Enhanced Information Systems Success Model for Patient Information Assurance

The current health information systems have many challenges such as lack of standard user interfaces, data security and privacy issues, inability to uniquely identify patients across multiple hospital information systems, probable misuse of patient data, high technological costs, resistance to technology deployments in hospital management, lack of data gathering, processing and analysis standardization. All these challenges, among others hamper either the acceptance of the health information systems, operational efficiency or expose patient information to cyber attacks. In this paper, an enhanced information systems success model for patient information assurance is developed using an amalgamation of Technology Acceptance Model (TAM) and Information Systems Success Model (ISS). This involved the usage of Linear Structured Relationship (LISREL) software to model a combination of ISS and Intention to Use (ITU), TAM and ITU, ISS and user satisfaction (US), and finally TAM and US. The sample size of 110 respondents was obtained based on the total population of 221 using the Conhrans formula. Thereafter, simple random sampling was employed to select members within each category of employees to take part in the study. The questionnaire as a research tool was checked for reliability via Cronbach’s Alpha. The results obtained showed that for ISS and ITU modeling, only perceived ease of use, system features, response time, flexibility, timeliness, accuracy, responsiveness and user training positively influenced the intention to use. However, for the TAM and ITU modeling, only TAM’s measures such as timely information, efficiency, increased transparency, and proper patient identification had a positive effect on intension to use. The ISS and US modeling revealed that perceived ease of use had the greatest impact on user satisfaction while response time had the least effect on user satisfaction. On its part, the TAM and US modeling showed that timely information, effectiveness, consistency, enhanced communication, and proper patients identification had a positive influence on user satisfaction

Implementation of Good Manufacturing Practices in Milk Processing Companies in Nairobi County and Microbial Contamination of Milk and Milk Products

Good manufacturing practice involves a series of measures to be adopted by the food industries in order to guarantee the safety and conformity of food products to specific regulations. Even though good manufacturing practices are vital systems in food safety and is associated with minimum sanitary and processing requirements for the food industry, only a few studies have reported GMP implementation by small milk processing companies. Therefore, the present study was undertaken in milk processing firms to evaluate the implementation of good manufacturing practices for control of microbial contamination in milk and milk products. Purposive, random and stratified sampling techniques was used to identify milk processing companies. Ten processing facilities were purposively sampled for the study. The representatives were interviewed, using a pretested questionnaire and data was collected and analyzed. All the processors had qualified personnel handling milk and milk products with a daily processing capacity of 20000-30000 litres. It was observed that the processors complied with all regulatory and licensing requirements and had in place critical process controls with majority indicating pasteurization at temperatures ranging from 80-90oC as the most common method. The processors had several food safety management systems such as ISO 22000, GMPs, and HACCP which were handled by trained and competent staff. It was observed that all the processors tested for total viable counts (TVC), and E. coli while only 50% and 33.3% of the processors tested for S. aureus and L. monocytogenes respectively. Furthermore, the processors (33.3%) reported E. coli as the main contaminant while L. monocytogenes were not detected. A majority (83.3%) had well-documented cleaning programs and had a system of controlling cross contamination which was enforced through different colour codes (66.7%), memos and notices (16.7%) and through colour coding of processing equipment (16.7%). In conclusion, the present study discovered that milk processors had implemented good manufacturing practices (GMP) and conformed to good processing practices

Prevalence of Common Microbiological Pathogen Contamination in Processed Milk and Milk Products in Nairobi County, Kenya

Milk has an outstanding nutritional quality but it is also an excellent medium for bacterial growth and an important source of bacterial infection when consumed without pasteurization. This study aimed at establishing the prevalence of Total Viable Count (TVC), Escherichia coli, Staphylococcus aureus and Listeria monocytogenes contamination on processed milk and milk products. The study was carried out in Karen, Kibera and Langata Sub- Counties of Nairobi County which were purposively chosen because they have glaring contrasts in living standards. Samples of fresh milk, yoghurt cheese and ice creams were collected from supermarkets and prepared for analysis of microorganisms. All isolates were characterized and identified based on their morphological and cultural characteristics. TVC were detected in 100% of the samples collected and there was significant statistical variation (P ≤ 0.05) in the contamination level among the products. Of the samples collected in Karen, ice cream had the highest contamination level (3.26 log10 CFU ml-1). Ice cream samples from Langata had the highest TVC contamination levels at 4.35 log10 CFU ml-1. The overall prevalence of E. coli in milk and milk products was 41.6% with a mean count of 0.34 log10 CFU ml-1 in Karen, 0.07 log 10 CFU ml -1 in Kibera and 0.11 log 10 CFU ml -1 in Langata while Staphylococcus aureus was detected in 33.3% of the milk and milk products. The occurrence and detection of E. coli and S. aureus foodborne pathogens in milk and milk products represent a health risk to consumers. Therefore, there is need to improve the microbial quality of milk and milk products by employing measures that will establish proper management practices to ensure improved hygiene, good manufacturing practices and food systems that will help to minimize microbial contamination

An assessment of the effect of a national fertiliser subsidy programme on farmer participation in private fertiliser markets in the North Rift region of Kenya

This study evaluated the effect of the national fertiliser subsidy on farmer participation in commercial fertiliser markets in the North Rift region of Kenya. The study used primary data collected from 710 households. A double-hurdle model and descriptive statistics were used to analyse the data. The results show that the national fertiliser subsidy reduces farmers’ probability of participating in commercial fertiliser markets by 30%. On average, an additional kilogram of subsidised fertiliser displaces 0.2 kg of commercial fertiliser from the market. This implies that the national fertiliser subsidy has a displacement effect on commercial sales. The government therefore should consider changes in programme design and implementation by distributing subsidised fertiliser to areas with weak commercial fertiliser distribution networks. In addition, proper targeting of resource-poor households is recommended if the programme objectives are to be achieved

The Levels of CD16/Fcγ Receptor IIIA on CD14+ CD16+ Monocytes Are Higher in Children with Severe Plasmodium falciparum Anemia than in Children with Cerebral or Uncomplicated Malaria▿

Fc gamma receptor IIIA (CD16/FcγRIIIA) on monocytes/macrophages may play an important role in the pathogenesis of severe malarial anemia (SMA) by promoting phagocytosis of IgG-coated uninfected red cells and by allowing the production of tumor necrosis factor alpha (TNF-α) upon cross-linking by immune complexes (ICs). However, not much is known about the differential expression of this receptor on monocytes of children with severe malaria and uncomplicated malaria. Therefore, we investigated the expression of CD16/FcγRIIIA on monocytes of children with SMA, cerebral malaria (CM), and their age-matched uncomplicated malaria controls by flow cytometry. Since CD14low (CD14+) monocytes are considered more mature and macrophage-like than CD14high (CD14++) monocytes, we also compared the level of expression of CD16/FcγRIIIA according to the CD14 level and studied the relationship between CD16/FcγRIIIA expression and intracellular TNF-α production upon stimulation by ICs. CD16/FcγRIIIA expression was the highest overall on CD14+ CD16+ monocytes of children with SMA at enrollment. At convalescence, SMA children were the only ones to show a significant decline in the same parameter. In contrast, there were no significant differences among groups in the expression of CD16/FcγRIIIA on CD14++ CD16+ monocytes. A greater percentage of CD14+ CD16+ monocytes produced TNF-α upon stimulation than any other monocyte subset, and the amount of intracellular TNF-α correlated positively with CD16/FcγRIIIA expression. Furthermore, there was an inverse correlation between hemoglobin levels and CD16/FcγRIIIA expression in children with SMA and their controls. These data suggest that monocytes of children with SMA respond differently to Plasmodium falciparum infection by overexpressing CD16/FcγRIIIA as they mature, which could enhance erythrophagocytosis and TNF-α production