Marketing Small Towns: A Preliminary Investigation

This study is a preliminary investigation into the marketing processes used by small towns/cities to attract business revenue and tourism dollars.  Because small town governments do not have the resources of large cities to spend on marketing, it is unclear if they utilize the marketing process in a manner similar to large cities or businesses.  Personal interviews were used to determine the process by which small towns attract businesses to their area as well as develop tourism. Small towns must develop business opportunities to encourage economic development in their cities as well as create tourism opportunities to increase the economic impact in the area. The findings indicate that, while some similarities exist due to common goals, different processes are used by different size cities.  While the process for economic development through the attraction of businesses is similar in most cities, the process to create tourism differs for small towns.  The smaller towns do not utilize the full marketing process which could create a better brand identity that could make them more successful.  Instead, they take a more entrepreneurial approach by sharing resources and developing partnerships with other small towns to utilize their resources more effectively

Resistance To Brand Switching: The Elderly Consumer

In this study, the authors examine one more aspect of the elderly consumer’s brand loyalty: resistance to brand switching. This study claims that elderly consumers are not only more likely to repurchase but also actively resist switching brands once they have established a favorite brand. This study looks at the unique cognitive psychology of elderly consumers likely to cause this behavior. A better understanding of such behavior can guide efforts of firms either trying to retain their existing consumers or attempting to convert customers of rival brands to their own brands

Experiences in Care Given During Child Birth at a Referral Hospital in Kenya

The fifth Millennium development Goal (MDG) calls for a reduction in the maternal mortality ratio (MMR) by 75% between 1990 and 2015, with a key indicator being the proportion of births attended to by skilled health personnel, (United Nations, 2007). In Kenya the MMR is 400 and has made insufficient progress towards improving maternal health, (UNICEF, WHO, World Bank, 2013). According to KDHS (2014), the proportion of skilled birth attendance is 46.5%, while in Kenya it is 62% against an MDG target of 90%. According to Zaers S., et al., (2008), prior experience in delivery care by skilled attendants affects their subsequent use of these services. In Africa little research has been carried out on the experiences of mothers in facility-based delivery care. This study was therefore set to describe the experiences of women during labour and delivery at a referral hospital in Kenya This was a cross sectional descriptive study that focused on experiences of delivery care by postnatal mothers at a referral hospital in Kenya. Systematic random sampling from a sampling frame of 327 was employed to recruit post-natal mothers who delivered in labour ward and four postnatal wards. A total of 109 participants were recruited into the study. Views and experiences of recently delivered women were elicited using a five-point Likert scale questionnaire focusing on four dimensions of participants’ intrapartum experience. Data was analyzed using ANOVA. Research results were presented in frequency distribution tables, graphs and charts. P-values were used to determine the statistical significance of the results obtained. Most participants (87.7%) agreed that they were treated with respect, accorded privacy and asked to consent, prior to the initiation of the procedures. A single aspect of communication, namely health provider explanation of health status with understandable terms was poorly rated (mean 1.8 to 2.2) as was the level of genuine interest in patient well-being (mean = 1.7 to 2.0) which was significant in the study. Most participant (n = 102(93.6%) said they would recommend delivery services at KNH to friends or family, although 6% of them said they would not recommend. Majority of the participants had a positive experience of quality in delivery care. This was evidenced by the fact that majority of then stated that they would come to deliver in the same institution again or recommend a relative or friend. Aspects of care such as health providers communicating to clients in understandable terms and showing genuine interest in patients wellbeing was rated poorly. Institutional factors such as inadequate space and shortage of staff were also noted to be significantly contributing to negative experience of delivery care in the study

An Analysis of Bachelor of Science Nursing Students’ Attitudes on Nursing Profession at the end of their Basic Training: Case of Public Universities, Kenyan.

Background information: Attitudes are learned predispositions to respond in a consistently favorable or unfavorable manner with respect to a given object. Thus they cannot be observed directly.  Their dimension on a particular aspect determines the end result of that activity.  Nurses are responsible for caring for patients and are directly involved in decisions regarding a patient’s care. Nurse’s attitudes are also influential on other health care providers. Today’s nursing students and future nurses make up the backbone of the health care forces in every country and a positive attitude is essential in provision of health care services. Methodology and objective This study investigated the attitude of BScN as they finish their training. Study subjects involved 46 final year Bachelor of Science in Nursing (BScN) students, randomly selected from purposefully selected Kenyan public universities which included, Kenyatta University, Moi University and University of Nairobi. Data was collected using self administered questionnaire and attitude scales. Statistical package of social studies version 17 was used for data analysis. Results and discussions: Most respondents had a positive attitude toward the nursing profession because their main reason for joining nurse training was to help and care for the sick (70%). This was supported by the fact that 45.7 % of them viewed nursing as a noble profession. However, 52.2% of the respondents had not made a definite choice to remain in the nursing profession. This was mainly associated to lack of recognition for the work performed by nurses and poor financial motivation. Conclusions and recommendations: Majority of the nursing students have a positive attitude toward the nursing profession but certain aspects in this noble profession tend to diminish the proportion of those who would like to take it up as a lifelong career. Therefore, effort to motivate nurses financially, improve the working schedules and recognize the work done by the nurses should be encouraged in order to increase the number of the students who would prefer to remain in the nursing profession in future. Key words: Bachelor of Science Nursing Students,               Attitudes on Nursing Profession, Public Universities in Kenya

Factors influencing anti-retroviral therapy uptake among HIV positive and exposed children aged below 14 years in Meru North District, Kenya

Background: Anti-retroviral Therapy (ART) is a major intervention for children infected and exposed to HIV infection and it influences their morbidity and mortality.Objective: To investigate factors influencing ARV uptake in HIV positive and exposed children aged below 14 years in Meru North District.Design: A descriptive cross-sectional study.Setting: The Nyambene District Hospital, Miathene Sub - District Hospital and Maua Methodist Hospital paediatrics comprehensive care clinics (PCCC) in Meru North District.Subjects: Parents or guardians with children less than 14 years of age exposed or infected with HIV who visited the selected health facilities.Results: About 222 caregivers were interviewed with mean age of 38.4 + 10.3 years ranging from 21 to 70 years. About 120 (54.0%) were aged between 30 to 39 years, Most of the caregivers 106 (47.7%) had acquired education up to primary level. Marital status of the caregivers revealed that 104 (46.8%) were married while 16 (6.3%) were cohabiting. Relationship between children ARV uptake and marital status of caregiver was significant (OR= 2.1, 95% C.I= 1.0 – 4.6, P=0.050). Significant association between source of medical advice and children ARV uptake (P<0.05) was evident.Conclusion: Achieving widespread public health benefits of ARV roll-out requires community - level interventions in marriages and information distribution to ensure local acceptability of antiretroviral drugs. Better management and improvement of health status of HIV exposed and infected children will be enhanced by improved ARV uptake.Recommendation: The study recommends integration and decentralization of ARV services through social supports, encouraging disclosure of HIV statuses for positive living and enhanced ARV uptake and enhanced awareness creation on ARVs and HIV information to caregivers at all levels

A survey of abandonment of student nurses at Greys Hospital

In all tertiary education, a certain percentage of drop-outs can be expected. In this instance, the authors were interested in the abandonment or withdrawal of students from the Diploma in General Nursing at Greys Hospital, Pietermaritzburg. Over the past few years the drop out rate at Greys Hospital was sufficiently high to cause concern - particularly at a time when there is a widely reported shortage of White nursing personnel. Also, in the South African context, very little active research has been reported in this regard

A nutrigenetic approach to investigate the relationship between metabolic traits and vitamin D status in an Asian Indian population

Studies in Asian Indians have examined the association of metabolic traits with vitamin D status. However, findings have been quite inconsistent. Hence, we aimed to explore the relationship between metabolic traits and 25-hydroxyvitamin D [25(OH)D] concentrations. We investigate whether this relationship was modified by lifestyle factors using a nutrigenetic approach in 545 Asian Indians randomly selected from the Chennai Urban Rural Epidemiology Study (219 normal glucose tolerant individuals, 151 with pre-diabetes and 175 individuals with type 2 diabetes). A metabolic genetic risk score (GRS) was developed using five common metabolic disease-related genetic variants. There was a significant interaction between metabolic GRS and carbohydrate intake (energy%) on 25(OH)D (Pinteraction = 0.047). Individuals consuming a low carbohydrate diet (≤62%) and those having lesser number of metabolic risk alleles (GRS ≤ 1) had significantly higher levels of 25(OH)D (p = 0.033). Conversely, individuals consuming a high carbohydrate diet despite having lesser number of risk alleles did not show a significant increase in 25(OH)D (p = 0.662). In summary, our findings show that individuals carrying a smaller number of metabolic risk alleles are likely to have higher 25(OH)D levels if they consume a low carbohydrate diet. These data support the current dietary carbohydrate recommendations of 50%–60% energy suggesting that reduced metabolic genetic risk increases 25(OH)D

Interaction between metabolic genetic risk score and dietary fatty acid intake on central obesity in a Ghanaian population

Obesity is a multifactorial condition arising from the interaction between genetic and lifestyle factors. We aimed to assess the impact of lifestyle and genetic factors on obesity-related traits in 302 healthy Ghanaian adults. Dietary intake and physical activity were assessed using a 3 day repeated 24 h dietary recall and global physical activity questionnaire, respectively. Twelve single nucleotide polymorphisms (SNPs) were used to construct 4-SNP, 8-SNP and 12-SNP genetic risk scores (GRSs). The 4-SNP GRS showed significant interactions with dietary fat intakes on waist circumference (WC) (Total fat, Pinteraction = 0.01; saturated fatty acids (SFA), Pinteraction = 0.02; polyunsaturated fatty acids (PUFA), Pinteraction = 0.01 and monounsaturated fatty acids (MUFA), Pinteraction = 0.01). Among individuals with higher intakes of total fat (>47 g/d), SFA (>14 g/d), PUFA (>16 g/d) and MUFA (>16 g/d), individuals with ≥3 risk alleles had a significantly higher WC compared to those with <3 risk alleles. This is the first study of its kind in this population, suggesting that a higher consumption of dietary fatty acid may have the potential to increase the genetic susceptibility of becoming centrally obese. These results support the general dietary recommendations to decrease the intakes of total fat and SFA, to reduce the risk of obesity, particularly in individuals with a higher genetic predisposition to central obesity

The APOB insertion/deletion polymorphism (rs17240441) influences postprandial lipaemia in healthy adults

BACKGROUND: Apolipoprotein (apo)B is the structural apoprotein of intestinally- and liver- derived lipoproteins and plays an important role in the transport of triacylglycerol (TAG) and cholesterol. Previous studies have examined the association between the APOB insertion/deletion (ins/del) polymorphism (rs17240441) and postprandial lipaemia in response to a single meal; however the findings have been inconsistent with studies often underpowered to detect genotype-lipaemia associations, focused mainly on men, or with limited postprandial characterisation of participants. In the present study, using a novel sequential test meal protocol which more closely mimics habitual eating patterns, we investigated the impact of APOB ins/del polymorphism on postprandial TAG, non-esterified fatty acids, glucose and insulin levels in healthy adults. FINDINGS: Healthy participants (n = 147) consumed a standard test breakfast (0 min; 49 g fat) and lunch (330 min; 29 g fat), with blood samples collected before (fasting) and on 11 subsequent occasions until 480 min after the test breakfast. The ins/ins homozygotes had higher fasting total cholesterol, LDL-cholesterol, TAG, insulin and HOMA-IR and lower HDL-cholesterol than del/del homozygotes (P < 0.017). A higher area under the time response curve (AUC) was evident for the postprandial TAG (P < 0.001) and insulin (P = 0.032) responses in the ins/ins homozygotes relative to the del/del homozygotes, where the genotype explained 35% and 7% of the variation in the TAG and insulin AUCs, respectively. CONCLUSIONS: In summary, our findings indicate that the APOB ins/del polymorphism is likely to be an important genetic determinant of the large inter-individual variability in the postprandial TAG and insulin responses to dietary fat intake