Ethical Practices For Effective Leadership: Fact Or Fallacy-The Kenyan Experience

The subject of ethics in Kenya has been a hot one for the last few years. The country has witnessed some of the worst corruption scandals in her history since independence. Even with the establishment of the Kenya Anti-Corruption Commission, the situation has not improved. This article tries to argue that laws alone cannot ‘convert’ the society that has developed and perfected the art of unethical practices. A new way of thinking is necessary that will involve and empower everyone to start thinking and behaving in an ethical way. I have in this article developed a model which can be used to transform societies. Several recommendations applicable not only to the Kenyan society but any other society that desires to transform its people into ethically responsible people has been made. Among the main recommendations is the adoption of a systemic approach to dealing with unethical practices as opposed to only a legalistic approach. In addition, the work of transformation begins with leaders who in turn mentor others to produce the desired behaviour. Hiring a person responsible for overseeing issues of ethics won’t do the job until everyone is involved. It is for that reason that I have adopted the systems approach in handling this challenge. The adoption of the proposed model will offer assistance to those who desire to influence their societies to be ethically responsible. In the light of this argument, ethical leadership can be a fact and not a fallacy

Resource Configurations on Sustainable Competitive Advantage of Food and Beverage Firms in Kenya: A Resource Based View of the Firm

The resource based view has gained immense importance in business theorizing and has been widely accepted as a theory. The Kenyan manufacturing sector contributes about 10 percent to the GDP of which agro-processing contributes 3 percent. The sector grows at about 4 percent annually and is set to be one of the main drivers of industrialization and economic growth in the Kenya. The resource based theory of the firm was tested on the food and beverage firms in Kenya on the basis of resource capability configurations that accord firms sustainable competitive advantage. From the 138 food and beverage manufacturing firms registered by the Kenya Association of Manufacturers in 2011, the study targeted 95 firms in and around Nairobi and Mombasa using purposive judgmental sampling. The study was carried out through a standardized questionnaire. The independent variables were mainly constructs of intangible assets like firm knowledge, firms’ information management, strategic planning, organizational structure and organizational culture. Out of the 95 firms surveyed, 32 responded giving 33.7 percent response rate. From the multivariate ordinary least squares regression analysis, the effects of organizational structure (p = 0.04, ?=0.05) were found significant at 95 percent confidence interval indicating the importance of the intangible asset to firms’ sustainable competitive advantage. The findings confirmed the importance of the organizational structure, whose building blocks are individuals in the firm, as a pattern of communication and relations among a group of human beings, including the process of making and implementing decisions as key contributors of firms sustainable competitive advantage in Kenya. Keywords:Firm resources, Organizational structure, sustainable competitive advantage

Pattern and spatial distribution of plague in Lushoto, north-eastern Tanzania

A review of plague records from 1986 to 2002 and household interviews were carried out in the plague endemic villages to establish a pattern and spatial distribution of the disease in Lushoto district, Tanzania. Spatial data of households and village centres were collected and mapped using a hand held Global Positioning System and Geographical Information System. During the 16-year period, there were 6249 cases of plague of which 5302 (84.8%) were bubonic, 391 (6.3%) septicaemic, and 438 (7.0%) pneumonic forms. A total of 118 (1.9%) cases were not categorized. Females and individuals aged 7-18 years old were the most affected groups accounting for 54.4% (95% CI: 52.4–56.0) and 47.0% (95% CI: 45–49) of all reported cases, respectively. Most cases were found in villages at high altitudes (1700-1900m); and there was a decline in case fatality rate (CFR) in areas that experienced frequent outbreaks. Overall, there was a reduction in mean reporting time (from symptoms onset to admission) to an average of 1.35 days (95% CI: 1.30–1.40) over the years, although this remained high among adult patients (>18 years). Despite the decrease in the number of cases and CFR over the years, our findings indicate that Lushoto district experiences human plague epidemic every year; with areas at high altitudes being more prone to outbreaks. The continued presence of plague in this focus warrants further studies. Nonetheless, our findings provide a platform for development of an epidemic preparedness plan to contain future outbreaks.. Keywords: plague, epidemics, pattern, spatial distribution, Tanzania Tanzania Health Research Bulletin Vol. 9 (1) 2007: pp. 12-1

Optimization of electricity trading using linear programming

In the last two decades, the liberalization of the electricity markets have been established in order to increase efficiency, harmonize and reduce electricity prices, make a better use of resources, give customers the right to choose their supplier and provide customers with a better service. This change made the electricity market competitive and introduced several new subjects. In this paper, we study one of these subjects: Electricity Trading Company (ETC) and its daily trading process. We present a linear mathematical model of total daily profit maximization subject to flow constraints. It is assumed that the demand and supply are known and some of them are arranged. Possible transmission capacities are known but also additional capacities can be purchased. All trading, transmission prices and amounts are subject of auctions. First, we present energy trading problem as directed multiple-source and multiple-sink network and then model it using linear programming. Also, we provide one realistic example which is slightly changed in order to save confidentiality of the given data

Satisfactory safety and immunogenicity of MSP3 malaria vaccine candidate in Tanzanian children aged 12-24 months.

BACKGROUND: Development and deployment of an effective malaria vaccine would complement existing malaria control measures. A blood stage malaria vaccine candidate, Merozoite Surface Protein-3 (MSP3), produced as a long synthetic peptide, has been shown to be safe in non-immune and semi-immune adults. A phase Ib dose-escalating study was conducted to assess the vaccine's safety and immunogenicity in children aged 12 to 24 months in Korogwe, Tanzania (ClinicalTrials.gov number: NCT00469651). METHODS: This was a double-blind, randomized, controlled, dose escalation phase Ib trial, in which children were given one of two different doses of the MSP3 antigen (15 microg or 30 microg) or a control vaccine (Engerix B). Children were randomly allocated either to the MSP3 candidate malaria vaccine or the control vaccine administered at a schedule of 0, 1, and 2 months. Immunization with lower and higher doses was staggered for safety reasons starting with the lower dose. The primary endpoint was safety and reactogenicity within 28 days post-vaccination. Blood samples were obtained at different time points to measure immunological responses. Results are presented up to 84 days post-vaccination. RESULTS: A total of 45 children were enrolled, 15 in each of the two MSP3 dose groups and 15 in the Engerix B group. There were no important differences in reactogenicity between the two MSP3 groups and Engerix B. Grade 3 adverse events were infrequent; only five were detected throughout the study, all of which were transient and resolved without sequelae. No serious adverse event reported was considered to be related to MSP3 vaccine. Both MSP3 dose regimens elicited strong cytophilic IgG responses (subclasses IgG1 and IgG3), the isotypes involved in the monocyte-dependant mechanism of Plasmodium falciparum parasite-killing. The titers reached are similar to those from African adults having reached a state of premunition. Furthermore, vaccination induced seroconversion in all vaccinees. CONCLUSION: The MSP3 malaria vaccine candidate was safe, well tolerated and immunogenic in children aged 12-24 months living in a malaria endemic community. Given the vaccine's safety and its induction of cytophilic IgG responses, its efficacy against P. falciparum infection and disease needs to be evaluated in Phase 2 studies

Integrated Pest Management (IPM) Components for Control of Armored Bush Cricket on Pearl Millet and Sorghum in Farmers' Fields in Namibia and Zambia

Armored bush crickets (Acanthoplus spp.) are sporadic pests on cereals in southern Africa. The performance of different IPM components on pearl millet [Pennisetum glaucum] in Namibia and sorghum in Namibia and Zambia is reported, based on on-farm participatory trials

Insect pests of pigeonpea in South Africa survey report

The incidence of pests in pigeon peas cultivated in South Africa was observed for the first time in surveys of field trials and plots undertaken in May 2000. The major insect pests observed were Clavigralla spp., Helicoverpa armigera and Callosobruchus spp

High burden of tuberculosis infection and disease among people receiving medication-assisted treatment for substance use disorder in Tanzania

OBJECTIVE: To determine the prevalence of tuberculosis (TB) disease and infection as well as incident TB disease among people who use drugs (PWUD) attending Medication Assisted Treatment (MAT) clinics in Dar-es-Salaam, Tanzania. METHODS: In this prospective cohort study, a total of 901 consenting participants were enrolled from November 2016 to February 2017 and a structured questionnaire administered to them through the open data kit application on android tablets. Twenty-two months later, we revisited the MAT clinics and reviewed 823 of the 901 enrolled participant's medical records in search for documentation on TB disease diagnosis and treatment. Medical records reviewed included those of participants whom at enrolment were asymptomatic, not on TB disease treatment, not on TB preventive therapy and those who had a documented tuberculin skin test (TST) result. RESULTS: Of the 823 medical records reviewed 22 months after enrolment, 42 had documentation of being diagnosed with TB disease and initiated on TB treatment. This is equivalent to a TB disease incidence rate of 2,925.2 patients per 100,000 person years with a total follow up time of 1,440 person-years. At enrolment the prevalence of TB disease and TB infection was 2.6% and 54% respectively and the HIV prevalence was 44% and 16% among females and males respectively. CONCLUSION: PWUD attending MAT clinics bear an extremely high burden of TB and HIV and are known to have driven TB epidemics in a number of countries. Our reported TB disease incidence is 12 times that of the general Tanzanian incidence of 237 per 100,000 further emphasizing that this group should be prioritized for TB screening, testing and treatment. Gender specific approaches should also be developed as female PWUDs are markedly more affected with HIV and TB disease than male PWUDs

Marked reduction in fertility among African women with urogenital infections:A prospective cohort study

<div><p>Background</p><p>There is paucity of data on risk factors for reduced fertility in low-income countries.</p><p>Objective</p><p>To investigate factors associated with fertility among women in rural north eastern Tanzania.</p><p>Subjects and methods</p><p>A cohort of 1248 non-pregnant women was followed with urine pregnancy testing every third month or more regularly if they reported a missed menstrual period. Pregnancy was confirmed with trans-abdominal ultrasound. Information regarding general health, socioeconomic status and obstetric-gynaecological history was collected. Factors associated with conceiving within 180 days were identified using multivariate logistic regression analyses.</p><p>Results</p><p>Among the 1248 women, 736 were followed for 180 days and 209 of these had an ultrasound confirmed pregnancy. During the follow-up period, 169/736 women were diagnosed with urogenital infections, including suspected sexually transmitted or reproductive tract infections, urinary tract infection, and vaginal candidiasis. Urogenital infections were significantly associated with reduced odds of conceiving within 180 days (adjusted OR (AOR) 0.21, 95% CI 0.11–0.36). Being above 30 years of age was also negatively associated with odds of conceiving (AOR 0.45, 95% CI 0.26–0.77). In contrast, women who recently stopped using hormonal contraceptives (AOR 2.86, 95% CI 1.45–5.70) and women with low socioeconomic status (AOR 1.56, 95% CI 1.04–2.33) were significantly more likely to become pregnant within 180 days.</p><p>Conclusion</p><p>Urogenital infection seems to be a major health factor associated with reduced chances of conceiving. Considering the availability of effective treatment options for these diseases, public health authorities should increase awareness of diagnostic tools in settings with limited resources in order to improve fertility.</p></div

SACRAL NEUROMODULATION FOR THE TREATMENT OF REFRACTORY LOWER URINARY TRACT DYSFUNCTION: RESULTS FROM A MULTICENTER STUDY

Hypothesis / aims of study Sacral neuromodulation (SNM) has been used as a safe, effective treatment option for patients with lower urinary tract dysfunction (LUTD). Several clinical studies demonstrated its positive effects on refractory urge incontinence, non-obstructive urinary retention, urgency frequency syndrome, as well as on other non urological disorders, such as faecal incontinence and chronic constipation. The aim of this research project was to evaluate the efficacy and safety of sacral neuromodulation on the management of LUTD refractory to the standardised first line treatment options. Study design, materials and methods We retrospectively collected and evaluated data from patients undergoing SNM between September 2001 and November 2010 in 4 Urological Centres of Northeast Italy. The patients were affected by Overactive Bladder Syndrome (OAB) and non-obstructive Urinary Retention (UR). All the patients were evaluated with voiding diaries, before and after implantation. Patients included in the present evaluation were followed in a network of 4 Italian urological centres which participate to the Italian Clinical Service project - a national urological database and medical care project aiming at describing and improving the use of implantable urological devices in the Italian clinical practice. To evaluate the patient reported outcome (PRO) of the impact of SNM on refractory OAB, we retrospective revised files from all implanted patients who completed pre and post-operatively the King\u2019s Health Questionnaire (KHQ). KHQ is a specific assessment instrument of the heath related quality of life (HRQoL) for patients with OAB, and incontinence symptoms. It consists of 21 items distributed in nine dimensions: general health (GH), incontinence impact (II), role limitations (RLs), personal limitations (PLs), social limitations (SLs), personal relationship (PR), emotions (Em), sleep/energy (Slp/En), and severity measures (SMs). The score of each dimension ranges from 0 (lower OAB symptoms impact; better HRQoL) to 100 (higher OAB symptoms impact; worse HRQoL). Continuous normally distributed variables were reported as the mean value \ub1 standard deviation (SD). Continuous non-normally distributed variables were presented as the median values and an interquartile range (IQR). The t-test, the Mann-Whitney and Wilcoxon tests were used to compare continuous variables, as appropriate. A two-sided p < 0.05 was considered statistically significant. Results Overall, 135 patients underwent implantation of SNM during the period under review. Eighty-three out of 135 (61.5%) patients complained of OAB, and 52 (38.5%) of UR. In patients treated for OAB, we documented a statistically significant reduction in the mean number of: incontinence episodes/die, pads/die, daily micturitions, nocturnal micturitions and global micturitions (see table I). In patients treated for UR, we observed a statistically significant reduction in the mean post voiding residual volume and in the number of self catheterization (see table II). Concerning the impact of SNM on HRQOL from patients complaining of refractory OAB, only nineteen patients (17 female and 2 male), from a single centre, filled-in the KHQ pre- and/or postoperatively The median patients\u2019 age was 70 years (range 65-74) with a median follow-up of 42 months (range 17.5-48). Median and range of quality of life KHQ of general health and personal relationship pre- and post-operatively were reported in table III. Table I. SNM clinical outcomes in patients with refractory OAB Variable N Baseline FU P-value Incontinence episode/die, mean\ub1SD 48 4.1\ub12.7 1.5\ub12.1 <0.001\ub0 Pads/die, mean\ub1SD 44 3.4\ub12.4 1.3\ub11.4 <0.001\ub0 Voided volume, mean\ub1SD 45 143.6\ub169.9 206.7\ub188.5 <0.001* Daily micturition, mean\ub1SD 48 10.4\ub14.2 7.4\ub12.5 <0.001\ub0 Nightly micturition, mean\ub1SD 48 2.6\ub11.8 0.8\ub10.9 <0.001\ub0 Global micturition, mean\ub1SD 48 13.0\ub15.3 8.1\ub12.7 <0.001\ub0 *T-Test; \ub0 Wilcoxon test Table II. SNM clinical outcomes in patients with non-obstructive urinary retention Variabile N Baseline FU P-value Post void reisdual urine, mean\ub1SD 30 321.4\ub1153.5 87.2\ub196.9 <0.001\ub0 Catheterism/die, mean\ub1SD 30 3.8\ub11.4 1.3\ub11.3 <0.001\ub0 Daily micturition, mean\ub1SD 29 4.7\ub13.8 5.4\ub12.0 0.159\ub0 Nightly micturition, mean\ub1SD 29 0.7\ub11.3 0.7\ub11.1 0.886\ub0 Global micturition, ,mean\ub1SD 29 5.4\ub14.6 6.1\ub12.5 0.328\ub0 *T-Test; \ub0 Wilcoxon test Table III. Median and range of HRQoL assessed pre- and postoperatively by King\u2019s Health Questionnaire* of general health and personal relationship of patients underwent SNM for refractory OAB. Dimension pre-SNM median (rance) post-SNM median (range) p-Value Wilcoxon matched pairs test GH 50 (37.5-50) 50 (25-62.5) 1 II 100 (100-100) 100 (50-100) 0.063 RLs 83.3 (50-100) 50 (33.3-100) 0.102 PLs 83.3 (66.7-100) 33.3 (16.7-83.3) 0.026 SLs 77.8 (50-94.4) 0 (0-50) 0.017 PR 0 (0-25) 0 (0-33.3) 0.785 Em 77.8 (22.2-88.9) 33.3 (11.1-44.4) 0.14 Slp/En 50 (33.3-75) 50 (16.7-66.7) 0.109 SMs 58.3 (33.3-79.2) 66.7 (25-75) 0.671 *The score ranges from 0 (lower OAB symptoms, better HRQoL) to 100 (higher OAB symptoms, worse HRQoL). In comparison of the preoperative setting, patients after the implant showed a better scores in many KHQ dimensions. In particular for personal limitations (p=0.026), and social limitations (p=0.017). The length of follow-up did not significantly impact on HRQoL scores. Interpretation of results SNM offers objective benefits for people with refractory OAB and for those with urinary retention without structural obstruction. Concerning the PRO, because OAB symptoms in general may have a serious impact on a person\u2019s daily activities and social life, the effect of treatment on disease-specific HRQoL also reflects its efficacy. In our series we observe a significant improvement of HRQoL for the following KHQ items: personal limitations and social limitations. We observe a better, although not significant, HRQoL also for the following items: Incontinence Impact, Role Limitations, and Emotions. We did not found any correlation between the follow-up length and HRQoL. We should take great caution in interpreting these results because all the measures of the impact of SNM on the HRQOL comes from a small number of patients\u2019 perspective. Concluding message This multicenter research project confirmed the midterm safety and effectiveness of sacral neuromodulation in the treatment of refractory overactive bladder syndrome and non-obstructive urinary retention, showing high cure rates and low complication rates