Demographic study of nasopharyngeal carcinoma in a hospital setting

Objectives: To highlight demographic pattern of nasopharyngeal carcinoma and determine mode and stage of presentation. Design: Prospective analytical study. Setting: Kenyatta National Hospital (KNH)/University of Nairobi, Kenya. Subjects: One hundred and twenty five patients seen at the ENT department of KNH. These were either referred from other peripheral hospitals or first seen at KNH and satisfied the inclusion criteria. Patients with open neck biopsy were excluded (among other criteria). Results: Age range of the patients was 13-85 years. Male: Female ratio was 2.2:1 with the highest frequency in the 31-40 years. Most patients presented in late disease (stages III and IV) which carry a poor prognosis. Majority of the patients had neck swelling as the first symptom followed by nose blockage. Several patients referred from peripheral major hospitals and open neck biopsy. Majority of the patients seen were from poor social-economic background. Conclusion: Nasopharyngeal carcinoma is a common malignancy at KNH. Diagnosis is usually made in late stages of the disease when prognosis after full treatment is poor. There is need to make early diagnosis by heightening the index of suspicion among health professionals and probably health education in the community on the need to seek treatment for persistent neck masses.East African Medical Journal Vol. 85 (8) 2008: pp. 181-18

The Impact of Cash Transfers on Labor Force Participation and Household Consumption: Evidence from Post-Apartheid South Africa

The Old Age Pension (OAP) program for elderly South Africans puts a significant cash transfer in the hands of many poor households. This dissertation investigates its impact on labor force participation and consumption of selected household items. In the first half of the dissertation, we take advantage of a policy reform that lowered men\u27s OAP eligibility age from 65 to 60 for men to match that of women for estimation identification. Using the General Household Survey data, we first demonstrate that both men and women respond to the eligibility age by dropping from labor force participation at the eligibility age, as expected. Using a difference-in-difference-in-difference estimator, we estimate that at the median predicted wage, age eligibility reduces men\u27s probability of labor force participation by approximately 6.14 percentage points. Previous studies show that not only is the OAP take-up rate high among the age-eligible, but its value is sufficiently high to generally make it a significant component of total household income for the majority of pensioners and their households. Other studies add that it is a dominant source of income in older households, such that it is often the sole source of income in these households, especially those in rural areas. In the second half of the dissertation, therefore, we examine the impact of age-eligibility status on a number of selected household outcomes, such as food security, sanitation, source of drinking water, and ownership of consumer durable goods. We also examine the extent to which gender influences its impact on household outcomes. We find positive effects on a select number of outcomes; however, we note this is more associated with females\u27 age-eligibility status, but not that of males

A Preliminary Yield Model for Natural Yushania Alpina Bamboo in Kenya

Natural bamboo resources in Kenya are about 150,000 ha and they are mainly found on the mountain slopes in the high potential areas in Mt Kenya, Aberdares ranges, Mau escarpment, Cherangani hills and Mt Elgon at high elevations between 2300 and 3200 meters above sea level.  There is only one indigenous bamboo species, Yushania alpina (formerly Arundinaria alpina). It grows in single culms grouped into clumps. The main use of Y. alpina bamboo in Kenya is construction and fencing. There is high demand for bamboo for use in horticulture farming, handcraft, residential fencing, and cottage industry for making furniture, baskets, tooth picks and match sticks. Some companies have expressed interest in using large amounts of bamboo for bio-energy, panels, particle boards and pulp. However, bamboo raw material is not available for use because of a Presidential ban imposed on harvesting bamboo resources in all Government and Trust lands. But even if the ban was lifted, harvesting of bamboo in the natural forests cannot be prudent because there is very little information on the quantity, quality and geographical distribution of the available amount. Many entrepreneurs have continued to request the Government through Kenya Forest Service (KFS) to be allowed to extract natural bamboo for various uses. On the other front Kenya Forestry Research Institute (KEFRI) has vigorously continued to promote growing and intensive use of bamboo. These two noble ideas cannot be realized in the absence of the bamboo resource data. The objective of this study was to develop a yield model that can be used to estimate total bamboo culms biomass in a given area and the proportion that can be harvested on a sustainable basis. This study used bamboo data from 25 rectangular temporary sample plots of 10 m x 20 m in natural stands of Y. alpina and trees at Kieni, Kamae and Kinale in Kiambu County to estimate density and model the dependence of culms merchantable green weight and oven dry weight on diameter at breast height. The culms mean stoking density was 21000 culms ha-1. The coefficient of determination (R2) for green weight model is 0.82 and the root mean square error (RMSE) is 1.45 kg. The model calculates mean weight of old Y. alpina culm as 9.6 kg. Keywords: Bamboo, stocking, yield, weight, culms, green weight mode

Availability and Adequacy of Physical Infrastructure as Determinants of Parental Choice of Primary Schools in Embakasi Sub-County, Nairobi City County, Kenya

The purpose of the study was to investigate the influence of physical facilities on parental choice of primary schools in Embakasi Sub-county, Nairobi City County, Kenya. Specifically, the study sought to determine the extent to which the adequacy and condition of physical facilities influenced parents’ choice of primary schools. The study also sought to compare the adequacy and condition of physical facilities in public and private schools in Embakasi Sub-county. Using a descriptive survey design, the study targeted 20 public schools with 30,201 parents and 97 private schools with 30,257 parents.  To pick the study sample, the population was stratified into two subgroups of public and private schools. Each of the subgroups was further subdivided into subgroups of school heads and parents from which 95 school heads and 600 parents were picked.  Systematic sampling was used to pick the respondents. Primary data were collected using questionnaires. Collected data was analyzed qualitatively based on themes and quantitatively using frequencies and percentages. The study findings revealed that majority (68.7%) of the parents were influenced by availability of permanent buildings. Well-stocked libraries ranked second at 54.4 percent while good furniture ranked third at 39.5 percent. The study recommends that the Ministry of Education, Science and Technology (MoEST) in partnership with other stakeholders ensures that schools have adequate facilities to meet parents’ expectations. There is also need for regular assessment of both public and private schools by MoEST to ensure that they operate above a given minimum standard of physical facilities. Keywords: Physical facilities, Parental choice, availability, adequacy (247 words

Preservice Student Teachers’ Attitudes Towards Chemistry Teaching: The Case Of Egerton University, Kenya

A ZJER study on the attitude of pre-service student teachers in Kenya towards the teaching Chemistry.The purpose of this study was to determine the attitudes held by pre-service chemistry student teachers. A survey was conducted on Egerton University students in the 2002/2003 academic year. The sample included all the Bachelor of Education (Science) pre-service chemistry students. These students had just covered the Chemistry Subject Methods course and were about to start their teaching practice programme. The sample consisted of 71 male and 34 female student teachers, making a total of 105 respondents. A modified Chemistry Teachers’ Attitudes Questionnaire (CTAQ) for measuring chemistry teachers’ attitudes towards teaching was developed and used for data collection. Data were analysed using descriptive statistics, t-test and Analysis of Variance (ANOVA). The results show that pre-service chemistry student teachers have high positive attitudes towards teaching. Student teachers’ gender and subject combination have no influence on their attitudes towards chemistry teaching. These findings suggest that the current teacher training approach at Egerton University should be maintained and enriched

Assessing water availability under pastoral livestock systems in drought-prone Isiolo District, Kenya

Water availability / Water demand / Surface water / Groundwater / Wells / Salinity / Livestock / Grazing / Land use / Water supply / Drainage / GIS / Databases / Cost recovery

NIMART rollout to primary healthcare facilities increases access to antiretrovirals in Johannesburg: An interrupted time series analysis

Introduction. South Africa has made remarkable progress in rolling out antiretroviral therapy (ART), with the largest number of people(more than 1.4 million) enrolled on antiretrovirals in the world. Decentralisation of services to primary health centres (PHCs) hasstrengthened retention of patients on ART and reduced the burden of managing uncomplicated cases at referral hospitals.Methods. This was a ten-step Nurse Initiatied Management of Antiretroviral Treatment (NIMART) rollout intervention in which nurses from 17 primary healthcare facilities of Region F, City of Johannesburg, South Africa, were trained and mentored in NIMART by the Wits Reproductive Health and HIV Research Institute (WRHI) to commence patients on ART in their PHCs. A total of 20 535 patients initiated ART during the 30-month study period. Monthly initiations at both PHCs and referral clinics were monitored. To test the statistical significance of the impact of NIMART rollout on the referral hospital initiations and Region F monthly initiations, interrupted time series analysis was applied. Findings. Ten-step NIMART rollout was applied, with the first step being establishment of NIMART as a priority in order to obtain primary buy-in by the Department of Health (DoH) and City of Johannesburg (CoJ). Forty-five professional nurses were trained in NIMART by WRHI quality improvement mentors. By the end of September 2011, all 17 PHCs in Region F were initiating patients on ART. Totalinitiations significantly increased by 99 patients immediately after NIMART rollout (p=0.013) and continued to increase by an average of 9 every month (p=0.013), while referral facility initiations decreased by 12 (p=0.791) immediately after NIMART and then decreased by anaverage of 18 every month (p=0.01).Conclusion. In this study, decentralisation of ART initiation by professional nurses was shown to increase ART uptake and reduce workload at referral facilities, enabling them to concentrate on complicated cases. However, it is important to ensure capacity building, training and mentoring of nurses to integrate HIV services in order to reduce workload and provide a comprehensive package of care to patients. Engaging and having buy-in from DoH/CoJ partners in rolling out NIMART was crucial in increasing outputs as well as for sustainability of the NIMART programme

THE AVAILABILITY OF INTERPRETATION MEDIA AND TOURISTS’ SATISFACTION WITH MOVIE INDUCED TOURISM IN KENYA

Purpose: This paper is anchored on the findings of a study that sought to assess the availability of interpretation media in movie induced tourism and its effect on tourists’ satisfaction in Kenya. Methodology: The study adopted explanatory and descriptive research designs. The study targeted 1,318 tourists from Karen Blixen Museum where the movie “Out of Africa” was filmed and Samburu County where the movie “The White Maasai” was filmed. In addition, a total of 658 bloggers airing their views on the filming locations were targeted. Simple random sampling and convenience sampling techniques were used to sample 345tourists and 221 bloggers, respectively. Structured closed-ended questionnaires were employed in collecting data. Main Findings: Findings from regression model showed that interpretation services had a positive and significant effect on tourists satisfaction (β = 0.647, p< 0.000).Based on the study findings and subsequent discussions, this paper concludes that the availability of interpretation media is effective in enhancing tourists’ understanding and appreciation of the destination being visited. Specifically, availability of guards in Karen Blixen Museum and Samburu and other interpretation media enhanced tourist experience and a majority were satisfied.  Implications: The findings can be used to improve practice by encouraging tour guides to have a clear knowledge of a destination to be able to guide tourist and facilitate the offering of quality products. It is therefore important to have interpretation services since they contribute to tourist satisfaction. Novelty: The study contributes to the creation of additional knowledge to the field of movie-induced tourism thus enhancing the understanding of the nature and characteristics of movie-induced tourism

Evidence against rapid emergence of praziquantel resistance in Schistosoma haematobium, Kenya.

We examined the long-term efficacy of praziquantel against Schistosoma haematobium, the causative agent of urinary schistosomiasis, during a school-based treatment program in the Msambweni area of Coast Province, Kenya, where the disease is highly endemic. Our results, derived from treating 4,031 of 7,641 children from 1984 to 1993, indicate substantial year-to- year variation in drug efficacy. However, the pattern of this variation was not consistent with primary or progressive emergence of praziquantel resistance. Mathematical modeling indicated that, at current treatment rates, praziquantel resistance will likely take 10 or more years to emerge

Reconstruction of Complex Post-Traumatic Perineal/Pelvic Defects Using a Pedicled Anterolateral Thigh Flap in a Child

The complexity of the female pelvis and perineum becomes evident when traumatic or surgical defects need to be reconstructed; consideration should be given to the restoration or preservation of the most important  functions subserved by this anatomic region. We used a composite pedicled  fasciocutaneous anterolateral thigh flap with an innervated vastus lateralis muscle to reconstruct the pelvic ring, vagina, clitoris, labia and mons pubis. Unaided ambulation, urinary and anal continence were successfully restored. An appropriately designed pedicled ALT flap can be successfully used to achieve excellent pelvic/perineal reconstruction and functional restoration in complex pelvic/ perineal defects, even in children.Key Words: Trauma, Perineum, Pedicled ALT, Reconstructio