Self-directed learning readiness and learning achievements of a flipped classroom model approach in research methods class: A quasi-experimental study.

AIM: This study sought to assess how the flipped classroom model of instruction affected self-directed learning readiness and learning outcomes among Nigerian nursing students enrolled in a research method class. BACKGROUND: Although the effectiveness of the flipped classroom model of instruction has been thoroughly and scientifically investigated in several fields, its potential to promote self-directed learning readiness and learning outcomes in a research method class has not yet been investigated. DESIGN: A quasi-experimental design was employed. To achieve the study's objectives, two experiments were conducted: a pre-test and a post-test. METHODS: Participants were 64 400-level nursing undergraduates purposively recruited from two government-owned universities in Southeast Nigeria. The experimental group received a flipped classroom model of teaching methods, while the control group received traditional teaching methods (TTM) from April - July 2021. A validated self-directed learning readiness scale and multiple-choice questions derived from a research method course were used to gather data. A structured questionnaire was used to collect demographic data. Descriptive statistics of frequencies, percentages, means and standard deviations were applied to the collected data. A one-factor independent measure analysis of covariance (ANCOVA) and an independent sample t-test was employed to compare the pre-and post-test results of FCM and TTM students. RESULTS: Pre-test results from self-directed learning readiness showed overall scores of 3.99 ± 0.39 and 3.95 ± 0.35 for the traditional teaching method and flipped classroom model, respectively, while post-test results showed overall scores of 3.84 ± 077 for the traditional teaching method and 4.01 ± 0.81 for flipped classroom model. The difference in mean scores between the pre-and post-tests was statistically significant (p=0.030). Pre- (p=.001) and post- (p =.025) learning outcomes for the flipped classroom model were significantly higher than those for the traditional teaching method. CONCLUSION: The flipped classroom model of instruction had a positive impact on nursing students' readiness for self-directed learning and learning outcomes in the research course. Since the method demonstrated statistically significant benefits in both the development of self-learning abilities and learning achievements, the need to improve learning experiences through the flipped learning method should be promoted.

Flipped classroom model versus conventional teaching method: effects on nursing students' self-directed learning readiness in a research methodology course.

Introduction: the effectiveness of the flipped classroom model (FCM) method for building self-directed learning readiness (SDLR) in a research methodology course has not yet been scientifically researched. This study aims to assess the effect of FCM on SDLR among Nigerian nursing students enrolled in a research methodology course. Methods: sixty-four 400-level nursing students from two government-owned universities in Southeast Nigeria were recruited for this quasi-experimental study. They were randomly divided into two groups, the experimental group, and the control group, and exposed to FCM and conventional teaching methods (CTM) throughout the months of April and July 2021. Before and after the intervention, the validated self-directed learning readiness scale (SDLRS) was used to gather data, and a structured questionnaire was used to collect demographic data. Results: the SDLR was high if the SDLRS mean score was ≥3.75. Pre-test results from SDLR showed overall scores of 3.99 ± 0.39 and 3.95 ± 0.35 for CTM and FCM, respectively, while post-test results showed overall scores of 3.84 ± 0.77 for CTM and 4.01 ± 0.81 for FCM. The mean scores between the pre-and post-tests were statistically different (p=0.030). Conclusion: the FCM had a positive effect on Nigerian nursing undergraduates' SDLR and should be encouraged as it provides a viable alternative to the traditional teaching method.

Menstruation behaviour influencer model: a grounded theory of menstrual experiences of shame, embarrassment, stigma and absenteeism among pubescent girls in semi-urban and rural secondary schools in Enugu State, Nigeria.

Introduction: severally, studies had identified menstrual-associated shame, embarrassment, stigma, and absenteeism among pubescents in school with resultant challenges on their bio psycho-social functioning. However, what is not clear is the contribution of the home and school to the experiences. The objectives of the study were to explore the experiences with menstruation and menstrual hygiene management; explore the experiences with menstrual-associated shame, embarrassment, stigma, and absenteeism among participants; explore the bio-psycho-social issues associated with the experiences; understand the meaning of the experiences and propose a mid-range theory that explains the influences on pubescents´ menstrual behaviours. Methods: constructivist grounded theory design was used to explore the experiences of 20 purposively recruited pubescents from rural and semi-urban secondary schools. In-depth Interviews, focused group discussions, key informant interviews, and observations were employed to collect data until data saturation. Open and focused coding was conducted to identify emerging themes and sub-themes. These themes were returned to participants and literature for verification. Results: four (4) categories and eleven (11) sub-categories emerged from the data and formed four (4) themes that influence pubescents´ menstrual behaviour. They include: 1) individuals´ bio-physiological status, knowledge of menstrual health and menstrual characteristics; 2) regimenting school through strict rule enforcement, punishment/motivation, forced participation, and compliance; 3) scheduling academic activities/examination, sporting and other extra curricula activities; and 4) providing menstrual support by individual and institutional efforts to pubescents. Based on the relationship with other themes, the menstrual behaviour influencer model was proposed. Conclusion: menstrual influencers require the interaction between menstrual support and menstrual enablers by institutions for positive menstrual behavior. Failure to achieve this balance will lead to menstrual-associated shame, embarrassment, stigma, absenteeism, and school drop-out.

Causes and effects of theory-practice gap during clinical practice: the lived experiences of baccalaureate nursing students.

PURPOSE: This study evaluated the baccalaureate nursing students' lived experiences of the causes and effects of TPG during clinical practice in a tertiary health institution in Enugu, Nigeria. METHOD: A qualitative design using existential descriptive phenomenological approach was adopted to explore 20 baccalaureate nursing students at 500 level of study. The class level of the students was purposively sampled and the exact number of students sampled using snowball technique. Semi-structured interview guide was the instrument for data collection. Data were collected using audio-tape recorder, face to face in depth discussions, and analyzed using qualitative thematic analysis. RESULT: Five broad themes and 12 subthemes emerged from this study namely: Resource constraints (limited resources, resource improvise); Unhealthy human attitudinal and behavioural factors (nurse clinicians, nurse educators, student nurses factors); Environmental system challenges (paradoxical academic design and structure, paradoxical clinical setting); Integration Inadequacy (team cooperation paucity, scarce surveillance, insufficient timing of clinical placement); Observing effects of TPG (observing adverse impacts, observing positive implications). CONCLUSION: The causes of TPG during clinical practice emerge from nursing education and practice. TPG have adverse impacts on patients, nursing students, nursing education and practice, other health practitioners, while linkage to response is its positive implication.

Effects of a structured health education on prevention of HIV risky behaviours among adolescents in Nigeria - a pragmatic randomized controlled trial.

Infection with HIV/AIDS continues to be a major public health concern around the world, particularly in low- and middle-income nations. To assess the effectiveness of structured health education on the prevention of HIV/AIDS risky behaviours among adolescents in secondary school. A pretest-posttest-control group randomized controlled trial where a sample of 647 adolescents was drawn from the population of 2,890 secondary school students and was block-randomized into the intervention (n = 400) and control (n = 224) groups. Data were collected using a content-validated (CVI = 4.2/5) and reliable (k = 0.791) self-developed structured questionnaire. Data were analyzed using descriptive statistics and with inferential statistics of independent and paired t-tests at α = 0.05. Pre-intervention risky behaviours in both groups were below average though lower in the intervention than in the control group. Pre-intervention risky behaviour was significantly higher among males than females in the rural school (p < 0.001) and in both schools together (p < 0.001). Health education significantly affected risky behaviour with the intervention group being associated with lesser risky behaviour than the control group. There was no significant difference in the post-intervention risky behaviour between males and females in the rural (0.285), urban (0.179) and both schools together (p = 0.956). Post-intervention reduced risky behaviours more significantly in the intervention than in the control groups. HIV/AIDS health education should be part of schools' curriculum, guidance and counsellor teachers should be trained as HIV counsellors.

Analysis of Author Gender in the Pediatric Orthopaedic Literature from 2011 to 2020.

INTRODUCTION: Orthopaedic surgery remains a male-dominated specialty. To date there has not been a focused analysis of gender in authorship within the pediatric orthopaedic literature. METHODS: The electronic table of contents from 2011 to 2020 of 3 major pediatric orthopaedic journals [Journal of Children's Orthopaedics (JCO), Journal of Pediatric Orthopaedics (JPO), and Journal of Pediatric Orthopaedics Part B (JPO-B)] were reviewed. Publications were reviewed for the number of articles with at least 1 female author and the number of articles with women listed as first authors. These were compared over the 10-year study period, and by individual year of publication. Statistical analysis included a general linear model with factorial one-way anslysis of variance and Bonferroni post hoc testing. RESULTS: A total of 4097 articles were reviewed. In 2020, there was a significantly higher percentage of articles with a female author when compared with 2011 (64% to 42%, P=0.010). A female was listed as first author in significantly more publications in 2020 as compared with 2011 (23% to 10%, P=0.031). During the 10-year study period, the highest mean proportion of articles with at least 1 female author was seen in JPO (60%), with similar findings in JCO (55%). Significantly fewer articles in JPO-B contained a female author (37%, P=0.001). The highest percentage of publications with a female first author across 10 years was in JCO (22%), followed by JPO (20%). Significantly fewer articles with a female first author were found in JPO-B (9%, P=0.001). CONCLUSION: There is an increasing proportion of publications in the pediatric orthopaedic literature with female authors and female first authors from 2011 to 2020. In addition, there was a statistical difference in female authorship when comparing specific publications, which should be investigated further. LEVEL OF EVIDENCE: Level IV.

Prevalence of mental illness among adolescents (15-18 years) treated at Federal Neurospsychiatric Hospital, Enugu Nigeria, from 2004 to 2013.

PURPOSE: The aim of this study was to investigate the prevalence of mental illness among adolescents treated at Federal Neurospsychiatric Hospital, Enugu Nigeria. METHODS: A retrospective descriptive design was used to assess 1255 adolescents within the age of 15-18 years diagnosed with mental illness from 2004 to 2013. A proforma designed by the researchers was used to document information on prevalence, type, and relationship with age and gender. RESULTS: The prevalence of mental illness within the 10 year period was 9.9%. Schizophrenia spectrum and other psychotic disorders 869 (69.2%) were the commonest conditions recorded. Higher prevalence of mental illness was seen among males 752 (59.9%) compared to females 503 (40.1%). Schizophrenia spectrum and other psychotic disorders 384 (76.3%); depressive disorders 20 (4.0%) were more common among female adolescents while substance-related and addictive disorders 84(11.2%) and neurodevelopmental disorders 48(6.8%) were more common among male adolescents. The prevalence of mental illness increased with age, being highest at 18 years and lowest at 15 years while prevalence of drug induced psychosis was 90 (7.2%). CONCLUSIONS: The study highlights the need to focus on the mental health of adolescents by planning preventive programs and creating awareness on mental health promoting strategies, and to introduce child and adolescent psychiatric health services in the study setting.

Knowledge, accessibility, and utilization of insecticide treated nets among pregnant women in a selected hospital in South-Eastern Nigeria.

INTRODUCTION: Prevention of malaria in pregnancy (MIP) with the use of insecticide treated nets (ITNs) is no doubt one of the major interventions aimed at reducing maternal and infant morbidity and mortality rates. This study aimed to determine the knowledge, accessibility and utilization of ITNs during pregnancy. METHODS: This is a quantitative survey conducted in 2014 among pregnant women attending ANC in Redeemer Hospital and Maternity, Abakpa-Nike, Enugu State, South-Eastern Nigeria. One hundred and forty participants were selected using convenience sampling and information elicited using a self-developed questionnaire. Data were analysed using SPSS (version 9) and results presented in frequency tables. RESULTS: Among the respondents, 90.7% knew of the effectiveness of ITNs in the prevention of MIP. Results also showed that most of the women (69.3%) own at least one ITN, and their major source was from the free house-to-house distribution by the government. Also, 62.9% revealed that the ITNs were readily available. Out of the 97 women that owned at least one ITN, the majority (69.1%) claimed to have started using ITNs even before pregnancy with 70% claiming to sleep under the ITNs always. Nevertheless, only 69.1% used an ITN correctly. CONCLUSIONS: There is high knowledge of ITNs and their effectiveness in prevention of MIP among pregnant women in Enugu South-Eastern Nigeria. However, there is a need for measures to increase awareness on their correct usage, and also to correct misconceptions and wrong beliefs associated with ITNs in order to enhance their utilization.

Notch3 is involved in adipogenesis of human adipose-derived stromal/stem cells.

Human adipose-derived stromal/stem cells (hASCs) have tremendous therapeutic potential and the ability to offer insight into human development and disease. Here we subject human ASCs to siRNA-mediated knockdown of Notch3 cultured under both self-renewing and adipogenic differentiation conditions. Self-renewal was monitored by assessing viability and proliferation rates through staining and alamarBlue assays, respectively. Adipogenesis was measured through Oil-Red O staining, western blot, and quantitative real-time RT-PCR that determined expression levels of multipotency and adipogenic markers over time. Notch3 was expressed in self-renewing hASCs but knockdown, as validated by qRT-PCR and western blot, showed no impact on cell viability, as measured through live-dead staining, or cell proliferation rates, as measured through alamarBlue assays. However, although Notch3 expression was observed to increase during adipogenesis, in the absence of Notch3 there was a significant increase in hASC adipogenesis as demonstrated through an increased number of lipid vesicles, and increased expression of adipogenic markers ppar-γ, adiponectin, fabp4, and plin2. Although Notch3 is only one of four Notch receptors expressed on the surface of hASCs, this receptor appears important for proper regulation of adipogenic differentiation, possibly serving as a negative regulator to prevent inappropriate adipogenesis or promote other lineage commitments of ASCs.

Differentials in health-related quality of life of employed and unemployed women with normal vaginal delivery.

BACKGROUND: The combination of child care and domestic work demands on both housewives and the employed (hired) women may impact their health-related quality-of-life. There is paucity of studies to ascertain this. This study investigated the differences in health-related quality of life of employed and unemployed women with normal vaginal delivery and associated socio-demographic variables. METHODS: This longitudinal study was done from March, 2012 to June, 2013. Modified SF-36v2™ health-related quality of life questionnaire was administered to 234 newly delivered women drawn from six selected hospitals in Enugu, Southeast Nigeria at 6, 12 and 18 weeks postpartum. Respondents were reached for data collection through personal contacts initially at the hospitals of delivery, and subsequently by visits to their homes/workplaces or cell-phone calls. Women were asked to indicate how each of 36 items applied to them at each of the three times. Data collection lasted for six calendar months and 17 days (from September 3rd 2012 to 20th March, 2013). RESULTS: All the women had their best HrQoL at 12 weeks postpartum. Employed women reported lower health-related quality-of-life than the unemployed at the three time-points, the lowest mean score being at 18 weeks postpartum (Mean = 73.9). Multiple comparison of scores of the two groups using Tukey HSD Repeated Mean showed significant variation on the eight subscales of the health-related quality-of-life. Physical functioning (p = 0.045), Physical role limitation (p = 0.000), bodily pain (p = 0.000), social functioning (p = 0.000) and general health (p = 0.000) were unequal guaranteeing type 1 error. Women with higher education and personal income reported higher health-related quality-of-life (p < 0.05). Employed women have more problems with physical health components and are more negatively affected by increasing age except those with higher education and personal income. CONCLUSIONS: Increased responsibilities combined with increasing age and low socio-economic status reduce women's health-related quality-of-life post-partum. The traditionally accepted paid 3 months maternity leave should be elongated by extra months to help women balance their daily work with baby care. Gender sensitive employment opportunities in favour of women are necessary to empower more women economically.

Complementary and alternative medicine use among adults in Enugu, Nigeria.

BACKGROUND: Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from studies carried out in different parts of the world has established that CAM use is very common and varies among populations. This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information on the prevalence of CAM use, forms of CAM remedies used and reasons for utilizing them METHODS: The study areas were three local government areas in Enugu urban of Enugu State. Cross-sectional survey using questionnaires were administered to randomly selected households. All consenting participants were used for the study RESULTS: 732 participants (37.2% males and 62.8% females) were used for the study. Ages ranged from 18 - 65 years. 620 (84.7%) of the adult population have used CAM ranging from one single type to twenty different types while 112 (15.3%) have not used any form of CAM. The most commonly used CAM product was the biological products, followed by prayer/faith healing. Major reasons for using CAM include their natural state and also for health promotion and maintenance. CONCLUSION: There is need for adequate policy formulation and regulation to ensure safety and efficacy of CAM products. Measures to ensure rational use of CAM should be instituted.