Relationship between perceived parental involvement and treatment adherence among adolescent substance use disorder patients in rehabilitation centers in Kiambu County, Kenya

Adolescent substance use is a concern to families, schools, psychologists, and society at large as it hampers the ability to achieve personal and national goals. Despite efforts to provide quality treatment to adolescent substance users, there is scarce information on how parenting influences treatment dynamics. The purpose of the study was to determine the relationship between perceived parental involvement and treatment adherence among adolescent substance use disorder patients in selected rehabilitation centers in Kiambu County. Based on attachment theory, the study utilized a correlational survey design to establish the significance of the relationship between the study variables. The population targeted was 72 adolescents undergoing treatment in various rehabilitation centers in Kiambu County. Multistage sampling was used to obtain the sample. A questionnaire developed by the researcher was used to collect quantitative data. Descriptive statistics were used to analyze demographic factors, levels of adherence to treatment and perceived parental involvement. Correlations between perceived parental involvement and adherence to treatment were established using Spearman’s Rank correlation coefficient. The study found that adolescents rated maternal involvement (p= 0.024) higher than paternal involvement (p= -0.080). There was a markedly weak relationship between perceived parental involvement and adherence to treatment among adolescents (p= -0.034). The study recommends more research into the current forms of parental involvement that facilities have adopted while treating in-patient adolescent SUD clients

The Mediating Effect of Stakeholder Commitment in the Relationship between Stakeholder Participation and Project Sustainability

This study examines the mediation effect of Stakeholder Commitment in the Relationship between Stakeholder Participation and Project Sustainability. A self administered structured questionnaire was used to collect data from 86 NGOs in Uganda. Data was analyzed using Baron and Kenny’s Approach to mediation (1986). Results revealed that Stakeholder Participation is a significant predictor of the Project Sustainability. This can be seen from the Beta value which was significant, showing a significant model (Beta = .619, p<.01). Results also revealed that the Stakeholder Participation is a significant predictor of Stakeholder Commitment and therefore the two are practically related variables (Beta = .464, p<.01). Results also show that Stakeholder Commitment is a predictor of project sustainability and therefore the two are statically significant with a Beta Value of (Beta = .569, p<.01). Overall, multiple regression model is significant with a Beta value of .457**. However, there was a significant decrease in the beta value from .619** to .457** when we introduced Stakeholder Commitment. This study provides empirical evidence from health projects to the effect that Stakeholder Commitment plays partial mediation role on the relationship between Stakeholder participation and project sustainability. Keywords: Stakeholder participation, Stakeholder commitment, Project sustainability

Risk factors of virologic failure and slow response to art among HIV-infected children and adolescents in Nairobi

Background: Antiretroviral therapy (ART) in resource-limited settings is effective when backed up with adequate clinical, immunological, and virologic monitoring. Undetected, virologic failure results in increased HIV-1 drug resistance mutations (DRMs), morbidity and mortality, or the need for costly second-line and third-line ART.Objective: To evaluate the prevalence, patterns, and risk factors of virologic failure and slow response to ART, among children and adolescents in resource-limited settings in Nairobi, Kenya.Design: A Retrospective study.Setting: The 8 Lea Toto Programme (LTP) Clinics in Dagoretti, Dandora, Kangemi, Kariobangi, Kawangware, Kibera, Mukuru, and Zimmerman areas of Nairobi. Subjects: One hundred and forty-six HIV-infected children and adolescents aged 1 month to 19 years of the LTP in Nairobi Kenya. Medical and demographic data including, HIV-1 viral loads, information on adherence to ART, HIV-1 DRMs and other key determinants of virologic failure, collected over a period of 2 years, was used for this study.Results: A threshold of 1,000 HIV RNA copies/ml was used to determine treatment outcome. The virologic failure rates in this cohort were 43.8% after 6 months, 32.2% after 12 months, 28.8% after 18 months, and 24.0% after 24 months of first-line ART. Twelve (8.2%) of 146 children showed a slow response to ART: they initially failed ART at 12 months, but had treatment success after 18 to 24 months. The rates of virologic rebound were 4 (2.7%) after 18 months and 3 (2.1%) after 24 months of ART. Multivariate Cox proportional hazards regression revealed that children with suboptimal adherence to ART were 37 times more likely to experience virologic failure (P = 0.000003).Conclusions: This study showed that ART implementation in resource-limited settings is effective when regular virologic monitoring, adherence counselling, and HIV-DR testing are available. Secondly, adherence to ART is a strong predictor of treatment outcome for children and adolescents in resourcelimited settings. Therefore, methods of optimizing adherence levels should be explored and implemented

NMDA receptors and BAX are essential for Aβ impairment of LTP

Accumulation of amyloid-β (Aβ) is a hallmark of Alzheimer’s disease, a neurodegenerative disorder in which synapse loss and dysfunction are early features. Acute exposure of hippocampal slices to Aβ leads to changes in synaptic plasticity, specifically reduced long-term potentiation (LTP) and enhanced long-term depression (LTD), with no change in basal synaptic transmission. We also report here that D-AP5, a non-selective NMDA receptor antagonist, completely prevented Aβ-mediated inhibition of LTP in area CA1 of the hippocampus. Ro25-6981, an antagonist selective for GluN2B (NR2B) NMDA receptors, only partially prevented this Aβ action, suggesting that GluN2A and GluN2B receptors may both contribute to Aβ suppression of LTP. The effect of Aβ on LTP was also examined in hippocampal slices from BAX −/− mice and wild-type littermates. Aβ failed to block LTP in hippocampal slices from BAX −/− mice, indicating that BAX is essential for Aβ inhibition of LTP

“Classroom practices of primary school teachers of english: examining the potential application of post method pedagogy in Kenya”

This study aimed to examine the classroom practices of primary school teachers of English that reflect application of post method pedagogy in teaching of English language. The teacher in the context of Post Method Pedagogy is a researcher and a facilitator in the teaching process, leading to the development of teachers’ own theory of practice and learner autonomy. Specifically the study was guided by the following three objectives; examine the classroom practices of teachers of English in teaching of English which overlap with the construct of post method pedagogy, examine the role of the primary school teacher of English in the context of Post Method Pedagogy and examine the opportunities and constraints that primary school teachers experience in teaching of English language in the context of Post Method Pedagogy. The study adopted Kumaravadivelu’s 1994 conceptual framework of 3 parameters of Particularity, Practicality and Possibility and the 10 macro strategies. A qualitative approach, descriptive case study design was used for the study with a sample of six English teachers sampled through the non-probability purposive technique. Data was collected through interviews and document analysis. Thematic and content analysis were utilized for the study. The transcripts were examined to develop codes and categorize the emerging codes within the pedagogical parameters proposed in the Post Method Pedagogy. Findings from the analysis reveal that teachers over rely on methods to teach alongside syllabus and text books leading to lack of creativity and innovativeness on the part of the teacher hence minimizing effective learning opportunities for learners. Opportunities available for the English teachers to teach English is the autonomy to adapt methods and the notional-functional syllabus. Constraints to the teaching of English include prescriptive teaching, government policy and lack of autonomy for teachers and learners. Based on the findings the study recommends a review of education policy in the design and implementation of the primary school English syllabus. Further, there is need for teachers to be more innovative by designing collaborative and interactive activities. Moreover, teachers of English should embark on advancing their teaching skills to enhance their professional growth

Facilitating public participation in water resources management: reflections from Tanzania

Access to adequate quantity and quality of fresh water is critical to the well-being of Tanzania's human population, currently approaching 50 million. In the early 2000s, Tanzania revamped its legal and institutional frameworks related to freshwater resources management with the passage of the National Water Policy (NAWAPO) and the Water Resources Management (WRM) Act. Three major components of these frameworks are: the use of natural hydrological boundaries as units for management; the designation of an order for decision making on water allocation that prioritizes basic human and ecosystem water needs; and the encouragement of community participation in freshwater resources management. Institutionally, WRM now follows a nested approach, with the Tanzanian Ministry of Water operating at a national scale, nine basin water offices responsible for water allocation at a river basin scale, and formally recognized water users' associations as mechanisms for public participation at the catchment scale. To date, 93 water users' associations have been formed. Although some are active and appear effective, others are almost dormant, and not achieving their full potential as partners in WRM. In this paper, we provide context for the sweeping changes in WRM in Tanzania and review the lessons from more than a decade of implementation of the NAWAPO. We focus in particular on the role of the water users' associations, and use case studies of three basins - the Pangani, Wami/Ruvu, and Lake Victoria - to examine their strengths and challenges. Tanzania's experience offers lessons for other countries considering revision to legal and institutional frameworks around fresh water