2017. However, limitations in data quality highlight the importance of improved suicide surveillance to effectively support prevention efforts.