Effects of Annealing Ambient on the Structural, Optical and Electrical Properties of TiO2:Ge Thin Films

TiO2, a semiconducting material with a wide energy band gap, has been researched intensively due to its interesting properties and many potential applications. The films properties can as well be modified by preparing the films under diverse ambient to suit diverse applications. In this work, the effects of the annealing atmosphere on the structural, optical and electrical properties of pure TiO2 and TiO2:Ge composite thin films deposited by sputtering from commercially available pure TiO2 and TiO2:Ge (85:15) targets respectively were studied. The films were deposited on fluorine doped tin oxide glass substrates by radio frequency magnetron sputtering technique at room temperature 23–25 ℃ and then annealed at 450 ℃ for one hour in three different atmospheres: air, argon and nitrogen. The XRD results revealed that, both pure TiO2 and TiO2:Ge thin films were crystalline and had a mixed phase of anatase and rutile regardless of the annealing ambient. The calculated crystallite sizes ranged between 19–21 nm with the particle sizes for TiO2:Ge films being larger compared to pure TiO2 as calculated from ImageJ software. Electrical measurements showed that the resistivity of as deposited pure TiO2 films (about 13.03 × 10–2 Ω-cm) was greater than the TiO2: Ge composite (5.91 × 10–2 Ω-cm). Furthermore, on annealing, pure TiO2 had a resistivity of 9.47 × 10–2 Ω-cm–10.4 × 10–2 Ω-cm, while the TiO2:Ge composite had a resistivity of 2.24 × 10–2 Ω-cm–3.61 × 10–2 Ω-cm depending on the annealing atmosphere. Variation of annealing atmosphere had minimal influence on the electrical resistivity of the films. The films annealed in nitrogen recorded the least resistivity values averaging about 5.86 × 10–2 Ω-cm, while those annealed in argon and air recorded a resistivity of 6.94 × 10–2 Ω-cm and 6.65 × 10–2 Ω-cm, respectively. The transmittance spectra showed that, all the annealed films were transparent in the visible region (400–700 nm) with a mean bandgap of 3.60 eV for each annealing atmosphere. It is recommended that films annealed in nitrogen atmosphere could be considered for potential applications in photovoltaics. Keywords: Titanium dioxide; Germanium; Ambient; Structural; Optical, Electrica

Using wearable sensors for remote healthcare monitoring system

Recent technological advances in wireless communications and wireless sensor networks have enabled the design of low-cost, intelligent, tiny, and lightweight medical sensor nodes that can be strategically placed on human body, create a wireless body area network (WBAN) to monitor various physiological vital signs for a long period of time and providing real-time feedback to the user and medical staff. WBANs promise to re-volutionize health monitoring. In this paper, medical sensors were used to collect physiological data from patients and transmit it to Intelligent Personal digital Assistant (IPDA) using ZigBee/IEEE802.15.4 standard and to medical server using 3G communications. We introduced priority scheduling and data compression into the system to increase transmission rate of physiological critical signals which improve the bandwidth utilization. It also extends the life time of hand-held personal server by reducing power consumption during transmission

Workload Indicators Of Staffing Need Method in determining optimal staffing levels at Moi Teaching and Referal Hospital

Background: There is an increasing demand for quality healthcare in the face of limited resources. With the health personnel consuming up to three quarters of recurrent budgets, a need arises to ascertain that a workforce for any health facility is the optimal level needed to produce the desired product. Objective: To highlight the experience and findings of an attempt at establishing the optimal staffing levels for a tertiary health institution using the Workload Indicators of Staffing Need (WISN) method popularised by the World Health Organisation (WHO), Geneva, Switzerland. Design: A descriptive study that captures the activities of a taskforce appointed to establish optimal staffing levels. Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, a tertiary hospital in the Rift Valley province of Kenya from September 2005 to May 2006. Main outcome measures: The cadres of workers, working schedules, main activities, time taken to accomplish the activities, available working hours, category and individual allowances, annual workloads from the previous year\'s statistics and optimal departmental establishment of workers. Results: There was initial resentment to the exercise because of the notion that it was aimed at retrenching workers. The team was given autonomy by the hospital management to objectively establish the optimal staffing levels. Very few departments were optimally established with the majority either under or over staffed. There were intradepartmental discrepancies in optimal levels of cadres even though many of them had the right number of total workforce. Conclusion: The WISN method is a very objective way of establishing staffing levels but requires a dedicated team with adequate expertise to make the raw data meaningful for calculations. East African Medical Journla Vol. 85 (5) 2008: pp. 232-23

HIV virological non-suppression is highly prevalent among 18- to 24-year-old youths on antiretroviral therapy at the Kenyan coast

Background: In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast. Methods: Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilif and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with VNS. In this study, VNS was defned as plasma viral load≥1000 copies/mL. Results: Among these YLWH with a mean age of 20.7 years (SD=2.2); 55.5% females, the overall prevalence of VNS was 32.0% (95% Confdence interval (95% CI): 27.5, 36.9%). In the multivariable logistic regression analysis, being from a largely rural setting (adjusted Odds Ratio (aOR) 1.73, 95% CI 1.10, 2.71; p=0.02), underweight (aOR 1.87, 95% CI 1.16, 3.01; p=0.01) and low self-reported ART adherence (aOR 2.83, 95% CI 1.34, 6.00; p=0.01) were signifcantly associated with higher odds of VNS in YLWH. Conclusions: In this study, high levels of VNS were observed among YLWH and this was signifcantly associated with rural residency, nutritional and ART adherence problems. ART adherence counselling and nutritional support and education should be intensifed in this setting targeting YLWH residing mostly in rural areas. Given the high frequency of VNS, there is need to closely monitor viral load and profle HIV drug resistance patterns in youths from the Kenyan coast with confrmed virologic failure. The latter will help understand whether drug resistance also contributes to poor viral suppression in addition to, or exclusive of suboptimal ART adherenc

Assessment of gender and innovations in climatesmart agriculture for food and nutrition security in Kenya: a case of Kalii watershed

Climate-change and variability (CC&V) exerts multiple stresses on agriculture production. It negatively impacts gender-cadres especially in Kenya’s arid and semi-arid lands that occupy 89% (area), 36% (population), 70% (livestock), and 90% (wildlife). Smallholders with limited resources endowments have adopted climate-smart agriculture technologies, which are viewed as a panacea to CC&V in addressing interlinked food-security challenges. This paper reports baseline survey results on 149 randomly selected households in Kalii watershed. Primary and secondary data were collected in March 2015. Data-analyses encompassed regressions, descriptive statistics and gender-analysis. Local perceptions/results revealed precipitations downwardtrend and an upward-trend of temperatures, and other elements, and outcomes of CC&V. Gender and innovations are statistically significant at (p<0.05). Decision-making on assets’ and proceeds’ control and use, was men’s domain. Invariably, gender and climate-smart agriculture innovations are critical in food and nutrition security strategy under CC&V

Malnutrition and cachexia among cancer out-patients in Nairobi, Kenya

Cancer is the third leading cause of death in Kenya. However, there is scarce information on the nutritional status of cancer patients to guide in decision making. The present study sought to assess the risk of malnutrition, and factors associated with malnutrition and cachexia, among cancer out-patients, with the aim of informing nutrition programmes for cancer management in Kenya and beyond. This was a facility-based cross-sectional study performed at Kenyatta National Hospital and Texas Cancer Centre in Nairobi, Kenya. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool (MUST). Diagnoses of malnutrition and cachexia were done using the European Society of Clinical Nutrition and Metabolism (ESPEN) and Fearon criteria, respectively. A total of 512 participants were assessed. Those at risk of malnutrition were 33·1 % (12·5 % at medium risk, 20·6 % at high risk). Prevalence of malnutrition was 13·4 %. The overall weight loss >5 % over 3 months was 18·2 % and low fat-free mass index was 43·1 %. Prevalence of cachexia was 14·1 % compared with 8·5 % obtained using the local criteria. Only 18·6 % participants had received any form of nutrition services. Age was a predictor of malnutrition and cachexia in addition to site of cancer for malnutrition and cigarette smoking for cachexia. The use of the MUST as a screening tool at the first point of care should be explored. The predictive value of current nutrition assessment tools, and the local diagnostic criteria for malnutrition and cachexia should be reassessed to inform the development of appropriate clinical guidelines and future capacity-building initiatives that will ensure the correct identification of patients at risk for timely care

Incidence of angioedema after initiation of angiotensin-converting enzyme inhibitors in adults with heart failure

Background: Angioedema, a potentially life-threatening adverse event associated with angiotensin-converting enzyme inhibitor (ACEI) use, occurs more often among Black patients than non-Black patients. Specific angioedema incidence rates (IRs) among heart failure (HF) patients initiating an ACEI are limited. Objectives: To provide estimates of angioedema incidence among HF patients initiating an ACEI, particularly among Black patients. Methods: We conducted a retrospective cohort study among adult (≥18 years) patients with HF who initiated ACEI use at 5 health care delivery systems within the Cardiovascular Research Network between July 2015 and May 2019. We required patients to have ≥12 months of continuous medical and prescription drug coverage and no ACEI dispensings in the 1 year before treatment initiation. Our primary outcome was serious angioedema, defined as a primary or secondary diagnosis of ICD-9 code 995.1 (‘Angioneurotic edema not elsewhere classified’) or ICD-10 codes in the T78.3 series (‘Angioneurotic edema’) during hospitalization. Our secondary out-come was ‘any angioedema’, which included serious angioedema and non-serious angioedema that was diagnosed in the outpatient setting. We followed patients from ACEI initiation until first angioedema diagnosis or a censoring event (treatment discontinuation, initiation of another renin-angiotensin-aldosterone system blocking agent, disenrollment, death, or end of 365-day follow-up or study). We calculated crude IRs and exact 95% confidence intervals (CI) for angioedema among HF patients initiating an ACEI. Results: We identified 14 ,241 ACEI users, of which 6,156 (43 .2%)were women and 2,105 (15%) were self-reported Black. Mean age was 70 ± 14 years. We observed 6 serious angioedema events overall (IR: 0.8/1,000 person-years (PYs), 95% CI: 0.3-1.7), with 2 events occurring among Black patients (IR: 1.8/1,000 PYs, 95%CI: 0.2-6.5) and 4 events among non-Black patients (IR: 0.6/1,000PYs, 95% CI: 0.2-1.5). We observed 43 angioedema events overall (IR: 5.4/1,000 PYs, 95% CI: 3.9-7.3), with 21 events occurring among Black patients (IR: 19/1,000 PYs, 95% CI: 11.8-29.1) and 22 events among non-Black patients (IR: 3.2/1,000 PYs, 95%CI: 2.0-4.9). Conclusions: Our estimate of angioedema incidence among HF patients who initiated an ACEI (5.4 events/1,000 PYs) is slightly higher than a previously published estimate (3.3/1,000 PYs) among a similarly-defined population identified through administrative claims data. Similar to prior reports, we found a higher incidence of angioedema, both serious and non-serious, among Black ACEI users than among non-black ACEI users

Interpersonal Psychotherapy’s problem areas as an organizing framework to understand depression and sexual and reproductive health needs of Kenyan pregnant and parenting adolescents: a qualitative study

Background: Peripartum adolescents experience signifcant interpersonal transitions in their lives. Depression and emotional distress are often exacerbated by adolescents’ responses to these interpersonal changes. Improved understanding of pregnancy-related social changes and maladaptive responses to these shifts may inform novel approaches to addressing the mental health needs of adolescents during the perinatal period. The paper aims to understand the sources of psychological distress in peripartum adolescents and map these to Interpersonal Psychotherapy’s (IPT) problem areas as a framework to understand depression. Method: We conducted interviews in two Nairobi primary care clinics with peripartum adolescents ages 16–18 years (n=23) with experiences of depression, keeping interpersonal psychotherapy framework of problem areas in mind. We explored the nature of their distress, triggers, antecedents of distress associated with an unplanned pregnancy, quality of their relationships with their partner, parents, and other family members, perceived needs, and sources of support. Results: We found that the interpersonal psychotherapy (IPT) framework of interpersonal problems covering grief and loss, role transitions, interpersonal disputes, and social isolation was instrumental in conceptualizing adolescent depression, anxiety, and stress in the perinatal period. Conclusion: Our interviews deepened understanding of peripartum adolescent mental health focusing on four IPT problem areas. The interpersonal framework yields meaningful information about adolescent depression and could help in identifying strategies for addressing their distress

Cervical HIV-1 RNA shedding after cryotherapy among HIV-positive women with cervical intraepithelial neoplasia stage 2 or 3

Objective: To determine the effect of cryotherapy on HIV-1 cervical shedding. Design: Prospective cohort study. Methods: Five hundred HIV-positive women enrolled at an HIV treatment clinic in Nairobi, Kenya were screened for cervical cancer. Women diagnosed with cervical intraepithelial neoplasia stage 2 or 3 (CIN 2/3) by histology were offered cryotherapy treatment. The first 50 women had cervical swabs taken at baseline and at 2 and 4 weeks following treatment. Swabs were analyzed for HIV-1 RNA and compared using General Estimating Equation (GEE) with binomial or Gaussian links. Results: Of the 50 women enrolled, 40 were receiving antiretroviral therapy (ART) and 10 were not receiving ART at the time of cryotherapy and during study follow-up. Among all women, the odds of detectable cervical HIV-1 RNA did not increase at 2 weeks [odds ratio (OR) 1.18; 95% confidence interval (CI) 0.65-2.13] or 4 weeks (OR 1.29; 95% CI 0.71-2.33) following cryotherapy. Among 10 women not receiving ART, the OR of detectable shedding at 2 weeks was higher, but not statistically significant (OR 4.02; 95% CI 0.53-30.79; P = 0.2), and at 4 weeks remained unchanged (OR 1.00; 95% CI 0.27-3.74). Conclusion: There was no increase in detectable cervical HIV-1 RNA among HIV-positive women after cryotherapy. The risk of HIV-1 transmission after cryotherapy may not be significant, particularly among women already on ART at the time of cervical treatment. However, further investigation is needed among women not receiving ART

Increased Cervical Human Immunodeficiency Virus (HIV) RNA Shedding Among HIV-Infected Women Randomized to Loop Electrosurgical Excision Procedure Compared to Cryotherapy for Cervical Intraepithelial Neoplasia 2/3

Background Treatment of human immunodeficiency virus (HIV)–infected women to prevent cervical cancer may stimulate HIV RNA cervical shedding and risk HIV transmission. Methods From 2011 to 2014, 400 HIV-infected women diagnosed with cervical intraepithelial neoplasia 2/3 in Kenya were randomized to loop electrosurgical excision procedure (LEEP) or cryotherapy. Cervical samples were collected at baseline and 3 weekly intervals. Samples were tested for HIV RNA using the Gen-Probe Aptima HIV assay with a minimum detection level of 60 copies/swab and analyzed using generalized estimating equations. Results Women who received LEEP had significantly higher cervical HIV RNA levels than those who received cryotherapy at weeks 2 (adjusted incident rate ratio [aIRR], 1.07; P = .038) and 3 (aIRR, 1.08; P = .046). Within LEEP, significantly higher cervical shedding was found at weeks 2 (2.03 log10 copies/swab; P < .001) and 3 (2.04 log10 copies/swab; P < .001) compared to baseline (1.80 log10 copies/swab). Cervical HIV RNA was significantly higher following LEEP for up to 3 weeks among women on antiretroviral treatment (ART) (0.18 log10 copies/swab increase; P = .003) and in ART-naive women (1.13 log10 copies/swab increase; P < .001) compared to baseline. Within cryotherapy, cervical shedding increased in ART-naive women (0.72 log10 copies/swab increase; P = 0.004) but did not increase in women on ART. Conclusions Women randomized to LEEP had a larger increase in post-procedural cervical HIV shedding than cryotherapy. Benefits of cervical cancer prevention outweigh the risk of HIV sexual transmission; our findings underscore the importance of risk-reduction counseling