Missed Physiotherapy Appointment and Its Influence on Cost, Efficiency and Patients' Outcomes.

Background: Missed appointments is a significant challenge to efficient running of physiotherapy departments and it has cost implications. In this study, wait time, and pattern, predictors and impact of Missed appointments (MAs) on cost, efficiency and recovery time was assessed among Nigerian patients receiving physiotherapy. Method: In this retrospective study a total of 3,243 physiotherapy appointments were booked between 2009 and 2019 at an Outpatient Physiotherapy Clinic in Nigeria. Data were collected on Missed appointments, on costs of of treatment and on socio-demographic characteristics. The total revenue loss due to missed appointments was calculated as a product of the total of Missed appointments and cost per treatment; recovery time was also estimated. Results: Missed appointments were 1,701 out of 3,243 booked (52.5%) and the average wait time for the first appointment was 9.6 ± 23.2 days. The proportion of Missed appointments was higher among females (50.2%), patients who were not resident of the same location as the clinic (45.3%), patients with orthopaedic conditions (56.2%) and patients referred from an orthopaedic surgeon (32.8%). Females, those who live within the city, and those with neurological/medical conditions were 1.68, 1.24, and 1.52 times more likely to have Missed appointments compared to males (OR = 1.68, Confidence intervals = 1.44 - 1.96, p = < 0.001), those who live outside the city (OR = 1.24, CI = 1.05 - 1.46, p = 0.01), and to those who have orthopaedic conditions (OR = 1.52, CI = 1.20 - 1.93, p = < 0.001), respectively. Using per treatment schedule cost of N1000 (an equivalent of $ 2.31), a 52.5% Missed appointments rate resulted in lower efficiency of 76.6% with an efficiency ratio of 0.23. Further, a 52.5% Missed appointments rate could potentially impact patient recovery time by 3402 days if Missed appointments slow a patient recovery process by 2 days. Conclusions: Missed appointments for physiotherapy treatment pose a significant challenge in terms of costs, efficiency, and patient recovery time. Thus, an innovative reminder system may help reduce patients' non-attendance to physiotherapy and its consequences.

Cultural adaptation and psychometric evaluation of the Yoruba version of the Health Literacy Questionnaire.

Background: Health literacy is an important multidimensional concept of public health concern and a determinant of health outcomes and access to healthcare which requires robust measurement. The objective of this study was to culturally adapt and establish the psychometric properties of the Yoruba version of the Health Literacy Questionnaire. Methods: A cross-sectional survey of Nigeria Yoruba speaking adults was conducted with the Health Literacy Questionnaire following its translation and adaptation. Data were subject to psychometric evaluation (confirmatory factor analysis, composite reliability, Cronbach's alpha, intra class correlation) and association with sociodemographic variables. Results: A total of 258 adults with mean age 26.7 years participated in the study. The easiest scale to score highly was 'Actively managing my health' and hardest was 'Ability to find good health information' and 'Navigating the healthcare system'. Six one-factor models fitted well without correlated residuals but the other three had a good fit after model modification. Composite reliability and Cronbach's α of ≥ 0.7 were observed for all scales, suggesting good internal consistency of the scales. Test-retest reliability of the Yoruba translation of the Health Literacy Questionnaire was moderate to good in all scales, intra class correlation ranging from 0.66 to 0.76. Conclusion: The Health Literacy Questionnaire was successfully translated and culturally adapted and demonstrated good content and construct validity and high composite reliability. The Yoruba translation of the Health Literacy Questionnaire has the potential of being a useful clinical tool for the assessment of health literacy, especially among Yoruba speaking community of Nigeria. Thereby helping to improve the health outcomes through access to healthcare.

Translation, cross-cultural adaptation and psychometric evaluation of yoruba version of the short-form 12 health survey.

Conclusion: This is the first study to assess the psychometric properties of the Y-SF-12. It appears to be valid and may be an appropriate tool for assessing health-related quality of life among Yoruba population. The tool may help to improve the health outcomes of individuals, and redress health inequalities in low and middle-income countries. Background: Short Form 12 (SF-12) health survey has found its utility in clinical and research settings because of its short length that spares time. Though several translations into other languages do exist there is none available in Yoruba language. Hence, this study's objective was to culturally adapt and determine the reliability and validity of the Yoruba translated version of the SF-12. Methods: Forward and backward translations of SF-12 into Yoruba version of SF-12 (Y-SF-12) were done using the International Quality of Life Assessment Project Guidelines. Healthy participants were assessed using both English and Yoruba versions of SF-12 for the validation phase, and two weeks later were reassessed with the Y-SF-12 for the reliability phase. Results: Participants were 225 males and 171 females. The mean scores for each scale range from 73.4 to 86.1, with no gender difference. All scale and domain scores evidenced a negative skew and ranges from -1.79 to -0.62. Concurrent validity (0.879 - 0.938) and convergent validity (0.786 - 0.907) appeared to be good as reflected by their correlation values. The internal consistency of Y-SF-12 was good as Cronbach's Alpha ranged between 0.899 and 0.968, while the Intraclass Correlation Coefficient (ICC) ranged between 0.775 and 0.949.

Translation and psychometric evaluation of the Yoruba version of the STarT Back tool among persons with long-term non-specific low-back pain.

Conclusion: The Y-SBT have acceptable psychometric properties. It is recommended for use among Yoruba speaking patients with LBP. Background: Translating questionnaires into local languages is essential as it aids easy accessibility and understanding of such questionnaires by patients and their health caregivers. The STarT Back Tool (SBT), validated tool used to classify subgroups of persons with Low-Back Pain, has few translated versions. We translated the STarT Back Tool into the Yoruba language and established its psychometric properties among patients with long-term non-specific Low-Back Pain. Methods: Following the Lenz protocol, the SBT was successfully cross-culturally adapted into the Yoruba language. One hundred consenting patients (mean age = 57.0±11.43 years, 55% females) took part in the validation phase, while 53 of them participated in the test-retest phase. Psychometric indices of the Y-SBT assessed showed internal consistency, intraclass correlation coefficient (ICC), ceiling and floor effects and divergent validity. Results: The sub- and total Cronbach's α score for Y-SBT was 0.704 and 0.857, respectively. The test-retest reliability of the sub- and total scores of the Y-SBT yielded an ICC of 0.82 (95% CI: 0.74 - 0.87) and 0.89 (95% CI: 0.84 - 0.93), respectively. The divergent validity for sub- and total-scores of the Y-SBT based on Quadruple Visual Analogue Scale score for on-going pain was r = 0.374 (p = 0.001) and r = 0.432 (p = 0.001), respectively. The Y-SBT had no ceiling or floor effects.

Phylogenetic analyses of bacteria associated with the processing of iru and ogiri condiments.

Analysis of the bacterial community dynamics during the production of traditional fermented condiments is important for food safety assessment, quality control and development of starter culture technology. In this study, bacteria isolated during the processing of iru and ogiri, two commonly consumed condiments in Nigeria, were characterized based on phylogenetic analyses of the bacterial 16S rRNA gene. A total of 227 isolates were obtained and clustered into 12 operational taxonomic units (OTUs) based on 97% 16S rRNA gene similarity. The OTUs spanned three phyla (Firmicutes, Actinobacteria and Proteobacteria), and nine genera: Acinetobacter, Aerococcus, Bacillus, Enterococcus, Enterobacter, Lysinibacillus, Micrococcus, Proteus and Staphylococcus. OTUs closely related to species of Bacillus dominated the processing stages of both condiments. Although no single OTU occurred throughout iru processing stages, an OTU (mostly related to B. safensis) dominated the ogiri processing stages indicating potentials for the development of starter culture. However, other isolates such as those of Enterococcus spp. and Lysinibacillus spp. may be potential starters for iru fermentation. Presumptive food-borne pathogens were also detected at some stages of the condiments' processing, possibly due to poor hygienic practices. SIGNIFICANCE AND IMPACT OF THE STUDY: Iru and ogiri are important condiments used for flavour enhancement in foods and serve as protein substitutes in diets among rural populations across West Africa. Consumption of these condiments is growing, reinforcing the need to scale up their production. Production of these condiments includes spontaneous fermentation, which often leads to inconsistent product quality and unguaranteed safety. This study has demonstrated the bacterial succession in iru and ogiri processing and highlights species that could be selected and exploited for starter culture development. This study provides a starting point to produce quality and microbiologically safe iru and ogiri condiments.

Knowledge and practices of nutritional care among day care staff in selected preschools in Ibadan North Local Government Area, Oyo State, Nigeria.

BACKGROUND: Studies have established that growth of children usually falters during the preschool age when the child is usually left in the hands of other care givers; as parents go to work. Feeding of the preschool children is sometimes solely under the care of Day Care Staff (DCS) whoselevel of knowledge and practice of nutritional care is unknown. Knowledge and practices of nutritional care among DCS in selected preschools were investigated. METHOD: A descriptive cross-sectional study design was used and 400 DCS were randomly selected for interview. A validated questionnaire with 50-point knowledge scale was used to collect information from the target population and this was complemented with observational checklist to assess the level of practice of nutritional care and environmental hygiene. Data obtained were analysed using both univariate and bivariate analyses including Chi-square test at p=0.05 level of significance. RESULTS: Most of the DCS were female (97.5%) and 47.5% specialised in child education. Few (28.8% and 25.0%) of the DCS had ever received training on child nutritional care during pre-service and in- service training, respectively. Only 20.0% of DCS had good knowledge of nutritional care, which reflected in the activities observed. Age was significantly associated with knowledge of preschool nutritional care.. CONCLUSION: Knowledge of day care staff on nutritional care of preschool children was found to be poorer as the age of staff increases. This may also contribute to the poor practices observed. Training on nutritional care among day care staff, especially the older ones is suggested.

Oxygen for children and newborns in non-tertiary hospitals in South-west Nigeria: A needs assessment.

BACKGROUND: Oxygen is important for the treatment of hypoxaemia associated with pneumonia, malaria, and other medical, obstetric, and surgical conditions. Access to oxygen therapy is limited in many of the high mortality settings where it would be of most benefit. METHODS: A needs assessment of 12 non-tertiary hospitals in south-west Nigeria, assessing structural, technical and clinical barriers to the provision of safe and effective oxygen therapy. RESULTS: Oxygen supply was reported to be a major challenge by hospital directors. All hospitals had some access to oxygen cylinders, which were expensive and frequently ran out. Nine (75%) hospitals used oxygen concentrators, which were limited by inadequate power supply and lack of maintenance capacity. Appropriate oxygen delivery and monitoring devices (nasal prongs, catheters, pulse oximeters) were poorly available, and no hospitals had clinical guidelines pertaining to the use of -oxygen for children. Oxygen was expensive to patients (median US$20/day) and to hospitals. Estimated oxygen demand is reported using both a constant mean-based estimate and adjustment for seasonal and other variability. CONCLUSIONS: Making oxygen available to sick children and neonates in Nigerian hospitals will require: improving detection of hypoxaemia through routine use of pulse oximetry; improving access to oxygen through equipment, training, and maintenance structures; and commitment to building hospital and state structures that can sustain and expand oxygen initiatives.

Effect of baking improvers on the quality of whole cassava biscuits.

Improving agents such as ascorbic acid, sodium metabisulphite, sorbic acid and soyflour were used in the production of whole cassava biscuits. Cassava flour and small amount of soyflour were produced. Bulk density, water binding capacity and amylograph viscosity of cassava flour were determined. Mixing and dough extrusion time were recorded for each sample of biscuit dough developed with addition of improvers. Length, width and thickness of cut-out dough were measured before and after baking to evaluate biscuits flow. Proximate and sensory analysis of the biscuits samples was also determined. The result showed that, there was a slight decrease in mixing time, extrusion time, length and width of the biscuits samples prepared with improvers. However, there was a considerable increase in biscuits thickness. Amylograph result showed an improvement in flour stability and low retrogadation tendency, most especially flour with inclusion of ascorbic acid. Crude protein and fat increased with sample contained soyflour. Sensory evaluation result indicated no significant difference among the samples except the texture of the biscuits.

Calciphylaxis causing digital, gangrene in end stage renal disease: a case report and review.

Calcific uraemic arteriolopathy (CUA), a potentially life-threatening vasculopathy of the skin and subcutaneous tissues is rarely associated with advanced chronic kidney disease (CKD) particularly in patients on haemodialysis. It is more frequently reported in whites than in blacks and commonly accompanies hyperphosphataemia, elevated calcium-phosphate product and marked secondary hyperparathyroidism. We report a rare case of CUA that complicated end stage renal disease secondary to obstructive uropathy in a 68 year old Nigerian. The risk factors for CUA, diagnosis, management and our peculiar limitations were reviewed and discussed.

Pre-hypertension and hypertension in adolescence: how much does it occur in a Nigerian community?

BACKGROUND: Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risks of cardiovascular and kidney disease. Previous studies have documented that hypertension may begin in adolescence, perhaps even in childhood. OBJECTIVES: This study set out to determine the prevalence of pre-hypertension and hypertension in adolescence in a Nigerian community. METHODS: A cross-sectional screening of blood pressure of secondary school students was conducted in Sagamu local government area of Ogun State, Nigeria. Total sample of 1638 adolescents aged between 12 and 18 years were chosen from stratified schools and from various classes of selected schools. Their blood pressure was assessed. RESULTS: The prevalence of pre-hypertension in this population ranged from 0-10.5% in male students and 0-2.9% in female students across the age. In the whole population the prevalence of systolic and diastolic pre-hypertension were 1.6% and 0.5% respectively for male adolescents while that of female students were 0.4% and 0.5% respectively. The low prevalence of 0.1% was observed for systolic and diastolic hypertension in male and 0.1% for female systolic hypertension. Furthermore, pre-hypertension prevalence was increased with age. CONCLUSION: In conclusion, our data demonstrated a low prevalence of pre-hypertension and hypertension in Nigerian adolescents living in Sagamu local government area of Ogun state, south west Nigeria.

Corchorus olitorius stem as corrosion inhibitor on mild steel in sulphuric acid.

The corrosion inhibition of mild steel in 0.5M H2SO4 solution was studied in the presence of Corchorus olitorius stem extract as inhibitor. Phytochemical analysis results confirmed the presence of organic constituents such as Alkaloids, Tannins, Glycosides, Saponins and Flavonoids which made the Corchorus olitorius stem extract act as a good inhibitor. The highest inhibition efficiency as observed from the experimental design was 93.29%, with process levels of 4 days, temperature: 60 °C and inhibitor concentration: 1.0 g/L respectively. The optimal process levels were: 4.11 days, temperature: 48.92 °C and inhibitor concentration: 1.16 g/L respectively, which gave an inhibition efficiency of 94.34%. The result from the Scanning Electron Micrographs showed that via the validated experiment, a more passive layer of film was formed on the surface of the coupon, confirming the high efficiency of the Corchorus olitorius extract's inhibiting role in corrosion prevention.

Public health nutrition concerns on consumption of red palm-oil (RPO): the scientific facts from literature.

There appears to be a state of uncertainty as far as the health benefits of consumption of Red Palm Oil (RPO) is concerned from public health point of view globally. Literatures are replete with conflicting information on saturated fatty acid content of palm-oil, with caution on the possibility of increasing low density lipoprotein (LDL) in the blood. The implication of this may be subsequent elevation of serum cholesterol when the oil is consumed. This review paper is aimed at providing scientific facts from well referenced journal articles on public health nutrition benefits of RPO. It considers findings from animal and human experiments, to arrive at conclusion based on scientific evidence on the potential health benefits associated with consumption of RPO. Although, the level of saturated fatty acids content may suggest health risk, the presence of carotenoids and other powerful anti-oxidants in RPO makes it one of the best cooking vegetable oils with health promoting properties.

Pressure-Assisted Fabrication of Perovskite Solar Cells.

This paper presents the results of a combined experimental and analytical/computational study of the effects of pressure on photoconversion efficiencies of perovskite solar cells (PSCs). First, an analytical model is used to predict the effects of pressure on interfacial contact in the multilayered structures of PSCs. The PSCs are then fabricated before applying a range of pressures to the devices to improve their interfacial surface contacts. The results show that the photoconversion efficiencies of PSCs increase by ~40%, for applied pressures between 0 and ~7 MPa. However, the photoconversion efficiencies decrease with increasing pressure beyond ~7 MPa. The implications of the results are discussed for the fabrication of efficient PSCs.

Knowledge, Perception and Management of Pre-eclampsia among Health Care Providers in a Maternity Hospital.

BACKGROUND: Morbidity and mortality of women and children associated with pre-eclampsia present major global health problems in low and middle income countries. The prevalence of pre-eclampsia in Nigeria ranges from 2% to 16.7%, with approximately 37,000 women dying from preeclampsia annually. This study examines knowledge, perception and management of preeclampsia among healthcare providers in a major maternity hospital in Lagos, southwest Nigeria. METHODS: In this descriptive cross-sectional study, 110 health care providers comprising of 75 Nurses, 9 Consultant Physicians, and 26 General Medical Practitioners with varying years of service were selected using purposive sampling technique. Data were collected using a self-administered 36-item semi-structured questionnaire. Data were analysed using the Statistical Package for Social Sciences to generate descriptive and inferential statistics with level of significance set at 0.05. RESULTS: Health care providers in the study had an average knowledge of pre-eclampsia with a mean score of 16.69±3.53. There was generally a good perception of pre-eclampsia with a mean sore of 28.31±3.71. The most-prevalent clinical management practices were emergency cesarean section (16%), magnesium sulphate infusion (29%), and fluid/electrolyte management (9%). Knowledge of pre-eclampsia and years of practice were significantly associated (F=3.31; p= 0.023). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Gaps in the knowledge of causes, diagnoses, and treatment of pre-eclampsia may be attributable to lack of refresher trainings and absence of written practice guidelines on pre-eclampsia management. Health care providers at this hospital may benefit from training courses that include current nationally and internationally-approved management of pre-eclampsia.

Nutrition education in medical training: the need to reconsider the sacrosanctity of medical education in Nigeria.

The "no controversy" status of the important role of nutrition in maintaining good health and disease management is becoming a gold standard in medical practice. Medical schools in developed countries and some in developing countries are beginning to renew interest in nutrition education for medical professionals. Despite difficulties envisaged in modifying the medical school curricula, it is inevitable that medical professionals need some basic nutrition knowledge appropriate for medical counselling in disease prevention and management. Cost effectiveness in providing health care services is now an important policy tool, which emphasizes preventive medical care. This is dependent on good nutrition education, which informs not only on food but healthcare and good environment. This article examines the need for nutrition education in medical schools, approaches that can be used to introduce nutrition education, using the available information from medical schools that have already integrated nutrition into their medical education curricula. It also identifies some of the barriers and strategies to overcome including specific actions for nutrition educators or whoever may be saddled with the responsibilities for initiating the development of nutrition curriculum for medical education.

Changes in mediators of inflammation and pro-thrombosis after 12 months of dietary modification in adults with metabolic syndrome.

OBJECTIVE: This study evaluated the effects of a 12-month dietary modification on indices of inflammation and pro-thrombosis in adults with metabolic syndrome (MS). MATERIALS AND METHODS: This longitudinal study involved 252 adults with MS recruited from the Bodija market, Ibadan and its environs. Participants were placed on 20%, 30% and 50% calories obtained from protein, total fat and carbohydrate respectively and were followed up monthly for 12 months. Anthropometry and blood pressure were measured using standard methods. Fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), fibrinogen, plasminogen activator inhibitor-1 (PAI-1)], interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured using spectrophotometric methods and ELISA as appropriate. Data was analysed using ANCOVA, Student's t-test, Mann-Whitney U and Wilcoxon signed-rank tests. P-values less than 0.05 were considered significant. RESULTS: After 6 months of dietary modification, there was a significant reduction in waist circumference (WC), while the levels of HDL-C, fibrinogen and PAI-1 were significantly increased when compared with the corresponding baseline values. However, WC and fibrinogen reduced significantly, while HDL-C and IL-10 significantly increased after 12 months of dietary modification as compared with the respective baseline values. CONCLUSION: Long-term regular dietary modification may be beneficial in ameliorating inflammation and pro-thrombosis in metabolic syndrome.

Nutrition transition and chronic diseases in Nigeria.

Nutrition transition goes with industrialisation that fosters human development which is usually desirable, especially in developing nations. However, the health consequences of this development include high rates of preventable non-communicable diseases which are usually undermined in the quest for industrialisation. The goal of the present paper is to provide evidence-based information that will promote healthy lifestyle including healthy consumption pattern among urban dwellers. Relevant local and international literature was accessed and reviewed to harvest evidence-based information through the use of validated review guide in addition to observation from the field experience. Industrialisation promotes creation of more job opportunities and this facilitates proliferation of fast-food eateries in the cities. However, it was also observed that many of the available workplaces in urban areas are not health-promoting because employees have poor access to preventive health information and sensitisation to healthy lifestyle has been poorly considered. Ironically, weight gain among urban workers which may be linked with increased intake of high-energy foods and low participation in physical activities as a result of accessibility to many energy saving devices have been highlighted as some of the pull-pull factors that attract many people to the cities. Using the concept of health promoting workplace, the workforce in urban areas can be trained as agent of change in health-promoting lifestyle. Consumption of healthy indigenous foods through aggressive promotion of its health potentials should be seriously advocated through the use of existing structure of urban fast-food vendors who constitute a strong stakeholder in nutrition transition.

Body Size Perceptions and Weight Status of Adults in a Nigerian Rural Community.

BACKGROUND: Overweight and obesity are now recognized worldwide as increasing public health problems throughout the life course and wrong perception of one's body size may reduce the motivation for an overweight person to lose weight. AIM: This study was conducted to investigate how Nigerian rural dwellers perceive their body size and how their perception agrees with their body mass index (BMI). SUBJECTS AND METHODS: A cross-sectional sample of 183 adults living in a rural community, South-West Nigeria was randomly recruited into the study. Their verbal and visual body size perceptions were assessed through structured questions and body images. Descriptive and inferential statistics were used to analyze the data. RESULTS: Thirty-five percent (64/183) of participants were classified as either overweight or obese by BMI. More than half of the participants perceived themselves as normal weight. More women perceived themselves to be obese than men in both verbal and visual perceptions. Based on BMI classification, 43% (79/183) and 54% (98/183) of participants misperceived themselves in verbal and visual perception, respectively. Underestimation of body size was higher in men (38.3%, 36/94) while overestimation was higher in women (9.0%, 8/89). Men had consistently higher values of kappa coefficient which indicate greater agreement than women in both types of perception. CONCLUSION: We found considerable gender differences in body weight perception of adults in the Nigerian rural community. A large proportion of these rural dwellers could not appropriately classify their weight status; and over 30% (64/183) and nearly 50% (92/183) of them underestimated their own body weight in verbal and visual perceptions respectively.

Propeller Flap for Complex Distal Leg Reconstruction: A Versatile Alternative when Reverse Sural Artery Flap is Not Feasible.

Reverse sural artery fasciocutaneous flap has become a workhorse for the reconstruction of distal leg soft tissue defects. When its use is not feasible, perforator-based propeller flap offers a better, easier, faster, and cheaper alternative to free flap. We present our experience with two men both aged 34 years who sustained Gustilo 3B injuries from gunshot. The donor area for reversed sural artery flap was involved in the injuries. They had early debridement, external fixation, and wound coverage with perforator-based propeller flaps. The donor sites were covered with skin graft. All flaps survived. There were minor wound edge ulcers due to the pressure of positioning that did not affect flap survival and the ulcers healed with conservative management. Perforator-based propeller flap is a versatile armamentarium for reconstruction of soft tissue defects of the distal leg in resource-constrained settings, especially when the donor area for a reverse flow sural flap artery is involved in the injury.

Scaled Quantum Mechanical scale factors for vibrational calculations using alternate polarized and augmented basis sets with the B3LYP density functional calculation model.

The Scaled Quantum Mechanical (SQM) method of scaling calculated force constants to predict theoretically calculated vibrational frequencies is expanded to include a broad array of polarized and augmented basis sets based on the split valence 6-31G and 6-311G basis sets with the B3LYP density functional. Pulay's original choice of a single polarized 6-31G(d) basis coupled with a B3LYP functional remains the most computationally economical choice for scaled frequency calculations. But it can be improved upon with additional polarization functions and added diffuse functions for complex molecular systems. The new scale factors for the B3LYP density functional and the 6-31G, 6-31G(d), 6-31G(d,p), 6-31G+(d,p), 6-31G++(d,p), 6-311G, 6-311G(d), 6-311G(d,p), 6-311G+(d,p), 6-311G++(d,p), 6-311G(2d,p), 6-311G++(2d,p), 6-311G++(df,p) basis sets are shown. The double d polarized models did not perform as well and the source of the decreased accuracy was investigated. An alternate system of generating internal coordinates that uses the out-of plane wagging coordinate whenever it is possible; makes vibrational assignments via potential energy distributions more meaningful. Automated software to produce SQM scaled vibrational calculations from different molecular orbital packages is presented.