STUDENT PREFERENCES OF A HELP-GIVER IN PUBLIC SECONDARY SCHOOLS IN NAIROBI COUNTY, KENYA AND IMPLICATIONS FOR THE GUIDANCE AND COUNSELLING PROGRAMME

School guidance and counselling plays a critical role in the development of learners’ wellbeing without which effective learning may not take place. This paper reports the findings of a study done in Nairobi County to ascertain students’ preferences of a help-giver. Nelson Le-Gall’s theory of help seeking was selected as the key theoretical perspective to anchor the study. The survey design was adopted for the study and a stratified random strategy used to draw a sample from form two students in public secondary schools in Nairobi County. The questionnaire comprising Likert-type items was the main research tool. Validity of the items was established by checking on the extent to which the items were aligned to the construct of interest while reliability was done using the split half technique. The study found that students in Public secondary schools in Nairobi County expressed experiencing concerns related to response to assignments and study habits for which counseling was sought. The students were least likely to share their concerns with teachers but preferred peers with whom they had much in common. Further, the study revealed that students would rather live without sharing their issues with teacher-counselors or other adults in the school. The study recommends the training of peer counselors in public secondary schools in Nairobi as a strategy to improve learner’s health and personal effectiveness.  Article visualizations

AN EXPLORATION OF THE PARATAXIC BEHAVIOUR AND IMPLICATIONS OF HOLE-IN-THE-WALLET PHENOMENON AMONG UNIVERSITY STUDENTS IN KENYA

Students in Kenyan Universities receive some form of pocket money for academic and non-academic endeavours. However, there exists a knowledge gap in relation to how this money is utilized particularly for non-academic activities. This Paper reports findings of a study done among Kenyan University students to explore how they used pocket money for non-academic activities and how this impacted on their unending quest for success in betting activities The study was guided by the theory of interpersonal interaction advanced by Harry Stack Sullivan (1950). The study employed two research designs; survey and ex post facto. The survey design was deemed appropriate because it enabled the researcher to describe the parataxic experiences of male and female students in the sample and generalize them to the larger group from which the sample was drawn. The ex post facto design was appropriate because the effects of the variables had already occurred and thus not manipulable. The study targeted male and female students pursuing different areas of training on full time basis in selected private and public Universities in Kenya. The sample was drawn using stratified random sampling. The questionnaire comprising Likert type items was the main research tool. Validity was established by expert judgement while reliability was sought by use of the split-half technique. The study found that peers introduced university students to betting activities based on unrealistic expectations of making quick money. The quest for quick money pushed the students to various betting activities and more males than females gambled away college fees leading to the hole-in the wallet phenomenon. The study established that university students experienced varied internal conflicts which could be attributed to betting. The study recommends an establishment of a support system to engage university students in socially acceptable ways for enhanced individual wellbeing so that they can reap the maximum benefits of learning.  Article visualizations

Analysis of Parental Involvement And Self-Esteem On Secondary School Students In Kieni West Sub-County, Nyeri County, Kenya

This study investigated the relationship between parental involvement and the self-esteem among adolescents in secondary school students in Kieni West District in Nyeri County. It was guided by Self Determination Theory (SDT) by James William and Baumrind Theory of Parenting Styles by Diana Blumberg Baumrind. Some of the gaps identified in the literature review were addressed. Emphasis was put on establishing the relationship between parental involvement in the perspective of autonomy, competence, and relatedness and development of self-esteem among adolescents. The study followed mixed methods research design where qualitative and quantitative methodology was combined. The study was based on investigation of form three students in secondary schools in Kieni West district, Nyeri County, Kenya. The instruments consisted of questionnaires and unstructured interviews. Two experts were given the research instruments to evaluate the validity and all the items were rated as relevant. Reliability of research instruments was established using test retest method and a reliability coefficient of 0.5 was obtained. Quantitative data was collected from 200 participants selected from 8 schools using probability sampling method. Qualitative data was collected from 8 participants selected from 8 schools using purpose sampling method. Data collected was computerized using statistical package for social sciences (SPSS version 21). It was analyzed and interpreted using inferential statistics with the aim of investigating the relationship between parental involvement and self esteem among adolescents. Both quantitative and qualitative data were analyzed. Quantitative data was descriptive in nature. Qualitative data analysis involved coding and categorizing of interview data and thereafter data were thematically organized.   This formed the basis of detailed analysis, conclusions and recommendations. The study found that parents in Kieni West District in Nyeri County were involved in the lives of adolescents. Adolescents in this research were found to have high self esteem. This research found a relationship between the dependent and independent variables. Self esteem among adolescents was found to be related to parental involvement. The study recommended that stakeholders in education needed to identify and understand the psychological needs of adolescents. Study, recommends future research on how parental involvement fluctuates and test if parental involvement can be taught by implementing parenting workshop. Key Words: Parental Involvement and Self-Esteem, Secondary School Students in Kieni West Sub-County, Nyeri County, Keny

Cross-sectional survey on prevalence of attention deficit hyperactivity disorder symptoms at a tertiary care health facility in Nairobi

Background:Attention deficit hyperactivity disorder is the most common childhood neurobehavioral disorder with well documented adverse consequences in adolescence and adulthood, yet 60-80% of cases go undiagnosed. Routine screening is not practiced in most pediatric outpatient services and little information exists on factors associated with the condition in developing countries. Methods:This was a questionnaire based cross-sectional survey whose primary objective was to determine prevalence of attention deficit hyperactivity disorder (ADHD) symptoms in children aged 6-12 years attending a tertiary care hospital Accidents and Emergency unit. Secondary objectives were to: (i) ascertain if physical injury and poor academic performance were associated with ADHD, (ii) compare diagnostic utility of parent-filled Vanderbilt Assessment Scale (VAS) against Statistical Manual of Mental Disorders-IV (DSM-IV) as the gold reference and (iii) establish if there exists an association between ADHD symptoms cluster and co-morbid conditions. Results:Prevalence of cluster of symptoms consistent with ADHD was 6.3% (95% CI; 3.72-10.33) in 240 children studied. Those affected were more likely to repeat classes than the asymptomatic (OR 20.2; 95% CI 4.02-100.43). Additionally, 67% of the symptomatic had previously experienced burns and 37% post-traumatic open wounds. The odds of having an injury in the symptomatic was 2.9 (95% CI; 1.01-8.42) compared to the asymptomatic. Using DSM-IV as reference, VAS had a sensitivity of 66.7% (95%; CI 39.03-87.12) and specificity of 99.0% (95% CI; 96.1-99.2). Positive predictive value was 83.0% (95% CI; 50.4-97.3) and negative predictive value 98.0% (CI 95.1-99.1). Oppositional defiant disorder symptoms, anxiety, depression and conduct problems were not significantly associated with ADHD cluster of symptoms. Conclusion:The study found a relatively high prevalence of symptoms associated with ADHD. Symptomatic children experienced poor school performance. These findings support introduction of a policy on routine screening for ADHD in pediatric outpatient service. Positive history of injury and poor academic performance should trigger further evaluation for ADHD. Vanderbilt assessment scale is easier to administer than DSM-IV but has low sensitivity and high specificity that make it inappropriate for screening. It however provides a suitable alternative confirmatory test to determine who among clinically symptomatic patients requires referral to a psychiatrist

Polymorphism in a lincRNA Associates with a Doubled Risk of Pneumococcal Bacteremia in Kenyan Children.

Bacteremia (bacterial bloodstream infection) is a major cause of illness and death in sub-Saharan Africa but little is known about the role of human genetics in susceptibility. We conducted a genome-wide association study of bacteremia susceptibility in more than 5,000 Kenyan children as part of the Wellcome Trust Case Control Consortium 2 (WTCCC2). Both the blood-culture-proven bacteremia case subjects and healthy infants as controls were recruited from Kilifi, on the east coast of Kenya. Streptococcus pneumoniae is the most common cause of bacteremia in Kilifi and was thus the focus of this study. We identified an association between polymorphisms in a long intergenic non-coding RNA (lincRNA) gene (AC011288.2) and pneumococcal bacteremia and replicated the results in the same population (p combined = 1.69 × 10(-9); OR = 2.47, 95% CI = 1.84-3.31). The susceptibility allele is African specific, derived rather than ancestral, and occurs at low frequency (2.7% in control subjects and 6.4% in case subjects). Our further studies showed AC011288.2 expression only in neutrophils, a cell type that is known to play a major role in pneumococcal clearance. Identification of this novel association will further focus research on the role of lincRNAs in human infectious disease.Wellcome Trust (Grant ID: 084716/Z/08/Z)This is the final version of the article. It first appeared from Cell Press/Elsevier via http://dx.doi.org/10.1016/j.ajhg.2016.03.02

African Head and Neck Society Clinical Practice guidelines for thyroid nodules and cancer in developing countries and limited resource settings

Background International thyroid nodule and cancer management guidelines generally fail to take into account potential limitations in diagnostic and treatment resources. Methods Thyroid cancer specialists from the African Head and Neck Society and American Head & Neck Society Endocrine Section developed guidelines for diagnosis and management of thyroid nodules and cancer in low resource settings. Recommendations were based on literature review and expert opinion, with level of evidence defined. Results Using the ADAPTE process, diagnostic and treatment algorithms were adapted from the National Comprehensive Cancer Network (NCCN). Low resource settings were simulated by systematically removing elements such as availability of laboratory testing, hormone replacement, imaging, and cytopathology from NCCN guidelines. Conclusions Successful management of thyroid nodules and cancer in low resource settings requires adaptation of treatment methodologies. These guidelines define specific scenarios where either more or less aggressive intervention for thyroid pathology may be advisable based on limited available resources

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Real-time reverse transcription recombinase polymerase amplification (RT-RPA) assay for detection of cassava brown streak viruses

Cassava brown streak disease (CBSD) caused by Cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV) is the most economically important viral disease of cassava. As cassava is a vegetatively propagated crop, the development of rapid and sensitive diagnostics would aid in the identification of virus-free planting material and development of effective management strategies. In this study, a rapid, specific and sensitive real-time reverse transcription recombinase polymerase amplification (RT-RPA) assay was developed for real-time detection of CBSV and UCBSV. The RT-RPA was able to detect as little as 2 pg/µl of purified RNA obtained from infected cassava leaves, a sensitivity equivalent to that obtained by quantitative real-time reverse transcription PCR (qRT-PCR), within 20 min at 37 °C. Further, the RT-RPA detected each target virus directly from crude leaf and stem extracts, avoiding the tedious and costly isolation of high-quality RNA. The developed RT-RPA assay provides a valuable diagnostic tool that can be adopted by cassava seed certification and virus resistance breeding programs to ensure distribution of virus-free cassava planting materials to farmers. This is the first report on the development and validation of crude sap-based RT-RPA assay for the detection of cassava brown streak viruses (UCBSV and CBSV) infection in cassava plants