Oxygen saturation ranges for healthy newborns within 24 hours at 1800 m.

There are minimal data to define normal oxygen saturation (SpO2) levels for infants within the first 24 hours of life and even fewer data generalisable to the 7% of the global population that resides at an altitude of >1500 m. The aim of this study was to establish the reference range for SpO2 in healthy term and preterm neonates within 24 hours in Nairobi, Kenya, located at 1800 m. A random sample of clinically well infants had SpO2 measured once in the first 24 hours. A total of 555 infants were enrolled. The 5th-95th percentile range for preductal and postductal SpO2 was 89%-97% for the term and normal birthweight groups, and 90%-98% for the preterm and low birthweight (LBW) groups. This may suggest that 89% and 97% are reasonable SpO2 bounds for well term, preterm and LBW infants within 24 hours at an altitude of 1800 m

Enteric Permeability, Systemic Inflammation, and Post-Discharge Growth among a Cohort of Hospitalized Children in Kenya and Pakistan

Funding Information: Sources of Funding: The CHAIN Network is supported by the Bill & Melinda Gates Foundation [OPP1131320]. For the purpose of Open Access, the authors have applied a CC-BY public copyright license to any author accepted manuscript version arising from this submission. The lactulose-rhamnose testing was funded by an Early Career Award from the Thrasher Research Foundation. The funders had no role in conduct of the study, interpretation, writing the manuscript or decision to submit. No authors were paid to write this article by any company, organization or agency. Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.Objectives: To determine whether gut permeability is associated with post-discharge growth and systemic inflammation among hospitalized children in low- and middle-income countries. Methods: Children aged 2-23 months being discharged from Civil Hospital Karachi (Pakistan) and Migori County Referral Hospital (Kenya) underwent lactulose-rhamnose ratio (LRR) permeability testing and were compared to age-matched children from their home communities. Linear mixed effect models estimated the associations between LRR among discharged children with change in length-for-age (LAZ) and weight-for-age z score (WAZ) at 45, 90, and 180 days after discharge. Linear regression tested if relationships between LRR, systemic inflammation [C-reative protein (CRP), Cluster of Differentiation 14 (CD14), Tumour Necrosis Factor Alpha (TNFα), Interleukin-6 (IL-6)], and enterocyte damage [Intestinal Fatty-Acid Binding protein (I-FABP)] differed between the hospitalized and community groups. Results: One hundred thirty-seven hospitalized and 84 community participants were included. The hospitalized group had higher log-LRR [0.43, 95% confidence interval (CI): 0.15-0.71, P = 0.003] than the community children. Adjustment for weight-for-length z score at discharge attenuated this association (0.31, 95% CI: 0.00-0.62, P = 0.049). LRR was not associated with changes in WAZ or LAZ in the post-discharge period. Associations between LRR and CRP (interaction P = 0.036), TNFα (P = 0.017), CD14 (P = 0.078), and IL-6 (P = 0.243) differed between community and hospitalized groups. LRR was associated with TNFα (P = 0.004) and approached significance with CD14 (P = 0.078) and IL-6 (P = 0.062) in community children, but there was no evidence of these associations among hospitalized children. Conclusions: Although increased enteric permeability is more prevalent among children being discharged from hospital compared to children in the community, it does not appear to be an important determinant of systemic inflammation or post-discharge growth among hospitalized children.Peer reviewe

Effects of GnRH vaccination in wild and captive African Elephant bulls (Loxodonta africana) on reproductive organs and semen quality

OBJECTIVES: Although the African elephant (Loxodonta africana) is classified as endangered by the International Union for Conservation of Nature (IUCN), in some isolated habitats in southern Africa, contraception is of major interest due to local overpopulation. GnRH vaccination has been promoted as a non-invasive contraceptive measure for population management of overabundant wildlife. We tested the efficacy of this treatment for fertility control in elephant bulls. METHODS: In total, 17 male African elephants that were treated with a GnRH vaccine were examined in two groups. In the prospective study group 1 (n = 11 bulls, ages: 8±36 years), semen quality, the testes, seminal vesicles, ampullae and prostate, which were all measured by means of transrectal ultrasound, and faecal androgen metabolite concentrations were monitored over a three-year period. Each bull in the prospective study received 5 ml of Improvac® (1000 μg GnRH conjugate) intramuscularly after the first examination, followed by a booster six weeks later and thereafter every 5±7 months. In a retrospective study group (group 2, n = 6, ages: 19±33 years), one examination was performed on bulls which had been treated with GnRH vaccine for 5±11 years. RESULTS: In all bulls of group 1, testicular and accessory sex gland sizes decreased significantly after the third vaccination. In six males examined prior to vaccination and again after more than five vaccinations, the testis size was reduced by 57.5%. Mean testicular height and length decreased from 13.3 ± 2.6 cm x 15.2 ± 2.8 cm at the beginning to 7.6 ± 2.1 cm x 10.2 ± 1.8 cm at the end of the study. Post pubertal bulls (>9 years, n = 6) examined prior to vaccination produced ejaculates with viable spermatozoa (volume: 8±175 ml, sperm concentration: 410-4000x106/ml, total motility: 0±90%), while after 5±8 injections, only 50% of these bulls produced ejaculates with a small number of immotile spermatozoa. The ejaculates of group 2 bulls (vaccinated >8 times) were devoid of spermatozoa. Faecal androgen metabolite concentrations measured in captive males decreased significantly after the fourth vaccination. None of the males entered musth during the treatment period. CONCLUSIONS: Our results showed a marked decrease in semen quality, testicle and secondary sex gland sizes following repeated GnRH vaccinations. After 2±4 years of continuous treatment every 5±7 months, the effects were similar to surgical castration.ISIScopu

Physiological Stress and Refuge Behavior by African Elephants

Physiological stress responses allow individuals to adapt to changes in their status or surroundings, but chronic exposure to stressors could have detrimental effects. Increased stress hormone secretion leads to short-term escape behavior; however, no studies have assessed the potential of longer-term escape behavior, when individuals are in a chronic physiological state. Such refuge behavior is likely to take two forms, where an individual or population restricts its space use patterns spatially (spatial refuge hypothesis), or alters its use of space temporally (temporal refuge hypothesis). We tested the spatial and temporal refuge hypotheses by comparing space use patterns among three African elephant populations maintaining different fecal glucocorticoid metabolite (FGM) concentrations. In support of the spatial refuge hypothesis, the elephant population that maintained elevated FGM concentrations (iSimangaliso) used 20% less of its reserve than did an elephant population with lower FGM concentrations (Pilanesberg) in a reserve of similar size, and 43% less than elephants in the smaller Phinda reserve. We found mixed support for the temporal refuge hypothesis; home range sizes in the iSimangaliso population did not differ by day compared to nighttime, but elephants used areas within their home ranges differently between day and night. Elephants in all three reserves generally selected forest and woodland habitats over grasslands, but elephants in iSimangaliso selected exotic forest plantations over native habitat types. Our findings suggest that chronic stress is associated with restricted space use and altered habitat preferences that resemble a facultative refuge behavioral response. Elephants can maintain elevated FGM levels for ≥6 years following translocation, during which they exhibit refuge behavior that is likely a result of human disturbance and habitat conditions. Wildlife managers planning to translocate animals, or to initiate other management activities that could result in chronic stress responses, should consider the potential for, and consequences of, refuge behavior

Validating physician-certified verbal autopsy and probabilistic modeling (InterVA) approaches to verbal autopsy interpretation using hospital causes of adult deaths

<p>Abstract</p> <p>Background</p> <p>The most common method for determining cause of death is certification by physicians based either on available medical records, or where such data are not available, through verbal autopsy (VA). The physician-certification approach is costly and inconvenient; however, recent work shows the potential of a computer-based probabilistic model (InterVA) to interpret verbal autopsy data in a more convenient, consistent, and rapid way. In this study we validate separately both physician-certified verbal autopsy (PCVA) and the InterVA probabilistic model against hospital cause of death (HCOD) in adults dying in a district hospital on the coast of Kenya.</p> <p>Methods</p> <p>Between March 2007 and June 2010, VA interviews were conducted for 145 adult deaths that occurred at Kilifi District Hospital. The VA data were reviewed by a physician and the cause of death established. A range of indicators (including age, gender, physical signs and symptoms, pregnancy status, medical history, and the circumstances of death) from the VA forms were included in the InterVA for interpretation. Cause-specific mortality fractions (CSMF), Cohen's kappa (κ) statistic, receiver operating characteristic (ROC) curves, sensitivity, specificity, and positive predictive values were applied to compare agreement between PCVA, InterVA, and HCOD.</p> <p>Results</p> <p>HCOD, InterVA, and PCVA yielded the same top five underlying causes of adult deaths. The InterVA overestimated tuberculosis as a cause of death compared to the HCOD. On the other hand, PCVA overestimated diabetes. Overall, CSMF for the five major cause groups by the InterVA, PCVA, and HCOD were 70%, 65%, and 60%, respectively. PCVA versus HCOD yielded a higher kappa value (κ = 0.52, 95% confidence interval [CI]: 0.48, 0.54) than the InterVA versus HCOD which yielded a kappa (κ) value of 0.32 (95% CI: 0.30, 0.38). Overall, (κ) agreement across the three methods was 0.41 (95% CI: 0.37, 0.48). The areas under the ROC curves were 0.82 for InterVA and 0.88 for PCVA. The observed sensitivities and specificities across the five major causes of death varied from 43% to 100% and 87% to 99%, respectively, for the InterVA/PCVA against the HCOD.</p> <p>Conclusion</p> <p>Both the InterVA and PCVA compared well with the HCOD at a population level and determined the top five underlying causes of death in the rural community of Kilifi. We hope that our study, albeit small, provides new and useful data that will stimulate further definitive work on methods of interpreting VA data.</p

Stakeholder Partnerships Impact on the Research by International Non-Governmental Organizations; Case of Centre for International Forestry Research, Kenya

A Research Project Report Submitted to the Chandaria School of Business in Partial Fulfillment of the Requirement for the Degree of Masters in Business Administration (MBAScientific research has been instrumental in finding solutions to the current problems of the world, explaining the occurrence of specific phenomenon and coming up with new ideas. Most research organizations have embraced collaboration and partnerships with different stakeholders in the last decade in a bid to ensure an improved output of their research work. In this study, the main objective therefore was to find out the impact of international, regional and local strategic partners on quality of research carried out by the Centre for International Forestry Research (CIFOR), an international research NGO. A sample size of 30 respondents was used for this study. It consisted 12 respondents from the CIFOR Nairobi hub directly involved in scientific research and 18 respondents from the different strategic partners. Both open and close ended questionnaires was used in data collection and analysis done using SPSS (Statistical Package for Social Sciences, version 17) at 95% level of confidence and results presented in the form tables and graphs The study showed that most of the CIFOR Nairobi’s strategic partners were local including local research institutions and universities. Additionally, the study showed that most of the CIFOR partnerships have lasted for less than 5 years and several of them lasted for more than a decade. This can be explained by the fact that CIFOR established an office in Kenya barely five years ago (in 2012). Those with partnerships of over a decade were established by the scientists while in the CIFOR Headquarters in Indonesia before relocated to the Nairobi Hub. Generally, the both the CIFOR staff and the strategic partners acknowledged value of the partnerships since all the respondents said it was either significant or very significant. No single respondent said the partnership was slightly significant or insignificant. Findings from this study were significant in informing CIFOR on the significance of current partnerships in place, addressing the challenges facing research partnerships and the organizations they need to partner with for a better quality scientific research output. From the study it was evident that strategic partnerships was significant for CIFOR as for the partners in relation to the quality of research that the organizations produces. Both parties enjoyed a number of benefits ranging from: co-publications; knowledge and data sharing; funding and co fundraising; facilitating outreach, especially for local and regional partners; feedback for improving research; and expertise and skills sharing. Notable partnership challenges included financial constraints; poor communications; language and culture diversities; conflicting interests; delayed feedbacks; and varying methodologies of conducting research. Minimization of the challenges and maximization of the benefits is paramount for better scientific research outcomes from the partnerships. . this can be achieved if both CIFOR and its strategic partners strive to improve on communication methods while maintaining transparency; strengthen the existing partnerships while widening the organizational strategic partnerships by adding relevant private sector organizations; and members of the strategic partnerships should consider co-designing of research methods to eliminate methodology ambiguities

A Health Production Approach to Bone Health in Kenya

Reduced density and quality in bones increase fracture risk, which becomes evident later in life through recognition of osteoporosis which is a skeletal disorder characterized by compromised bone strength, pre-disposing to an increased risk of fracture and is a global health problem that affects men as well as women. Shocks are inevitable to everyone everywhere and in the wake of shock of chronic/severe illness like Corona virus (Covid-19) which is infecting and affecting individuals worldwide and countrywide; the response may be negative or positive. The negative responses acts like additional shocks, hence focus will be on the positive responses (good reports) which are meant to counter the shocks and improve individuals and consequently household’s welfare. In some cases covid-19 results to death of a household member, this calls for immediate response to the shock. During the outbreak of corona virus, many individuals have lost their employment and at such a time when loss of salaried employment or non-payment of salary results, individuals may need to respond to the shock positively. A time like this the health care facilities are overstrained with many hospitalizations as a result of day to day increase in the shocks (corona virus) and its associated shocks like loss of employment and death. Likewise, the governments’ curfews have made individuals to experience business failure, limit their movements, reduce physical activity, and change their food and nutrition and as a result may affect their health outcomes. This study sought to establish the determinants of bone health, based on the health production approach by isolating the effects of response to shocks, and food and nutrition on bone health. The current study found that good report (positive response to shocks), exercising (through use of non-motorized transport), completing secondary education, taking wine, consuming fruits like apples, pineapples and melons and vegetables such as lettuce, cucumber and courgette, and increased consumption of peanut butter, tinned fish, and minced meat, chocolate and cheese significantly helps in improvement of bone health as they reduce bone fracture. However, bad reports deteriorate bone health, increased consumption of bread and corned beef significantly depletes bone health as they increase the occurrence of fracture. This study recommends that in order to improve individuals’ bone health there is need to convey good reports especially during shocks like Covid-19. Individuals who have experienced non-agricultural household business failure due to the outbreak of corona virus, they need not to give up but ought to respond by starting a new business. For improved bone health, individuals also need to continually exercise by using non-motorized means of travel like walking or cycling; they may need to take a little wine especially as their age increases; and strengthening their bones through increased consumption of apples, pineapples and melons, lettuce, cucumber and courgette, peanut butter, tinned fish, and minced meat, chocolate and cheese. Keywords: Bone Health, Health Production, Corona Virus, Covid-19, Response to Shocks, Food and Nutrition DOI: 10.7176/JHMN/85-15 Publication date: January 31st 202

Analisis Penerapan Manajemen Strategik dan Pengaruhnya terhadap Kinerja Usaha

This research was conducted to determine the degree of implementation of Strategic Management and the level of MSME (Miicro. Small, and Medium Enterprise) business performance in the Batik, Craft and Furniture sector in Probolinggo District, East Java and to examine the relationship between Strategic Management Application and Business Performance. The population of this research is the MSMEs of the Batik, Craft and Furniture sectors in Probolinggo District with a purposive sampling method, and those who meet the requirements of 30 samples. The method used is a survey through a questionnaire to find out primary data of degrees in the Implementation of Strategic Management and secondary data on business performance. To test the relationship between variables, a statistical test was carried out using the linear regression method with the SPSS tool. The results showed that the degree of implementation of Strategic Management and Business Performance of respondents was included in the medium category. Statistical test results show that there is a positive and significant effect of the Implementation of Strategic Management on Business Performance. The results of this study should be input for stakeholders in an effort to improve the competence of MSMEs in dealing with business competition

Influence of multi-stakeholder linkages and practices on the adoption of technologies and innovations in lower Eastern Kenya

The study is an assessment of how the factors related to multi-stakeholder linkages and practices (MSLIAD) influence the adoption of Gadam sorghum technologies and practices by farmers in six sub-counties in lower eastern Kenya where past public-private-partnership development initiatives have been implemented. The factors studied included: (i) farmers’ attitude towards MSLIAD, (ii) prevailing policies, (iii) coordination of stakeholders in production and provision of services, (iv) competition among the stakeholders, (v) information sharing among the stakeholders, and (vi) collective action in access to markets. Stratified random sampling was used to select 165 household heads who were interviewed using a structured questionnaire. Data were analysed using both descriptive and inferential statistics. Significant (p <.05) negative influences were found to exist between the MSLIAD factors and the adoption of technologies and practices by the farmers. Strong linkages between research, policy and practice were found necessary to enhance technology adoption. Further, existing linkages should be clearly defined for proper coordination of information sharing and feedback across all communication levels