The City of Riverside Food System Map and Healthy Food Accessibility Analysis

Food security is a component of both accessibility and nutritional value of food to the consumer. Food access is dependent on income and the distance a consumer covers to get to a food source. Healthy food access is therefore both a geographical and socio economic problem. In this project, the City of Riverside sought GIS technology to understand and tackle issues related to healthy food access. This was achieved through the development of an online application that maps local food resources and spatial analysis to investigate food access in relation to the spatial distribution of these resources. Income levels and distance from a food source were the criteria used to identify areas in the city that have low healthy food access and require attention by policy makers and other stakeholders. The results of the food analysis were communicated through the web application. The application is also an interactive platform that consumers and food distribution sources could use to connect with each other

Effects of Hedging Foreign Exchange Risk on Financial Performance of Non-Banking Companies Listed at the Nairobi Securities Exchange

The general objective of this study was to establish the effects ofhedging foreign exchange risk on financial performance of non-bankingcompanies listed at the Nairobi securities exchange. A descriptive researchdesign was adopted on the target population of 49 non-banking firms listed atthe NSE. Primary data collected using a questionnaire was used containingboth open and close ended questions. Data was analyzed using SPSS togenerate descriptive statistics such as percentages, frequency distribution,measures of central tendencies (mean) and the data was presented in tables.The study conducted multiple regression analysis to establish the extent towhich the hedging techniques affected firm’s performance. The resultsshowed that, taking all factors into account (internal hedging techniques,external hedging technique, inflation and interest rates) performance of nonfinancialfirms would be 0.564. The findings presented further indicated thatinternal hedging had the greatest effect on the firm performance (β = 0.551),Inflation (β = 0.322), External hedging (β = 0.133 while interest rate (β =0.024) had the least effect to the firms performance. However, all thevariables were significant (p<0.05). Hedging techniques affected firm’sperformance i.e. profitability, sales revenue and the cash flow and liquidityposition of the firm. The internal techniques were more effective on theperformance than the external techniques. The four independent variablesstudied accounted for 75.5% of the variations in non-banking firms’performance as represented by the adjusted R2. This therefore means the fourvariables contribute to 75.5% of performance, while other factors not studiedin this research contributes 24.5%. The study recommends that, firmsdevelop a robust foreign exchange risk management framework whichclearly shows its currency risk assessment procedure and implementation of currency risk management strategies. It also recommends that the variousaspects of firm’s financial performance be taken into consideration beforeadopting a particular technique to hedge to protect cash flow, liquidity,profitability and sales revenue

Kinetics of the neutralizing antibody response to respiratory syncytial virus infections in a birth cohort

The kinetics of respiratory syncytial virus (RSV) neutralizing antibodies following birth, primary and secondary infections are poorly defined. The aims of the study were to measure and compare neutralizing antibody responses at different time points in a birth cohort followed-up over three RSV epidemics. Rural Kenyan children, recruited at birth between 2002 and 2003, were monitored for RSV infection over three epidemic seasons. Cord and 3-monthly sera, and acute and convalescent sera following RSV infection, were assayed in 28 children by plaque reduction neutralization test (PRNT). Relative to the neutralizing antibody titers of pre-exposure control sera (1.8 log10 PRNT), antibody titers following primary infection were (i) no different in sera collected between 0 and 0.4 months post-infection (1.9 log10 PRNT, P = 0.146), (ii) higher in sera collected between 0.5 and 0.9 (2.8 log10 PRNT, P < 0.0001), 1.0–1.9 (2.5 log10 PRNT, P < 0.0001), and 2.0–2.9 (2.3 log10 PRNT, P < 0.001) months post-infection, and (iii) no different in sera collected at between 3.0 and 3.9 months post-infection (2.0 log10 PRNT, P = 0.052). The early serum neutralizing response to secondary infection (3.02 log10 PRNT) was significantly greater than the early primary response (1.9 log10 PRNT, P < 0.0001). Variation in population-level virus transmission corresponded with changes in the mean cohort-level neutralizing titers. It is concluded that following primary RSV infection the neutralizing antibody response declines to pre-infection levels rapidly (∼3 months) which may facilitate repeat infection. The kinetics of the aggregate levels of acquired antibody reflect seasonal RSV occurrence, age, and infection history

Impact of traffic congestion on spatial access to healthcare services in Nairobi

Background: Geographic accessibility is an important determinant of healthcare utilization and is critical for achievement of universal health coverage. Despite the high disease burden and severe traffic congestion in many African cities, few studies have assessed how traffic congestion impacts geographical access to healthcare facilities and to health professionals in these settings. In this study, we assessed the impact of traffic congestion on access to healthcare facilities, and to the healthcare professionals across the healthcare facilities.Methods: Using data on health facilities obtained from the Ministry of Health in Kenya, we mapped 944 primary, 94 secondary and four tertiary healthcare facilities in Nairobi County. We then used traffic probe data to identify areas within a 15-, 30- and 45-min drive from each health facility during peak and off-peak hours and calculated the proportion of the population with access to healthcare in the County. We employed a 2-step floating catchment area model to calculate the ratio of healthcare and healthcare professionals to population during these times.Results: During peak hours, &lt;70% of Nairobi's 4.1 million population was within a 30-min drive from a health facility. This increased to &gt;75% during off-peak hours. In 45 min, the majority of the population had an accessibility index of one health facility accessible to more than 100 people (&lt;0.01) for primary health care facilities, one to 10,000 people for secondary facilities, and two health facilities per 100,000 people for tertiary health facilities. Of people with access to health facilities, a sub-optimal ratio of &lt;4.45 healthcare professionals per 1,000 people was observed in facilities offering primary and secondary healthcare during peak and off-peak hours.Conclusion: Our study shows access to healthcare being negatively impacted by traffic congestion, highlighting the need for multisectoral collaborations between urban planners, health sector and policymakers to optimize health access for the city residents. Additionally, growing availability of traffic probe data in African cities should enable similar analysis and understanding of healthcare access for city residents in other countries on the continent

Neonatal Ebstein’s Anomaly: Surgical Decision Making

Ebstein’s Anomaly (EA) is a rare form of congenital heart disease. Surgical decision-making in neonates is controversial. In developing countries, neonates with Ebstein’s anomaly requiring surgical intervention rarely present to health institutions capable of providing intervention. We present a 2.2 kg term female neonate who presented with Ebstein’s anomaly. Data was obtained retrospectively from clinical case notes. We describe our surgical decision-making process and outcome in relation to prevailing thought regarding the management of this condition and we make a recommendation on what we consider to be the best surgical option for these patients.Key words: Ebstein's anomaly, Neonatal, Treatmen

Rainfall and Temperature Trends and Variability in Arid and Semi-arid Lands of Kitui County, Kenya

A study was carried out to analyse rainfall and temperature trends and variability in selected agro-ecological zones in Kitui County. Climate Hazards Group Infrared Precipitation with Stations (CHIRPS) rainfall dataset was used while temperature data was obtained from the Climatic Research Unit gridded Time Series (CRU TS) dataset. The results indicated that there was a non-significant decreasing trend (p&lt;0.05) in average annual rainfall in all the four agro-ecological zones (p&lt;0.05) for a 30-years period (1988-2018) in the study area. A decreasing trend in March-April-May (MAM) seasonal rainfall trend was reported in the arid and semi-arid agro-ecological zones while an increasing trend was recorded in the transitional and semi-humid zones. For the October-November-December (OND) seasonal rainfall, a non-significant decreasing trend was reported in all the four agro-ecological zones. Additionally, a higher annual rainfall variability was recorded in the drier (arid) and wetter (semi-humid) zones compared to that in semi-arid and transitional zones. Moreover, the study established that there was a spatial variation in both MAM and OND seasonal rainfall variability and that rainfall variability was higher in the OND seasonal rainfall than that of the MAM seasonal rainfall in all the agro-ecological zones. With reference to temperature trends, a statistically significant increasing trend in annual and OND seasonal average maximum and minimum temperatures was reported in all the four agro-ecological zones. Further, the study noted a non-significant increasing trend in maximum and minimum temperatures for the MAM season in all the agro-ecological zones. In regard to temperature variability, the study deduced that there was low temperature variability compared to rainfall variability in all the four agro-ecological zones. The study recommends that location-specific rainfall and temperature analysis should guide planning and implementation of adaptation strategies for effective response to climate variability. Keywords: Agro-ecological Zones, Mann-Kendall Test, Coefficient of Variation, CHIRPS, CRU TS DOI: 10.7176/JEES/12-12-05 Publication date: December 31st 202

Perceptions and experiences of dementia and its care in rural Kenya

Objectives We aimed to explore the perceptions towards dementia and related care across three stakeholder groups in rural Kenya. Methods A total of 38 key stakeholders (carers of persons with dementia, health care providers and the general public) participated in focus group discussions. Additional five individual interviews were held with carers. Thematic analysis was used to analyse the data. Findings Across the three participant groups, a total of four themes were identified: (i) negative stereotypes of dementia, (ii) limited knowledge about dementia, (iii) diagnostic pathway and (iv) neglect and abuse. Conclusions We found a general lack of knowledge of dementia amongst family carers, healthcare professionals and the general public. The combination of poor awareness and ill-equipped healthcare systems leads to stigma manifested in the form of patchy diagnostic pathways, neglect and abuse. Local governments could take advantage of the existing family- and community-based systems to improve understanding of dementia nationally

Spatio-temporal distribution of rhinovirus types in Kenya: a retrospective analysis, 2014

The epidemiology and circulation patterns of various rhinovirus types within populations remains under-explored. We generated 803 VP4/VP2 gene sequences from rhinovirus-positive samples collected from acute respiratory illness (ARI) patients, including both in-patient and outpatient cases, between 1st January and 31st December 2014 from eleven surveillance sites across Kenya and used phylogenetics to characterise virus introductions and spread. RVs were detected throughout the year, with the highest detection rates observed from January to March and June to July. We detected a total of 114 of the 169 currently classified types. Our analysis revealed numerous virus introductions into Kenya characterized by local expansion and extinction, and extensive spatial mixing of types within the country due to the widespread transmission of the virus after an introduction. This work demonstrates that in a single year, the circulation of rhinovirus in Kenya was characterized by substantial genetic diversity, multiple introductions, and extensive geographical spread

Use of Maerua Decumbens as a Natural Coagulant for Water Purification in the Dry Lands of Kenya

ABSTRACT: Indigenous management and utilization of naturally occurring tree species and shrubs/lianas is not a new culture worldwide. Various communities in the world use their indigenous tree /shrub / liana species to meet their needs for food (human and livestock), shelter and medicine among other diverse wood and non-wood forest products. Introduction of new exotic species has eroded the importance of some of these important indigenous plant species to great extends. It is however, important to consider that while these exotic species have multiple uses, most of them are not well adapted to our arid and semi-arid regions hence the need to promote the management and sustainable use of the indigenous species. Maerua decumbens is a shrub or woody herb species in the Capparaceae family and grows to a height of 0.5 to 3m with a large swollen root. It mostly occurs naturally in the arid and semiarid areas in Kenya and is used traditionally by rural communities for medicinal and water purification purposes. Members of the Mearua species are indicated as poisonous and probably a health risk and yet some of the communities chew the roots of Mearua decumbens against thirst and also use them for purifying water (Beenje H.1994). The study was done to enhance the use of Maerua decumbens as a natural coagulant for water purification by determining whether the plant used for water purification in Mutha in Kitui County is toxic or not. A reconnaissance survey was done to confirm its use for water purification and toxicity tests were done to determine the safety of the plant for human utilization as a natural coagulant for water purification. The results of the study revealed that M.decumbens is completely safe for human consumption and does not have any heavy metals that pose a risk to human health