Constraints of Implementing Free Secondary Education in Mandera West Sub-County, Mandera County, Kenya

This study sought to find out the constraints of implementing free secondary education (FSE) in secondary schools in Mandera West Sub-County, Mandera County, Kenya. The study is based on the theory of constraints as the researcher examines the factors constraining the achievement of FSE objectives. The study used the survey design. The main research instrument was the questionnaire. The validity and reliability of the questionnaire was determined before being used for data collection. The main findings of the study were that the management capacity of the principals, time of funds disbursement to schools and parental support affect the implementation of FSE.  In addition, while members of Board of Management had   a positive influence, the socioeconomic variables impacted negatively on the implementation process.  It was concluded   the   FPE policy was not fully realizing its noble objectives of facilitating access to, and quality education. It was recommended that the Government of Kenya through the Ministry of education should increase the capitation and expedite the process of cash disbursement   to the schools. In addition, the principals should not only be subjected to compulsory training in resource management but also the Directorate of Quality Assurance and Standards should increase the frequency of school supervision

Arviointi valtioneuvoston Yhdenvertainen Suomi -toimintaohjelmasta rasismin torjumiseksi ja väestösuhteiden edistämiseksi

Raportti arvioi Yhdenvertainen Suomi -toimintaohjelmaa Euroopan-komission kansallisten rasisminvastaisten toimintaohjelmien kriteeristöllä. Arviointi toteutettiin osana Euroopan neuvoston ja Euroopan Unionin toteuttamaa Building an Inclusive Integration Approach in Finland -hanketta. Oikeusministeriö osallistuu hankkeeseen. Arvioinnin tarkoituksena oli tunnistaa kehittämiskohteita tulevissa rasismin torjuntaan tähtäävissä kansallisissa hankkeissa huomioitaviksi. Arvioinnissa on hyödynnetty toimintaohjelman valmistelu- ja toimeenpanoasiakirjoja, arviointikyselyitä sekä avainhenkilöiden haastatteluja. Arvioinnin mukaan toimintaohjelma täyttää varsin hyvin EU:n asettamat kriteerit. Sen valmistelua ja toimeenpanoa koordinoi laajapohjainen työryhmä, toimenpiteiden suunnittelussa ja tilannearvion tekemisessä kuultiin laajasti eri väestöryhmiä, toimenpiteiden toteuttamiseen varattiin rahoitusta, valitut toimenpiteet kattoivat laajasti eri elämänalueita ja rasisminvastaisen työn muotoja, ja toimintaohjelmana seurattiin ja arvioitiin eri menetelmin. Toimintaohjelman toimeenpanoa alueellisella ja paikallistasolla vahvisti Hyvien väestösuhteiden -pilottihanke. Positiivisesta yleiskuvasta huolimatta arvioinnista nousee esiin kehittämiskohteita. Kehittämisehdotukset koskevat esimerkiksi ohjelman valmisteluun liittyvää tiedonkeruuta, toimenpiteitä ja niiden resurssointia sekä seurannan ja arvioinnin menetelmiä.Julkaisu on päivitetty 31.8.2023, s. 28

Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study

Objectives: To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya. Design: Pilot cross-sectional study. Setting: Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020. Participants: Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD). Outcome measures: Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels. Results: Across 200 PLHIV (median age 46 years, IQR 38–53; 61% women), the prevalence of hypercholesterolaemia (total cholesterol \u3e6.1 mmol/L) and hypertension were 19% (n=30/199) and 30% (n=60/200), respectively. Smoking and diabetes prevalence was 3% (n=5/200) and 4% (n=7/200). HscTnI was below the limit of quantification (\u3c2.5 ng/L) in 65% (n=109/169). High (\u3e3 mg/L), intermediate (1–3 mg/L) and low (\u3c1 mg/L) hsCRP levels were found in 38% (n=75/198), 33% (n=65/198) and 29% (n=58/198), respectively. Framingham laboratory-based risk scores classified 83% of PLHIV at low risk with 12% and 5% at intermediate and high risk, respectively. Older age (adjusted OR (aOR) per year increase 1.05, 95% CI 1.01 to 1.08) and systolic blood pressure (140–159 mm Hg (aOR 2.96; 95% CI 1.09 to 7.90) and \u3e160 mm Hg (aOR 4.68, 95% CI 1.55 to 14) compared with \u3c140 mm Hg) were associated with hscTnI levels. No associations were observed between hsCRP and CVD risk factors. Conclusion: The majority of PLHIV—using traditional risk estimation systems—have a low estimated CVD risk likely reflecting a younger aged population predominantly consisting of women. Hypertension and hypercholesterolaemia were common while smoking and diabetes rates remained low. While hscTnI values were associated with increasing age and raised blood pressure, no associations between hsCRP levels and traditional cardiovascular risk factors were observed

High-speed shaking of frozen blood clots for extraction of human and malaria parasite DNA

<p>Abstract</p> <p>Background</p> <p>Frozen blood clots remaining after serum collection is an often disregarded source of host and pathogen DNA due to troublesome handling and suboptimal outcome.</p> <p>Methods</p> <p>High-speed shaking of clot samples in a cell disruptor manufactured for homogenization of tissue and faecal specimens was evaluated for processing frozen blood clots for DNA extraction. The method was compared to two commercial clot protocols based on a chemical kit and centrifugation through a plastic sieve, followed by the same DNA extraction protocol. Blood clots with different levels of parasitaemia (1-1,000 p/μl) were prepared from parasite cultures to assess sensitivity of PCR detection. In addition, clots retrieved from serum samples collected within two epidemiological studies in Kenya (n = 630) were processed by high speed shaking and analysed by PCR for detection of malaria parasites and the human α-thalassaemia gene.</p> <p>Results</p> <p>High speed shaking succeeded in fully dispersing the clots and the method generated the highest DNA yield. The level of PCR detection of <it>P. falciparum </it>parasites and the human thalassaemia gene was the same as samples optimally collected with an anticoagulant. The commercial clot protocol and centrifugation through a sieve failed to fully dissolve the clots and resulted in lower sensitivity of PCR detection.</p> <p>Conclusions</p> <p>High speed shaking was a simple and efficacious method for homogenizing frozen blood clots before DNA purification and resulted in PCR templates of high quality both from humans and malaria parasites. This novel method enables genetic studies from stored blood clots.</p

Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study.

OBJECTIVES: To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya. DESIGN: Pilot cross-sectional study. SETTING: Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020. PARTICIPANTS: Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD). OUTCOME MEASURES: Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels. RESULTS: Across 200 PLHIV (median age 46 years, IQR 38-53; 61% women), the prevalence of hypercholesterolaemia (total cholesterol >6.1 mmol/L) and hypertension were 19% (n=30/199) and 30% (n=60/200), respectively. Smoking and diabetes prevalence was 3% (n=5/200) and 4% (n=7/200). HscTnI was below the limit of quantification (3 mg/L), intermediate (1-3 mg/L) and low (160 mm Hg (aOR 4.68, 95% CI 1.55 to 14) compared with <140 mm Hg) were associated with hscTnI levels. No associations were observed between hsCRP and CVD risk factors. CONCLUSION: The majority of PLHIV-using traditional risk estimation systems-have a low estimated CVD risk likely reflecting a younger aged population predominantly consisting of women. Hypertension and hypercholesterolaemia were common while smoking and diabetes rates remained low. While hscTnI values were associated with increasing age and raised blood pressure, no associations between hsCRP levels and traditional cardiovascular risk factors were observed

Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: fundamentals of care for uveitis (focus) initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic reviewof the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE,CINAHL,SCOPUS,BIOSIS, andWeb of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review.Atotal of 44 globally representativegroupmembersmet in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents

Nuclear modification of Y states in pPb collisions at √SNN_{NN} = 5.02 TeV

Production cross sections of Υ(1S), Υ(2S), and Υ(3S) states decaying into μ+μ− in proton-lead (pPb) collisions are reported using data collected by the CMS experiment at √sNN = 5.02 TeV. A comparison is made with corresponding cross sections obtained with pp data measured at the same collision energy and scaled by the Pb nucleus mass number. The nuclear modification factor for Υ(1S) is found to be RpPb(Υ(1S)) = 0.806±0.024 (stat)±0.059 (syst). Similar results for the excited states indicate a sequential suppression pattern, such that RpPb(Υ(1S)) > RpPb(Υ(2S)) > RpPb(Υ(3S)). The suppression of all states is much less pronounced in pPb than in PbPb collisions, and independent of transverse momentum pΥT and center-of-mass rapidity yΥCM of the individual Υ state in the studied range p ΥT < 30 GeV/c and |yΥCM| <1.93. Models that incorporate final-state effects of bottomonia in pPb collisions are in better agreement with the data than those which only assume initial-state modifications

Measurement of the top quark Yukawa coupling from tt ̄ kinematic distributions in the dilepton final state in proton-proton collisions at s=13 TeV

A measurement of the Higgs boson Yukawa coupling to the top quark is presented using proton-proton collision data at s=13 TeV, corresponding to an integrated luminosity of 137 fb-1, recorded with the CMS detector. The coupling strength with respect to the standard model value, Yt, is determined from kinematic distributions in tt ̄ final states containing ee, μμ, or eμ pairs. Variations of the Yukawa coupling strength lead to modified distributions for tt ̄ production. In particular, the distributions of the mass of the tt ̄ system and the rapidity difference of the top quark and antiquark are sensitive to the value of Yt. The measurement yields a best fit value of Yt=1.16-0.35+0.24, bounding Yt&lt;1.54 at a 95% confidence level

Search for resonant pair production of Higgs bosons in the bbZZ channel in proton-proton collisions at root s=13 TeV

A search for the production of a narrow-width resonance decaying into a pair of Higgs bosons decaying into the bbZZ channel is presented. The analysis is based on data collected with the CMS detector during 2016, in proton-proton collisions at the LHC, corresponding to an integrated luminosity of 35.9 fb(-1). The final states considered are the ones where one of the Z bosons decays into a pair of muons or electrons, and the other Z boson decays to either a pair of quarks or a pair of neutrinos. Upper limits at 95% confidence level are placed on the production of narrow-width spin-0 or spin-2 particles decaying to a pair of Higgs bosons, in models with and without an extended Higgs sector. For a resonance mass range between 260 and 1000 GeV, limits on the production cross section times branching fraction of a spin-0 and spin-2 resonance range from 0.1 to 5.0 pb and 0.1 to 3.6 pb, respectively. These results set limits in parameter space in bulk Randall-Sundrum radion, Kaluza-Klein excitation of the graviton, and next-to-minimal two-Higgs doublet models (N2HDMs). For specific choices of parameters the N2HDM can be excluded in a mass range between 360 and 620 GeV for a resonance decaying to two Higgs bosons. This is the first search for Higgs boson resonant pair production in the bbZZ channel.Peer reviewe