Edible insects regulatory national standards in Kenya: An incentive or a deterrent?

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Allergens associated with edible insects unlikely to cause adverse health effects to consumers

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Future food systems

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Caregiver factors influencing nutritional status of preschool children in Mwingi West, Kitui County Kenya

Children are at an increased risk of malnutrition, with many undernourished children being highly susceptible to preventable premature death and morbidity. Insufficient dietary intake, infections, food insecurity, and inadequate care are the main causes of child malnutrition. These factors are sequentially influenced by caregivers’ characteristics. Despite this, the effect of a caregiver’s characteristics on a child's nutrition status has not been exhaustively studied in rural areas of Kenya. It is important to continuously examine the trends in the prevalence of malnutrition for effective interventions. Regular updates on the prevalence of malnutrition are crucial for appropriate interventions. In this study, the nutritional status of children was evaluated alongside their association with caregivers’ characteristics. The study was based in Migwani ward, Mwingi West Sub-County in Kitui County. The study was conducted between October and December 2020 and involved 106 caregivers with their 106 children aged 36–42 months. The characteristics of the caregivers were determined by the use of a pretested study questionnaire. To evaluate the nutritional status of children, the height and weight measures, age, and sex of the child were taken and transferred into the WHO Anthro software, and z-scores were derived. The Statistical Package for the Social Sciences (SPSS) was used to carry out additional data analysis. Children's nutritional status and caregivers’ characteristics were bivariate tested to determine the association. In the present study, the prevalence of stunting was 33.0%, wasting was 15.1%, and underweight was 20.8%. In this study, the caregivers that had lower income had more children that were underweight (χ2 = 9.2 p = 0.02), stunted (χ2 = 10.4 p = 0.015) and wasted (χ2 = 16.9, p<0.001) compared to those with higher incomes. More so, the caregivers that were younger had more children that were wasted (χ2 = 20.04, p<0.001), stunted (χ2 = 9.65, p = 0.032) and underweight (χ2 = 8.26, p = 0.041). Households that were headed by women had more children that were stunted (p = 0.022), wasted (p = 0.041) and underweight (p = 0.003). Similarly, respondents with lower education levels had more children that were stunted (χ2 = 14.02, p = 0.003), wasted (χ2 = 4.85, p = 0.037) and underweight (χ2 = 4.76, p = 0.045). In this study, the caregiver’s occupation was significantly associated with children's stunting (χ2 = 12.23, p = 0.007) and underweight levels (χ2 = 6.12, p = 0.034). The caregiver’s occupation had no influence on the children's wasting levels. The present study found that the marital status of a caregiver did not influence a child's nutritional status. These study results affirm that nutritional problems of stunting, wasting, and underweight among preschool children in Kitui County require public health actions. That caregivers’ characteristics play a role in the nutritional status of preschool children in Kitui County. Based on these study findings, priority should be given to children's nutrition programs that incorporate the dynamics of caregivers' characteristics. By doing this, such programs will be more effective

Communication in Surgery for Patient Safety

One of the cardinal pieces of the Hippocratic Oath is “do no harm”; yet, even in the very best of contexts, errors, at times fatal, do occur as was reported by the Institute of Medicine. Surgical procedures are known to cause the majority of serious adverse events. The Joint Commission report indicates that 60% of serious adverse events are caused by the lack of physician-patient communication. Some of the factors that make surgical processes prone to medical errors include the number of steps and people involved and the fact that the interventions intended for the healing are often in themselves invasive and can also complicate. The involvement of more than one discipline and individual requires communication that is clear, understandable, culturally sensitive, and contextually relevant. One of the center pieces of quality care is its patient-centeredness. This refers to providing service that is not only respectful but also responsive to individual patients involving them in the decisions, ensuring their values and preferences are taken into consideration. It also demands that the care giver provides the patients with relevant and understandable information to enable them in the decision-making and make informed choices

Base Deficit as an Indicator of Significant Blunt Abdominal Trauma

Background: Blunt abdominal trauma (BAT) is an important cause of morbidity and mortality among trauma patients. Base deficit (BD) has been proposed as an early available tool alongside focused assessment with sonography for trauma (FAST) in the screening of patients suspected to have BAT and also to help guide the selective use of CT scan. Objective: To determine the use of BD as an indicator of significant BAT. Methods: This was an observational study carried out at the Kenyatta National Hospital from February to May 2015. Patient with suspected BAT admitted into Accident & Emergency were enrolled. Data collected included clinical assessment, BD, FAST findings, CT-scan, and laparotomy were recorded. Data was analyzed using SPSS 17.0. Comparison of mean values of BD between different groups of patients (discharged from A&E, managed conservatively or operated) was performed using ANOVA. Results: Patients who had significant abdominal injury had sensitivity and specificity of 82.98% and 65.91 % respectively at BD of -4.15.The PPV and NPV were 56.52% and 87.88 % respectively. At this cut-off point, AUC was 0.863 (p=0.037). Conclusion: Due to high NPV, BD could rule out significant abdominal injuries but can also predict need for exploratory laparotomy when less than -6.85.Key words: Base deficit, Blunt abdominal trauma, Predictor

Effects of substituting skimmed milk powder with modified starch in yoghurt production

Rheological properties of yoghurt are known to be influenced by several factors during processing including the milk composition, additives, the type of culture (ropy or non ropy), heat treatment and mechanical processes it undergoes after fermentation. The objective of this study was to determine the most appropriate levels of modified starch that could be added in the yoghurt without noticeably altering the keeping quality and consumer acceptability of the yoghurt. A stirred type of yoghurt was developed using modified corn starch as a stabiliser to variably replace skimmed milk powder (partially or in totally) while maintaining the samequality and consumer acceptability on the yoghurt product. Different formulations were made and their quality characteristics studied using the 3% skimmed milk powder sample as the control. The results showed that the modified corn starch addition did not affect the gelation process, texture, fermentation time and the desired pH end point. Two sample formulations were identified as the most comparable to the control in terms of viscosity, taste, mouth]feel and general acceptability. These were the 0.5% modified corn starch alone and 0.5% modified corn starch with 1% skimmed milk powder. These reduced the cost of production per litre by 22% and 13% respectively. The samples were stable for three consecutive weeks in all the desirable yoghurt quality parameters tested includingconsumer acceptability. In conclusion, the application of modified starch at the level of 0.4% was found to have the most significant reduction in cost of production while having the least effect on the keeping quality and consumer acceptability of the yoghurt. Key words: Yoghurt, starch, quality, acceptability, cos

THE MODERATING EFFECT OF INDUSTRIAL CONTEXT ON THE RELATIONSHIP BETWEEN BRAND EQUITY AND CONSUMER CHOICE IN BRANDED BOTTLED WATER NAIROBI, KENYA

Previous research has shown that brand equity influence consumer choice, however this literature has been limited to broad base view of choice in which specific industry and location characteristic have not been explicitly been examined. This study examines the moderating effect of the Industry context on the relationship between brand equity and consumer choice in the branded bottled water, among supermarkets customers in Nairobi Central Business District, Kenya. The sample size was 400 respondents, comprising of 373 customers and 13 employees of supermarkets. Data was collected using a semi structured questionnaire and an interview guide. Industry context factors influence on the relationship of brand equity influence consumer choice was predicted through the use of a logit model. The research findings indicated that market place efficacy and valence have a moderating role on the influence of brand equity on consumer choice

Correlation between receptor status and presence of axillary lymph node metastasis in breast cancer in Kenya

Background: Breast cancer survival is linked to early detection, and timely and appropriate treatment. Survival depends on the stage and biological behaviour of the tumour. It is unclear how different molecular subtypes impact on axillary node involvement.Objective: This study sought to determine the correlation between hormonal receptor status with axillary nodal status in breast carcinoma.Methodology: A cross sectional study was carried out at Kenyatta National Hospital surgical wards and histopathology laboratory. Patients with a histological diagnosis of breast cancer, scheduled to undergo a modified radical mastectomy, were recruited. Data collected included age at diagnosis, parity, menopausal status, clinical examination findings, stage of the disease clinically and pathologically, and hormonal receptor status. Data were analyzed using SPSS version 21.0.Results: We enrolled 79 women with invasive breast carcinoma. Mean age was 48(SD=14.5) years. Most (48.1%) presented with stage III tumour. Most tumours (58.2%) were luminal A. Correlation between molecular type and nodal involvement was not significant. Luminal B was significantly present in those above 50 years (p=0.011).Conclusion: The most common molecular type of breast cancer was luminal A, but luminal B disease which was prevalent in women more than 50 years old was the only molecular subtype that had a positive correlation with axillary nodal status.Keywords: Breast cancer, Axillary lymph nodes, Molecular subtypes, Hormonal receptor status, HER-2 statu

Nurturing Medical Professionalism in the Surgical Community

Introduction: The teaching of professionalism worldwide is changing for effectiveness. Our aim was to explore the reflection of the surgical teaching community in a Kenyan context on how professionalism can be effectively inculcated through the socio-cultural concept of activity theory.Methods: A sequential mixed-methods study was conducted among clinicians and students within the surgical community of the University of Nairobi from March to December 2014. . Individual interviews and focusgroup- discussions were conducted using grounded theory methods. A survey of the resultant views was performed through a pre-determined questionnaire which utilized a 4-point Likert scale for response ranging from “strongly agree” to “strongly disagree”. Factor analysis was used to analyze the responses to the survey. Internal reliability was determined by Cronbach’s α.Results: Four themes emerged from the interviews; change of values, regulation, enabling environment and formal curriculum. In the survey, the participants strongly agreed with strengthening mentorship (77.5%) and a teaching facility (74.7%) with a rewarding or recognition (69.5%). The reliability test of the items showed a Cronbach’s α of 0.827.Conclusion: This study demonstrates that the participants would like to see a different and transforming path in inculcating professionalism through changing values and enabling environment among others.Key words: Nurturing, Medical professionalism, Surgical communit