Impact of welding occupation on serum aluminium level and its association with physical health, cognitive function, and quality of life: a cross-sectional study.

OBJECTIVE: There is an occupational health concern about welders' inhalation of toxic aluminium fumes. We investigated whether serum aluminium level (SAL) and demographic variables can significantly predict physical health parameters, cognition, and quality of life (QoL) among welders. METHODS: The cross-sectional study involved 100 age- and location-matched men (50 welders and 50 non-welders). SAL obtained using a graphite furnace atomic absorption spectrometer, and data collected using blood pressure and body mass index (BMI) apparatuses, biodata form, pain rating scale, General Practitioner Assessment of Cognition, WHOQoL-BREF, and Nordic musculoskeletal symptoms (MSS) questionnaire were analysed using independent samples t test, chi-square, Pearson's correlation, and hierarchical linear regression. RESULTS: Welders had significantly higher SAL (mean difference [MD] = 1.77 µg/L, p < 0.001), lower QoL (MD = 3.92, p = 0.039), and higher prevalence of MSS on the neck (χ2 = 10.187, p = 0.001), shoulder (χ2 = 9.007, p = 0.003), upper back (χ2 = 6.832, p = 0.009), and knee (χ2 = 12.190, p < 0.001) than non-welders. There was a significant bivariate association between SAL, systolic blood pressure (ß = 0.313, p = 0.002), and BMI (ß = 0.279, p = 0.005), but not pain intensity, cognition, or QoL. SAL remained a significant predictor of systolic blood pressure after adjustment for physical health and QoL parameters (ß = 0.191, p = 0.044). The association between SAL and social QoL became significant after adjustment for physical health and other QoL domains (ß = - 0.210, p = 0.032) and demographic variables (ß = - 0.233, p = 0.046). CONCLUSION: Welders had significantly higher SAL, musculoskeletal symptoms, blood pressure, and lower QoL than non-welders. SAL was associated with adverse physical health parameters and social-related QoL, not cognition. We recommend routine aluminium bioavailability and physical health checks among welders.

Well-being of professional older adults' caregivers in Alberta's assisted living and long-term care facilities: a cross-sectional study.

BACKGROUND: For the care need of older adults, long-term care (LTC) and assisted living (AL) facilities are expanding in Alberta, but little is known about the caregivers' well-being. The purpose of the study was to investigate the physical health conditions, mental and emotional health (MEH), health behaviour, stress levels, quality of life (QOL), and turnover and absenteeism (TAA) among professional caregivers in Alberta's LTC and AL facilities. METHODS: This cross-sectional survey involved 933 conveniently selected caregivers working in Alberta's LTC and AL facilities. Standardised questions were selected from the Canadian Community Health Survey, Patient Health Questionnaire-9, and Short Form-36 QOL survey revalidated and administered to the participants. The new questionnaire was used to assess the caregivers' general health condition (GHC), physical health, health behaviour, stress level, QOL, and TAA. Data were analysed using descriptive statistics, Cronbach alpha, Pearson's correlation, one-way analysis of variance, and multiple linear regression. RESULTS: Of 1385 surveys sent to 39 facilities, 933 valid responses were received (response rate = 67.4%). The majority of the caregivers were females (90.8%) who were ≥ 35 years (73.6%), worked between 20 to 40 h weekly (67.3%), and were satisfied with their GHC (68.1%). The Registered Nurses had better GHC (mean difference [MD] = 0.18, p = 0.004) and higher TAA than the Health Care Aides (MD = 0.24, p = 0.005). There were correlations between caregivers' TAA and each of MEH (r = 0.398), QOL (r = 0.308), and stress (r = 0.251); p < 0.001. The most significant predictors of TAA were the propensity to quit a workplace or the profession, illness, job stress, and work-related injury, F (5, 551) = 76.62, p < 0.001, adjusted R2 = 0.998. CONCLUSION: Reducing the caregivers' job stressors such as work overload, inflexible schedule, and poor remuneration, and improving their quality of life, health behaviour, and mental, emotional, and physical health conditions may increase their job satisfaction and reduce turnover and absenteeism.

Perceived strategies for reducing staff-turnover and improving well-being and retention among professional caregivers in Alberta's continuing-care facilities: A qualitative study.

This qualitative study explored potential factors that lead to turnover and absenteeism and how to improve well-being and retention among professional older-adult-caregivers in Alberta's assisted living (AL) and long-term care (LTC) facilities. Four hundred and forty-seven participants aged 45-54 years were interviewed through a five-item, content-validated open-ended questionnaire. The questionnaire was self-administered in the English language and the soft copy of their responses was transferred into NVIVO version 12 software for coding. A thematic narrative analysis grounded in the "happy productive worker" theory was completed. The main themes were caregivers' perception of the factors affecting their well-being, absenteeism, and turnover, and caregivers' suggestions on ways to improve their well-being and retention. Participants reported that their professional well-being was suboptimal. They suggested that their employers should provide them with the needed social, psychological, and professional support, improve wages and hire more staff to ameliorate absenteeism and turnover rates.

Transcutaneous electrical nerve stimulation effects on pain-intensity and endogenous opioids levels among chronic low-back pain patients: A randomised controlled trial.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is a promising non-pharmacological modality for the management of chronic low back pain (CLBP), but its efficacy and mode of action have not been clearly established. OBJECTIVE: To evaluate the responses of plasma beta-endorphin (ßE), met-enkephalin (ME), and pain intensity (PI) among patients with CLBP exposed to TENS or sham-TENS. METHODS: This double-blind trial involved 62 participants (aged 53.29 ± 5.07 years) randomised into TENS group (frequency 100 Hz, burst-rate 2 Hz, burst-width 150 µs, intensity 40 mA, duration 30 min), and sham-TENS group. The PI and plasma concentrations of ßE and ME were measured at baseline, immediately (0 hr), 1 hr, 24 hrs, and 48 hrs post-intervention. Data were analysed using general linear model repeated measures, ordinal regression, one-way analysis of variance, Kruskal-Wallis test, independent and paired samples t-tests, Mann-Whitney U test, Wilcoxon signed-rank test, and Kendall's tau coefficient. RESULTS: There was a significant temporal difference in PI between groups, F (1, 58) = 18.83, p< 0.001; the TENS group had better pain relief. The relative analgesic effect of TENS started immediately after the intervention (median difference [M⁢D] =-3, p< 0.001), peaked at 1 hr (M⁢D=-4, p< 0.001), and worn out by 24 hrs (M⁢D=-1, p= 0.029). However, there was no significant difference in ßE and ME between the groups from 0 hr to 24 hrs post interventions, and no significant correlation between the PI, and ßE, or ME. CONCLUSION: TENS significantly reduced PI up to 24 hrs after treatment.

Physical activity level, fear of falling and quality of life: a comparison between community-dwelling and assisted-living older adults.

BACKGROUND: Physical activity (PA), fear of falling (FOF) and quality of life (QOL) are very important constructs in geriatrics. The interplay among these constructs may vary between community-dwelling and assisted-living older adults. However, studies comparing the wellbeing of community-dwelling older adults with those residing in the assisted-living facilities (ALFs) are rather rare especially from developing countries. This study was aimed at comparing PA, FOF and QOL between assisted-living and community-dwelling older adults and also determining the correlations amongst the constructs for each group. METHODS: This cross-sectional survey involved consecutively sampled 114 older adults (≥65 years, ambulant and well-oriented in time, place and person) residing in conveniently selected ALFs (11.3% males) and adjoining communities (54.1% males). PA, FOF and QOL were evaluated using the Physical Activity Scale for the Elderly, the Modified Fall Efficacy Scale and the Short-form Health Survey (SF-36) questionnaire respectively. Data was analysed using descriptive statistics, analysis of covariance and Spearman rank-order correlation test at 0.05 level of significance. RESULTS: Participants from the ALFs had significantly lower domain and overall PA (F=5.6-103.34; p< 0.05) and QOL (F=11.12-118.05; p< 0,05) scores than community-dwelling groups. FOF was significantly more prevalent in assisted-living group (p< 0.05). There were significant positive correlations (p< 0.05) between each pair of PA, FOF and QOL for both assisted-living and community-dwelling groups. CONCLUSIONS: Older adults in the ALFs had lower PA and QOL scores with higher prevalence of FOF than their community-dwelling counterparts. Significant relationships existed between PA, FOF and QOL for participants in either group. Present results may be suggesting that ageing in place ensures better health outcomes than institutionalised ageing. Whenever possible, older adults should therefore be encouraged to age in place rather than moving into ALFs.

Prevalence and correlates of bullying in physiotherapy education in Nigeria.

BACKGROUND: Bullying is an unexpressed part and parcel of medical education but it is largely unexplored in physiotherapy. This study assessed the prevalence and socio-demographic correlates of bullying in physiotherapy education in Nigeria. METHODS: Two hundred and nineteen clinical physiotherapy students from three purposively selected Federal Universities in Nigeria participated in this study. Following a cross-sectional design, the Students Perception of Professor Bullying Questionnaire (SPPBQ) was used to obtain information on bullying. The SPPBQ includes a working definition of lecturer bullying followed by other sections inquiring about lecturers bullying experiences. Data was collected on socio-demographic characteristics, bullying experiences and availability of adequate policy and support on bullying. Descriptive and inferential statistics were used analyze data. Alpha level was set at p < 0.05. RESULTS: Lifetime and point prevalence of bullying in physiotherapy education were 98.6 and 99.1%. 94.5% of the respondents had witnessed physiotherapy students bullying and there was a 100% rate of 'no attempt' to stop a physiotherapy lecturer from bullying. 38.4 and 44.7% of the respondents believed there was adequate school policy and support available on bullying. There was no significant association between bullying and each of age (휒2 = 0.117, p = 0.943), gender (휒2 = 0.001, p = 0.974), level of study (휒2 = 0.000, p = 0.995) and any specific university (휒2 = 1.343, p = 0.511). CONCLUSION: There is high lifetime and point prevalence of bullying in physiotherapy education in Nigeria, which are largely unchallenged or redressed. Being a clinical physiotherapy student ordinarily predisposes to bullying without necessary contributions of intrinsic and extrinsic factors.

Cross-cultural adaptation and psychometric evaluation of the Yoruba version of Oswestry disability index.

INTRODUCTION: Low-Back Pain (LBP) is a common public health problem that is often worsened by maladaptive beliefs and disability. Thus, necessitating the need for availability of outcome measures to assess these sequelae among patients with chronic LBP. This study aimed to cross-culturally adapt and determine the psychometric properties of the Yoruba version of the ODI (ODI-Y). METHODS: The ODI-Y was cross-culturally adapted following the process involving forward translation, synthesis, backward translation, expert review, and pilot testing. Internal consistency and test-retest reliability of the ODI-Y were determined using the Cronbach's alpha and intra-class correlation. Other psychometric properties explored included the factor structure, convergent validity, standard error of measurement and the minimal detectable change. RESULTS: One hundred and thirty-six patients with chronic LBP took part in the validation of the ODI-Y; 86 of these individuals took part in the test-retest reliability (within 1-week interval) of the translated instrument. The mean age of the respondents was 50.5±10.6years. The ODI-Y showed a high internal consistency, with a Cronbach's alpha (α) of 0.81. Test-retest of the Yoruba version of the ODI within 1-week interval yielded an Intra-Class Correlation coefficient of 0.89. The ODI-Y yielded a three-factor structure which accounted for 61.56% of the variance. Correlation of ODI-Y with the visual analogue scale was moderate (r = 0.30; p = 0.001). The standard error of measurement and minimal detectable change of the ODI-Y were 2.0 and 5.5. CONCLUSIONS: The ODI was adapted into the Yoruba language and proved to have good psychometric properties that replicated the results of other obtainable versions. We recommend it for use among Yoruba speaking patients with LBP.

Cross-cultural adaptation and validation of the Igbo language version of the stroke-specific quality of life scale 2.0.

INTRODUCTION: availability of the Stroke-Specific Quality of Life scale 2.0 (SS-QoL(E)) in Yoruba and Hausa, two of the three major indigenous languages in Nigeria have the potential to promote its uptake among these population, however, its non-availability in the Igbo languages makes its use restrictive among the south-eastern Nigerians. This study was aimed at cross-culturally adapting and assessing validity and reliability of the Igbo version of the SS-QoL. METHODS: the SS-QoL(E) was cross-culturally adapted to Igbo following the American Association of Orthopaedic Surgeons' guideline. This involved forward and back-translations, expert committee review, pretesting and cognitive debriefing interview to produce the final Igbo version, SS-QoL(I). The validity and reliability test involved 50 consenting Igbo stroke survivors. The construct validity was assessed by administering SS-QoL(E) and SS-QoL(I) on all 50 respondents, while SS-QoL(I) was re-administered at 7-day interval to assess test-retest reliability. Each scale was administered in random order. Data were analysed using Spearman's correlation, Wilcoxon's signed-rank test, Cronbach's alpha, Intra-class Correlation Coefficient (ICC), independent t-test and one-way ANOVA at p<0.05. RESULTS: respondents' domains scores on SS-QoL(E) and SS-QoL(I) did not differ significantly except in mobility and work (r=0.58 to 0.87; p=0.001). Cronbach's alpha was 0.69 to 0.87 for domains scores. The ICC ranged from 0.48 to 0.84, while no significant differences was found across different age groups or gender for the domains or overall scores of SS-QoL(I). CONCLUSION: the Igbo version of the SS-QoL has limited alterations from the original version and has moderate to excellent validity and reliability values.

Interprofessional education among Nigerian clinical students: implications for interprofessional care.

Interprofessional education (IPE) is effective for teaching health profession students about the roles of different healthcare professionals for collaborative practice. This study was designed to investigate clinical students' awareness, knowledge, and perception of IPE. A mixed method convergent parallel design of Cross-Sectional Survey (CSS) and Focus Group Discussion (FGD) was used. Data on awareness, perception and knowledge about IPE were collected using a self-developed, content-validated questionnaire and Readiness for Interprofessional Learning Scale, respectively, and was analysed using Chi-Square, and Mann-Whitney U test at α = 0.05. For the FGD, data were collected from 13 purposively selected students in a Nigerian university and analysed through content thematic analysis. Participants in the CSS were aged 21.9 ± 2.0 years. Over half of the participants (57.4%) reported being unaware of IPE. More than half (73.0%) of the participants that were aware had good knowledge. Majority (93.3%) had a positive perception of IPE. There was a significant association between participants' knowledge and perception (p = 0.008) of IPE; however, there was no significant association (p = 0.051) between their awareness and perception. Also, there were no significant sex variations in the knowledge of IPE (0.371). However, there was a significant sex difference in their perception (p = 0.008). Some of the discussants in the FGD reported being aware of the term IPE. Discussants had at least fair knowledge of IPE and reported that IPE is important; and supports its formal implementation and inclusion in the curricula of study; emphasizing that it should be started early enough in their training. Awareness of interprofessional education is sub-optimal among these clinical students, however more than half of those who were aware had good knowledge. Most of them had a positive perception. There is a need to improve clinical students' awareness and knowledge about IPE by using integrated seminars and implementing IPE into the curricula of their training.

Informal caregiving burden and perceived social support in an acute stroke care facility.

BACKGROUND: Providing informal caregiving in the acute in-patient and post-hospital discharge phases places enormous burden on the caregivers who often require some form of social support. However, it appears there are few published studies about informal caregiving in the acute in-patient phase of individuals with stroke particularly in poor-resource countries. This study was designed to evaluate the prevalence of caregiving burden and its association with patient and caregiver-related variables and also level of perceived social support in a sample of informal caregivers of stroke survivors at an acute stroke-care facility in Nigeria. METHODS: Ethical approval was sought and obtained. Fifty-six (21 males, 35 females) consecutively recruited informal caregivers of stroke survivors at the medical ward of a tertiary health facility in South-Southern Nigeria participated in this cross-sectional survey. Participants' level of care-giving strain/burden and perceived social support were assessed using the Caregiver Strain Index and the Multidimensional Scale of Perceived Social Support respectively. Caregivers' and stroke survivors' socio-demographics were also obtained. Data was analysed using frequency count and percentages, independent t-test, analysis of variance (ANOVA) and partial correlation at α =0.05. RESULTS: The prevalence of care-giving burden among caregivers is 96.7% with a high level of strain while 17.9% perceived social support as low. No significant association was found between caregiver burden and any of the caregiver- or survivor-related socio-demographics aside primary level education. Only the family domain of the Multidimensional Scale of Perceived Social Support was significantly correlated with burden (r = - 0.295). CONCLUSION: Informal care-giving burden was highly prevalent in this acute stroke caregiver sample and about one in every five of these caregivers rated social support low. This is a single center study. Healthcare managers and professionals in acute care facilities should device strategies to minimize caregiver burden and these may include family education and involvement.

Validity and reliability of a Nigerian-Yoruba version of the stroke-specific quality of life scale 2.0.

BACKGROUND: Psychometric evidence is necessary to establish scientific integrity and clinical usefulness of translations and cultural adaptations of the Stroke-Specific Quality of Life (SS-QoL) scale. However, the limited evidence on psychometrics of Yoruba version of SS-QoL 2.0 (SS-QoL(Y)) is a significant shortcoming. This study assessed the test-retest reliability, internal consistency, convergent, divergent, discriminant and known-group validity of the SS-QoL(Y). METHODS: Yoruba version of the WHOQoL-BREF was used to test the convergent and divergent validity of the SS-QoL(Y) among 100 consenting stroke survivors. The WHOQoL-BREF and SS-QoL(Y) was administered randomly in order to eliminate bias. The test-retest reliability of the SS-QoL(Y) was carried out among 68 of the respondents within an interval of 7 days. All respondents were purposively recruited from selected secondary and tertiary health facilities in South-west Nigeria. Data were analysed using descriptive statistics of mean and standard deviation, and inferential statistics of Spearman correlation, Cronbach's alpha, Intra-class Correlation Coefficient (ICC), Independent t-test and One-way ANOVA. Alpha level was set at p < 0.05. RESULT: The physical health, psychological health, social relationship and environment domains on WHOQoL-BREF with correlation coefficient that ranged from 0.214 to 0.360 showed significant correlation with similar domains on SS-QoL(Y). Dissimilar domains between the two scales had r values from 0.035 to 0.366. Discriminant validity of SS-QoL(Y) showed that items' r value ranged from 0.711 to 0.920 with their hypothesized domains. The scale demonstrated moderate to strong test-retest reliability with Intra-class correlation coefficient (ICC) for the domains and overall scores (r = 0.47 to 0.81) and moderate to high internal consistency (Cronbach's alpha =0.61 to 0.82) for domains scores. These correlations were also significant for the domains and overall scores (p < 0.05). There were no significant differences across different age groups or gender for the domains or overall scores of SS-QoL(Y). CONCLUSIONS: Discriminant and known-group validity, test-retest reliability and internal consistency of the Yoruba version of the Stroke Specific Quality of Life 2.0 are adequate while the convergent and divergent validity are low but acceptable. The SS-QoL(Y) is recommended for assessing health-related quality of life among Yoruba stroke survivors.

Effectiveness of three modes of kinetic-chain exercises on quadriceps muscle strength and thigh girth among individuals with knee osteoarthritis.

BACKGROUND: The study was designed to evaluate and compare the effectiveness of 12-week open, closed and combined kinetic-chain exercises (OKCE, CKCE and CCE) on quadriceps muscle strength and thigh girth of patients with knee osteoarthritis (OA). METHOD: The randomized clinical trial involved ninety-six consecutive patients with knee OA who were randomly assigned to one of OKCE, CKCE or CCE groups. Participants' static quadriceps muscle strength (SQS), dynamic quadriceps muscle strength (DQS) and thigh girth (TG) were assessed using cable tensiometer, one repetition method and inelastic tape measure respectively at baseline and at the end of weeks 4, 8 and 12 of study. RESULTS: The three groups were comparable regarding their demographic and dependent variables at baseline; there was significant time effect (p < 0.001each) as all three measures significantly increased over time from baseline to week 12 [mean difference: SQS: 3.30 (95% CI: 2.52-4.08) N; DQS: 0.74 (95% CI: 0.45-1.02) N; TG: 1.32 (95% CI: 0.93-1.71) cm]. The effect of intervention-time interaction was not significant (p > 0.05) for all three measures. Changes in SQS, DQS and TG between baseline and week 12 were also not significantly different (p > 0.05) among the three groups. CONCLUSION: All three exercise regimens are effective and demonstrate similar effects on quadriceps muscle strength and muscular trophism. TRIAL REGISTRATION: NHREC/05/01/2008a. Registered 20th March, 2014 Retrospectively.

Establishing the reliability and construct validity of the Igbo version of Screening Activity Limitation and Safety Awareness scale in persons with Hansen disease.

OBJECTIVE: Leprosy or Hansen's disease is an infectious disease affecting skin and peripheral nerves. The World Health Organization (WHO) Recent Report reveals Africa as having 20,599 new cases, America 36, 178, Eastern Asia 166,445, Western pacific 5,400; totally up to 232,875 new cases. Nigeria as at 2012 had 3,805 new cases. Nerve dysfunction can lead to severe impairments, such as wounds, clawing and shortening of digits, and visual impairments that are often indicated as WHO Grade 2 disabilities. The Screening Activity Limitation Safety Awareness (SALSA) scale however, was developed to-measure self-reported activity limitation in people affected by peripheral neuropathy, and has been translated into several languages world-wide, including two of the three major indigenous languages in Nigeria (i.e. Yoruba and Hausa), leaving the Igbo language yet to be translated. This resulted in the present study, in which the scale was translated into Igbo and the psychometric properties also established to help in data collection and to promote research among the Igbo speaking people living with disabilities from Hansen's disease. DESIGN: The research design was a cross-sectional survey, facility based with 70% RFT and 30% on MDT. Data were analysed using Cronbach's alpha and factor analyses. RESULT: A quantitative exploration of participants' characteristics revealed that of the 40 respondents that participated in the study; 87.5% of them were predominantly from a rural population; 42.5% were males and 57.5% females. Their ages ranged between 15 and 64 years; 55% were uneducated; while 45% were educated. The SALSA Scale was interviewer-administered to the participants. Reliability analysis conducted on the data revealed high Cronbach's alpha co-efficient of 0.93 - 0.94 for the entire items on the scale. Firstly, most of the scale items correlated at least 0.3 with at least one other item on the scale, Secondly, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.71, Bartlett's test of sphericity was significant (Χ2 (190) = 482.63, P < 0.001). Finally, the communalities were all above 0.3. The principal factor analysis of the scale revealed a five factor scale, having fulfilled all the necessary conditions. CONCLUSION: It can be concluded that the Igbo version of SALSA is reliable and valid for use among the Igbo speaking group in Nigeria.

Catastrophising, pain, and disability in patients with nonspecific low back pain.

BACKGROUND: Attention has been drawn to examining the contributions of "catastrophising" to the prediction of pain and disability in individuals with low back pain (LBP). OBJECTIVES: This study investigated the proportion of patients with LBP who engaged in catastrophic thinking about pain and its association with pain intensity and disability. We also investigated the components of pain catastrophising that is predictive of disability. METHODS: A total of 275 participants with nonspecific LBP completed the Pain Catastrophizing Scale, the quadruple visual analog scale, and the Revised Oswestry Disability Questionnaire (RODQ). The associations among pain intensity, disability, and catastrophising were investigated using t test. The components of catastrophising that best predicts disability were investigated using multiple linear regressions, and the level of significance was set at 0.05. RESULTS: The majority (85.5%) of the participants had LBP for more than 6 weeks, with 45.5% of the participants having moderate disability and 52.7% being high catastrophisers. High catastrophisers to pain had a significantly higher rating of pain intensity (p < 0.001) and higher score on the RODQ than low catastrophisers to pain. The main components of catastrophising that predicts disability were magnification (p < 0.001) and rumination (p = 0.006). CONCLUSION: Clinicians should screen patients with nonspecific LBP for a heightened level of catastrophic thinking and endeavour to manage such when present.