Time to presentation and diagnosis of esophageal cancer in patients seen at the Kenyatta National Hospital

Background: Esophageal Cancer (EC) is one of the leading causes of cancer death in Kenya. Majority of the patients with esophageal cancer at Kenyatta National Hospital (KNH) present at an advanced stage limiting their treatment options. Objective: To determine diagnostic time lines and factors associated with delayed health care service delivery among patients with established histological diagnosis of EC at KNH. Design and Setting: A retrospective diagnostic cohort study was carried out at the Cardiothoracic, endoscopy and radiotherapy units at KNH.Results: Eighty-five participants with established histological diagnosis of EC consented and were enrolled into the study. Majority (89.4%) were diagnosed in stage III and IV of the disease. The median time to  histological diagnosis of EC was 90 days. The time to first presentation was more than 30 days among 78.8% of subjects. The median time from first consultation to referral to a diagnostic-capable facility was 30 days, with 76.5% of the participants taking more than 30 days to reach KNH. Those who could not afford transport and consultation were more likely to report delay to first presentation (OR 3.6 95% CI 1.2-11.3, p=0.022). Referral delay was associated with residence, with those living in the rural areas less likely to delay (OR 0.2, 95% CI 0.0-0.8, p=0.019). Conclusion: Overall this study found that there was significant delay in the diagnostic process of EC patients. Over 75% of the patients delayed in presenting for the first consultation, being referred to higher level facilities, getting an endoscopy done and receiving histological diagnosis.  Consequently, about 90% of the patients were diagnosed at an advanced stage of the disease

Cooperative Learning Method and Development of Pre-School Children’s Competences Acquisition in Mathematical Concepts in Kirinyaga County, Kenya

The research from which this paper is derived explored the effect of cooperative learning method on development of pre-schoolers’ competences in mathematical concepts. 20 pre-school teachers on their regular teaching in their pre-schools were observed teaching their 639 Pre-primary Two learners. The purpose of this study was to establish the difference between the mean score index of pre-school learners taught by a teacher who facilitates learning using the Cooperative Learning Method (CLM) and those taught by a teacher who does not. Data was collected through the use of observation schedule and teacher questionnaire. Each of the twenty pre-school teachers was observed by the researcher while facilitating mathematical concepts’ competences during number work lessons. A documentary analysis guide was used to access the pre-school teachers’ schemes of work and lesson plans to establish their level of preparation in line with CLM. Descriptive and inferential statistics were used to analyse the collected data and guided by the themes arising from the objective of the study the key findings were arrived at. The various levels of the teachers’ facilitation of CLM were tied to the pre-school leaners’ performance in the mathematical concepts competences achievement test. The findings emerging showed that those learners who were taught using CLM achieved higher mean score indices than those who were not. The implication here is that the use of CLM improves pre-school learners’ levels of achievement, indicating that it is a more effective method of teaching. Teachers’ facilitation of CLM seemed to have a significant positive influence on the learners’ Mathematical Concepts Competences Acquisition. These features were; availability of groupings and teacher preparedness, level of provision of learning resources, level of coordination, level of interaction, time taken in CLM activities. This implies that CLM imparts the required mathematical concepts competences better than traditional instructional methods. The study recommends that the Ministry of Education should develop programmes and policies that provide regular in-service training, in which CLM training forms a key part of the agenda and to refresh the mathematical concepts competences instructional skills of pre-school teachers. Keywords: Competences; Cooperative Learning Method; Mathematical Concepts DOI: 10.7176/JEP/12-32-05 Publication date: November 30th 202

Knowledge of Staff Nurses on Management of Deconditioning in Older Adults: A Cross- Sectional Study

Introduction: A significant issue facing today’s acute care nurse is the ability to respond to the rising number of  older adults admitted to the hospital, while simultaneously preventing complications of hospitalization, specifically deconditioning. Objective: The aim of this paper was to examine knowledge of staff nurses on management of deconditioning in older adults, in Baguio- Benguet area in the Philippines. Methods: The study made use of cross- sectional design. Sampling technique used was total enumeration, where 130 out of 135 nurses met the inclusion criteria. A 65 item questionnaire was used in gathering data. Data was subjected to statistical treatment where T- test and F- test were used accordingly. Results: Number of years of nursing experience tends to deteriorate the staff nurses’ knowledge on deconditioning management. Hospital affiliation is a significant factor that affects the knowledge of staff nurses on deconditioning management. Continuing education improves the knowledge of staff nurses on deconditioning management. Conclusion: Study suggests that it is important to establish gerontology continuing education programs with a core component on deconditioning treatment and prevention to enhance nurses’ knowledge on management of deconditioning so as to improve the care provided to older adults. Keywords: Continuing Education, Deconditioning Management, Gerontological Nursing, Gerontological Program, Staff Nurses and Older adults

Health related quality of life of patients on maintenance haemodialysis at Kenyatta National Hospital

Background: Health related quality of life is increasingly being recognised as a primary outcome measure in treatment of end-stage renal disease. The health related quality of life of patients on maintenance haemodialysis is reduced. Several interventions directed at modifiable risk factors have been shown to improve quality of life of patients on haemodialysis.Objective: To assess the health-related quality of life of patients on maintenance haemodialysis at the Kenyatta National Hospital.Design: Cross sectional descriptive study.Setting: Kenyatta National Hospital, Renal Unit.Subjects: The study was conducted on 96 patients with end-stage renal disease on maintenance haemodialysis. Socio-demographic and clinical factors were recorded for all patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life-36 questionnaire. Two summary scores and three subscale scores were calculated.Results: The mean physical composite summary and mental composite summary scores were 39.09±9.49 and 41.87±10.56 respectively. The burden of kidney disease subscale, symptom and problems subscale and effect of kidney disease on daily life subscale scores were 16.15±21.83, 73.46±18.061 and 67.63±23.45 respectively.Conclusion: Health-related quality of life of patients on maintenance haemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. The burden of kidney disease subscale is the most affected subscale score

Transmission and evolutionary dynamics of human coronavirus OC43 strains in coastal Kenya investigated by partial spike sequence analysis, 2015-2016

Human coronavirus OC43 (HCoV-OC43) is a major contributor to seasonal outbreaks of acute respiratory illness (ARI). The origins of locally circulating HCoV-OC43 strains and characteristics of their genetic diversity are unknown for most settings despite significance to effective HCoV control strategies. Between December 2015 and June 2016, we undertook ARI surveillance in coastal Kenya in nine outpatients and one inpatient health facility (HF). Ninety-two patient samples tested HCoV-OC43 positive and forty (43.5%) were successfully sequenced in spike (S) gene region (2,864 long, ∼70%). Phylogenetic analysis confirmed co-circulation of two distinct HCoV-OC43 clades that closely clustered with genotype G (n = 34, 85%) and genotype H (n = 6, 15%) reference strains. Local viruses within the same clade displayed low genetic diversity yielding identical sequences in multiple HF. Furthermore, the newly sequenced Kenyan viruses showed close phylogenetic relationship to other contemporaneous sampled strains (2015–16) including those originating from distant places (e.g. USA and China). Using a genetic similarity threshold of 99.1 per cent at nucleotide level, the HCoV-OC43 strains sampled globally between 1967 and 2019 fell into nine sequence clusters. Notably, some of these clusters appeared to have become extinct, or occurred only sporadically in a few geographical areas while others persisted globally for multiple years. In conclusion, we found that HCoV-OC43 strains spread rapidly both locally and across the globe with limited genetic evolution in the spike gene. Full-genome sequences that are spatio-temporally representative are required to advance understanding of the transmission pathways of this important human respiratory pathogen

Corrigendum: Immune Responses to Gametocyte Antigens in a Malaria Endemic Population-The African falciparum Context: A Systematic Review and Meta-Analysis.

[This corrects the article DOI: 10.3389/fimmu.2019.02480.]

Coping with perceived abusive supervision: the role of paranoia

Two studies (a cross-sectional survey of 90 U.K. workers and an experiment with 100 U.K. workers) examined the cognitive and behavioral effects of abusive supervision. Both studies confirmed the hypothesis that workers who experience abusive supervision show paranoia and that makes them more prone to a type of cognitive error called the "sinister attribution error." This is where workers misattribute innocent workplace events such as tripping over something or hearing colleagues laughing to malevolent motives such as wanting to harm or mock them. Study 1 also showed that abusive supervision is associated with lower well-being. Perceived organizational support buffers these effects, and this is associated with workers making fewer sinister attribution errors, thereby protecting well-being. Study 2 explored the role of contextual cues by exposing workers to images of abusive supervision. This increased their paranoia and contributed to workers making sinister attribution errors when they were asked to interpret workplace events. Moreover, depending on the types of contextual cues, workers were more likely to express the intention of workplace deviance after thinking about past experiences of abusive supervision. We recommend that corporate ethical responsibilities include training managers and workers about the negative cognitive and mental health effects of abusive supervision

Free-running L-band VCSEL for 1.25 Gbps hybrid radio-fiber cloud optical interconnects

International audienceWe demonstrate a free-running directly-modulated 1580 nm VCSEL suitable for hybrid wireless/optical interconnects supporting cloud data centers. Error-free transmission at 1.25 Gbps was achieved after 6.5 GHz wireless link and 1 km bend-insensitive fiber

Cohort 2013 Four-Year Graduation Rates -- State Results

From September 2016-April 2017, Am Timan, Chad, experienced a large HEV outbreak in an urban setting with a limited impact in terms of morbidity and mortality. To better understand HEV epidemiology in this context, we estimated the seroprevalence of anti-HEV antibodies (IgM and IgG) and assessed the risk factors for recent HEV infections (positive anti-HEV IgM) during this outbreak