Cost estimation of a school-based intervention for improving HIV/AIDS risk perception among secondary school adolescents in Enugu State, Nigeria.

Early sexual debut is common in Nigeria and increases HIV risk among adolescents. About 152,000 adolescents are living with HIV. Lack of knowledge and appropriate sexual reproductive health services are some factors responsible. This paper estimated the cost of secondary school-based HIV/AIDS intervention for schools in Enugu State, Nigeria. The rationale for estimation is to avoid unaffordable and ineffective interventions. The cost was estimated between March to October 2019 for schools in urban and rural areas with population of 1595 students. The cost estimation was aided through UNAID proposed guideline. The estimation was done by classifying intervention into cost of training, cost of services and cost of commodities. The cost was estimated at $5954. The estimated cost in urban is lesser than that of rural. This estimated cost of intervention may inform stakeholders with the knowledge of cost implications to avoid unaffordable school-based HIV interventions in Enugu State, Nigeria.

Cognitive-behavioural reflective training for improving critical thinking disposition of nursing students.

BACKGROUND/OBJECTIVE: The importance of critical thinking in improving treatment practices in, for instance, the nursing profession, cannot be overemphasized. Despite this importance, empirical studies have shown that helping strategies to train learners on critical thinking disposition are needed. Given this knowledge gap, this study investigated the impacts of cognitive-behavioral reflective training for improving the critical thinking disposition of nursing students. METHOD: Of all the students screened, a total of 167 participants were assigned to the treatment group and waitlisted control group. A researchers-developed training program aimed at improving critical thinking disposition was delivered in English language by therapists. RESULTS: Repeated-measures ANOVA showed that there was no significant difference between the critical thinking disposition of nursing students in the treatment and control groups as measured by CTDI-M at the posttest. At the posttreatment and follow-up measures, there were consistently improved impacts of CBRT on the critical thinking disposition of nursing students in Nigeria as measured by CTDI-M. CONCLUSION: Following the results, we concluded that cognitive-behavioral reflective training was beneficial and had sustained improvement in enhancing the critical thinking disposition of nursing students.

Effect of a critical thinking intervention on stress management among undergraduates of adult education and extramural studies programs.

OBJECTIVE: The objective of this study was to examine the effect of a critical thinking intervention (CTI) on stress management among undergraduates of adult education and extramural studies programs. METHOD: A total of 44 undergraduates were randomly sorted into experimental and waitlist control groups. We used the Perceived Stress Scale for data collection at the pre-test, post-test, and follow-up stages. We used unpaired t and paired t-tests to analyze the data collected. SPSS version 22.0 was used for the data analyses (SPSS Inc., Chicago, IL). RESULTS: It was shown that the CTI was effective in reducing the mean stress of the participants compared to the control group both in the post-test (t[42] = -22.453, P < .001) and follow-up periods (t[42] = -34.292, P < .001). There were statistically significant changes in the mean stress of participants in the experimental group from the pre-test to post-test phases (t[23] = 26.30, P = .000, r = .08], and from pre-test to follow-up(t[23] = 37.10, P = .000, r = .30). The mean stress of the participants in the experimental group from post-test to follow-up signified the sustained positive influence of the CTI on the mean stress (t[23] = 2.41, P = .000, r = .46) of the undergraduates. CONCLUSION: This study adds to the literature by showing that a CTI is a valuable strategy for stress reduction in a university environment. Given that the CTI demonstrated the ability to reduce stress among undergraduates enrolled in adult education and extramural studies programs, we hope that similar interventions will be adopted to manage and prevent stress among students in other departments and disciplines.

The effect of a video-guided educational technology intervention on the academic self-concept of adolescent students with hearing impairment: Implications for physical education.

BACKGROUND/OBJECTIVE: Academic self-concept is an important construct within the disciplines of medicine, psychology, and education. Enhancing the academic self-concept of students with special educational needs is very crucial because it is associated with their quality of life. This study aimed to examine the effect of a video-guided educational technology intervention on the academic self-concept of adolescents with hearing impairment who were attending inclusive nonresidential public schools in Southeast Nigeria. METHODS: This study adopted a randomized controlled trial design. The participants were 60 junior secondary students with hearing impairment. We implemented a video-guided educational technology intervention. It relied on the use of 13-minute video clips with captions/subtitles, which covered academic self-concept-related themes. The Academic Self-Concept Questionnaire, which has been developed by Liu and Wang, was used to collect baseline, posttreatment, and follow-up data. We conducted independent-samples and paired t test and computed Cohen d and Glass Δ to analyze the data. RESULTS: The video-guided educational technology intervention significantly improved the academic self-concept of the treatment group participants, when compared with the care-as-usual control group participants, t(58) = 9.07, P < .001. These improvements in academic self-concept were sustained at follow up among the treatment group participants, when compared with the care-as-usual control group participants, t(48.56) = 10.898, P < .001. Within-subjects comparisons showed that the academic self-concept of the treatment group participants had significantly improved across the different time points at which they were assessed. CONCLUSION: The video-guided educational technology intervention was effective in improving the academic self-concept of adolescents with hearing impairment who were attending inclusive nonresidential public schools. Large-scale studies are needed to maximize the impact of video-guided educational technology interventions on students with hearing impairments who attend inclusive non residential public schools in Nigeria.

Effect of digital storytelling intervention on burnout thoughts of adolescent: Athletes with disabilities.

BACKGROUND/OBJECTIVE: Both athletes with and without disabilities can develop burnout symptoms. However, athletes with disabilities may face different or more challenges compared to their counterparts without disabilities. The present study aimed at ascertaining the effect of digital storytelling intervention on burnout thoughts of adolescent-athletes with disabilities. METHOD: This study is a randomized controlled trial involving a total of 171 adolescent-athletes with disabilities who showed a high degree of burnout symptoms. These adolescent-athletes were randomly assigned to either an intervention group (n = 85) or a waitlisted control group (n = 86). The treatment intervention for the adolescent-athletes was digital stories which were created based on the framework of rational emotive behaviour therapy (REBT). The Athlete Burnout Questionnaire was used for gathering of data at three different times (baseline, post-test and follow up). Data were analyzed using repeated measure analysis of variance at a significant level of 0.05. RESULTS: Results showed that the digital storytelling intervention based on REBT significantly reduced burnout thoughts among disabled adolescent-athletes in the intervention group compared to athletes in the waitlisted control group as measured by the Athlete Burnout Questionnaire. Additionally, at follow-up evaluation, it was observed that the decrease in burnout scores was maintained by those athletes in the digital storytelling intervention. CONCLUSION: Digital storytelling intervention based on rational emotive behaviour therapy shows great potentials in addressing burnout among adolescent-athletes with disabilities.

Effect of video-guided educational intervention on school engagement of adolescent students with hearing impairment: Implications for health and physical education.

BACKGROUND/OBJECTIVE: Hearing impaired students still face stigmatization and marginalization especially in inclusive classrooms in developing regions. This negatively impacts their school engagement. The present study aimed at ascertaining the effect of video-guided educational intervention on school engagement of hearing impaired students. METHOD: Randomized controlled trial design was adopted for the present study. A total of 46 junior secondary school students with hearing impairment and low school engagement symptoms participated in this study. The students were randomly assigned to groups - intervention group and care-as-usual control group. A video-guided educational intervention package which consists of 13-minutes captioned video clips with school engagement themes served as the treatment intervention. Data were collected at 3 different times (pre-test, post-test and follow up) using School Engagement Scale created by Fredericks, Blumenfeld, Friedel and Paris (2005). Data were analyzed using independent sample t-test, paired sample t-test, Cohen d and Chi-square. RESULTS: Results showed that the video-guided educational intervention significantly improved school engagement level among hearing impaired adolescent students in the intervention group in comparison with the students in the care-as-usual control group as measured by the Student Engagement Scale [Behavioral: t(24) = -9.305, P < .001; Emotional: t(24) = -7.772, P < .001; Cognitive: t(24) = -7.330 P < .001) as well as total student engagement (t(24) = 12.022, P < .001, Δ = 5.362). Also, the students who took part in the video-guided educational intervention maintained improved school engagement at follow-up. CONCLUSION: Video-guided educational intervention is an effective intervention for improving school engagement of hearing impaired adolescent students. Since acquiring relevant education is essential for leading a quality life especially among the special needs population, it was recommended that students with hearing impairment should be helped to acquire life skills through education by fostering their school engagement.

Mechanism of aortic medial matrix remodeling is distinct in patients with bicuspid aortic valve.

OBJECTIVES: Patients with bicuspid aortic valves (BAV) are predisposed to developing ascending thoracic aortic aneurysms (TAA) at an earlier age than patients who develop degenerative TAAs and have a tricuspid aortic valve (TAV). The hypothesis tested is that BAV-associated aortopathy is mediated by a mechanism of matrix remodeling that is distinct from that seen in TAAs of patients with tricuspid aortic valves. METHODS: Aortic specimens were collected during ascending aortic replacement, aortic valve replacement, and heart transplants from nonaneurysmal (NA) donors and recipients. Matrix architecture of the aortic media was assessed qualitatively using multiphoton microscopy followed by quantification of collagen and elastin fiber orientation. α-Elastin was determined and matrix maturity was assessed by quantifying immature and mature collagen and lysyl oxidase (Lox) expression and activity in aortic specimens. Matrix metalloproteinase-2/9 activity was quantified in aortic smooth muscle cells. RESULTS: Elastin and collagen fibers were more highly aligned in BAV-NA and BAV-TAA cases than in TAV-TAA cases, whereas TAV-TAA cases were more disorganized than TAV-NA cases. α-Elastin content was unchanged. Immature collagen was reduced in BAV-NA and BAV-TAA cases when compared with TAV-NA and TAV-TAA cases. Mature collagen was elevated in TAV-TAA cases compared with TAV-NA and BAV-TAA cases. There was a trend toward elevated Lox gene expression and activity and matrix metalloproteinase-2/9 activity for TAV-TAA, BAV-NA, and BAV-TAA specimens. CONCLUSIONS: The highly aligned matrix architecture in patients with BAVs indicates that wall remodeling is distinct from TAV-TAA. Altered matrix architecture and reduced collagen maturity suggest that the effector molecules mediating the remodeling of TAAs are different in BAV and TAV cases.

Altered oxidative stress responses and increased type I collagen expression in bicuspid aortic valve patients.

BACKGROUND: The mechanisms governing extracellular matrix degradation and smooth muscle cell (SMC) loss in the ascending aorta of bicuspid aortic valve (BAV) patients are unknown. We recently reported that expression and induction of metallothionein, a reactive oxygen species scavenger, is reduced in BAV ascending aortic aneurysms relative to nonaneurysmal patients. METHODS: Tissue and primary SMCs from patients with and without thoracic aortic aneurysms and metallothionein-null and wild-type mice were analyzed for cell viability, vascular endothelial growth factor (VEGF), and type I collagen gene expression during exposure to reactive oxygen species. RESULTS: The BAV SMCs and metallothionein -/- mice failed to induce VEGF under conditions of oxidative stress in vitro. Exogenous VEGF restored resistance to oxidative stress in BAV SMCs to normal. Type I collagen gene induction was increased in BAV aorta. CONCLUSIONS: Lack of VEGF induction during exposure to reactive oxygen species suggest that the oxidative stress response is faulty upstream of metallothionein and VEGF in BAV SMCs. Improvement of cell viability with VEGF treatment suggests that the deficient pathway can be rescued by VEGF. Increased type I collagen in BAV suggests that lack of metallothionein/VEGF activation in response to reactive oxygen species may play a role in extracellular matrix homeostasis of the ascending aorta. These data continue to support our hypothesis that BAV SMCs lack sufficient resistance to reactive oxygen species to maintain extracellular matrix homeostasis, which imparts a predisposition to thoracic aortic aneurysms.

Basal and oxidative stress-induced expression of metallothionein is decreased in ascending aortic aneurysms of bicuspid aortic valve patients.

BACKGROUND: Bicuspid aortic valve (BAV) is a heritable condition that has been linked by an unknown mechanism to a predisposition for ascending aortic aneurysm. Matrix metalloproteinases have been implicated in this predisposition. Metallothionein is a poorly characterized, metal-binding protein that regulates matrix metalloproteinases and is an antioxidant known to be upregulated under oxidative stress. METHODS AND RESULTS: To determine putative factors involved in the pathogenesis of aortic aneurysm in BAV patients, our first goal was to identify genes that are dysregulated in ascending aortic aneurysms of BAV patients compared with tricuspid aortic valve patients and nondiseased (control) donors. By microarray analysis (22,000 probe sets), 110 dysregulated genes were identified in BAV compared with tricuspid aortic valve patients and control donors; 8 were genes of the metallothionein family. Metallothionein gene expression and protein expression were significantly lower in aortic tissue and cultured aortic smooth muscle cells from BAV patients compared with control subjects. Matrix metalloproteinase-9 expression was increased in BAV aortic samples relative to controls. BAV aorta was more susceptible to oxidative stress, and induction of metallothionein under oxidative stress was reduced in BAV patients compared with control subjects. CONCLUSIONS: These results demonstrate dysregulated metallothionein expression in ascending aortic smooth muscle cells of BAV patients that may contribute to an inadequate response to oxidative stress and provoke aneurysm formation. We hypothesize that metallothionein plays a pivotal role in the response of ascending aortic smooth muscle cells to oxidative stress cues normally involved in the maintenance of the extracellular matrix, including the regulation of matrix metalloproteinase expression.

Disability: a view from selected cultural perspectives.

The concept of disability has been examined from various cultural perspectives across the globe. The author explores how services and specific support networks have been provided to people with disabilities. Small-scale and large-scale societies have had to deal with unique challenges in monitoring services for the disabled, regardless of their geographical location; financial resources, accountability and adequate staffing are primary problems in delivery of services to the disabled. Prospects and challenges facing people with disabilities require policy reforms and advancements in special education in all countries.