A pilot study comparing pre-analytic tissue processes before and after implementation of a quality improvement program for handling breast cancer specimens

Background: Breast cancer as the most frequently occurring cancer in women is highly heterogeneous in its pathological characteristics. Assessment of tumor biologic characteristics including hormone receptor profile and growth factor receptor activity is important in characterizing the pathologic nature of such cancers. Tumor biomarker activity plays a big role in diagnosis and management of invasive breast cancer (IBC). Biological specimens are the primary sources of this molecular information. Optimal handling of the specimen through the various analytic phases assures of the validity of the final pathologic diagnosis. Objective: To assess the feasibility of implementing an intervention plan to improve specific breast specimen pre-analytic processes which include cold ischemia time, usage of 10% neutral buffered formalin as fixative media, appropriate ratio of tissue mass to fixative volume and total time spent in fixative media. Methods: A pre-post study examining these specific pre-analytic variables in breast specimen handling. Specimens’ charts were reviewed in the retrospective phase and their findings compared with the prospective phase specimens’ chart audit after an interventional training workshop was carried out in the intervening period between the two study phases. Significance of change was calculated using the Fisher’s exact test. Results: Improvement of documentation and compliance with guidelines advocated by the American Society of Oncology-College of American Pathologists (ASCO-CAP) occurred across board after holding a training workshop on the importance of these guidelines with significant change seen in the cold ischemia time. Conclusion: The study shows that it is feasible to improve on breast specimens’ pre-analytic processes to comply with universally agreed guidelines. Greater integration of impact and process assessment, more stringent formulation and measurement of scale-up targets, and outcome evaluation strategies that allow for comparison of effects at different phases of scale-up can all help to achieve program scalability

Influence of school leadership culture on students’ academic performance in mixed public secondary schools in Gucha region Kisii county

A study in social science rekindles a link between organizational culture and its effectiveness. Effective school has also come up with many attributes that were evident in schools that seem to contribute to academic achievement. The aim of this study was to investigate the influence of school culture and its influence on students’ academic performance at KCSE level. The objectives of this study were; to examine the influence of school leadership on students’ academic performance and to assess the influence of school routines on students’ academic performance in mixed public secondary schools in Gucha region Kisii County. The study was guided by Edgar Schein’s organizational culture theory and Effective schools’ theory. Mixed methodology and concurrent triangulation research design guided the study. Qualitative and quantitative data was collected, analyzed and results merged for discussions and conclusions. The target population included 37 principals, 650 teachers and 15,865 students yielding 16, 552 participants. Purposeful sampling raised 17 principals, 150 teachers were randomly selected and 300 students sampled through stratified random sampling. 467 respondents were sampled for study. Questionnaires were given to teachers and students, interview guide was used by the researcher and interview guide was used by the researcher when interviewing the principals. The instruments were piloted on 10% of the sample size. Validity of the instruments was ascertained through expert judgment and reliability was attained through test re-test and calculated using statistical package for social sciences (SPSS) version 24 and Cronbach alpha technique. Internal consistency of 0.7 was obtained. Credibility of the instruments was ascertained through data triangulation to ensure that findings were dependable at every step, well-articulated and detailed. Qualitative data was analyzed thematically and presented in narrative form while quantitative data was analyzed using descriptive and inferential statistics. Linear regression was carried out and findings presented using tables and graphs. The study concluded that influence of school routines on students’ academic performance, leading by example had a strong positive correlation of .539**indicating that strengthening school culture help in improving academic performance Gucha region, Kisii County. The study recommended that leaders of secondary schools should lead by example and promote a positive performance culture in schools

Food Prices: Eastern and Southern Africa Defy Global Trends

Global food prices started rising sharply in 2006 and reached record levels in the second quarter of 2008. Although domestic food prices in Eastern and Southern Africa (ESA) are not totally unrelated to world prices, a study by the Association for Strengthening Agricultural Research in East and Central Africa (ASARECA), the Regional Strategic and Knowledge Support System for Eastern and Central Africa (ReSAKSS-ECA), and the Consultative Group on International Agricultural Research (CGIAR) Alliance shows that national and regional factors are very important in driving domestic food prices. While global food prices have exhibited declining trends since June 2008, several ESA countries have experienced increasing prices in 2008 and early 2009. The price surges appear to be further fuelled by some of the policy responses that countries have employed in their attempts to address the food price problem. This brief provides an update on food price trends in ESA. It starts by comparing the Food and Agricultural Organization of the United Nations (FAO) global food price index and food price indexes (FPI) in individual countries followed by an update on price trends for specifi c commodities. This information serves to remind policymakers that the easing global food prices do not present any immediate relief to the food crises facing their individual countries

Knowledge, attitude and practice(KAP) of tuberculosis patients enrolled on treatment in Juba City, South Sudan 2010: a pilot study

Study setting: Juba Teaching Hospital, Juba city, Republic of South Sudan, 2010.Objective: To examine, knowledge, attitude and practices of tuberculosis (TB) patients enrolled on tuberculosis treatment, Juba, South Sudan.Design: Descriptive studyResults: Knowledge in TB: Of the 102 patients interviewed; up to 80.4% were not knowledgeable on cause of TB, 52% did not know correct signs and symptoms of TB, 39.2% did not know overall treatment duration, 54.9% did not know the importance of strict adherence to treatment. Knowledge on correct diagnosis was 87.3% and on correct means of TB transmission was 79.4%.Practices and Attitudes: On practices; 94.1% respondents were able to perform at least one task to stop spread of disease, access to free TB test occurred in 100% of cases and for free drugs in 99% cases. Health care workers correctly suspected TB on first contact in 95.1% of cases. Patients were offered health education on drug side effects in 93.1% of cases, on HIV testing and counselling in 74.5% of cases. Disclosure of TB diagnosis by patient to family or community did not occur in 91.2% cases. Family, community and employers offered support to patients in 92.2%, 95.1% and 98% of cases respectively.Conclusion: We found key knowledge gaps among Juba TB patients enrolled on treatment. These knowledge gaps are probably responsible for the high treatment defaulter rates reported in Juba, South Sudan. Tuberculosis patients are still not interested to freely reveal disease diagnosis to members of the family and community at large

Status and Trends of Agricultural and Rural Development Indicators in the COMESA Region

This report is divided into eight sections, section one provides an introduction about the COMESA region and the structure of the economy in the region. Section two presents trends of various socioeconomic indicators in the region. Section three contains gender related information while section four focuses on food security in COMESA. Some examples of subnational food security situations are also given here. Section five focuses on various indicators related to agriculture in COMESA including agriculture and food production, input utilization in agriculture, and application of irrigation in agriculture. Section six provides information on expenditures in agriculture and agricultural value addition in the region. In section seven, various indicators on trade are reviewed. The last section, section eight, contains summary, conclusions, and policy recommendations

Determination of Pesticide Residues in Organic and Conventional Exotic Vegetables

Pesticides are used to protect crops from diseases and pests. Their application in agriculture has been in existence since ancient times to date. They have also been used in growing vegetables especially exotic vegetables that are more prone to pests and diseases. There have been concerns over indiscriminate use of pesticides by farmers to grow vegetables especially for local markets since there are no guidelines on Maximum residue levels. This study was done to determine the concentration of cypermethrin and lambda-cyhalothrin pesticide residues in Collard (Brassica oleracea var. acephala) Tomatoes (Solanum lycopersicum) and swiss chard (Beta vulgaris subsp. cicla). The samples included both organic and conventional vegetables that use chemical pesticides. Experimental study design was used which involved laboratory analysis of the samples. Sample extraction was done using AOAC official method 2007.01 known as Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) method. The method involves use of Acetonitrile, sodium chloride and anhydrous magnesium sulphate for extraction. Clean-up was done using dispersive-solid phase extraction method using Primary-Secondary Amine and anhydrous magnesium sulphate. Residues analysis was done using Reverse-phase High Performance Liquid chromatography. Peak areas of the curves were calculated using Motic Images plus 2.0 and data analysis was done using SPSS 22. Recovery rates of pesticide ranged from 87.78% to 97.93% for cypermethrin and 90.65% to 95.72% for lambda-cyhalothrin. The results indicated that organic vegetable samples had pesticide residues below detectable levels while conventional vegetable samples had levels ranging from 2.495mg/kg to 0.238mg/kg for cypermethrin and 0.352mg/kg to 0.119mg/kg for lambda-cyhalothrin. The residues of both pesticides were above the recommended, this is likely to cause negative health effects such as uncoordination, whole-body tremors and seizures. This indicates that conventional vegetable consumers are exposed to pesticide residues. Farmers should strictly adhere to good agricultural practice to reduce pesticide residues

Turn-Around Strategy by Kwale International Sugar Company Limited

Turnaround strategic management philosophy revolves around short-term survivability while endeavoring not to compromise longer-term turnaround viability thereafter. The study sought to bring out clearly the strategies employed by Kwale Sugar Company Limited to revamp back to life after having collapsed for a very long period of time. The main objectives of the study included identifying the turnaround strategies adopted by the company and also establish the factors influencing the turnaround process. One of the important strategies included reorganizing, refocusing of the existing team under new leadership, turnaround management consulting support and the extensive support from turnaround interim managers. The study applied a case study since it is a research on one organization targeting senior managers as the respondents. The study used both primary and secondary data. Primary data was collected using interview guide as data instrument whereas secondary data was collected from the organization brochures, available documents and the web. Data was analyzed using content analysis and findings of the study were analyzed in prose. From the findings of the study, some of the many strategies employed by the Company to revamp back to business included financial restructuring, reorganization, strategic repositioning, modernization and asset reduction. Execution of the turnaround strategy faces immense complexities, pressure of limited time, information and resources, as well as uncertainty about the future which have to be addressed. As a conclusion, the study found out that various strategies need to be applied in plural to have a successful turnaround process. Keywords: Turn-around strategy and survival abilit

Socio – Economic Baseline Survey For Proposed Mining Of Niobium And Rare Earth Elements At Mrima Hill, Kwale County.

The overall aim of this survey is to provide baseline information on the socio-economic conditions of the communities living in Dzombo Location, the environs of Mrima Hill. The survey seeks to enhance understanding of the livelihood strategies these communities employ in meeting their livelihood needs. It also seeks to improve understanding of the problems they face in their efforts to secure food, education, health and a sustainable living. It further seeks to understand the perceptions of these communities with respect to the economic/livelihood opportunities linked to the proposed mining of Niobium and Rare Earth Elements in Mrima Hill. Background information on Mrima Hill and its environs that was considered to be of socio-economic relevance was obtained from various government offices at Dzombo and Msambweni. Information on the current socio-economic characteristics and conditions was obtained through administration of two sets of questionnaires. One was filled by community leaders while a more detailed one was filled by household heads. The data collected from primary sources was processed with aid of the Statistical Packaged for Social Sciences (SPSS) software. Keywords: Socio- Economic Baseline and Niobium plus Rare eart