TABLE (TABLE AND BED LABORATORY EXPERIMENT) TRIAL: A RANDOMIZED CONTROLLED TRIAL OF CONSULTATION ROOM LAYOUTS.

Abstract OBJECTIVE: The outpatient consultation room remains unchanged despite increasing use of technology mediated information sharing in the clinical encounter. The growth of outpatient medical care makes outpatient facilities the primary point of healthcare contact for many Americans. We propose implementing an adaptive design that supports a patient-centered approach to care. STUDY DESIGN: A randomized control trial conducted at the University of Kansas School of Medicine (KUSM) internal medicine resident clinic in Wichita, Kansas. METHODS: Fifty-nine patients were randomly assigned to consultation in a traditional room (n = 33) with a rectangular shaped examination table or in an experimental room (n = 26) with a round pedestal table. The care offered by the physician was not affected; however, room layouts and strategic placement of the laptop computer were different for both groups. Physicians did not have access to the survey. Patients completed a 5-point Likert scale post-visit questionnaire. The key features of this program were: a newly redesigned (experimental) consultation room featuring a round pedestal table in the experimental room allowing for a sitting style that enhances good proximity between the physician, patient and the computer screen used in information sharing during the visit; and a traditional room, featuring a rectangular padded examination table. All other features in the room layout were the same including room size, sink location, and number of seats in the room. Wilcoxon rank sum test was used to assess the combination score on each domain between the intervention and control group. The questionnaire was broken into domains with calculated response scores within each domain scaled from 0 to 100. RESULTS: A statistically significant difference in interpersonal-room interaction was found between the experimental room (65.24 ± 17.25) versus the traditional room (49.12 ± 22.35) scores (P = 0.0038). A higher percentage of participants in the experimental room reported their ability "to look at the information on the computer screen at any time they wanted" (24% vs. 12.9%) compared with the control group. More participants indicated that "provider shared information on the computer screen" for the experimental room (54.2% vs. 22.6%) than in the traditional room. Over half of subjects (72%) in the experimental room compared to the traditional room (40.6%) indicated complete agreement to "provider's engaging them in conversation about the information in the monitor". Patients reported that they were "able to look at the internet with the provider" with a total agreement response of 32% among the experimental room compared to 9.7% in the control group. There was no difference in patient satisfaction (P = 0.5524), mutual respect and communication quality (P = 0.8288), people-room interaction (P = 0.5892), or trust in physician (P = 0.5892). CONCLUSION: Changing the layout of a consultation room has the potential to improve information sharing. Clinicians who are interested in maximizing the benefits of their clinical encounter could consider changing the layout of their consultation room, especially the positioning of the computer screen

Public Opinion and Democratic Decision Making in Nigeria

While“Public”referred to common interest and common good, it isalso usedinterchangeably to explain Public Opinion in democratic decision.  Therefore, the term “Public” from the Latin wordPublicus meaning “the people”. In other words, it could be referred to “common access”with area open to the general population deemed public (Habermas, 1962,1989cited in the sage Handbook of Public Opinion Research 2007).  Opinion was first considered as popular concept in democratic decision in the work of JeremyBentham. Bentham then was much concerned with people’s reaction to government policy with utmost benefits derivation. This writing is synonymous to Edmund Burke and John Stuart Mill.And these sets of analystsalso believe that certain people’s interests were more important to other in the society. The major concerned area of ourdiscussion focused on how to design workable preferences for able representation to triumph in the process of reliable policies that reflect the popular interest of citizen. In his discussion of descriptive representation, Stuart andChristopher narrowed down the contestable clauses of public opinion to some explicit adjectives while furtherstressing the focus of research on representative characters, such as the extent to which representative resemble the represented, interm of demographic characteristics, race, ethnicity, gender, language, sexual orientation and added to these in Nigeria is the experience of colonialism that loom large. A number of theories according to Stuart and Christopher referred to this type of representation as “microcosmic representation” cited Birth 1971, 2001. Public Opinion and democratic decision making in Nigeria governance and administration principally involved all the units, size, population and structure that composed federal government. The resources which serve as the life wire of the country are naturally available in abundance, such as limestone, coal, tin, columbite, iron, ore Gold, silver and zinc. The country also has natural gas and it is one of the world’s major producers of petroleum. Agricultural products also flourish well in most part of the country in relation to the types of crop and vegetable applicable to such environment, this explain why groundnut, beans, maize are well found in the North and firm product like palm oil, cocoa and coffee are also more available in the Southern part of Nigeria. The climates are of two distinct seasons, the dry season and the rainy season. In essence, the climate is equatorial in the South, tropical in the center and avid in the North of the Country. The country (Nigeria) of about 923,768 square kilometers is surrounded by or shared boundaries with five major countries with Cameroon (1690km) and Chad (87km) to the east, Benin (773km) to the west, Niger (1,496km) to the North and the Atlantic Ocean (853km) to the South. The country’s typical outlook and its natural characteristics had obviously conditioned its social and political stratification. Worthy of mention are about 250 different ethnic groups identified on the basis of distinct languages in the country of close to 20 million populations. The Hausa – Fulani in the northern part of the country are about 29 percent, the Yoruba in the West are 21 percent and the Igbo in the eastern part are 18 percent of the total population. Among these ethnic cleavages, there is religious interlude of predominantly Muslims among the Hausa – Fulani reside with exception of Middle belt in the north that are mixed up with Christians. The Yoruba in the South – West are comprised of Muslims and Christians while Igbo in the South – East are predominantly Christians. In a nutshell, 50 percent of the country are Muslims, 40 percent are Christians and the remaining 10 percent are traditional believers. Much of their public interest could be viewed on geographical contingencies: social,religion,economic and political affinity.Politicaladministrative set up involved three major levels of government which are Federal, State, and Local Government. The States in Nigeria comprises 36, with 774 Local Governments as well as 8,810 political wards within the ethnic groups aforementioned. In the aspect of power classification between the three levels of government i.e. Federal, State and Local Government, about 66 items were specified for Exclusive list, (meant for the Federal Government to legislate), 44 are concurrent meant for both Federal and State. The fiscal power sharing mechanisms which should guarantee the smooth and orderly running of government is frequently changing at the will and caprices of Federal Government discretion

Women Empowerment as a Determinant of Investments in Children in Selected Rural Communities in Nigeria

The study established the influence of women empowerment on investments in children in selected rural communities in Nigeria. A total of two hundred and fifty rural women from Ile-Ife and its environs constituted the sample for the study. Their ages ranged from 15years to 39years with a mean age of 26.7years and standard deviation of 7.08. The two instruments used were author-constructed interview guide questionnaires with 0.69 and 0.74 reliability coefficient respectively. The data obtained were analyzed using frequency counts, percentages, chi-square, and multiple regression statistics. The results obtained from the study indicated that, a combination of the six independent variables significantly predicted the dependent variable. The result also indicated that, significant relationship existed between each of the variables and children schooling, health and survival. Based on the results of these findings, it was recommended that those in the helping professions should take cognizance of those variables that have been found to influence investing in children schooling, health and survival. The result also recommended intervention strategy to help families, couples and the individuals for modifying attitudes and behaviours on gender issues.Key words: Decision-making autonomy, Access to economic resources, Freedom from fear and coercion, Schooling, health and survival

A Survey of Facebook Addiction Level among Selected Nigerian University Undergraduates

The undesirable consequences emanating from excessive internet usage on individual lives has been described as Internet Spectrum Addiction Disorder. Also, the potential clinical relevance of Facebook Addiction has also been conceptualized under Internet Spectrum Addiction Disorder. Observation have shown that many young adults in Nigeria are undiscerning users of Social network sites with many already tending toward excessive usage or are already entrapped in the ‘web’ of addictions. This fact remains hazy and needs empirical investigation. This study therefore surveyed the level of addiction to Facebook among selected Nigerian University undergraduates.  Stratified and purposive sampling techniques were employed in selecting 1000 undergraduates from four universities in South-west, Nigeria. Data were generated with Facebook Addiction Symptoms Scale (FASS). FASS, developed and validated by the researcher yielded reliability co-efficient of 0.73 (Cronbach Alpha). Data were analyzed with simple percentages, cross tabulation and t-test.  Findings show ‘meeting people’ and ‘chatting’ as the most frequent activities of undergraduates on Facebook. ’Facebook chat’, ‘Wall post’, and ‘Picture uploading’ were features used most. Many undergraduates access Facebook account every passing hour, every two hours and every day. The study reveals low level addiction (1.6%) particularly among university undergraduates in private universities. Although the study observed low level of addiction, this result may be due to the low level of internet access generally in Nigeria.  The study therefore suggests that stake holders must do something to prevent rampancy of Facebook addiction in particular and internet addiction in general among Nigerian youths. Key words: Social media, Facebook addiction, Internet, University undergraduat

Effects of Mobile Phone Withdrawal, Gender and Academic Level on Mobile Phone Dependency Among Mass Communication Students in Ajayi Crowther University, Oyo, Oyo State, Nigeria

Noticeable among young adults in Nigeria is their dependence on mobile phone for relational communication. This study is therefore one attempt at subjecting such observation to empirical testing. The study examined the effects of Mobile phone withdrawal, gender and academic level of students’ dependency on mobile phone. It was a quasi-experiment with 2×2×>2 non-randomized pre-test post-test control group designs. Subjects in experimental and control groups were 100 and 400 level Mass Communication students of Ajayi Crowther University in Oyo, Oyo State, Nigeria. Students’ Mobile Phone Dependency Questionnaire(r=0.72) was administered as pre and post-test measures. Data generated were analysed with frequency count, percentage, t-test and Analysis of Covariance. Findings show that 55% of the students used their phones ‘very frequently’, 30% used it ‘frequently’. Before the intervention, students’ dependency on mobile phone was ‘moderate’ (60.8%) but after the treatment, there was upward adjustment ‘High’ (45%). Statistical significant difference was found between students’ dependency pre-test and post-test scores in favour of the post-test (t= -5.665; p<0.05). Treatment (F= 3.832; p<0.05) and academic level (F= 12.185; p<0.05) were found to have significant main effects. Hence, the study concluded that students are actually dependent on their mobile phones and that, in considering and controlling mobile phone dependency, students’ academic level is a potent factor

Mass Housing in Nigeria, Customize the Brief: Provide a Desired House

The nature of the housing designs in mass housing schemes in Nigeria is a function of how architects were trained to handle mass housing designs. It is common practice to find that the houses in majority of the mass housing schemes in Nigeria are never owner specific. It is often assumed by architects working on mass housing schemes that the process of making the houses specific is cumbersome. The nature of the construction method of these mass housing schemes allows for the design briefs of the individual house to be different. This paper examines how design brief in mass housing in Nigeria can be customized. This is done through the development of a customization brief model with aid of a network of computers. It is expected that if the model is applied into mass housing in Nigeria, desired house by house owners in mass housing schemes would be met. Keywords: architects, customization, house owner, mass housing, mode

Tobacco use and oral health of inmates in a Nigerian prison

Objectives: To determine the effect of tobacco use on oral health status of inmates of a federal prison in Enugu, Nigeria.Materials and Methods: The study involved 230 inmates of the Nigerian Prison in Enugu. An interviewer‑administered questionnaire was used to collect data on the demographic characteristics of the participants, oral hygiene methods, and smoking habits. An intra‑oral examination to determine their oral health status was done using simplified oral hygiene index (OHI‑S) for the oral hygiene status, the modified decayed missing and filled teeth (DMFT) index for caries status, and community periodontal index of treatment needs (CPITN) for the periodontal needs. Statistical Package for Social Sciences software, version 15 was used to analyze data.Results: One hundred and twenty participants (52.2%) were current smokers. Mean DMFT of smokers and nonsmokers were 2.38 ± 0.71 and 2.25 ± 0.83 respectively (P = 0.508) while mean Community Periodontal Index (CPI) scores of smokers and nonsmokers were 4.71 ± 1.26 and 2.27 ± 0.86, respectively (P = 0.276). Oral soft tissue lesions such as mucosal burn, oral leukoplakia‑like lesions were found mainly in the tobacco users.Conclusion: Tobacco use had a negative effect on the oral health of the participants as smokers had worse oral health profile than non‑smokers. They may benefit from counseling programs with the view to educate them on the effect of tobacco use on oral health and by extension, the general health. The full implementation of the Framework Convention on Tobacco Control (FCTC) treaty in Nigeria could help in curtailing these unwanted consequences of tobacco use.Keywords: Oral health promotion, prisoners, periodontal health, tobacco useNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Personal Factors As Predictors of Content-Specific Use of the Internet by Ajayi Crowther University Students in Nigeria

The individual interest of the internet users on the content depends solely on some factors that are personal to users. These factors are the suspected drives that determine their choice of internet content. It is in this regard that this study examines the composite and relative contributions of personal factors (age, gender, religious background, socio-economic status and; academic level) to the choice of internet content. The survey method was employed in this study. The subjects of the investigation were drawn from the three faculties of Ajayi Crowther University using stratified sampling. Based on student enrolment in each of the Faculties, 10% (200) of the entire student population (2000) was selected. Purposive sampling was used in selecting 100 students from the Faculty of Social and Management Sciences, 70 students from the Faculty of Natural Sciences and 30 students from Humanities. Data were generated with the Undergraduates Personal Factors and Internet Content Preference Questionnaire (UPFICPQ) which yielded reliability co-efficient of .79 (Cronbach Alpha). Data were analyzed with frequency count, percentage, and regression analysis. Findings of the study show that 79 (40.5%) of the undergraduates use the internet for social networking, 64 (32.8%) use it for news and information while 36 (18.5%) use it for entertainment. While all the considered personal factors accounted for 67% ( R square =.67) of the variation in students’ choice of internet content, it was found that only academic level, religion and socio-economic background of the students made significant contributions to the choice of internet content. Key Words: Personal factors, Predictors, Content-specific, Interne

Effect of Leadership Style on Political Participation in Nigeria

This paper explains that, pattern of political grouping, pressure groups, social economic as well as business organization, so also the voting pattern in Nigeria portrays the unrelenting quest in search of political leadership by the inhabitant of the country to avail them from such perpetual deteriorating condition, subjected to by the past administrations, that had long sub-due sustainable development in all aspects of human endeavour quintessentially pre-conditioned their unanimous stands out in political participation of the recent time. It further suggested that, there is no doubt that the negative and pernicious role perpetrated by the Nigeria leaders contributed to the rise and fall of political participation, which had further strangulate social political line cut-across the diverse unit of the country. Political party, the platform by which electorates expressed their political loyalty and solidarity in favour of a particular political associate or person determined at the level of ideology, Kinship (in Nigerian) or ethnic diversity (as the case may be) plays a plethora of roles which include acting as symbol that provides for candidates to contest election in other to form (acceptable) governments.  In other words, and by the virtue of this pivotal function ascribed to political party, it serves as undesirable link (in the contemporary democracy ) between the people and the government .The paper hence concluded that, attitude of political actors in the recent occurring situation and the dynamic social political participation had obviously vindicated the perpetual act of greed and selfishness among principal political leaders/actors as they change from one party to another.Therefore, the paper demonstrated that the hope and aspiration of the electorates remains both on reliable judicial precedents andelectoral college

Changes in Serum Level of ALT, GGT and LDH in Human Immunodeficiency Mono-infected and HIV-HBV Co-Infected Patients

Liver markers indicate liver disorders that could be caused by drugs and infection such as hepatotropic viruses or its co-infection with HIV. Standard antiretroviral therapy (ART) consists of the combination of at least three antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease. This study was designed to determine the effect of antiretroviral therapy in co-infection of HIV with hepatitis B virus on serum ALT, GGT and LDH. Seventy six patients aged 16-65years including 50 HIV mono-infected and 26 HIV-HBV patients that have not initiated antiretroviral therapy were recruited from Federal Medical Centre, Owo-Nigeria. Viral serological study of the patients were carried out by ELIZA and Immunoblotting. LDH, GGT and ALT were determined biochemically by Spectrophotometry. The results obtained showed a significantly higher mean values of LDH, GGT and ALT in the HIV-mono-infected after drug administration (334.4 ± 11.2, 24.9 ± 2.3, and 42.4 ± 1.1) than the results (296.5 ± 7.4; 14.8 ± 1.4 and 27.8 ± 1.7) of the parameters obtained before the initiation of the drug with p &lt;0.05. There was a significantly higher mean values of LDH and ALT in the HIV patients co-infected with HBV before drug administration 440.3 ± 8.2 and 52.3 ± 0.5 ) than the results (288.3 ± 5.7 and 36.6 ± 0.6) of the parameters  obtained after the initiation of the drug with p&lt;0.05. However, there was a significantly lower mean value of GGT in the HIV-HBV patients before drug administration than after the initiation of the antiretroviral drug (p&lt;0.05). This work revealed a significant increase in the values of LDH, GGT and ALT in the HIV-mono-infected patients after antiretroviral drug administration and in HIV-HBV patients before antiretroviral therapy. A significantly lower mean value of GGT in the HIV-HBV patients before drug administration than after the initiation of the antiretroviral drug. Evaluation of liver biomarkers in the treatment of HIV mono-infected and HIV-HBV patients is essential to avoid liver disorder and possible complications. Keywords: ALT, γGT,LDH, HIV, Coinfectio, HIV-HBV, Monoinfectio