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Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

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• Published: 20 August 2020
• Volume 55 , pages 1397–1413, ( 2020 )

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• Andrea B. Martinez   ORCID: orcid.org/0000-0002-4437-769X 1 , 2 ,
• Melissa Co 3 ,
• Jennifer Lau 2 &
• June S. L. Brown 2  

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This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking.

Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis.

Filipinos across the world have general reluctance and unfavourable attitude towards formal help-seeking despite high rates of psychological distress. They prefer seeking help from close family and friends. Barriers cited by Filipinos living in the Philippines include financial constraints and inaccessibility of services, whereas overseas Filipinos were hampered by immigration status, lack of health insurance, language difficulty, experience of discrimination and lack of acculturation to host culture. Both groups were hindered by self and social stigma attached to mental disorder, and by concern for loss of face, sense of shame, and adherence to Asian values of conformity to norms where mental illness is considered unacceptable. Filipinos are also prevented from seeking help by their sense of resilience and self-reliance, but this is explored only in qualitative studies. They utilize special mental health care only as the last resort or when problems become severe. Other prominent facilitators include perception of distress, influence of social support, financial capacity and previous positive experience in formal help.

We confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as primary barrier, while resilience and self-reliance as coping strategies were cited in qualitative studies. Social support and problem severity were cited as prominent facilitators.

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Introduction

Mental illness is the third most common disability in the Philippines. Around 6 million Filipinos are estimated to live with depression and/or anxiety, making the Philippines the country with the third highest rate of mental health problems in the Western Pacific Region [ 1 ]. Suicide rates are pegged at 3.2 per 100,000 population with numbers possibly higher due to underreporting or misclassification of suicide cases as ‘undetermined deaths’ [ 2 ]. Despite these figures, government spending on mental health is at 0.22% of total health expenditures with a lack of health professionals working in the mental health sector [ 1 , 3 ]. Elevated mental health problems also characterise ‘overseas Filipinos’, that is, Filipinos living abroad [ 4 ]. Indeed, 12% of Filipinos living in the US suffer from psychological distress [ 5 ], higher than the US prevalence rate of depression and anxiety [ 1 ]. Long periods of separation from their families and a different cultural background may make them more prone to acculturative stress, depression, anxiety, substance use and trauma especially those who are exposed to abuse, violence and discrimination whilst abroad [ 6 ].

One crucial barrier to achieving well-being and improved mental health among both ‘local’ and overseas Filipinos is their propensity to not seek psychological help [ 7 , 8 ]. Not only are help-seeking rates much lower than rates found in general US populations [ 9 ], they are also low compared to other minority Asian groups [ 10 ]. Yet, few studies have been published on Filipino psychological help-seeking either in the Philippines or among those overseas [ 11 ]. Most available studies have focused on such factors as stigma tolerance, loss of face and acculturation factors [ 12 , 13 ].

To date, no systematic review of studies on Filipino psychological help-seeking, both living in the Philippines and overseas, has been conducted. In 2014, Tuliao conducted a narrative review of the literature on Filipino mental health help-seeking in the US which provided a comprehensive treatise on cultural context of Filipino help-seeking behavior [ 11 ]. However, new studies have been published since which examine help-seeking in other country contexts, such as Norway, Iceland, Israel and Canada [ 6 , 14 , 15 , 16 ]. Alongside recent studies on local Filipinos, these new studies can provide basis for comparison of the local and overseas Filipinos [ 7 , 8 , 12 , 17 ].

This systematic review aims to critically appraise the evidence on behavioural and attitudinal patterns of psychological help-seeking among Filipinos in the Philippines and abroad and examine barriers and enablers of their help-seeking. While the majority of studies undertaken have been among Filipino migrants especially in the US where they needed to handle additional immigration challenges, studying help-seeking attitudes and behaviours of local Filipinos is important as this may inform those living abroad [ 10 , 13 , 18 ]. This review aims to: (1) examine the commonly reported help-seeking attitudes and behaviors among local and overseas Filipinos with mental health problems; and (2) expound on the most commonly reported barriers and facilitators that influence their help-seeking.

The review aims to synthesize available data on formal help-seeking behavior and attitudes of local and overseas Filipinos for their mental health problems, as well as commonly reported barriers and facilitators. Formal psychological help-seeking behavior is defined as seeking services and treatment, such as psychotherapy, counseling, information and advice, from trained and recognized mental health care providers [ 19 ]. Attitudes on psychological help-seeking refer to the evaluative beliefs in seeking help from these professional sources [ 20 ].

Eligibility criteria

Inclusion criteria for the studies were the following: (1) those that address either formal help-seeking behavior OR attitude related to a mental health AND those that discuss barriers OR facilitators of psychological help-seeking; (2) those that involve Filipino participants, or of Filipino descent; in studies that involve multi-cultural or multi-ethnic groups, they must have at least 20% Filipino participants with disaggregated data on Filipino psychological help-seeking; (3) those that employed any type of study designs, whether quantitative, qualitative or mixed-methods; (4) must be full-text peer-reviewed articles published in scholarly journals or book chapters, with no publication date restrictions; (5) written either in English or Filipino; and (6) available in printed or downloadable format. Multiple articles based on the same research are treated as one study/paper.

Exclusion criteria were: (1) studies in which the reported problems that prompted help-seeking are medical (e.g. cancer), career or vocational (e.g., career choice), academic (e.g., school difficulties) or developmental disorders (e.g., autism), unless specified that there is an associated mental health concern (e.g., anxiety, depression, trauma); (2) studies that discuss general health-seeking behaviors; (3) studies that are not from the perspective of mental health service users (e.g., counselor’s perspective); (4) systematic reviews, meta-analyses and other forms of literature review; and (5) unpublished studies including dissertations and theses, clinical reports, theory or methods papers, commentaries or editorials.

Search strategy and study selection

The search for relevant studies was conducted through electronic database searching, hand-searching and web-based searching. Ten bibliographic databases were searched in August to September 2018: PsychInfo, Global Health, MedLine, Embase, EBSCO , ProQuest , PubMed , Science Direct, Scopus and Emerald Insight. The following search terms were used: “help-seeking behavior” OR “utilization of mental health services” OR “access to mental health services” OR “psychological help-seeking” AND “barriers to help-seeking” OR “facilitators of help-seeking” AND “mental health” OR “mental health problem” OR “mental disorder” OR “mental illness” OR “psychological distress” OR “emotional problem” AND “Filipino” OR “Philippines”. Filters were used to select only publications from peer-reviewed journals. Internet searches through Google Scholar and websites of Philippine-based publications were also performed using the search term “Filipino mental health help-seeking” as well as hand-searching of reference lists of relevant studies. A total of 3038 records were obtained. Duplicates were removed and a total of 2659 records were screened for their relevance based on their titles and abstracts.

Preliminary screening of titles and abstracts of articles resulted in 162 potentially relevant studies, their full-text papers were obtained and were reviewed for eligibility by two reviewers (AM and MC). Divergent opinions on the results of eligibility screening were deliberated and any further disagreement was resolved by the third reviewer (JB). A total of 15 relevant studies (from 24 papers) published in English were included in the review and assessed for quality. There were seven studies with multiple publications (two of them have 3 papers) and a core paper was chosen on the basis of having more comprehensive key study data on formal help-seeking. Results of the literature search are reported in Fig.  1 using the PRISMA diagram [ 21 ]. A protocol for this review was registered at PROSPERO Registry of the Centre for Reviews and Dissemination of the University of York ( https://www.crd.york.ac.uk/PROSPERO ; ID: CRD42018102836).

PRISMA flow diagram

Data extraction and quality assessment

Data extracted by the main author were crosschecked by a second reviewer (JB). A data extraction table with thematic headings was prepared and pilot tested for two quantitative and two qualitative studies to check data comparability. Extraction was performed using the following descriptive data: (1) study information (e.g. name of authors, publication date, study location, setting, study design, measurement tools used); (2) socio-demographic characteristics of participants (e.g. sample size, age, gender); and (3) overarching themes on psychological help-seeking behavior and attitudes, as well as barriers and facilitators of help-seeking.

Two reviewers (AM and MC) did quality assessment of the studies separately, using the following criteria: (1) relevance to the research question; (2) transparency of the methods; (3) robustness of the evidence presented; and (4) soundness of the data interpretation and analysis. Design-specific quality assessment tools were used in the evaluation of risk of bias of the studies, namely: (1) Critical Appraisal Skills Programme Qualitative Checklist [ 22 ]; and (2) Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project [ 23 ]. The appraisals for mixed-methods studies were done separately for quantitative and qualitative components to ensure trustworthiness [ 24 ] of the quality of each assessment.

For studies reported in multiple publications, quality assessment was done only on the core papers [ 25 ]. All the papers ( n  = 6) assessed for their qualitative study design (including the 4 mixed-methods studies) met the minimum quality assessment criteria of fair ( n  = 1) and good ( n  = 5) and were, thus, included in the review. Only 11 out of the 13 quantitative studies (including the 4 mixed-methods studies) satisfied the minimum ratings for the review, with five getting strong quality rating. The two mixed-methods studies that did not meet the minimum quality rating for quantitative designs were excluded as sources of quantitative data but were used in the qualitative data analysis because they satisfied the minimum quality rating for qualitative designs.

Strategy for data analysis

Due to the substantial heterogeneity of the studies in terms of participant characteristics, study design, measurement tools used and reporting methods of the key findings, narrative synthesis approach was used in data analysis to interpret and integrate the quantitative and qualitative evidence [ 26 , 27 ]. However, one crucial methodological limitation of studies in this review is the lack of agreement on what constitutes formal help-seeking. Some researchers include the utilization of traditional or indigenous healers as formal help-seeking, while others limit the concept to professional health care providers. As such, consistent with Rickwood and Thomas’ definition of formal help-seeking [ 19 ], data extraction and analysis were done only on those that reported utilization of professional health care providers.

Using a textual approach, text data were coded using both predetermined and emerging codes [ 28 ]. They were then tabulated, analyzed, categorized into themes and integrated into a narrative synthesis [ 29 ]. Exemplar quotations and author interpretations were also used to support the narrative synthesis. The following were the themes on barriers and facilitators of formal help-seeking: (1) psychosocial barriers/facilitators, which include social support from family and friends, perceived severity of mental illness, awareness of mental health issues, self-stigmatizing beliefs, treatment fears and other individual concerns; (2) socio-cultural barriers/facilitators, which include the perceived social norms and beliefs on mental health, social stigma, influence of religious beliefs, and language and acculturation factors; and (3) systemic/structural and economic barriers/facilitators, which include financial or employment status, the health care system and its accessibility, availability and affordability, and ethnicity, nativity or immigration status.

Study and participant characteristics

The 15 studies were published between 2002 and 2018. Five studies were conducted in the US, four in the Philippines and one study each was done in Australia, Canada, Iceland, Israel and Norway. One study included participants working in different countries, the majority were in the Middle East. Data extracted from the four studies done in the Philippines were used to report on the help-seeking behaviors and attitudes, and barriers/facilitators to help-seeking of local Filipinos, while the ten studies conducted in different countries were used to report on help-seeking of overseas Filipinos. Nine studies were quantitative and used a cross-sectional design except for one cohort study; the majority of them used research-validated questionnaires. Four studies used mixed methods with surveys and open-ended questionnaires, and another two were purely qualitative studies that used interviews and focus group discussions. Only three studies recruited participants through random sampling and the rest used purposive sampling methods. All quantitative studies used questionnaires in measures of formal help-seeking behaviors, and western-standardized measures to assess participants’ attitudes towards help-seeking. Qualitative studies utilized semi-structured interview guides that were developed to explore the psychological help-seeking of participants.

A total of 5096 Filipinos aged 17–70 years participated in the studies. Additionally, 13 studies reported on the mean age of participants, with the computed overall mean age at 39.52 (SD 11.34). The sample sizes in the quantitative studies ranged from 70 to 2285, while qualitative studies ranged from 10 to 25 participants. Of the participants, 59% ( n  = 3012) were female which is probably explained by five studies focusing on Filipino women. Ten studies were conducted in community settings, five in health or social centre-based settings and 1 in a university (Table 1 ).

Formal help-seeking behaviors

12 studies examined the formal help-seeking behaviors of Filipinos (Table 2 ), eight of them were from community-based studies and four were from centre-based studies. Nine studies reported on formal help-seeking of overseas Filipinos and three reported on local Filipinos.

Community-based vs health/social centres Data from quantitative community studies show that the rates of formal help-seeking behaviors among the Filipino general population ranged from 2.2% [ 30 ] to 17.5% [ 6 ]. This was supported by reports from qualitative studies where participants did not seek help at all. The frequency of reports of formal help-seeking from studies conducted in crisis centres and online counseling tended to be higher. For instance, the rate of engagement in online counseling among overseas Filipinos was 10.68% [ 31 ], those receiving treatment in crisis centers was 39.32% [ 17 ] while 100% of participants who were victims of intimate partner violence were already receiving help from a women’s support agency [ 8 , 32 ].

Local vs overseas Filipinos’ formal help-seeking The rate of formal psychological help-seeking of local Filipinos was at 22.19% [ 12 ] while overseas rates were lower and ranged from 2.2% of Filipino Americans [ 30 ] to 17.5% of Filipinos in Israel [ 6 ]. Both local and overseas Filipinos indicated that professional help is sought only as a last resort because they were more inclined to get help from family and friends or lay network [ 7 , 16 ].

Attitudes towards formal help-seeking

13 studies reported on participants’ attitudes towards seeking formal help. Seven studies identified family and friends as preferred sources of help [ 7 , 14 , 16 ] rather than mental health specialists and other professionals even when they were already receiving help from them [ 17 , 32 ]. When Filipinos seek professional help, it is usually done in combination with other sources of care [ 13 ] or only used when the mental health problem is severe [ 14 , 16 , 33 ]. Other studies reported that in the absence of social networks, individuals prefer to rely on themselves [ 32 , 33 ].

Community-based vs health/social centres Community-based studies reported that Filipinos have negative attitudes marked by low stigma tolerance towards formal help-seeking [ 7 , 14 , 16 ]. However, different findings were reported by studies conducted in crisis centres. Hechanova et al. found a positive attitude towards help-seeking among users of online counseling [ 31 ], whereas Cabbigat and Kangas found that Filipinos in crisis centres still prefer receiving help from religious clergy or family members, with mental health units as the least preferred setting in receiving help [ 17 ]. This is supported by the findings of Shoultz and her colleagues who reported that Filipino women did not believe in disclosing their problems to others [ 32 ].

Local vs overseas Filipinos Filipinos, regardless of location, have negative attitudes towards help-seeking, except later-generation Filipino migrants who have been acculturated in their host countries and tended to have more positive attitudes towards mental health specialists [ 10 , 13 , 15 , 34 ]. However, this was only cited in quantitative studies. Qualitative studies reported the general reluctance of both overseas and local Filipinos to seek help.

Barriers in formal help-seeking

All 15 studies examined a range of barriers in psychological help-seeking (Table 3 ). The most commonly endorsed barriers were: (1) financial constraints due to high cost of service, lack of health insurance, or precarious employment condition; (2) self-stigma, with associated fear of negative judgment, sense of shame, embarrassment and being a disgrace, fear of being labeled as ‘crazy’, self-blame and concern for loss of face; and (3) social stigma that puts the family’s reputation at stake or places one’s cultural group in bad light.

Local vs overseas Filipinos In studies conducted among overseas Filipinos, strong adherence to Asian values of conformity to norms is an impediment to help-seeking but cited only in quantitative studies [ 10 , 13 , 15 , 34 ] while perceived resilience, coping ability or self-reliance was mentioned only in qualitative studies [ 14 , 16 , 33 ]. Other common barriers to help-seeking cited by overseas Filipinos were inaccessibility of mental health services, immigration status, sense of religiosity, language problem, experience of discrimination and lack of awareness of mental health needs [ 10 , 13 , 18 , 34 ]. Self-reliance and fear of being a burden to others as barriers were only found among overseas Filipinos [ 6 , 16 , 32 ]. On the other hand, local Filipinos have consistently cited the influence of social support as a hindrance to help-seeking [ 7 , 17 ].

Stigmatized attitude towards mental health and illness was reported as topmost barriers to help-seeking among overseas and local Filipinos. This included notions of mental illness as a sign of personal weakness or failure of character resulting to loss of face. There is a general consensus in these studies that the reluctance of Filipinos to seek professional help is mainly due to their fear of being labeled or judged negatively, or even their fear of fueling negative perceptions of the Filipino community. Other overseas Filipinos were afraid that having mental illness would affect their jobs and immigration status, especially for those who are in precarious employment conditions [ 6 , 16 ].

Facilitators of formal help-seeking

All 15 studies discussed facilitators of formal help-seeking, but the identified enablers were few (Table 4 ). Among the top and commonly cited factors that promote help-seeking are: (1) perceived severity of the mental health problem or awareness of mental health needs; (2) influence of social support, such as the presence/absence of family and friends, witnessing friends seeking help, having supportive friends and family who encourage help-seeking, or having others taking the initiative to help; and (3) financial capacity.

Local vs overseas Filipinos Studies on overseas Filipinos frequently cited financial capacity, immigration status, language proficiency, lower adherence to Asian values and stigma tolerance as enablers of help-seeking [ 15 , 30 , 32 , 34 ], while studies done on local Filipinos reported that awareness of mental health issues and previous positive experience of seeking help serve as facilitator [ 7 , 12 ].

Community-based vs health/social centres Those who were receiving help from crisis centres mentioned that previous positive experience with mental health professionals encouraged their formal help-seeking [ 8 , 17 , 31 ]. On the other hand, community-based studies cited the positive influence of encouraging family and friends as well as higher awareness of mental health problems as enablers of help-seeking [ 12 , 14 , 16 ].

To the best of our knowledge, this is the first systematic review conducted on psychological help-seeking among Filipinos, including its barriers and facilitators. The heterogeneity of participants (e.g., age, gender, socio-economic status, geographic location or residence, range of mental health problems) was large.

Filipino mental health help-seeking behavior and attitudes The rate of mental health problems appears to be high among Filipinos both local and overseas, but the rate of help-seeking is low. This is consistent with findings of a study among Chinese immigrants in Australia which reported higher psychological distress but with low utilization of mental health services [ 35 ]. The actual help-seeking behavior of both local and overseas Filipinos recorded at 10.72% ( n  = 461) is lower than the 19% of the general population in the US [ 36 ] and 16% in the United Kingdom (UK) [ 37 ], and even far below the global prevalence rate of 30% of people with mental illness receiving treatment [ 38 ]. This finding is also comparable with the low prevalence rate of mental health service use among the Chinese population in Hong Kong [ 39 ] and in Australia [ 35 ], Vietnamese immigrants in Canada [ 30 ], East Asian migrants in North America [ 41 ] and other ethnic minorities [ 42 ] but is in sharp contrast with the increased use of professional help among West African migrants in The Netherlands [ 43 ].

Most of the studies identified informal help through family and friends as the most widely utilized source of support, while professional service providers were only used as a last resort. Filipinos who are already accessing specialist services in crisis centres also used informal help to supplement professional help. This is consistent with reports on the frequent use of informal help in conjunction with formal help-seeking among the adult population in UK [ 44 ]. However, this pattern contrasts with informal help-seeking among African Americans who are less likely to seek help from social networks of family and friends [ 45 ]. Filipinos also tend to use their social networks of friends and family members as ‘go-between’ [ 46 ] for formal help, serving to intercede between mental health specialists and the individual. This was reiterated in a study by Shoultz et al. (2009) in which women who were victims of violence are reluctant to report the abuse to authorities but felt relieved if neighbours and friends would interfere for professional help in their behalf [ 32 ].

Different patterns of help-seeking among local and overseas Filipinos were evident and may be attributed to the differences in the health care system of the Philippines and their host countries. For instance, the greater use of general medical services by overseas Filipinos is due to the gatekeeper role of general practitioners (GP) in their host countries [ 47 ] where patients have to go through their GPs before they get access to mental health specialists. In contrast, local Filipinos have direct access to psychiatrists or psychologists without a GP referral. Additionally, those studies conducted in the Philippines were done in urban centers where participants have greater access to mental health specialists. While Filipinos generally are reluctant to seek help, later-generation overseas Filipinos have more positive attitudes towards psychological help-seeking. Their exposure and acculturation to cultures that are more tolerant of mental health stigma probably influenced their more favorable attitude [ 41 , 48 ].

Prominent barrier themes in help-seeking Findings of studies on frequently endorsed barriers in psychological help-seeking are consistent with commonly reported impediments to health care utilization among Filipino migrants in Australia [ 49 ] and Asian migrants in the US [ 47 , 50 ]. The same barriers in this review, such as preference for self-reliance as alternative coping strategy, poor mental health awareness, perceived stigma, are also identified in mental health help-seeking among adolescents and young adults [ 51 ] and among those suffering from depression [ 52 ].

Social and self-stigmatizing attitudes to mental illness are prominent barriers to help-seeking among Filipinos. Social stigma is evident in their fears of negative perception of the Filipino community, ruining the family reputation, or fear of social exclusion, discrimination and disapproval. Self-stigma manifests in their concern for loss of face, sense of shame or embarrassment, self-blame, sense of being a disgrace or being judged negatively and the notion that mental illness is a sign of personal weakness or failure of character [ 16 ]. The deterrent role of mental health stigma is consistent with the findings of other studies [ 51 , 52 ]. Overseas Filipinos who are not fully acculturated to the more stigma-tolerant culture of their host countries still hold these stigmatizing beliefs. There is also a general apprehension of becoming a burden to others.

Practical barriers to the use of mental health services like accessibility and financial constraints are also consistently rated as important barriers by Filipinos, similar to Chinese Americans [ 53 ]. In the Philippines where mental health services are costly and inaccessible [ 54 ], financial constraints serve as a hindrance to formal help-seeking, as mentioned by a participant in the study of Straiton and his colleagues, “In the Philippines… it takes really long time to decide for us that this condition is serious. We don’t want to use our money right away” [ 14 , p.6]. Local Filipinos are confronted with problems of lack of mental health facilities, services and professionals due to meager government spending on health. Despite the recent ratification of the Philippines’ Mental Health Act of 2018 and the Universal Health Care Act of 2019, the current coverage for mental health services provided by the Philippine Health Insurance Corporation only amounts to US$154 per hospitalization and only for acute episodes of mental disorders [ 55 ]. Specialist services for mental health in the Philippines are restricted in tertiary hospitals located in urban areas, with only one major mental hospital and 84 psychiatric units in general hospitals [ 1 ].

Overseas Filipinos cited the lack of health insurance and immigration status without health care privileges as financial barrier. In countries where people have access to universal health care, being employed is a barrier to psychological help-seeking because individuals prefer to work instead of attending medical check-ups or consultations [ 13 ]. Higher income is also associated with better mental health [ 56 ] and hence, the need for mental health services is low, whereas poor socio-economic status is related to greater risk of developing mental health problems [ 57 , 58 ]. Lack of familiarity with healthcare system in host countries among new Filipino migrants also discourages them from seeking help.

Studies have shown that reliance on, and accessibility of sympathetic, reliable and trusted family and friends are detrimental to formal help-seeking since professional help is sought only in the absence of this social support [ 6 , 8 ]. This is consistent with the predominating cultural values that govern Filipino interpersonal relationships called kapwa (or shared identity) in which trusted family and friends are considered as “hindi-ibang-tao” (one-of-us/insider), while doctors or professionals are seen as “ibang-tao” (outsider) [ 59 ]. Filipinos are apt to disclose and be more open and honest about their mental illness to those whom they considered as “hindi-ibang-tao” (insider) as against those who are “ibang-tao” (outsider), hence their preference for family members and close friends as source of informal help [ 59 ]. For Filipinos, it is difficult to trust a mental health specialist who is not part of the family [ 60 ].

Qualitative studies in this review frequently mentioned resilience and self-reliance among overseas Filipinos as barriers to help-seeking. As an adaptive coping strategy for adversity [ 61 ], overseas Filipinos believe that they were better equipped in overcoming emotional challenges of immigration [ 16 ] without professional assistance [ 14 ]. It supports the findings of studies on overseas Filipino domestic workers who attributed their sense of well-being despite stress to their sense of resilience which prevents them from developing mental health problems [ 62 ] and among Filipino disaster survivors who used their capacity to adapt as protective mechanism from experience of trauma [ 63 ]. However, self-reliant individuals also tend to hold stigmatizing beliefs on mental health and as such resort to handling problems on their own instead of seeking help [ 51 , 64 ].

Prominent facilitator themes in help-seeking In terms of enablers of psychological help-seeking, only a few facilitators were mentioned in the studies, which supported findings in other studies asserting that factors that promote help-seeking are less often emphasized [ 42 , 51 ].

Consistent with other studies [ 44 , 49 ], problem severity is predictive of intention to seek help from mental health providers [ 18 , 30 ] because Filipinos perceive that professional services are only warranted when symptoms have disabling effects [ 5 , 53 ]. As such, those who are experiencing heightened emotional distress were found to be receptive to intervention [ 17 ]. In most cases, symptom severity is determined only when somatic or behavioral symptoms manifest [ 13 ] or occupational dysfunction occurs late in the course of the mental illness [ 65 ]. This is most likely due to the initial denial of the problem [ 66 ] or attempts at maintaining normalcy of the situation as an important coping mechanism [ 67 ]. Furthermore, this poses as a hindrance to any attempts at early intervention because Filipinos are likely to seek professional help only when the problem is severe or has somatic manifestations. It also indicates the lack of preventive measure to avert any deterioration in mental health and well-being.

More positive attitudes towards help-seeking and higher rates of mental health care utilization have been found among later-generation Filipino immigrants or those who have acquired residency status in their host country [ 10 , 15 ]. Immigration status and length of stay in the host country are also associated with language proficiency, higher acculturation and familiarity with the host culture that are more open to discussing mental health issues [ 13 ], which present fewer barriers in help-seeking. This is consistent with facilitators of formal help-seeking among other ethnic minorities, such as acculturation, social integration and positive attitude towards mental health [ 43 ].

Cultural context of Filipinos’ reluctance to seek help Several explanations have been proposed to account for the general reluctance of Filipinos to seek psychological help. In Filipino culture, mental illness is attributed to superstitious or supernatural causes, such as God’s will, witchcraft, and sorcery [ 68 , 69 ], which contradict the biopsychosocial model used by mental health care professionals. Within this cultural context, Filipinos prefer to seek help from traditional folk healers who are using religious rituals in their healing process instead of availing the services of professionals [ 70 , 71 ]. This was reaffirmed by participants in the study of Thompson and her colleagues who said that “psychiatrists are not a way to deal with emotional problems” [ 74 , p.685]. The common misconception on the cause and nature of mental illness, seeing it as temporary due to cold weather [ 14 ] or as a failure in character and as an individual responsibility to overcome [ 16 , 72 ] also discourages Filipinos from seeking help.

Synthesis of the studies included in the review also found conflicting findings on various cultural and psychosocial influences that served both as enablers and deterrents to Filipino help-seeking, namely: (1) level of spirituality; (2) concern on loss of face or sense of shame; and (3) presence of social support.

Level of spirituality Higher spirituality or greater religious beliefs have disparate roles in Filipino psychological help-seeking. Some studies [ 8 , 14 , 16 ] consider it a hindrance to formal help-seeking, whereas others [ 10 , 15 ] asserted that it can facilitate the utilization of mental health services [ 15 , 73 ]. Being predominantly Catholics, Filipinos had drawn strength from their religious faith to endure difficult situations and challenges, accordingly ‘leaving everything to God’ [ 74 ] which explains their preference for clergy as sources of help instead of professional mental health providers. This is connected with the Filipino attribution of mental illness to spiritual or religious causes [ 62 ] mentioned earlier. On the contrary, Hermansdottir and Aegisdottir argued that there is a positive link between spirituality and help-seeking, and cited connectedness with host culture as mediating factor [ 15 ]. Alternately, because higher spirituality and religiosity are predictors of greater sense of well-being [ 75 ], there is, thus, a decreased need for mental health services.

Concern on loss of face or sense of shame The enabler/deterrent role of higher concern on loss of face and sense of shame on psychological help-seeking was also identified. The majority of studies in this review asserted the deterrent role of loss of face and stigma consistent with the findings of other studies [ 51 ], although Clement et al. stated that stigma is the fourth barrier in deterring help-seeking [ 76 ]. Mental illness is highly stigmatized in the Philippines and to avoid the derogatory label of ‘crazy’, Filipinos tend to conceal their mental illness and consequently avoid seeking professional help. This is aligned with the Filipino value of hiya (sense of propriety) which considers any deviation from socially acceptable behavior as a source of shame [ 11 ]. The stigmatized belief is reinforced by the notion that formal help-seeking is not the way to deal with emotional problems, as reflected in the response of a Filipino participant in the study by Straiton et. al., “It has not occurred to me to see a doctor for that kind of feeling” [ 14 , p.6]. However, other studies in this review [ 12 , 13 ] posited contrary views that lower stigma tolerance and higher concern for loss of face could also motivate psychological help-seeking for individuals who want to avoid embarrassing their family. As such, stigma tolerance and loss of face may have a more nuanced influence on help-seeking depending on whether the individual avoids the stigma by not seeking help or prevent the stigma by actively seeking help.

Presence of social support The contradictory role of social networks either as helpful or unhelpful in formal help-seeking was also noted in this review. The presence of friends and family can discourage Filipinos from seeking professional help because their social support serves as protective factor that buffer one’s experience of distress [ 77 , 78 ]. Consequently, individuals are less likely to use professional services [ 42 , 79 ]. On the contrary, other studies have found that the presence of friends and family who have positive attitudes towards formal help-seeking can promote the utilization of mental health services [ 8 , 80 ]. Friends who sought formal help and, thus, serve as role models [ 14 ], and those who take the initiative in seeking help for the distressed individual [ 32 ] also encourage such behavior. Thus, the positive influence of friends and family on mental health and formal help-seeking of Filipinos is not merely to serve only as emotional buffer for stress, but to also favourably influence the decision of the individual to seek formal help.

Research implications of findings

This review highlights particular evidence gaps that need further research: (1) operationalization of help-seeking behavior as a construct separating intention and attitude; (2) studies on actual help-seeking behavior among local and overseas Filipinos with identified mental health problems; (3) longitudinal study on intervention effectiveness and best practices; (4) studies that triangulate findings of qualitative studies with quantitative studies on the role of resilience and self-reliance in help-seeking; and (5) factors that promote help-seeking.

Some studies in this review reported help-seeking intention or attitude as actual behaviors even though they are separate constructs, hence leading to reporting biases and misinterpretations. For instance, the conflicting findings of Tuliao et al. [ 12 ] on the negative association of loss of face with help-seeking attitude and the positive association between loss of face and intention to seek help demonstrate that attitudes and intentions are separate constructs and, thus, need further operationalization. Future research should strive to operationalize concretely these terms through the use of robust measurement tools and systematic reporting of results. There is also a lack of data on the actual help-seeking behaviors among Filipinos with mental illness as most of the reports were from the general population and on their help-seeking attitudes and intentions. Thus, research should focus on those with mental health problems and their actual utilization of healthcare services to gain a better understanding of how specific factors prevent or promote formal help-seeking behaviors.

Moreover, the majority of the studies in this review were descriptive cross-sectional studies, with only one cohort analytic study. Future research should consider a longitudinal study design to ensure a more rigorous and conclusive findings especially on testing the effectiveness of interventions and documenting best practices. Because of the lack of quantitative research that could triangulate the findings of several qualitative studies on the detrimental role of resilience and self-reliance, quantitative studies using pathway analysis may help identify how these barriers affect help-seeking. A preponderance of studies also focused on discussing the roles of barriers in help-seeking, but less is known about the facilitators of help-seeking. For this reason, factors that promote help-seeking should be systematically investigated.

Practice, service delivery and policy implications

Findings of this review also indicate several implications for practice, service delivery, intervention and policy. Cultural nuances that underlie help-seeking behavior of Filipinos, such as the relational orientation of their interactions [ 81 ], should inform the design of culturally appropriate interventions for mental health and well-being and improving access and utilization of health services. Interventions aimed at improving psychological help-seeking should also target friends and family as potential and significant influencers in changing help-seeking attitude and behavior. They may be encouraged to help the individual to seek help from the mental health professional. Other approaches include psychoeducation that promotes mental health literacy and reduces stigma which could be undertaken both as preventive and treatment strategies because of their positive influence on help-seeking. Strategies to reduce self-reliance may also be helpful in encouraging help-seeking.

This review also has implications for structural changes to overcome economic and other practical barriers in Filipino seeking help for mental health problems. Newly enacted laws on mental health and universal healthcare in the Philippines may jumpstart significant policy changes, including increased expenditure for mental health treatment.

Since lack of awareness of available services was also identified as significant barrier, overseas Filipinos could be given competency training in utilizing the health care system of host countries, possibly together with other migrants and ethnic minorities. Philippine consular agencies in foreign countries should not merely only resort to repatriation acts, but could also take an active role in service delivery especially for overseas Filipinos who experience trauma and/or may have immigration-related constraints that hamper their access to specialist care.

Limitations of findings

A crucial limitation of studies in this review is the use of different standardized measures of help-seeking that render incomparable results. These measures were western-based inventories, and only three studies mentioned using cultural validation, such as forward-and-back-translations, to adapt them to cross-cultural research on Filipino participants. This may pose as a limitation on the cultural appropriateness and applicability of foreign-made tests [ 73 ] in capturing the true essence of Filipino experience and perspectives [ 74 ]. Additionally, the majority of the studies used non-probability sampling that limits the generalizability of results. They also failed to measure the type of assistance or actual support sought by Filipinos, such as psychoeducation, referral services, supportive counseling or psychotherapy, and whether or not they are effective in addressing mental health concerns of Filipinos. Another inherent limitation of this review is the lack of access to grey literature, such as thesis and dissertations published in other countries, or those published in the Philippines and are not available online. A number of studies on multi-ethnic studies with Filipino participants do not provide disaggregated data, which limits the scope and inclusion of studies in this review.

This review has confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as a primary barrier resilience and self-reliance as coping strategies were also cited, especially in qualitative studies, but may be important in addressing issues of non-utilization of mental health services. Social support and problem severity were cited as prominent facilitators in help-seeking. However, different structural, cultural and practical barriers and facilitators of psychological help-seeking between overseas and local Filipinos were also found.

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Martinez, A.B., Co, M., Lau, J. et al. Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review. Soc Psychiatry Psychiatr Epidemiol 55 , 1397–1413 (2020). https://doi.org/10.1007/s00127-020-01937-2

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General Resources and Yearbooks

Fookien Times Philippines Yearbook. Manila: Fookien Times. 1936 - . Master Index: 1936-1980 Asia Ref DS666 .C5 F66 Latest volume in reference.

Southeast Asian Affairs. Singapore: Institute of Southeast Asian Studies. 1974 - . Asia DS502 .S76

Country Profile: Philippines. London: Economist Intelligence Unit. 1986 - . Asia HC451 .Q331 Online edition for UHM only

Archdiocesan Archives of Manila: A Catalogue of Archival Documents, Testaments and Holdings. Manila: Archidiocesan Archives of Manila, 1994. 401 p. Asia Ref BX1661 .M3 A73 1994

Philippine-American Relations: A Guide to Manuscript Sources in the United States: comp. and ed. by Shiro Saito. Westport: Greenwood Press, 1982. 256 p. Asia Ref E183.8 .P5 P54

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Southeast Asian Research Tools. Volume 5 - The Philippines , by Edita A. Baradi. Honolulu: Southeast Asian Studies, Asian Studies Program, University of Hawaii; 1979. Asia Ref Z3221 .S69 v. 5

Bibliography of Philippine Bibliographies, 1593-1961 ; by Gabriel Adriano Bernardo. Quezon City: Ateneo University Press, 1968. 192 p. Asia Ref Z3291 .A1B47

Bibliography of Philippine Bibliographies, 1962-1985; comp. by Lily O. Orbase and Yolanda E. Jacinto. Manila: National Library, Bibliography Division; 1987. 128 p Asia Ref DS654 .O725 1987

Philippines , by Jim Richardson. Oxford, England: Clio Pr., 1989. 372 p. Asia Ref DS655 .R53 1989

Union Catalog on Philippine Culture. Broadcast Media. Manila: Cultural Center of the Philippines Library, 1992. 161 leaves. Asia Ref PN1990.6 .P6 U55 1992

Union Catalog on Philippine Culture. Dance. Manila: Cultural Center of the Philippines Library, 1989. 117 leaves. Asia Ref GV1703.P4 U65 1989 Union Catalog on Philippine Culture. Film. Manila: Cultural Center of the Philippines Library, 1990. 497 p. Asia Ref NX581 .U544 1990

Union Catalog on Philippine Culture. Music. Manila: Cultural Center of the Philippines Library, 1989. 3 v. Asia Ref ML120.P55 U65 1989

Union Catalog on Philippine Culture. Theater. Manila: Cultural Center of the Philippines Library, 1990. 2 v. Asia Ref NX581 .U545 1990

Union Catalog on Philippine Culture. Visual Arts and Architecture. Manila: Cultural Center of the Philippines Library, 1991. 445 leaves. Asia Ref N7327 .U45 1991

Biographies

Dictionary of Philippine Biography, by E. Arsenio Manuel. Quezon City: Filipiniana Publications; 1955 - . Asia Ref DS653.7 .M3 v. 1 -

Dictionaries

Diksyunaryong ng Wikang Filipino. San Miguel, Manila: Komisyon ng Wikang Filipino, 1998. 1040 p. Asia Ref PL6057. D55 1998

Diksyunaryong Filipino-English. Pasig, Metro Manila: Komisyon sa Wikang Filipino, 1993. 702 p. Asia Ref PL6056 .D55 1993 New Vicassan's English-Pilipino Dictionary, by Vito C. Santos and Luningning E. Santos. Pasig: Anvil Pub., 1995. 1603 p. Asia Ref PL6056 .S34 1995

Ilocano Dictionary and Grammar, by Carl Ralph Galvez Rubino. Honolulu: University of Hawaii Press, 2000. 775 p. Asia Ref PL5753 .R83 2000

Ilokano-English Dictionary, by George P. Gelad. Manila: CICM Missionaries, Inc.; 1993. 719 p. Asia Ref PL5753 .G44 1993

Encyclopedias

Encyclopedia of the Philippines, by Zoilo Galang. Manila: E. Floro, 1950-1958. 20 v. Asia Ref DS655 .G323 1950

Filipino Heritage: The Making of a Nation, ed. by Alfredo R. Roces. Manila: Lahing Pilipino Publications, 1977. 10 v. Asia Ref DS655 .F55

Kasaysayan: The Story of the Filipino People. Teresa M. Custodio, project director; Jose Y. Dalisay, Jr. executive director. Manila: Asia Pub. Co.; Pleasantville, NY: Reader's Guide, 1998. 10 v. Asia Ref DS668 .K37 1998

CCP Encyclopedia of Philippine Art. Manila: Cultural Center of the Philippines, 1994. 10 v. Asia Ref NX581 .A1 C37 1994

Encyclopedia of Philippine Folk Beliefs and Customs , comp. and ed.by Francisco R. Demetrio. Cagayan de Oro: Xavier University, 1991. 2 v. Asia Ref GR325 .E53 1991

Encyclopedia of the Spanish-American and Philippine-American Wars: A Political, Social, and Military History , Spencer C. Tucker, volume editor  Asia E715.E53 2009

Enclyclopedia of the Spanish-American & Philippine-American Wars by Jerry Keenan.  Asia E715.K27 2001.

Philippine Encyclopedia of the Social Sciences. Quezon City: Philippine Social Science Council, 1993- . Asia Ref H62.5 .P5 P474 1993

Historical Sources

The Philippine Islands, 1493-1898: Explorations by Early Navigators, Descriptions of the Islands and Their Peoples, Their History and Records of the Catholic Missions, as Related in Contemporaneous Books and Manuscripts, Showing the Political, Economic, Commercial and Religious Conditions of Those Islands from Their Earliest Relations with European Nations to the Beginning of the Nineteenth Century , edited and annotated by Emma Helen Blair and James Alexander Robertson. 55 vol. Reissue of . . . originally published in Cleveland, 1903-1909. Index v. 54-55. Asia DS653 .B63 1973

Documentary Sources of Philippine History; compiled, edited and annotated by Gregorio F. Zaide. Metro Manila: National Book Store, 1990. 12 v. Asia DS668 .D6 1990

The Philippines under Spain: A Compilation and Translation of Original Documents; ed. by Virginia Benitez Licuanan and Jose Llavador Mira. Manila: National Trust For Historical and Cultural Preservation of the Philippines, 1990 - . Asia DS674 .P54 1990 v. 1 -

The Philippine Insurrection against the United States, comp. by John R.M. Taylor. Pasay City: Eugenio Lopez Foundation, 1971. 5 v. Asia DS676 .T38

Philippine Radical Papers in the University of the Philippines Diliman Main Library. Diliman, Quezon City: University Library, University of the Philippines; 1998. 25 reels. Asia Microfilm S11384 Index to the microfilm set. Asia Ref DS653 .P48 1998

Index to Philippine Periodicals . Quezon City: University of the Philippines Library. 1955 - . Asia Ref AI3 .I63

Index to Philippine Periodical Literature, 1946-1967 . Quezon City: Library, University of the Philippines, 1972. 5 v. Asia Ref Z955 .Q4 no.10

Tagalog Periodical Literature, compiled by Teodoro A. Agoncillo. Manila: Institute of National Language, 1953. 264 p. Asia Ref PL6058.45 .A36 1953

Index to Filipino Poetry in English, 1905-1950 , compiled by Edna Zapanta-Manlapaz, Gemino H. Abad. Manila: National Book Store, 1988. 748 p. Asia Ref PR9550.2 .Z36 1988

Index to Philippine Book Reviews, 1972-1982 , compiled by Verna C. Lee. Sydney: Bibliographic Information on Southeast Asia, University of Sydney, 1986. 94 p. Asia Ref DS655.Z99 L44 1986

Index to Philippine Plays, 1923-1983; by Maria Nena R. Mata. Metro Manila: National Book Store, 1984. 67 p. Asia Ref PR9550.3 .M275 1984

Philippine Essay and General Literature Index, compiled by Maria Nena R. Mata. Metro Manila: National Book Store, 1984. 323 p. Asia Ref AI19.P4 M383 1984

Literary Index, 1932-1945. Quezon City : Library, University of the Philippines, 1971. 114 p. Asia Ref Z955 .Q4 no.9

Index to Plays, 1946-1967. Diliman: Library, University of the Philippines, 1970. 23 p. Asia Ref Z955 .Q4 no. 8

Index to Periodical Articles on Filipino Women. Manila: National Centennial Commission, Women Sector: Task Force for the Librarians' Group, 1998. 529 p. Asia Ref Z 7964 .P6 I63 1998

Philippine Treaties Index, 1946-1982. Manila: Foreign Service Institute, 1983. 166 p. Asia Ref JX907.5 .P45 1983

A Preliminary Index to the United States Congressional and Governmental Documents Set and to the Congressional Record re the Philippine Islands, compiled by E.M. Holt. Townsville, Qld: Centre for South East Asian Studies, James Cook University, 1985. 305 p. Asia Ref DS653 .H64 1985

Philippine Newspapers: An International Union List; comp.by Shiro Saito and Alice W. Mak. Honolulu: Philippine Studies Program, Center for Asian and Pacific Studies, University of Hawaii. 1984. 273 p. Asia Ref Z6958 .P5 S32 1984

**Check out the Periodicals page for more information. 

Inventory of Statistics Available in Government. Manila: National Statistical Coordination Board, 1993. 151p. Asia Ref HA37 .P55 1993

Philippine Statistical Yearbook. Manila: National Economic and Development Authority. 1977 - . Asia Ref HA1821 .N37a

Philippine Yearbook. Manila: National Census and Statistics Office. 1971 - . Asia Ref HA1821 .A45

NSO Monthly Bulletin of Statistics. Manila: National Statistics Office. Asia HA1821 .A43 Theses and Dissertations Theses and Dissertations (Part 2 of Philippine National Bibliography). Manila: National Library of the Philippines, 1985 - . Irreg. Asia Ref Z3291 .P484

Theses and Dissertations on the Philippines at the University of Hawaii at Manoa. Honolulu: Center for Philippine Studies, University of Hawaii, 1998. 22 p. Asia Ref DS655 .T44 1998

Selected Internet Resources

CIA Factbook

Portal to Asian Internet Resources (PAIR)

IPAG - Integrated Performing Arts Guild, MSU-Iligan Institute of Technology

Socio Economic Research Portal for the Philippines.   Philippine Institute for Development Studies

Department of Education (from Gov.ph)

Agimat: Sining at Kulturang Pinoy

Philippine History . Philippine-History.org

Philippine Photographs Digital Archive. Special Collections Library, University of Michigan

SEAiT: Southeast Asian Images and Text. University of Wisconsin - Madison

The Motion Picture Camera Goes to War: The Philippine Revolution. Library of Congress

Retrato: Photo Archive of the Filipinas Heritage Library

Computerized Index for Philippine Periodical Articles . Rizal Library, Ateneo de Manila University

Bibliography of Asian Studies

Ingenta (Uncover)

Asian Business & Reference  

SEAsite: Interactive Language and Filipino Culture Resources. A project of the Center for Southeast Asian Studies, Northern Illinois University

Learn Tagalog . From mylanguages.org

Ilocano Learner . A blog on learning Ilocano.

Learn Ilocano/Ilokano Language: Free Lessons . Another blog with lessons for beginners.

Learn Bisaya Now . A blog on learning Bisaya from a Cebuano native speaker.

Learn Cebuano . From LanguageLinks.org.

Chan Robles Virtual Law Library

Supreme Court of the Philippines

Australian National University-- Asia Pacific

Netherlands

Royal Netherlands Institute Library-- KITLV

North America

Center for Research Libraries-- Southeast Asia Microform Project (SEAM)

Cornell University-- John M. Echols Southeast Asia Collection

Library of Congress-- Asian Reading Room

Northern Illinois Unviersity-- Southeast Asia Studies Library Resources

University of California at Berkeley-- South/Southeast Asia Library

University of California at Los Angeles-- Southeast Asian Studies Resources

University of Michigan-- Southeast Asia Division

University of Oregon-- Research in Southeast Asian Studies

University of Washington-- Southeast Asia Section

University of Wisconsin-Madison-- Southeast Asia Guide

Yale University-- Southeast Asia Collection

Philippines

LibraryLink: A Union Catalogue of Filipiniana Libraries ,  hosted by the Filipinas Heritage Library

National Library of the Philippines University of the Philippines, Diliman; Main Library

United Kingdom

British Library-- Asia Collections, Philippine Studies

A Critical Survey of Philppine Literature , Department of English and Literature, Silliman University

Panitikan.com.ph , Your Portal to Philippine Literature

Kirtika Kultura: A Refereed Journal of Literary/Cultural and Language Studies , English Department, Ateneo de Manila University

Likhaan Online , Creative Writign Center, University of the Philippines

Perry-Castaneda Library Map Collection , University of Texas at Austin- Philippines Maps

ABS-CBN News

BusinessWorld Online

Malaya Business Insight

Manila Bulletin

Manila Times

Philippine Center for Investigative Journalism

Philippine Daily Inquirer

Philippine Journalism Review , by the Center for Media Freedom and Responsibility

Philippine Star

Sunstar Daily

  Regional News

Ilocos Sentinel

The Ilocos Times

Tawid News Magasin

Mindanao Times

MindaNews , The Mindanao News and Information Cooperative Center (MNICC)

Visayan Daily Star

PROFESSIONAL ORGANIZATIONS

Philippine Social Science Council

Philippine Studies Group, Association for Asian Studies

Ibon Foundation, Inc.

Philippine National Statistical Coordination Board

Philippine National Statistics Office

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Journal articles on the topic 'Tagalog (Filipino)'

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Jacobo, J. Pilapil, and Eileen Legaspi-Ramirez. "Tagalog/Filipino." Southeast of Now: Directions in Contemporary and Modern Art in Asia 2, no. 2 (2018): 101–11. http://dx.doi.org/10.1353/sen.2018.0022.

Tappy, Yunita Peggy. "EXPERIENCE ON NURSE-PATIENT INTERACTION WITH FILIPINO CLIENTS AMONG NON-TAGALOG SPEAKING BSN STUDENTS." Abstract Proceedings International Scholars Conference 7, no. 1 (December 18, 2019): 155–67. http://dx.doi.org/10.35974/isc.v7i1.937.

Alburo, Jade. "Boxed In or Out?" Ethnologies 27, no. 2 (February 23, 2007): 137–57. http://dx.doi.org/10.7202/014044ar.

Amora, Kathleen Kay, Rowena Garcia, and Natalia Gagarina. "Tagalog adaptation of the Multilingual Assessment Instrument for Narratives: History, process and preliminary results." ZAS Papers in Linguistics 64 (August 31, 2020): 221–33. http://dx.doi.org/10.21248/zaspil.64.2020.577.

Roces, Mina. "Filipino Identity in Fiction, 1945–1972." Modern Asian Studies 28, no. 2 (May 1994): 279–315. http://dx.doi.org/10.1017/s0026749x00012415.

de Leon, Kristine D., and Jose Cristina Parina. "A Study of Filipino Complaints in English and Tagalog." 3L The Southeast Asian Journal of English Language Studies 22, no. 1 (March 7, 2016): 191–206. http://dx.doi.org/10.17576/3l-2016-2201-15.

Lesho, Marivic. "Philippine English (Metro Manila acrolect)." Journal of the International Phonetic Association 48, no. 3 (December 18, 2017): 357–70. http://dx.doi.org/10.1017/s0025100317000548.

Bardwell-Jones, Celia T. "Feminist-Pragmatist Reflections on the Filial Obligations of a Filipina American Daughter." Hypatia 36, no. 2 (2021): 384–90. http://dx.doi.org/10.1017/hyp.2021.12.

Sales, Marlon James. "Missionary position: The grammar of Philippine colonial sexualities as a locus of translation." TranscUlturAl: A Journal of Translation and Cultural Studies 7, no. 1 (June 15, 2015): 131. http://dx.doi.org/10.21992/t94c9q.

Wong Gonzales, Wilkinson Daniel, and Rebecca Lurie Starr. "Vowel system or vowel systems?" Journal of Pidgin and Creole Languages 35, no. 2 (October 1, 2020): 253–92. http://dx.doi.org/10.1075/jpcl.00061.won.

Lee, Jaehak. "National Language Policy and Filino Identity: Tagalog, Filipino, English and Spanish." Latin American and Caribbean Studies 38, no. 4 (November 30, 2019): 63–88. http://dx.doi.org/10.17855/jlas.2019.11.38.4.63.

Parba, Jayson. "Teaching Critical Vocabulary to Filipino Heritage Language Learners." Education Sciences 11, no. 6 (May 26, 2021): 260. http://dx.doi.org/10.3390/educsci11060260.

Smith, Nigel Vaughan. "Equality, Justice and Identity in an Expatriate/Local Setting: Which Human Factors Enable Empowerment of Filipino Aid Workers?" Journal of Pacific Rim Psychology 6, no. 2 (December 2012): 57–74. http://dx.doi.org/10.1017/prp.2012.10.

Asuncion, Zayda S., and Marilu Rañosa-Madrunio, Ph.D. "Language Attitudes of the Gaddang Speakers towards Gaddang, Ilocano, Tagalog and English." Studies in English Language Teaching 5, no. 4 (November 15, 2017): 720. http://dx.doi.org/10.22158/selt.v5n4p720.

Lising, Loy, Pam Peters, and Adam Smith. "Code-switching in online academic discourse." English World-Wide 41, no. 2 (June 9, 2020): 131–61. http://dx.doi.org/10.1075/eww.00044.lis.

Scalice, Joseph. "Pamitinan and Tapusi: Using the Carpio legend to reconstruct lower-class consciousness in the late Spanish Philippines." Journal of Southeast Asian Studies 49, no. 2 (June 2018): 250–76. http://dx.doi.org/10.1017/s0022463418000218.

Stallsmith, Glenn. "Protestant Congregational Song in the Philippines: Localization through Translation and Hybridization." Religions 12, no. 9 (August 31, 2021): 708. http://dx.doi.org/10.3390/rel12090708.

Holmes, Hannah, Vanessa Araujo Almeida, Carol Boushey, and Jinan Banna. "Use of Technology for Dietary Assessment in Immigrant Populations." American Journal of Lifestyle Medicine 14, no. 2 (December 6, 2019): 118–21. http://dx.doi.org/10.1177/1559827619890948.

Lasquety-Reyes, Jeremiah, and Allen Alvarez. "Ethics and collective identity building: Scandinavian semicommunication and the possibilities of Philippine ethics." Etikk i praksis - Nordic Journal of Applied Ethics 9, no. 2 (November 9, 2015): 71. http://dx.doi.org/10.5324/eip.v9i2.1866.

Patilan, Josephine C. "Mga Salik Sa Kakayahan Sa Paggamit Ng Pandiwa At Pang-Uri Sa Mga Isinulat Na Komposisyon Ng Mga Mag-Aaral Sa Sekondarya." Proceedings Journal of Interdisciplinary Research 1 (November 22, 2014): 84–89. http://dx.doi.org/10.21016/irrc.2014.14ntt041.

Cabantac-Lumabi, Bethany Marie. "The Lexical Trend of Backward Speech among Filipino Millenials on Facebook." International Journal of English and Comparative Literary Studies 1, no. 1 (November 22, 2020): 44–54. http://dx.doi.org/10.47631/ijecls.v1i1.148.

Ortega Pérez, Marta. "La labor lexicográfica bilingüe de Fray Domingo de los Santos: Vocabulario de la lengua Tagala." RILEX. Revista sobre investigaciones léxicas 1, no. 1 (July 9, 2018): 29–53. http://dx.doi.org/10.17561/rilex.v1.n1.2.

Sales, Marlon James. "Tagalog Missionary Grammars as a Translation Resource: Translation, Book History and the Production of Linguistic Knowledge in the Spanish Philippines." Comparative Critical Studies 16, no. 2-3 (October 2019): 301–22. http://dx.doi.org/10.3366/ccs.2019.0332.

Rafael, Vicente L. "Telling Times." positions: asia critique 29, no. 1 (February 1, 2021): 121–39. http://dx.doi.org/10.1215/10679847-8722810.

Xiao, Sanrong, Ranran Liu, Kang Yao, and Ting Wang. "Psychosocial Predictors of Acculturative Stress among Female and Male Immigrant Asian Americans: A Gender Comparison Study." SHS Web of Conferences 60 (2019): 01004. http://dx.doi.org/10.1051/shsconf/20196001004.

Johnson, Maree, Cathy Noble, and Clair Mathews. "Towards culturally competent health care: Language use of bilingual staff." Australian Health Review 21, no. 3 (1998): 49. http://dx.doi.org/10.1071/ah980049.

Guinto, Nicanor. "The place/s of Tagalog in Hong Kong’s Central district." Linguistic Landscape. An international journal 5, no. 2 (July 22, 2019): 160–78. http://dx.doi.org/10.1075/ll.18024.gui.

Chotpradit, Thanavi, J. Pilapil Jacobo, Eileen Legaspi-Ramirez, Roger Nelson, Nguyen Nhu Huy, Chairat Polmuk, San Lin Tun, Phoebe Scott, Simon Soon, and Jim Supangkat. "Terminologies of "Modern" and "Contemporary" "Art" in Southeast Asia's Vernacular Languages: Indonesian, Javanese, Khmer, Lao, Malay, Myanmar/Burmese, Tagalog/Filipino, Thai and Vietnamese." Southeast of Now: Directions in Contemporary and Modern Art in Asia 2, no. 2 (2018): 65–95. http://dx.doi.org/10.1353/sen.2018.0015.

Pack, Sam. "“Fucking Koreans!”: Sexual Relations and Immigration in the Philippines." Slovenský národopis / Slovak Ethnology 68, no. 2 (June 1, 2020): 161–74. http://dx.doi.org/10.2478/se-2020-0009.

Albarrán González, Beningno. "Producción filológica española en Filipinas (1656-1898)." Estudios Humanísticos. Filología , no. 14 (December 1, 1992): 193. http://dx.doi.org/10.18002/ehf.v0i14.4270.

Gonzales, Wilkinson Daniel Wong, and Mie Hiramoto. "Two Englishes diverged in the Philippines?" Journal of Pidgin and Creole Languages 35, no. 1 (May 13, 2020): 125–59. http://dx.doi.org/10.1075/jpcl.00057.gon.

Wattimena, Rebecca Urip, and Christine Manara. "Language use in shifting contexts: Two multilingual Filipinos’ narratives of language and mobility." Indonesian JELT: Indonesian Journal of English Language Teaching 11, no. 2 (October 31, 2016): 153–67. http://dx.doi.org/10.25170/ijelt.v11i2.1495.

Gonzales, Wilkinson Daniel Wong. "Language contact in the Philippines." Language Ecology 1, no. 2 (December 31, 2017): 185–212. http://dx.doi.org/10.1075/le.1.2.04gon.

Bernardo, Diane Carla, Ralph Jason Li, and Cecilia Jimeno. "Validity and Reliability of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 – Tagalog among Adult Filipinos with Differentiated Thyroid Cancer." Journal of the ASEAN Federation of Endocrine Societies 33, no. 2 (September 13, 2018): 174–80. http://dx.doi.org/10.15605/jafes.033.02.10.

Baklanova, Ekaterina. "Types of Borrowings in Tagalog/Filipino." Kritika Kultura , no. 28 (March 20, 2017). http://dx.doi.org/10.13185/kk2017.02803.

Enriquez, Elizabeth. "Iginiit na Himig sa Himpapawid: Musikang Filipino sa Radyo sa Panahon ng Kolonyalismong Amerikano." Plaridel , 2021. http://dx.doi.org/10.52518/2020-08enrqz.

Castillo-Carandang, Nina T., Olivia T. Sison, Rody G. Sy, Hwee Lin Wee, Elmer Jasper B. Llanes, Felix Eduardo R. Punzalan, Paul Ferdinand M. Reganit, Allan Wilbert G. Gumatay, Felicidad V. Velandria, and E. Shyong Tai. "Establishing Validity of EQ-5D-3L (Tagalog) to Measure Health-Related Quality of Life States among Adult Filipinos (20-50 years old)." Acta Medica Philippina 52, no. 5 (September 30, 2019). http://dx.doi.org/10.47895/amp.v52i5.301.

Umbal, Pocholo. "Filipinos front too! A sociophonetic analysis of Toronto English /u/-fronting." American Speech , March 24, 2021, 1–37. http://dx.doi.org/10.1215/00031283-9116273.

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Ang estilo ng APA ay ang format na karaniwang kinakailangan ng mga mag-aaral na sumusulat ng mga sanaysay at mga ulat para sa mga kurso sa sikolohiya at mga agham panlipunan. Ang estilo na ito ay katulad ng MLA, ngunit mayroong mga maliit ngunit mahalagang pagkakaiba. Halimbawa, ang APA format ay humihiling ng mas kaunting mga pagdadaglat sa mga pagsipi, ngunit ito ay naglalagay ng karagdagang diin sa mga petsa ng paglalathala sa mga notasyon.

Ang may-akda at petsa ay nakasaad sa anumang oras na ginagamit mo ang impormasyon mula sa isang panlabas na mapagkukunan.

Inilagay mo agad ang mga ito sa panaklong pagkatapos ng nabanggit na materyal, maliban kung nabanggit mo ang pangalan ng may-akda sa iyong teksto. Kung ang may-akda ay nakasaad sa daloy ng iyong teksto ng sanaysay, ang petsa ay nakasulat nang husto pagkatapos ng nabanggit na materyal.

Sa panahon ng pagsiklab, naisip ng mga doktor na ang mga sintomas ng sikolohikal ay walang kaugnayan (Juarez, 1993) .

Kung ang may-akda ay pinangalanan sa teksto, ilagay lamang ang petsa sa panaklong.

Sinuri ni Juarez (1993) ang maraming ulat na isinulat ng mga psychologist na direktang kasangkot sa pag-aaral.

Kapag binabanggit ang isang trabaho na may dalawang may-akda, dapat mong banggitin ang mga huling pangalan ng parehong may-akda. Gumamit ng isang ampersand (&) upang paghiwalayin ang mga pangalan sa pagsipi, ngunit gamitin ang salita at sa teksto.

Ang mga maliliit na tribo sa kahabaan ng Amazon na nakaligtas sa mga siglo ay umunlad sa mga parallel na paraan (Hanes & Roberts, 1978).

Sinasabi ni Hanes at Roberts (1978) na ang mga paraan kung paano lumaki ang mga maliit na tribu ng Amazon sa mga siglo ay pareho sa bawat isa.

Minsan kailangan mong banggitin ang isang trabaho na may tatlo hanggang limang may-akda, kung gayon, banggitin ang lahat ng ito sa unang sanggunian. Pagkatapos, sa sumusunod na mga pagsipi, ihayag lamang ang pangalan ng unang may-akda na sinusundan ng et al .

Ang pamumuhay sa kalsada para sa linggo ay nauugnay sa maraming negatibong emosyonal, sikolohikal, at pisikal na mga isyu sa kalusugan (Hans, Ludwig, Martin, & Varner, 1999).

at pagkatapos ay:

Ayon sa Hans et al. (1999), ang kakulangan ng katatagan ay isang pangunahing kadahilanan.

Kung gumagamit ka ng isang teksto na may anim o higit pang mga may-akda, banggitin ang huling pangalan ng unang may-akda na sinusundan ng et al . at ang taon ng publikasyon. Ang kumpletong listahan ng mga may-akda ay dapat na kasama sa mga listahan ng nabanggit na gawa sa dulo ng papel.

Bilang Carnes et al. (2002), nabanggit na ang agarang bono sa pagitan ng isang bagong panganak na sanggol at ang ina nito ay maraming pinag-aralan ng maraming disiplina.

Kung binabanggit mo ang isang may-akda ng korporasyon, dapat mong sabihin ang buong pangalan sa bawat sanggunian sa text na sinusundan ng petsa ng paglalathala. Kung ang pangalan ay matagal at ang abbreviated na bersyon ay makikilala, maaari itong i-abbreviated sa kasunod na mga sanggunian.

Ipinakikita ng mga bagong istatistika na ang pagmamay-ari ng mga alagang hayop ay nagpapabuti ng emosyonal na kalusugan (United Pet Lovers Association [UPLA], 2007).

Ang uri ng alagang hayop ay parang maliit na pagkakaiba (UPLA, 2007).

Kung kailangan mong isaalang-alang ang higit sa isang trabaho sa pamamagitan ng parehong may-akda na inilathala sa parehong taon, iba-iba sa pagitan ng mga ito sa mga nakasulat na sipi sa pamamagitan ng paglalagay ng mga ito sa alpabetikong pagkakasunud-sunod sa listahan ng sanggunian at pagtatalaga ng bawat trabaho na may isang mas mababang titik na letra.

Ang "Ants and the Plants Love They" ni Kevin Walker ay Walker, 1978a, habang ang kanyang "Beetle Bonanza" ay Walker, 1978b.

Kung mayroon kang materyal na isinulat ng mga may-akda na may parehong huling pangalan, gamitin ang unang paunang bahagi ng bawat may-akda sa bawat pagsipi upang makilala sila.

Sinulat ni K. Smith (1932) ang unang pag-aaral na ginawa sa kanyang estado.

Ang materyal na nakuha mula sa mga mapagkukunan tulad ng mga titik, mga personal na panayam , mga tawag sa telepono, at iba pa ay dapat na nakasaad sa teksto gamit ang pangalan ng tao, ang pagkakakilanlan ng personal na komunikasyon at ang petsa na sinabi ang komunikasyon ay nakuha o naganap.

Si Criag Jackson, Direktor ng Passion Fashion, ay nagsabi na ang pagbabago ng kulay dresses ay ang alon ng hinaharap (personal na komunikasyon, Abril 17, 2009).

Tandaan din ang ilang mga panuntunan sa bantas:

• Laging ilagay ang pagsipi sa dulo ng materyal na ginamit.
• Kung gumagamit ka ng isang direktang quote, ilagay ang pagsipi sa labas ng pagsasara ng marka ng panipi .
• Ang pagtatapos ng bantas (tagal, punto ng exclamation ) para sa teksto ay sumusunod sa nakasulat na sipi .
• Kung gumagamit ka ng isang panipi ng bloke , ilagay ang sipi pagkatapos ng pangwakas na marka ng bantas ng talata.
• Palaging isama ang isang reference na pahina para sa materyal na binanggit.

100 Mga Salita ng Paglipat

Paano sumulat ng proseso o paano-upang sanaysay, mga etikal na dilemmas para sa mga paksa sa sanaysay, isulat ang isang pansin-pagsupil sa pangungusap na pagbubuod para sa isang sanaysay, paano sumulat ng tugon na papel, ang mga panuntunan para sa pagsusulat ng mga numero, paano sumulat ng mapaglarawang sanaysay, mga contest ng estudyante ng mag-aaral, mga paksa ng personal na sanaysay, ang five-paragraph essay, 100 mga mapanghikayat na mga paksa sa sanaysay, istraktura ng isang mapaglarawang sanaysay, newest ideas, pagkilala sa mga puno ng basswood ng amerika, paano makahanap ng klinika sa pagpapalaglag, ang mga dinosaur at mga sinaunang hayop ng vermont, bumili, by, at bye, golf backswing exercise with dumbbell, noble gas photo gallery, au fur et à mesure - ipinaliwanag ng french expression, taoist practice & diet, ano ang ebolusyon, ang human being sa mata ng hindu, red algae (rhodophyta), napoleonics wars: battle of friedland, atomic solid definition, world war ii: uss reprisal (cv-35), paano magpinta ng kulay ng teorya ng triangle, ang tradisyon ng araw ng rogation sa simbahang katoliko, alternative articles, ang mga kalamangan at di-angkop na mga tagubilin para sa mga mag-aaral na homeschooled, comet tempel-tuttle: magulang ng shower ng meteor, zeugma (retorika), otode mga katotohanan at mga numero, kahulugan ng covalent radius, paggamit (grammar), ang malupit na kulto ng roman diana at ang kanyang sword-wielding priest, mga tula sa hardin, ano ang pagkakaiba sa pagitan ng pribadong paaralan at isang independent school, halimbawa ng mga pangungusap ng pandiwa pay, repasuhin: basil urban fold bike bag.

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Open access journals.

Asian-Pacific Law & Policy Journal, University of Hawaii This website provides online Journal articles about law and policy study in Asia-Pacific regions. Browse the journal or type a related topic in search after connecting to the link.

Journal of Asian Studies This is a website of the Journal of Asian Studies. It covers a range of research topics about Asia, and some articles are free for download.

Journal of Education, Management and Development Studies (JEMDS)

The Journal of Education, Management and Development Studies (JEMDS) publishes original research papers, reviews, and case studies related to broad areas of disciplines, including Education, Agriculture and Biological Sciences, Environment and Natural Resources, Health Sciences, Social and Behavioral Sciences, Public Management, Business Management and Entrepreneurship, Development Management, and Gender and Development. This also covers multidisciplinary and interdisciplinary studies on sustainable development in regional, national and global perspectives.

Journal of Health and Caring Sciences

The Journal of Health and Caring Sciences (JHCS) is an OPEN-ACCESS, international, peer-reviewed, interdisciplinary, official health and caring science publication of the San Beda University. It welcomes submission in various formats, including but not limited to original completed research studies, systematic reviews, case studies, book reviews, commentaries, letter to the editor and innovative research proposals which explores timely and emerging topics on human health, wellness and caring science.

Kyoto Review of Southeast Asia This website provides reviews of socio-political topics related to the Philippines and Southeast Asia. Type a related topic in search after connecting to the link.

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Center for Southeast Asian Studies, University of Hawaii This website contains a collection of 301 pictures of the Philippines, taken in 2000.

Digital Collection, the United States and Its Territories, the Age of Imperialism (1870-1925), the University of Michigan Library This is the University of Michigan Library’s Southeast Asia Collection of full text monographs and government documents published in the United States, Spain and the Philippines between 1870 and 1925.

Digital Collections, University of Washington Libraries This websites contains old photograph collection of the Philippines in the early 1900s and other countries in Southeast Asia. Type a related topic in search after connecting to the link.

Library of Congress Philippine Elections Web Archive The Philippine Elections web archive documents the Philippine general elections of 2010 and 2019.

Mangyan Bamboo Collection from Mindoro, Philippines, circa 1900-1939, at the Library of Congress The Asian Division's Southeast Asian Rare Book Collection counts among its most unique items a collection of 71 bamboo slats and 6 cylinders from the island of Mindoro in the Philippines. These items are etched with either verses or prose in the Mangyan script.

Philippines Maps, Perry-Castaneda Library, Map Collection, University of Texas Libraries This website holds a collection of old Philippines maps. It provides online version of a scanned-quality map produced by the U.S. Central Intelligence Agency.

SEAsite, Southeast Asia Picture Database (Northern Illinois University) This site provides a digital photograph collection of contemporary Philippines and Southeast Asia.

Southeast Asia Vision Collection (Cornell University Library) This site provides full download of old texts and rare book collections about Philippines and countries in Southeast Asia. Type a related topic in search after connecting to the link.

Southeast Asian Images and Texts, University of Wisconsin Digital Collection This website contains a digital photograph collection from the Philippines during the American colonial period and Laos in 1957, 1959 and 1969.

The Digital Library of the Commons, Indiana University This site provides full download of articles about the Philippines and countries in Southeast Asia. Type a related topic in search after connecting to the link.

The National Library of Australia This website provides a digital photograph collection of the early and contemporary Philippines and Southeast Asia. Type a related topic in search after connecting to the link.

The Spanish-American War in Motion Pictures Home Page This website contains information in the Philippines during the war.

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Bibliometrics Overview

Welcome to Purdue University's Citation Databases Research Guide

Here you will find...

• Information on citation databases
• Descriptions of these databases
• Helpful examples on how to use them
• Use cases for each of the major citation databases
• Useful tips and tricks on how to best make use of them

Here are some definitions of common terms made use of by citation databases

• Bibliometrics is the statistical analysis of scholarly output like articles, book chapters, and reviews.
• Altmetrics: is the statistical analysis of alternative forms of capture such as twitter impressions of a piece of scholarly output.

Some common metrics are the H-index, Journal Impact Factor, and the FWCI (called CNCI in Web of Science).

• H-Index is a measure of how many times a journals published articles are cited, an index of fifteen means an article has been cited 15 times.
• Journal Impact Factor (IF) – A measurement of how many times a journal’s published articles are cited by different researchers.
• FWCI – Publication Field weighted citation indices indicate how the number of citations received by researcher’s publications compared to the average number for similar publications.
• Category Normalized Citation Impact (CNCI) – Calculated using Web of Science, CNCI is “an indicator of impact normalized for subject focus, age and document type. A CNCI of 1 is at par with the world average, anything above 2 is twice the global average
• SJR - Scimago Journal Rank is a measure of the "prestige" of journals which makes use of both the number of citations a journal accrues and the perception of those journals in the wider academic community
• SNIP - Source Normalized Impact per Paper is a metric which accounts for the field specific differences between journals. The need for this is that some fields have different publishing practices, time frames, and constraints. This results in the need for a metric like SNIP which is calculated by comparing the citations per journal with the citation potential of the field as a whole, in other words it would measure of history journal against other history journals and vice versa for other academic disciplines

Here are the five most common Citation Databases' Key Strengths and Use Cases

• Web of Science: Core Collection Access the world’s leading scholarly literature in the sciences, social sciences, arts, and humanities and examine proceedings of international conferences, symposia, seminars, colloquia, workshops, and conventions. -Science Citation Index Expanded (1900-present) -Social Sciences Citation Index (1900-present) -Arts & Humanities Citation Index (1975-present) -Conference Proceedings Citation Index- Science (1990-present) -Conference Proceedings Citation Index- Social Science & Humanities (1990-present) -Book Citation Index– Science (2005-present) -Book Citation Index– Social Sciences & Humanities (2005-present) -Current Chemical Reactions (1985-present) (Includes Institut National de la Propriete Industrielle structure data back to 1840) -Index Chemicus (1993-present) -Emerging Sources Citation Index (2005 – present)
• Google Scholar Searches for scholarly materials such as peer-reviewed papers, theses, books, preprints, abstracts and technical reports from broad areas of research. It includes a variety of academic publishers, professional societies, preprint repositories and universities, as well as scholarly articles available across the web.
• Dimensions Dimensions is a citations database which specializes in providing abstracts, citations, and patents to users. While the Library does not currently subscribe, you can access the free version of the database from this link

• Next: Scopus >>
• Last Updated: Apr 11, 2024 9:42 AM
• URL: https://guides.lib.purdue.edu/citationdatabases

Chemical Society Reviews

Sers in 3d cell models: a powerful tool in cancer research.

* Corresponding authors

a BioNanoPlasmonics Laboratory, CIC biomaGUNE, Basque Research and Technology Alliance (BRTA), 20014 Donostia-San Sebastián, Spain E-mail: [email protected]

b Department of Applied Chemistry, University of the Basque Country, 20018 Donostia-San Sebastián, Gipuzkoa, Spain

c Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales, y Nanomedicina (CIBER-BBN), Paseo de Miramón 182, 20014 Donostia-San Sebastián, Spain

d Ikerbasque Basque Foundation for Science, 48013 Bilbao, Spain

Unraveling the cellular and molecular mechanisms underlying tumoral processes is fundamental for the diagnosis and treatment of cancer. In this regard, three-dimensional (3D) cancer cell models more realistically mimic tumors compared to conventional 2D cell cultures and are more attractive for performing such studies. Nonetheless, the analysis of such architectures is challenging because most available techniques are destructive, resulting in the loss of biochemical information. On the contrary, surface-enhanced Raman spectroscopy (SERS) is a non-invasive analytical tool that can record the structural fingerprint of molecules present in complex biological environments. The implementation of SERS in 3D cancer models can be leveraged to track therapeutics, the production of cancer-related metabolites, different signaling and communication pathways, and to image the different cellular components and structural features. In this review, we highlight recent progress in the use of SERS for the evaluation of cancer diagnosis and therapy in 3D tumoral models. We outline strategies for the delivery and design of SERS tags and shed light on the possibilities this technique offers for studying different cellular processes, through either biosensing or bioimaging modalities. Finally, we address current challenges and future directions, such as overcoming the limitations of SERS and the need for the development of user-friendly and robust data analysis methods. Continued development of SERS 3D bioimaging and biosensing systems, techniques, and analytical strategies, can provide significant contributions for early disease detection, novel cancer therapies, and the realization of patient-tailored medicine.

Article information

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L. Troncoso-Afonso, G. A. Vinnacombe-Willson, C. García-Astrain and L. M. Liz-Márzan, Chem. Soc. Rev. , 2024, Advance Article , DOI: 10.1039/D3CS01049J

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Philippines' Marcos Has No Plans to Grant U.S. Access to More Bases

Philippines' Marcos Has No Plans to Grant U.S. Access to More Bases

FILE PHOTO: U.S. President Joe Biden hosts Philippines President Ferdinand Marcos Jr. and Japan Prime Minister Fumio Kishida for a trilateral summit at the White House in Washington, U.S., April 11, 2024. REUTERS/Kevin Lamarque/File Photo

(Refiles to add TV to media identifier, no changes to text)

By Mikhail Flores and Karen Lema

MANILA (Reuters) -The Philippines has no plans to grant the United States access to more military bases, President Ferdinand Marcos Jr said on Monday, after nearly doubling the number last year under a joint defence pact.

Beijing has previously accused the Philippines of "stoking the fire" when it increased the number of bases the U.S. military could use to nine from five, with the new sites located close to potential flashpoints.

"The answer to that is no," Marcos said in response to a query whether the Philippines would allow the U.S. access to more bases.

"The Philippines has no plan to create any more bases or give access to any more bases," he told a forum with foreign correspondents.

Photos You Should See - April 2024

Last year Washington and Manila discussed further expanding the number of bases U.S. forces could access under the Enhanced Defense Cooperation Agreement (EDCA) from nine.

Three of the four sites faced north towards Taiwan and one was near the Spratly Islands in the South China Sea, where Manila and Beijing have had frequent maritime run-ins that included China's use of water cannon and collision tactics.

U.S. President Joe Biden, who hosted Marcos and Japanese Prime Minister Fumio Kishida in Washington last week at a first-of-its-kind three-way summit, has asked Congress for a further $128 million for infrastructure projects at the nine EDCA sites.

The three leaders expressed "serious concerns" about China's "dangerous and aggressive behaviour" in the South China Sea, a conduit for more than $3 trillion of annual ship-borne commerce claimed by China despite overlapping claims by other countries.

The three countries' co-operation was not "directed at anyone or against anyone", Marcos told the forum, but was merely a strengthening of ties among them.

A deepening row between China and the Philippines has also made it challenging for the latter to explore oil and gas in the South China Sea, despite an agreement between them to resume talks about joint exploration.

"When we say that we would like to explore, they insist that these areas are in Chinese territory and therefore Chinese law must prevail," Marcos said.

"We, of course, do not accept that. We say this is Philippine territory, and therefore, Philippine law should prevail."

He added, "I don't really think we have a proper agreement and it really comes down to that issue, which law should apply."

Last year Chinese President Xi Jinping said Beijing was willing to resume talks with the Philippines for potential joint oil and gas exploration in the South China Sea.

(Reporting by Mikhail Flores and Karen Lema; Writing by Kanupriya Kapoor; Editing by John Mair and Clarence Fernandez)

Copyright 2024 Thomson Reuters .

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