What Are the Most Effective Risk Factor Management Strategies for The Prevention and Control of Hypertension?

Hypertension (HTN) affects millions of people globally. With the rising burden of HTN in primary care and its associated morbidity and mortality, it is necessary to explore effective risk factor management to control and prevent it in people most at risk. This research addressed both modifiable risk factors such as obesity, smoking, alcohol, and diet as well as non- modifiable risk factors such as age, race/ethnicity, and family history. The aim of this paper was to examine the most effective risk factor management strategies to control and prevent hypertension. The studies reviewed indicate that there are various risk factor management strategies that are deemed effective in reducing blood pressure (BP) and improving HTN management. These approaches include increasing physical exercise, diet therapy such as the DASH diet, weight loss, and smoking cessation and limited alcohol intake. While each of these strategies is effective, patient adherence to guidelines is essential to promote desirable outcomes. Lastly, regular health check-ups among at-risk populations are effective in managing the risk factors through early detection. Future studies can examine how the implementation of these strategies can minimize or eliminate the need for medication

ATR vowel harmony in Ateso

Vowels in Ateso, an Eastern Nilotic language, are subject to Advanced Tongue Root (ATR) harmony. Accordingly, the vowels are divided into two harmony sets which differ in terms of tongue root position. The two sets of tongue root position are the Advanced Tongue Root [+ATR] set and the Retracted Tongue Root [-ATR] set. Comparably, Bari and Lutuko, related Eastern Nilotic languages, have a ten-vowel system consisting of five closed and five open vowels, with clearly discernible laws of ATR vowel harmony (Tucker & Bryan 1966ː 444). A similar system applies to Ateso which has the following nine phonemic vowels: /i ɪ e ɛ u ʊ o ɔ a/ and the phonetic vowel [ä]. The presence of the [ä] variant is conditioned by neighbouring [+ATR] vowels or glides, and hence does not have phonemic status; instead, it is treated as an allophone of /a/. In this paper, I follow the general discussion of vowel harmony in African languages (e.g. by Casali (2003, 2008)), albeit in Ateso. Firstly, I introduce the Ateso vowel articulatory parameters and the phonetic realisation of /a/. Secondly, I show that in Ateso /a/ behaves like an underlying [-ATR] vowel and that, generally, though the ATR affects tongue height and thereby accounts for the relative tongue height, ATR is not a category of tongue height but rather of the position of the tongue root. Lastly, I demonstrate that Ateso ATR vowel harmony has two dimensions. One is the condition that vowels ideally belong to a [-ATR] or [+ATR] set within a word and the second is that there is a dynamic dimension where ATR qualities may change as a result of affixation.Keywords: ATR, assimilation, vowel harmony, Ateso, Niloti

Ateso Grammar: A descriptive account of an Eastern Nilotic Language

This study discusses the structure of Ateso, an Eastern Nilotic language. Based on interview and recorded data from fieldwork conducted in both Uganda and Kenya, where Ateso is spoken, the study provides the first comprehensive description of the phonology, morphology and syntax of the language. The main findings of this study are as follows: The key feature of Ateso's phonological structure is that vowel alternation strategies are constrained by three harmony rules: root-control, feature-control, and, finally, mid-vowel assimilation. While Ateso shares this structure with the other Eastern Nilotic languages, it has its unique features as well. For example, while the other members of the Eastern Nilotic family have lost the vowel */ä/, Ateso has retained it phonetically. Ateso's noun morphology has noun-inflectional affixes associated with gender- and number marking. The language employs noun prefixes for gender and uses suffixes to express number and to derive words from others. With regard to its verbal morphology, Ateso verb forms are inflected for a variety of functions. Inflectional categories such as person, number, tense, aspect and mood are marked on the verb either segmentally or supra-segmentally. Tense is expressed suprasegmentally by tone on the nucleus of verb roots, while different morphemes mark person, number, aspect and mood. The discussion of Ateso verb morphology covers verbal derivations and extensions; namely, causatives, ventives, itives, datives, iterative, passives and instrumentals. Regarding its syntactic structure, as a VS/VO language, Ateso allows for a complete clause made up of an inflected verb only, or an inflected verb followed by one or two NPs/or an NP and a pronoun. The language can also have sentence structures involving strategies such as coordination, subordination and clause chaining

Teachers' Competency in Integration of Information Communication Technology in Early Learning in Bungoma County, Kenya

Integrating Information Communication Technology into curricula with the intent of positively influencing teaching and learning has been in a state of evolution over the past 20 years. The purpose of the study was to analyse teachers' competency in integration of ICT, into teaching and learning in early learning in Bungoma County, Kenya. The study was guided by Technological Pedagogical Content Knowledge Framework (TPACK) by Punya Mishra and Matthew J. Koehler’s. The study population included Early Childhood Development (ECD) teachers, education officers in charge of ECD in the county and public primary school headteachers. Simple random sampling was used to obtain 177 ECD teachers which is 10% of 1,768 ECD teachers from 884 public primary schools in Bungoma County. The study adopted a descriptive research design. A questionnaire and interview schedule were the main primary data tools for data collection. The findings showed that Integration of ICT in early education is highly related to teachers’ ICT competencies, planning for instruction, teaching methods, teaching and learning materials and how assessment is done. The central issue in the integration of ICT into early learning is pegged on the instructors having the requisite ICT training. ICT integration in early learning is often attributed to the teachers thus, those teachers who competency and higher confidence are expected to integrate ICT in their classes. Teacher's underutilization of ICT in the classroom and their resistance to embedding ICT across the curriculum can be detrimental to attempts to introduce new teaching and learning technologies in education. Therefore, it is crucial to monitor teacher's ICT utilization and examine factors that contribute to their skeptical practices of teaching with technology. Keywords: Integration, Competency, Information Communication Technology DOI: 10.7176/JEP/11-30-11 Publication date:October 31st 202

Cyto-histological correlation of thyroid cytology and associated adverse surgical outcomes at aga khan university hospital, Nairobi.

Background: Solitary thyroid nodules are commonly encountered endocrine disorders in surgical practice. Fine Needle Aspiration Cytology (FNAC) is a minimally invasive, accurate and cost-effective diagnostic tool that provides basis for surgical decisions-making in thyroid lesions management. Thus, it’s imperative that such a test should have high diagnostic accuracy in order to avoid under or over-treatment arising from false negative or positive results respectively. Studies from the African region, compared to the developed world have reported higher thyroid cyto-histologic discrepancy. Objective: To determine the diagnostic accuracy and adverse surgical outcome of discrepant thyroid cytology. Methods: Retrospective cross-sectional analytical study conducted at the Aga Khan University Hospital Nairobi (AKUHN) between January 2013 and December 2017. Results: Overall, 176 patients were sampled, the female: male ratio was 5:1 and majority of patients in 30 to 40 years age bracket. Sensitivity and specificity of thyroid cytology obtained in the study was 83.2% and 95.2% respectively with a diagnostic accuracy of 84.7%. The majority of the discordant cases were false positive follicular neoplasm, followed by false negative papillary carcinoma, thyroiditis and Hurthle cell carcinoma. No difference in adverse surgical outcomes was noted between concordant and discrepant cytology cases. Conclusion: The study showed diagnostic accuracy and false positive rate comparable to those reported from the developed world. No difference in adverse surgical outcomes was noted between concordant and discrepant cytology cases

Inequality and Exclusion in the New Era of Capital

The IDS 50th Anniversary Conference held in July 2016 revisited the age-old debate concerning the changing nature of the relationship between states, markets and society in relation to the problem of inequality. The deliberations at the conference made it clear that inequalities go beyond disparities between households in their income or asset ownership, to intersecting inequalities along the lines of age, gender, location and access to public services such as healthcare and education. This article addresses three areas of inequality that were given pre-eminence at the conference, namely, gender inequality, youth unemployment and social protection. The conclusion recaptures the main argument and suggests a rebalancing of power between states, markets and society because the key problem is that market forces have become too dominant

Gender and poverty: the agriculture sector programme support in Uganda.

At the time of writings, Uganda was the only country in Africa with an established Ministry of Gender. The country has an operational National Gender Policy to facilitate the process of mainstreaming gender concerns in the national development process. The policy outlines the strategies to be followed and the institutional framework. It is concluded that poverty eradication and gender equity can only be achieved through recognition of the fact that the two are complementary

Implementation of Inquiry Method in Christian Education: Forming Highly Competitive Students Based on Critical Thinking

Critical thinking is needed by every student in solving problems, including finding problem-solving strategies. This study examines the implementation of inquiry methods in Christian religious education in forming critical thinking. Students are positioned as active learning subjects to create their learning experience independently and create critical thinking. Critical thinking is an effort to frame considerations from various points of view, understanding, interpretation, assumptions, and decision-making from relevant information. This study used a quantitative approach with instruments in the form of tests. The respondents were students of IAKN Tarutung, with a sample of 100 students. The data was analyzed with the paired sample t-test and processed with the help of SPSS 25.0 software. The analysis results showed a significance value of 0.000, or < 0.05, meaning a significant difference exists between the pre-test and post-test results. Thus, educators can implement inquiry methods in Christian education learning to form students who have high competitiveness

Assessment of palliative care needs in a Kenyan intensive care unit based on a trigger-based model.

Background: Palliative care triggers have been used in the Intensive Care Unit (ICU) setting, usually in high-income countries, to identify patients who may benefit from palliative care consults. The utility and benefits of palliative care triggers in the ICU have not been previously studied in sub-Saharan Africa. Objectives: The primary objective of this study was to estimate the prevalence of ICU admissions who meet the criteria for one or more palliative care triggers. The secondary objectives were to determine an association between palliative care consults and length of ICU stay, mortality, and time to formal change of goals of care orders. Methods: A prospective observational cohort study was conducted within the ICU at The Aga Khan University Hospital, Nairobi between December 2019 and August 2020. All adults age ≥ 18 years admitted to the ICU in that period at Aga Khan University Hospital were recruited. Data including initiation of a palliative care consult, length of ICU stay, mortality, and time to change of goals of care orders were collected. Results: During the study period, 72 of 159 (45.9%) patients met at least one criterion for palliative care referral. Of the patients who met the palliative care triggers, only 29.2% received a palliative care consult. Patients who received palliative care consults had higher rates of change of goals of care orders signed (52.3%) versus those who did not (P=0.009). There was no statistically significant difference between the consult and non-consult groups in regard to length of ICU stay, mortality, and time to change of goals of care orders. Conclusion: A trigger-based model, geared to the needs of the specific ICU, maybe one way of improving integration of palliative care into the ICU

Tourism, poverty and poverty reduction in Msambweni district, Kenya

A thesis submitted to the University of Bedfordshire, Faculty of Education, Sport & Tourism, in fulfilment for the degree of Doctor of Philosophy in June 2010.This thesis examines the potential of tourism’s contribution to poverty reduction as perceived by local people in Msambweni district in Kenya. Whilst many studies in tourism have focused mainly on the macro-economic impacts of tourism in developing countries, there is little empirical work on understanding its effects upon poverty reduction. Furthermore, researches on how the poor or local people define poverty are also at their embryonic stage. The research utilises multiple qualitative methods and participatory approaches including focus group discussions and meetings. Key objectives of the research are: to critically analyse how poverty is conceptualised by local people; to identify the barriers to participation in the tourism industry and development process; and make recommendations on how to overcome them. The thesis reviews the theoretical framework of poverty within the discourse of development studies. Contrary to the conventional economic definition of poverty, poor people in Msambweni view it as a multidimensional concept. The understanding of the concept of poverty as perceived by the ‘poor’ themselves is critical for addressing barriers to their participation in the tourism development process and in designing meaningful tourism-led anti-poverty strategies. The thesis also reviews other relevant tourism concepts and development paradigms. The central argument of this thesis is that the current model of tourism development in Msambweni is not suitable for addressing poverty. The study identifies barriers to local people’s participation in tourism development in Msambweni. Key barriers include weak capacity in the context of physical, human, financial and institutional capital; corruption; poverty; lack of information; weak linkages with the local economy attributable to the lack of access to tourist markets; and the inability to develop and promote the ‘right’ types of tourism. Ecotourism, volunteer tourism and ‘philanthropy tourism’, although practiced on a small scale, are the most preferred types of tourism by local people. Philanthropy tourism, an emergent term of this study, involves tourists visiting local attractions, villages, and schools and making donations to support various projects. The study concludes that for tourism to have meaningful contribution to poverty reduction, barriers that limit local people’s participation must be addressed. There is also the need for a paradigm shift to embrace policies that facilitate the transfer of economic benefits from the macro-level towards the poor at the micro-level, combined with the development and promotion of the ‘right’ types of tourism as identified by local people