Students’ Perception of Cognitive Load in an Accelerated DPT Program with a Blended Curriculum

Administrators and educators in higher education are interested in how academic tutoring services and gender impact perceptions of cognitive load and, therefore, students’ academic success. However, a lack of evidence existed in the literature regarding physical therapy students’ perception of cognitive load in an accelerated Doctor of Physical Therapy program with blended learning. Participants in this quantitative, non-experimental study completed the adapted Cognitive Load Scale to indicate their perception of cognitive load, participation in academic tutoring services, gender, and age. The DPT students perceived high cognitive overload, but a t value of 0.37 and a p value of 0.71 indicated that their perception was not significantly related to gender. Further, a t value of -3.09 and a p value of 0.005 indicated that academic tutoring services played a vital role in minimizing the perception of cognitive overload. However, the p value of 0.11 of the parametric multiple linear regression analysis and the p value of 0.59 of the interaction term indicated no moderating relationship between academic tutoring services and gender. This evidence may assist physical therapy administrators and educators of DPT students in re-structuring blended learning programs and accelerated curricula to reduce student perceptions of cognitive overload.

Relationship between Job Satisfaction, Pay, Affective Commitment and Turnover Intention among Registered Nurses in Nigeria

This study aims to examine the relationship between job satisfaction, pay, affective commitment, and turnover intentions of public hospitals-based Registered Nurses in Ondo State, Nigeria. Using the quantitative, cross-sectional survey design, data from 220 Registered Nurses were analysed. Results indicate that pay and job satisfaction have significant positive relationship with nurses’ affective commitment; pay has significant positive relationship with their job satisfaction but pay, job satisfaction and affective commitment have negative relationship with turnover intentions. Job satisfaction is of critical importance in gaining nurses’ affective commitment and enhancing retention. Pay is often considered as a hygiene factor in theories of motivation – meaning, even though pay decreases might cause dissatisfaction, pay increases would not increase satisfaction. This does not appear to be the case in Nigeria. These findings have implications for health human resource management in general and the management of nursing staff in the public hospitals of Ondo State, Nigeria in particular.

The Effect of Oral Care and Chlorhexidine on the Rate of Ventilator Associated Pneumonia (VAP)

OBJECTIVE: Ventilator-associated pneumonia is considered major pneumonia, which develops in the intensive care unit patients following mechanical ventilation for about two days. This study reviews oral care and chlorhexidine effect on ventilator associated pneumonia occurrence. METHODS: A critical review approach was adopted where publications from 2007 to 2017 were considered. These publications were gathered from electronic searches through the different databases, for instance, MEDLINE, EMBASE, CINAHL, and Cochrane Library. This protocol was used for the selection of the studies and their analysis. RESULTS: The review showed that 0.12% Chlorhexidine use assists in reducing bacterial growth. It also suggests that the use of affirmative outcomes for mechanically ventilated patients, including improved patient outcomes, decreased in the duration of the patients’ hospital stays, and reduced health care cost.

Advancing Healthcare for COVID-19 by Strengthening Providers’ Capacity for Best Practices in African, Caribbean and Black Community Service Provision in Ontario: A Multisite Mixed-Method Study Protocol

BACKGROUND: The ongoing COVID-19 pandemic has emerged as an unprecedented challenge for public and private life, and healthcare systems worldwide. African, Caribbean, and Black communities (ACB) represent some of the most vulnerable populations in terms of their susceptibility to health hazards, difficulty receiving adequate health care and relatively lower chances of recovery. OBJECTIVES: The main aim of this study is to improve the health system’s response during and after the COVID-19 pandemic by developing evidence-based models to inform policy and collaborative best practices to mitigate its spread and ameliorate related health consequences in vulnerable communities. METHODS: This is a mixed-method, multisite study based in Ottawa and Toronto that will involve in-depth qualitative interviews and surveys using a structured questionnaire. Data will be analyzed using NVivo for qualitative interviews, Stata 16 and IBM SPSS version 26 for statistical analyses. DISCUSSION: The findings of this study gained from highly professional health practitioners will produce strong evidence on current gaps in knowledge and practice in the healthcare system’s capacity to meet the health needs of ACB population. The distinct insights and perspectives will be disseminated with policymakers and researchers at all levels which will facilitate strategic policy making with the goal of addressing the unique challenges for health

A Comparative Study of Prevalence and Risk Factors Associated with Depressive Symptoms in Two Long-Lived Elderly Populations in Brazil

This cross-sectional study aimed to investigate and compare the prevalence and risk factors associated with depressive symptoms among long-lived elderly, aged 80 and over, in two Brazilian populations. Face-to-face interviews were performed with 417 seniors: 179 living in the poor and rural town of Brejo dos Santos, Paraíba, and 238 in one of the largest urban centers in Latin America, the city of São Paulo, São Paulo. In the rural region of Brejo dos Santos, these depressive symptoms were more associated with the family support network, co-residence, and the number of members of the social network; in São Paulo, on the other hand, depression is more associated with the elderly's difficulty in performing basic and instrumental daily-living activities and with their overall satisfaction with life. From the results obtained, it was possible to verify that a very significant portion of the longevous elderly in Brejo dos Santos, Paraíba, have symptoms that suggest depression, and it is necessary to further investigate environmental and genetic factors that could explain this observation, given that this community has a high frequency of consanguinity.

Adults on the Autism Spectrum Face Significant Challenges Accessing Health Care Services

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties with social skills, verbal and non-verbal communication, repetitive behaviours and atypical sensory processing. Individuals on the autism spectrum face a higher prevalence of health conditions and have a higher mortality rate than the general population. There is a critical need to understand adults’ experiences on the autism spectrum when accessing health care services to understand how to improve accessibility to health care for these individuals. The purpose of this scoping review was to investigate how adults on the autism spectrum access and experience health care services. Four databases, including Embase, MEDLINE, CINAHL, and PsycInfo, were systematically searched for literature exploring how individuals on the autism spectrum access and experience health care. Results were extracted and categorized into five determinants based on the accessibility framework described by Levesque et al. (2013). Results indicated adults on the autism spectrum experience numerous barriers when accessing health care services. The dimension of access most frequently cited was the appropriateness of care, followed by the acceptability of care. It is essential to explore access as it is often conceptualized as the availability and affordability of services; however, results of this study indicate the broader experience of quality care provision and acceptance of the individual are important in understanding the complex experience individuals on the autism spectrum face. Based on these findings, there is a need to provide comprehensive education and clinical practice guidelines for health care providers to help reduce barriers to providing appropriate care for adults on the autism spectrum. Efforts to destigmatize intrapersonal and extra-personal perceptions of individuals on the autism spectrum will help overcome the barriers that affect care acceptability. Further research must understand how to design and implement strategies to maximize health service access for adults on the autism spectrum.

The Perspective of the Oncology Health Care Professionals on Educational Conferences

BACKGROUND: Continuous education is vital to update the knowledge of the health care professionals (HCPs) engaged in cancer management. We aim to explore the perspective of the oncology HCPs on oncology conferences. METHODS: A questionnaire was handed to the delegates and faculty of an oncology educational scientific conference in the Kingdom of Saudi Arabia (KSA). The questionnaire explored the perspective on the ideal number, duration and the educational value of such conferences. RESULTS: Medical oncologists represented 70.5% of the 78 responders. All responders attended oncology conferences in the preceding year with 24.4% have attended >9 conferences. The educational value of these conferences was rated 7.98/10. Two thirds are satisfied with the frequency of conducted event or desire more. Short (half to one day) meetings are preferred by 66.67% and the mean number of optimum educational events is 5.7 per year. Educational events were highly valued (score ≥ 8/10) as venues to meet colleagues. CONCLUSION: The findings suggest that the current frequency and scientific value of oncology conferences and educational events are satisfactory to the majority of the relevant HCPs in the KSA. More CME events of up to one day in duration seem to be desired.

Exploring Physical and Social Wellness of High School Students in Suva, Fiji

BACKGROUND: Given the characteristics of the adolescence life stage, the physical and social wellness dimensions remain a challenge. The aim of this study was to determine adolescent perceptions of physical and social wellness in secondary schools in Fiji. MATERIALS & METHODS: Four purposively selected secondary schools in Suva, Fiji were part of this qualitative cross sectional study in 2019. Fijian students enrolled into years 11 to 13 in the selected schools were invited to participate. Participants were purposively sampled. Data was collected using a structured self-administered questionnaire. Descriptive statistics were generated through the Statistical Package for the Social Sciences software version 25. RESULTS: A total of 350 high school students, with the mean age of 17.5 (SD = ±0.9), participated in the study. The majority (48%) had very high scores for physical wellness and a fifth of the participants (28%) had low scores. In terms of social wellness, about a third (28.9%) scored low whilst the majority (40.3%) had high scores of social wellness. CONCLUSION: This study adds to the pool of knowledge for wellness increases chances of improvement in adolescent program development specifically in terms of physical and social wellness. Appropriate interventions are recommended to improve physical and social wellness in high school students in Fiji.

The Level of utilization and Satisfaction of Complete Denture Treatment Provided in Fiji from 2010-2016

BACKGROUND: Wearing dentures helps rehabilitate the oral health status for the older people. Due to lack of previous data, this objective of this study was to determine the level of utilization and satisfaction of complete denture treatment at dental clinics in Fiji. MATERIALS & METHODS: A cross sectional descriptive study was conducted on 85 edentulous patients and dentures at the Fiji National University (FNU) teaching dental clinic from 2010-2016.Patients who utilized the dentures fabricated at FNU and identified as complete denture patients from 2010-2016 were included in this study. Data was collected using the denture assessment form and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT) questionnaire. Correlation test was done and p less than 0.05 was considered as level of significance. RESULTS: Participants were between the age range of 40-79 years with majority being male (54%). Greater level of satisfaction noted among 60-69 years male participants and those wearing the dentures for 3-4 years than other groups. Difficulty in chewing (40%) and food catching underneath the denture (33%) were common denture related complains. One thirds of participants reported of uncomfortable dentures while 24% had sore spots due to their dentures. More than two thirds of them, (71%) were unable to eat and enjoy food and for most patients, the vertical dimension (94%), esthetics assessment (94%), tooth selection (91%), boarder extension (78%), posterior seal (99%) and centric relation (99%) were acceptable. Patients with acceptable vertical dimension (46.1±7.6), acceptable esthetics (45.8±7.9) and boarder extension (48.0±7.2) showed greater satisfaction level compared to those with unacceptable denture characteristics. CONCLUSION: This study highlighted that satisfaction among recent denture wearers was low and majority participants portrayed poor understanding regarding denture aftercare and hygiene. It can be recommended for the teaching institutes and dental clinics to evaluate the quality of treatments and help to improve the quality of services being provided to the patients. Further study is needed to determine the in- depth perceptions of denture wearers. It also can be recommended for the patients to take heed of the post operative denture hygiene instructions being given.

Malnutrition and the Risk of Catastrophic Health Expenditure in Nigeria

BACKGROUND: Malnutrition among children not only affects their health consequences but also does it burden their households’ finance especially in developing countries. This study evaluates the household risk of catastrophic health expenditure (CHE) due to malnutrition treatments among malnourished children in Nigeria, according to zones and wealth quintiles. We simulate the CHE risk among households with malnourished children who seek treatment.  METHODS: The CHE risk due to malnutrition among treated was computed based on 1) the out-of-pocket (OOP) expenditure and indirect costs associated with malnutrition treatment, and 2) household consumption expenditures. I derived the CHE risk associated with malnutrition across zones and wealth quintiles in Nigeria, using secondary data sources for healthcare utilization, OOP expenditures, and consumption expenditures. RESULTS: There was a large variation of CHE risk according to zones and wealth quintiles. Among the poorest households, those in northeast and northwest would have the highest risk of CHE, up to 59 and 47%, while those in southwest would have the lowest risk of 14%. For all zones, as the wealth increases, the CHE risk would decrease. There would be zero or very little CHE risk among the richest households in any zones. INTERPRETATION: Nutrition interventions will help malnourished children improve their health status. However, we should also be wary about the financial consequences of the treatment that households should bear.