Graduate Student Research and Publications

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Perspectives on Indigenous cultural competency and safety in Canadian hospital emergency departments: a scoping review
(Elsevier, 2019) Berg, Kelsey; McLane, Patrick; Eshkakogan, Nicole; Mantha, Jennifer; Lee, Tracy; Crowshoe, Chelsea; Phillips, Ann
Background: Emergency departments are primary health care entry points for Indigenous persons in Canada. They are also among the settings where Indigenous patients report access barriers and discriminatory treatment. Cultural competency and cultural safety have been proposed as approaches to improving emergency care. Aim:To identify and elaborate upon barriers and facilitators of cultural competency and safety in Canadian Emergency Departments. Methods: We conducted a scoping review to search published and grey literature to identify and extract data on definitions, measures, facilitators and barriers of cultura lcompetency and safety. Results: Six articles met inclusion criteria. Studies presented perspectives from patients, care providers, health care organizations, and Indigenous knowledge holders. Key themes emerged across studies and stakeholders. These include: Interpersonal relationships between patients and care providers; cultural competency training; Emergency Department capacity; and racism and discrimination. Conclusion: We recommend that Emergency Department cultural competency and safety initiatives i) be built up on post-colonial understanding and partnerships with local Indigenous communities ii) provide practitioners with competencie sin relationship-building and self-awareness iii) orient ED resources and services to meet the needs of patients with limited access to non-emergency health care and iv) aim to prevent discrimination.
Demographic and disease characteristics associated with pain intensity, kinesiophobia, balance, and fall self-efficacy among people with osteoarthritis: a cross-sectional study
(Springer, 2022) Ekediegwu, Ezinne C.; Akpaenyi, Chigbogu E.; Nwosu, Ifeoma B.; Onyeso, Ogochukwu K.
Background: Osteoarthritis (OA) is a common degenerative joint disease leading to significant pain, mobility limita- tion, economic burden, reduced quality of life, and disability among adults globally. Psychological factors related to pain intensity (PI), kinesiophobia, fall self-efficacy (FSE), and balance may lead to a poor OA prognosis. This study was designed to explore the association between PI, kinesiophobia, FSE, balance, and age, gender, marital status, site of OA, duration, symmetry, comorbidity, and adaptive behaviours among patients with knee or hip OA. Methods: This cross-sectional study involved 70 purposively selected participants aged 59.91 ± 11.12 years. Numeric pain rating scale, Tampa scale for kinesiophobia, fall-efficacy scale, and timed up and go test were used to measure PI, kinesiophobia, FSE, and balance, respectively. Statistical analyses were completed with the Pearson correlation test, independent samples t-test, and multiple linear regression. Results: The participants were mainly women (n = 59, 84.3%). However, there was no gender difference in the reported PI, kinesiophobia, FSE, and balance. There was a significant correlation between FSE and balance (r = 0.422, p<0.001). Kinesiophobia was significantly associated with the presence of comorbidity (β = 0.240, p = 0.001) and knee OA (β = 0.208, p<0.042). There was an association between FSE and the use of a walking aid (β = ˗0.442, p<0.042), stop-for-rest during walking (β = ˗0.292, p = 0.002), presence of comorbidity (β = 0.209, p = 0.014), and bilateral lower limb OA (β = 0.167, p = 0.057). Balance was associated with the use of a walking aid (β = ˗0.421, p<0.001) and stop-for- rest during walking (β = − 0.294, p = 0.006). Conclusion: Osteoarthritis-related psychological distress affects both men and women. This study support integra- tion of psychological outcomes in the assessment, management, and follow-up of people with lower limb osteo- arthritis. Moreover, comorbidity worsened psychological distress among people with osteoarthritis. Therefore, the traditional biomedical management of osteoarthritis can be optimised by timely diagnosis and treatment of comor- bidities, and the inclusion of psychotherapy.
Methodology and reporting quality of 544 studies related to ageing: a continued discussion in setting priorities for ageing research in Africa
(Gen-info Ltd., 2022) Kalu, Michael E.; Okeke, Chukwuebuka; Nwachukwu, Ernest; Okoh, Augustine; Akinrolie, Olayinka; Ezulike, Chigozie D.; Adandom, Henrietha; Onyeso, Ogochukwu K.; Egbumike, Joesph; Olatunji, Funmibi D.; Ugwuodo, Ebere P.; Ojembe, Blessing U.; Adandom, Israel I.; Anagbaso, Akaolisa J.; Akinrolie, Omobolade M.; Anieto, Ebuka M.; Ekoh, Prince C.; Makanjuola, John O.; Ibekaku, Michael C.; Iwuagwu, Anthony O.; Onyekere, Chukwuebuka P.; Muomaife, Kelechi J.; Nkoroh, Chinonyerem; Odega, Adaobi; Ogbueche, Chukwudi M.; Omeje, Chidimma; Onyekwuluje, Chisom I.; Oyinlola, Oluwagbemiga; Rayner, Daniel; Ugwuja, Immaculata A.
Background: The quality assessment provides information on the overall strength of evidence and methodological quality of a research design, highlighting the level of confidence the reader should place on the findings for decision making. This paper aimed to assess the quality (methodology and quality of reporting) of ageing studies in Sub-Saharan Africa (SSA). Method: This paper is the second of a Four-Part Series paper of a previous systematic mapping review of peer-reviewed literature on ageing studies conducted in SSA. We updated the literature search to include additional 32 articles, a total of 544 articles included in this paper. Downs & Black checklist, Case Report guidelines checklist, the 45-items Lundgren et al. checklist, and the Mixed Method Appraisal Tool were used to assess the methodological quality of quantitative, case reports, qualitative, and mixed-method studies. Quality assessment was piloted and conducted in pairs for each study type. Depending on the checklist, each study was classified as excellent, good, fair, or poor. Result: Of the 544 articles, we performed the quality assessment of a total of 451 quantitative studies [Randomized control trials (RCTs) and pre-post (n=15), longitudinal (n=122), case-control (n=15) and cross-sectional (n=300); 4 case reports, 74 qualitative and 15 mixed-method studies. Only 20.4% (n=111) articles were of high quality [one RCT, 27 longitudinal, 4 case-control, 48 cross-sectional studies, 19 qualitative, and 12 mixed-method studies]. The remaining 433 were rated as moderate quality (n=292, 53.7%), fair quality (n = 96, 17.7%) and poor quality (n = 45, 8.2%). Most (80%) quantitative articles’ sample size is small, resulting in insufficient power to detect a clinically or significant important effect. Three-quarter (75%) of the qualitative studies did not report their research team characteristics and a reflexivity component of the 45-items Lundgren et al. checklist. Mixed-method studies with low quality did not report the qualitative studies properly. Conclusion: We conclude that the methodological and quality reporting of published studies on ageing in SSA show variable quality, albeit primarily moderate quality, against high quality. Studies with a large sample size are recommended, and qualitative researchers should provide a section on research team members’ characteristics and reflexivity in their paper or as an appendix.
Musculoskeletal imaging authority, levels of training, attitude, competence, and utilisation among clinical physiotherpists in Nigeria: a cross-sectional survey
(Springer Nature, 2022) Onyeso, Ogochukwu K.; Umunnah, Joseph O.; Eze, Joseph C.; Onigbinde, Ayodele T.; Anyachukwu, Canice C.; Ezema, Charles I.; Onwuakagba, Ifeoma U.; Abaraogu, Ukachukwu O.; Awhen, Agba P.; Anikwe, Ernest E.; Akinola, Odunayo T.; Kalu, Michael E.
Background: Direct-access physiotherapy practice has led to a global review of the use of differential-diagnostic modalities such as musculoskeletal imaging (MI) in physiotherapy. Objective: To explore the MI authority, levels of training, attitude, utilisation, and competence among clinical physi- otherapists in Nigeria. Methods: This national cross-sectional study analysed a voluntary response sample of 400 Nigerian physiotherapists that completed the online version of the Physiotherapist’s Musculoskeletal Imaging Profiling Questionnaire (PMIPQ), using descriptive statistics, Spearman’s correlation, Mann-Whitney U, Kruskal-Wallis, and Friedman’s ANOVA tests. Results: Of the 400 participants, 93.2% believed that physiotherapists should use MI in clinical practice. However, only 79.8% reported having MI authority in their practice settings. The participants’ median (interquartile range) levels of training =10 (24) and competence =16 (24) were moderate. Nonetheless, levels of training (χ2 [15] = 1285.899, p = 0.001), and competence (χ2 [15] = 1310.769, p < 0.001) differed across MI procedures. The level of training and competence in x-ray referral and utilisation was significantly higher than magnetic resonance imaging, computed tomography scan, ultrasonography, scintigraphy, and dual-energy x-ray absorptiometry, in that order (p < 0.05). There was a significant positive correlation between the levels of training and competence (rho =0.61, p < 0.001). The par- ticipants had a positive attitude =32 (32) and occasionally used MI in clinical practice =21 (28). Conclusion: Majority of the respondents believed they had MI authority although there was no explicit affirmation of MI authority in the Nigerian Physiotherapy Practice Act. Participants had a positive attitude towards MI. How- ever, levels of MI training, competence, and utilisation were moderate. Our findings have legislative and curriculum implications
Physical inactivity among internally displaced persons in Nigeria
(2022) Akinroli, Olayinka; Masta, Ali M.; Jasper, Unyime S.; Fawole, Henrietta O.; Onyeso, Ogochukwu K.; Akinrolie, Omobolade; Jumbo, Ugochukwu S.
Background: Physical inactivity may complicate physical and mental health problems among internally displaced persons (IDPs). This study aimed to assess the prevalence of physical inactivity and its sociodemographic cor- relates among IDPs in Northeastern Nigeria. Methods: A total of 363 participants recruited from four IDP camps were categorized into physically inactive and active using International Physical Activity Questionnaire. Multiple logistic regression was used to explore the association between physical inactivity and sociodemographic correlates. Results: The prevalence of physical inactivity was 36.2%. Those who were males (Odd Ratio (OR) = 4.52, 95% Confidence Interval (CI) = 2.33 to 8.78) and Kanuri (OR = 2.53, 95% CI = 1.44 to 4.45) were more likely to be physically inactive. Younger participants were less likely to be physically inactive than those who were aged >49 years old. Conclusion: There is a high prevalence of physical inactivity among IDPs in Nigeria, and we found important sociodemographic factors associated with physical inactivity.
An exploratory cohort study of serum estradiol, testosterone, osteoprotegerin, interleukin-6, calcium, and magnesium as potential biomarkers of cervical spondylosis
(Springer, 2023) Igwe, Augustine A.; Onyeso, Ogochukwu K.; Adandom, Israel; Onyeso, Kelechi M.; Anyachukwu, Canice C.; Awosoga, Olu A.; Ezema, Charles I.; Okoye, Goddy C.
Background: Exploration of biomarkers for debilitating diseases such as cervical spondylosis is important to revolutionize clinical diagnosis and management of such conditions. The study aimed to determine the correlation between neck pain and disability and serum levels of interleukin-6 (IL-6), osteoprotegerin (OPG), estradiol (E2), testosterone (TES), calcium (Ca), and magnesium (Mg) among individuals with symptomatic cervical spondylosis. Methods: This study was a cohort design. The participants were new referrals to two Nigerian physical therapy clinics. Participants’ neck pain intensity (PI), neck disability index (NDI), IL-6, OPG, E2, TES, Ca, and Mg were measured at baseline and after 13 weeks of follow-up. Data were analyzed using descriptive statistics, independent samples t test, Pearson’s correlation, and multiple linear regression. Results: Forty individuals aged 52.40 ± 8.60 years participated in the study. Women had significantly higher levels of IL-6 (t = − 2.392, p = 0.026), OPG (t = − 3.235, p = 0.005), E2 (t = − 6.841, p = 0.001), but lower TES (t = 17.776, p = 0.001). There were no significant sex differences in PI and NDI. There were significant correlations between PI and OPG (r = 0.385, p < 0.001), NDI and OPG (r = 0.402, p < 0.001), and IL-6 (r = 0.235, p = 0.036). Significant predictors of PI were OPG (β = 0.442, p < 0.001) and E2 (β = − 0.285, p = 0.011), and NDI were OPG (β = 0.453, p < 0.001), E2 (β = − 0.292, p = 0.005), and IL-6 (β = 0.225, p = 0.024). Conclusion: High serum levels of IL-6 and OPG were associated with cervical spondylosis severity. However, high serum levels of E2 and TES correlated with lesser severity. Moreover, TES inversely correlated with the proinflammatory cytokines.
Influence of sport type and gender on bone turnover markers in young athletes
(2023) Apiloki, Joy O.; Aje, Oluwakayode S.; Awotidebe, Taofeek O.; Okhawere, Martin I.; Mbada, Chidozie E.; Onyeso, Ogochukwu, K.; Idomeh, Festus A.; Adagbusi, Charles O.; Oke, Kayode I.
Background Exercise is beneficial to bone health. However, little is known about the interaction effect of gender and sport type on bone turnover in young athletes. This study aimed to examine the influence of gender and sports categories (high, medium, and low impact) on bone turnover: reabsorption markers–osteocalcin, calcium, inorganic phosphate (IP), alkaline phosphatase (ALP), and resorption marker–cross-linked N-telopeptides of type 1 collagen (NTx) among a university’s undergraduate athletes. Methods The study was an ex-post facto design involving forty-seven purposively recruited gender- and sporttype- matched undergraduate athletes whose demographic characteristics and BMI were obtained. Participants’ 5 mL antecubital blood samples were collected and analysed for serum levels of osteocalcin, calcium, IP, ALP, and NTx using standard laboratory protocols, Bio-Tek spectrometer, and KC4 (3.3) software. Data were analysed using descriptive statistics and two-way ANOVA. Results The study involved 24 females and 23 males (n = 47) aged 22.15 ± 3.35 years with an average BMI of 23.34 ± 4.66. There was no significant gender effect on the biomarkers. However, there was a significant effect of the sports category on IP (F = 4.307, p = 0.020), calcium (F = 6.807, p = 0.003), and ALP serum levels (F = 11.511, p < 0.001). Specifically, mid-impact sports participants had a higher IP than the low-impact group (mean difference [MD] = 0.81 mg/dL, p = 0.036). Low-impact had a higher calcium level than mid-impact (MD = 0.40 mg/dL, p = 0.022) and high-impact (MD = 0.49 mg/dL, p = 0.003). Conversely, low-impact had lower ALP than mid-impact (MD = − 11.13 U/L, p = 0.013) and high-impact (MD = − 17.44 IU/L, p < 0.001). Conclusion Moderate to high-impact sports positively affected bone turnover in young athletes. However, gender had no significant impact.
COVID-19 hand hygiene practices and its barriers among health care workers in a low-resource setting: a cross-sectional study in Nigeria
(Springer, 2024) Ekediegwu, Ezinne C.; Onyeso, Ogochukwu K.; Nwanne, Chiamaka; Nwosu, Ifeoma B.; Alumona, Chiedozie J.; Onyeso, Kelechi M.; Ekechukwu, Echezona N.; Ihegihu, Ebere Y.; Amaechi, Ifeoma A.; Aruma, Okwukweka E.; Odole, Adesola C.
Background: Poor hand hygiene (HH) among health care workers (HCWs) in low-resource healthcare settings has continued to increase the spread of infectious diseases, including COVID-19. The present study aimed to assess the knowledge, attitude, adherence, and barriers to HH practices among HCWs during the COVID-19 pandemic in Nigeria. Methods: The study was an online cross-sectional survey using a tailored questionnaire distributed through chain referral sampling among southern Nigerian HCWs during the first wave of the COVID-19 pandemic (February to August 2020). The primary outcomes were knowledge, attitude, adherence to HH guidelines, and the barriers limiting compliance with the guidelines. Data were analysed using percentage, frequency, mean, standard deviation, one-way ANOVA, and multiple linear regression. The study timeline was from 15 April to 31 July 2020. Results: Four hundred and fifty-four HCWs (236 males and 218 females) participated in the study. The participants had a moderate knowledge of standard HH protocol (mean ± SD) 62.45 ± 10.82%, positive attitude 84.34 ± 11.32%, and high adherence to the standard guidelines 81.21 ± 9.49%. There was no significant difference in knowledge, attitude, and adherence across the healthcare professions. Increasing age (β = 0.186, p < 0.003) and knowledge (β = 0.229, p < 0.001), and decreasing negligence (β = − 0.178, p = 0.004), and forgetfulness (β = − 0.159, p = 0.012) were the significant predictors of effective HH practices. Conclusion: Nigerian HCWs had moderate knowledge, a positive attitude, and adhered to the standard HH practices during the COVID-19 pandemic. However, the major barriers were institutional-based factors such as the inadequate supply of HH items, competing job demands, emergencies, increased workload, and personal characteristics such as age, poor knowledge, negligence, and forgetfulness. We recommend that hospital management provide their staff with adequate HH materials and continued infectious disease training.