Determinants of Successful Implementation of Early Childhood Development Education by County Governments in Kenya; Implementing Partners Perspective

The purpose of this study was to assess the determinants of successful implementation of Early Childhood Development Education (ECDE) by County Governments in Kenya from the implementing partners‟ perspective. This study was guided by the following specific objectives: to determine the influence of the capacities of the County Government staff on the implementation of early childhood development education by County Governments in Kenya, to determine the how management of early childhood development education affects its implementation by County Governments in Kenya, to assess how availability of physical facilities affect the implementation of early childhood development education by County Governments in Kenya and to examine how policies affect the implementation of early childhood development education by County Governments in Kenya. Decentralization theory and organization learning theory were used to explain the relationship between the study variables. Descriptive research design was used in the study. The population for the study was implementing partners working with County Governments in Kenya to support ECDE. Purposive sampling technique was used to select the respondents to participate in the study. A total of 100 respondents were targeted from the 10 organizations studied out of which 70 participated giving a response rate of 70%. Questionnaire was used as instrument for data collection. Both qualitative and quantitative data analysis techniques were used to analyze the data. The study found that the implementation of ECDE by County governments in Kenya was generally successful from the implementing partners‟ perspective and indicated by 56.8%. It is also worth noting that beside the general success, there were myriads of challenges facing the implementation of the program by county governments. Findings from regression analysis showed that the coefficient of determination indicated that 63.5% of the variations on the implementation of ECDE by county governments can be explained by staff capacity, management of ECDE, availability of physical facilities and ECDE policies. The remaining 36.5% can be explained by other variables not included in the study. R square and adjusted R is above average an implication that an above average variation can be explained by the model. The study recommended that county governments should allocate more funds for the renovation and construction of more ECDE centres, allocate adequate funds for the implementation of ECDE and that they should organize consistent in-service training for ECDE teachers and at the same time employ more ECDE staff to cater for the large number of children in ECDE centres.

Comprehensive Immune Monitoring of Clinical Trials to Advance Human Immunotherapy.

The success of immunotherapy has led to a myriad of clinical trials accompanied by efforts to gain mechanistic insight and identify predictive signatures for personalization. However, many immune monitoring technologies face investigator bias, missing unanticipated cellular responses in limited clinical material. We present here a mass cytometry (CyTOF) workflow for standardized, systems-level biomarker discovery in immunotherapy trials. To broadly enumerate immune cell identity and activity, we established and extensively assessed a reference panel of 33 antibodies to cover major cell subsets, simultaneously quantifying activation and immune checkpoint molecules in a single assay. This assay enumerates ≥98% of peripheral immune cells with ≥4 positively identifying antigens. Robustness and reproducibility are demonstrated on multiple samples types, across two research centers and by orthogonal measurements. Using automated analysis, we identify stratifying immune signatures in bone marrow transplantation-associated graft-versus-host disease. Together, this validated workflow ensures comprehensive immunophenotypic analysis and data comparability and will accelerate biomarker discovery

DiFX2: A more flexible, efficient, robust and powerful software correlator

Software correlation, where a correlation algorithm written in a high-level language such as C++ is run on commodity computer hardware, has become increasingly attractive for small to medium sized and/or bandwidth constrained radio interferometers. In particular, many long baseline arrays (which typically have fewer than 20 elements and are restricted in observing bandwidth by costly recording hardware and media) have utilized software correlators for rapid, cost-effective correlator upgrades to allow compatibility with new, wider bandwidth recording systems and improve correlator flexibility. The DiFX correlator, made publicly available in 2007, has been a popular choice in such upgrades and is now used for production correlation by a number of observatories and research groups worldwide. Here we describe the evolution in the capabilities of the DiFX correlator over the past three years, including a number of new capabilities, substantial performance improvements, and a large amount of supporting infrastructure to ease use of the code. New capabilities include the ability to correlate a large number of phase centers in a single correlation pass, the extraction of phase calibration tones, correlation of disparate but overlapping sub-bands, the production of rapidly sampled filterbank and kurtosis data at minimal cost, and many more. The latest version of the code is at least 15% faster than the original, and in certain situations many times this value. Finally, we also present detailed test results validating the correctness of the new code.Comment: 28 pages, 9 figures, accepted for publication in PAS

A Minimum-Cost Flow Model for Workload Optimization on Cloud Infrastructure

Recent technology advancements in the areas of compute, storage and networking, along with the increased demand for organizations to cut costs while remaining responsive to increasing service demands have led to the growth in the adoption of cloud computing services. Cloud services provide the promise of improved agility, resiliency, scalability and a lowered Total Cost of Ownership (TCO). This research introduces a framework for minimizing cost and maximizing resource utilization by using an Integer Linear Programming (ILP) approach to optimize the assignment of workloads to servers on Amazon Web Services (AWS) cloud infrastructure. The model is based on the classical minimum-cost flow model, known as the assignment model.Comment: 2017 IEEE 10th International Conference on Cloud Computin

Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED).

BackgroundRecurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease. In addition, community health workers (CHWs) have played an integral role in reducing health disparities; however, their effectiveness in reducing vascular risk among stroke survivors remains unknown. Our objectives are to develop, test, and assess the economic value of a CCM-based intervention using an Advanced Practice Clinician (APC)-CHW team to improve risk factor control after stroke in an under-resourced, racially/ethnically diverse population.Methods/designIn this single-blind randomized controlled trial, 516 adults (≥40 years) with an ischemic stroke, transient ischemic attack or intracerebral hemorrhage within the prior 90 days are being enrolled at five sites within the Los Angeles County safety-net setting and randomized 1:1 to intervention vs usual care. Participants are excluded if they do not speak English, Spanish, Cantonese, Mandarin, or Korean or if they are unable to consent. The intervention includes a minimum of three clinic visits in the healthcare setting, three home visits, and Chronic Disease Self-Management Program group workshops in community venues. The primary outcome is blood pressure (BP) control (systolic BP <130 mmHg) at 1 year. Secondary outcomes include: (1) mean change in systolic BP; (2) control of other vascular risk factors including lipids and hemoglobin A1c, (3) inflammation (C reactive protein [CRP]), (4) medication adherence, (5) lifestyle factors (smoking, diet, and physical activity), (6) estimated relative reduction in risk for recurrent stroke or myocardial infarction (MI), and (7) cost-effectiveness of the intervention versus usual care.DiscussionIf this multi-component interdisciplinary intervention is shown to be effective in improving risk factor control after stroke, it may serve as a model that can be used internationally to reduce race/ethnic and socioeconomic disparities in stroke in resource-constrained settings.Trial registrationClinicalTrials.gov Identifier NCT01763203