Registered Nurses Assignment-Workload for Teaching Hospitals in Kenya: Utilizing the Research Brief with Annotated Bibliography Approach.

Nursing is important in quality and safety of hospital care and in patients' perceptions of their care. There seems to be a close association between patient safety, undergraduate nursing students' learning with nurse staffing levels in Kenya. The Ministry of Health as well as the Ministry of education does not yet support changing nurse workforce standards for teaching medical institutions. This research brief targeted the nursing units of two teaching hospitals in Kenya. Purpose:  There are a lot on staffing issues in research that could be applied in Kenya and nurses might be interested in a staff-understandable review of what has been researched.  This brief sought to: establish the relationship between nurse workload and nurse-sensitive patient safety outcome indicators. This review focuses on the staffing issue on the effect of workload on patient outcomes or staff outcomes. The search spanned period of between 2003 and 2013. Conclusion: Nurse managers ought to implement staffing processes that align staff skills and competencies with prioritized patient needs supported on a shift-to-shift basis. A fair and balanced patient assignment increases nurse satisfaction in their daily work. Keywords: Nursing ratios, RN workload, Patient safety, Research brief, RN assignment, Kenyan nurse

Nurse Managers’ Perceptions towards the Roles They Play in a Resource- Limited Hospital Setting in Western Kenya

Aim: This report is an excerpt from a wider study on job description of nurse managers. To describe the experiences and perceptions of nurse managers towards the various factors that affect their roles as nurse managers in the hospital. Methods: This was a qualitative phenomenological design, drawing lived experiences and perceptions of nurse managers. Study was done in February 2011 in a 600 bed public hospital in western Kenya, targeting all the 16 consenting nurse managers working in the institution. Data was collected from a focus group discussion and subjected to content analysis into key points.                                                    Results: Problem Recognition: Nurse as employee, awareness of the demanding job, reflecting. Some respondents disagreed that the job was satisfying to them. Some apprehension was obvious. Commitment: Accepting the role, altruism, duplicating and reciprocating. All respondents agreed that they did work that someone else was supposed to do. Exhaustion: High expectations, lowly appreciated, stagnating but not redundant, wearing out, frustration. Lack of recognition, supplies and equipment came out strongly as limiting factors in the performance of their complex roles. The nurse managers felt generally overworked and were not paid in commensurate. Discussions: There is great need to clearly outline the nurse managers’ role in the hospital as their job description. Their roles were either complex, multidimensional or both. There is need to equip the nurse managers with leadership skills. Keywords: Job description(s), Nurse manager(s), Nurse manager(s) role, Perceptions

Digital Rights Management: Improving Online Digital Images Copy Rights Management through an Enhanced Least Significant Bit Steganographic Algorithm

Digital media no doubt presents numerous advantages compared to the traditional analog media. Of the most importance is the fact that digital content (images, graphics, audio and video) can be easily copied, transmitted, retrieved and distributed over private and open access networks. The global availability of the internet- certainly the most impactful information exchange tool today- plus the numerous file sharing tools freely available have made the distribution of copyrighted digital media files simple and straightforward. Duplication of exact copies of original images, for example can be easily done and circulated without authentication. As much as this is an advantage in trying to enhance sharing of information, it certainly creates problems of ownership and authenticity and digital rights protection. There already exists copyright laws that provide for protection of all online content but the task of continuously guarding the web and correctly identifying those that infringe against these laws is increasingly becoming enormous. There is therefore need to continuously invest in development of new technologies and algorithms that will make it more and more difficult to illegally copy or use someone else content. To improve security of copyrighted online digital images, this paper proposes the use of an enhanced LSB steganographic algorithm that employs a selective and randomized approach in picking specific number of target image bits to swap with the owners signature authentication bits using a pseudo random number generator (PRNG). The carefully selected password seed is used to determine the set of selected numbers used for targeting specific image bits for the signature hiding. An experimental design is setup to determine the effectiveness of the method by comparing and analyzing the stego images’ statistical characteristics and the ability of steganalysis methods to detect the hidden signature. The experimental results indicate improved levels of imperceptibility and hence improved security against illegal copying. Keywords: Digital Media, Steganography, Copyright, Steganalysis, Stego image, imperceptibilit

An enhanced Least Significant Bit Steganographic Method for Information Hiding

The least significant bit (LSB) insertion method is a simple steganographic algorithm that takes the least significant bit in some bytes of the cover medium and swaps them with a sequence of bytes containing the secret data in order to conceal the information in the cover medium. However its imperceptibility and hiding capacity are relatively low. This is as revealed by the statistical characteristics of its resultant stego images compared to the original cover images. To increase the level of imperceptibility and the hiding capacity in the LSB insertion method, this research proposes an enhanced LSB method that employs a selective and randomized approach in picking specific number of target image bits to swap with the secret data bits during the embedding process. To facilitate the selective picking of the target image bits, the standard minimal linear congruential number generator (LCG) is used. The message digest (digital signature) of a user supplied password is used to seed the LCG and to extract the message from the cover medium. In measuring the effectiveness of the proposed method, the study adopted an experimental research design where the statistical characteristics of the proposed method stego images were compared with those of the traditional LSB method in a comparative experiment designed to establish the levels of image distortion (noise) introduced in the original cover image when either of the methods is used under the same payload and image. The experiment results indicated improved levels of imperceptibility and hiding capacity in the proposed method. Key Words: Steganography, Steganalysis, Stego image, payload, imperceptibilit

Assessment of relationship between management policies and transfer of skills: A case of public secondary school heads in Nyeri County, Kenya

Despite heavy investments in training and development, low-quality education standards and challenges in management practices have been a sticky problem in the Kenyan education sector. Organization Theory guided the main aim of this study in establishing the relationship between management policies and transfer of skills for public secondary school headteachers in schools management. The study adopted a descriptive research design. Questionnaires were used to collect quantitative and qualitative data. Data were analyzed through descriptive and inferential statistics. The study population comprised 226 headteachers.  A mixture of stratified random sampling and census study was adopted in sampling 69 respondents. The results established that management policies explained a 23.4% variation in the transfer of skills for school heads. ?1 = 0.536 and p-value = 0.000 (p<0.05) indicated that management policies had positive and significant effects on transfer of skills. The study established that unsupportive policies like the Students Council, two centers of power, strict policies, and lack of inclusivity in policy formulation adversely affected school heads in implementing learned skills. The study recommends fair representation of all categories of education stakeholders in policies review and formulation to alleviate challenges associated with management policies to enhance the transfer of skills. The Government should address the issue of two centers of power in the public basic education sector. The paper sought to call the attention of the professional development trainers to exercise follow-ups to assess post-training behavioral outcomes in the context of organizational climate

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

The Extent of Influence of Factors on Cigarette Smoking Among Teenagers in Baguio City: A Cross-Sectional Study

Introduction: Although there are several studies conducted on teenage smoking, the causes to become smokers in adolescence remain unclear. Several factors were identified but the extent of its influence still obscure. Therefore, the purpose of this study is to investigate the significant difference in the extent of influence of these identified factors when teens are group according to gender and age group of 13 to 16 years old versus 17-19 years of age. Objective: A quantitative study was conducted to determine the extent of influence of factors on cigarette smoking among teenagers in City high school and St. Louis high school. Methods: A total of 100 respondents were investigated using a structured questionnaire. The study sought to explore the factors that influenced cigarette smoking among teenagers and to what extent they can influence. A questionnaire, in the form of a checklist was the primary tool used in the data gathering relevant to the study. The questionnaire explored the extent of influence of factors affecting smoking among teenagers in Baguio City. The design used for this study was the quantitative research design. The subjects were 100 students (Male and female) studying in Baguio City, Philippines. The age bracket for subjects was 13-19 years for males and females. The sample for this quantitative study was constructed by purposive sampling students in Baguio City who were asked to voluntarily answer the questionnaire. Descriptive statistics which included frequency, % distribution, average and weighted mean was used. Average mean was used to determine the extent of influence of factors on smoking among teenagers of Baguio City. Standard deviation and t-test were used to determine the extent of influence when the teenagers were grouped according to age and gender. Results: The study found out that there was a significant difference in the extent of influence of factors when the teenagers were grouped according to gender, the females smoked more than the males. However, when grouped according to age (13-16 & 17-19), there was no significant difference in their extent of influence. The teenagers were very much aware of the effects of cigarette smoking on the biological, physical and social implications. Despite this awareness, the drive to perform the behavior is strong. Conclusion: Finding solutions to modify the belief on the identified potent factor will alter the attitude in the performance of smoking behavior. Successful cessation often requires multiple strategies since continuous smoking is associated with several factors.  The researchers would recommend the formulation programs and campaigns on anti-smoking. The researchers are also optimistically looking for the possibility of this study to help assess the need to strictly or creatively implement enacted laws stated in Republic Act 2011.  The researchers believe an epidemic of tobacco use is imminent if drastic action is not taken, and recommend that anti-smoking campaigns with an emphasis on the religious aspect should start as early as in elementary school. Intervention programs to encourage behavior modification of adolescents are also recommended. Keywords: Gender, Age group, Adolescents and Tobacco use

Rhinovirus dynamics across different social structures

Rhinoviruses (RV), common human respiratory viruses, exhibit significant antigenic diversity, yet their dynamics across distinct social structures remain poorly understood. Our study delves into RV dynamics within Kenya by analysing VP4/2 sequences across four different social structures: households, a public primary school, outpatient clinics in the Kilifi Health and Demographics Surveillance System (HDSS), and countrywide hospital admissions and outpatients. The study revealed the greatest diversity of RV infections at the countrywide level (114 types), followed by the Kilifi HDSS (78 types), the school (47 types), and households (40 types), cumulatively representing >90% of all known RV types. Notably, RV diversity correlated directly with the size of the population under observation, and several RV type variants occasionally fuelled RV infection waves. Our findings highlight the critical role of social structures in shaping RV dynamics, information that can be leveraged to enhance public health strategies. Future research should incorporate whole-genome analysis to understand fine-scale evolution across various social structures