Determinants of Academic Performance in Kenya Certificate of Secondary Education in Public Secondary Schools in Kiambu County, Kenya

this article sought to investigate the determinants of academic performance in Kenya Certificate of Secondary Education Examination (KCSE) in public secondary schools in Kiambu County, Kenya. Four research questions were formulated to guide the study. The study adopted the ex-post-facto research design. Simple stratified random sampling techniques were used to select the sample; 260 teachers, 246 students, 36 principals and the County Director of Education (CDEO) Kiambu County. Data was collected through the use of questionnaires for students and teachers, while interview schedule was used to collect data from the principals and the County Director of Education. The findings revealed that, majority of the teachers (72.8%) did not use apparatus in the teaching of science subjects while 55.6% of the students felt that their science laboratories were not well equipped. From the study, 55.7% of the schools had no libraries and where they existed, they were poorly equipped. lecture method was more widely used than any other method of teaching. Again further 63.8% of the sampled students had scored 201-300 marks out of 500 marks at primary school level hence poor academic background. Most teachers lived outside the schools as indicated by 57.3% of the students’ respondents, hence remedial teaching during morning and evening was not possible. From the study majority of the students (56.9%) revealed that, the syllabus was never covered before the end of every year. Among the recommendations of the study were; the Board of Governors should equip the science laboratories and libraries and put up teachers houses. A variety of teaching methods should be used to create interest in learning and teachers should focus on value addition of the learners’ due to their low Kenya Certificate of Primary Education (KCPE) entry marks to secondary school. internal supervision of the implementation of the curriculum by the principals needs to be intensified. keywords: Academic performance, Curriculum, Entry marks, Implementation of curriculum, teaching methods, teaching and learning resources, school education day, school academic da

Post-operative Trachomatous Trichiasis in Africa: a systematic review and online survey

Background High incidence of post-operative trichiasis and other poor outcomes after surgery in most trachoma-endemic settings poses a major challenge to global elimination of trachoma. This systematic review aimed to assess the incidence of post-operative trichiasis and other poor outcomes of trichiasis surgery in Africa, based on findings of observational and interventional studies. Search methods We searched PubMed, Academic Search Premier, Africa-Wide Information, CINAHL and Health Source Nursing through EBSCOhost, Web of Science [all databases], and Cochrane Central Register of Controlled Trials for relevant studies on the subject. We also searched the reference lists of included studies to identify further potentially relevant studies. We included all observational and interventional studies that measured post-operative trichiasis as one of the primary outcomes. Only studies conducted in Africa were included in this review. Data collection and analysis Two reviewers independently screened the titles and abstracts, selected and assessed the articles for inclusion in this review. Any disagreements were resolved through discussion or by consulting a third reviewer. Where necessary, the corresponding authors of included studies were contacted to provide any missing data. Our primary outcome was post-operative trichiasis, which was defined as any eyelash touching the globe at different time points after surgery. Main results Thirty-five studies, including 12,943 participants, met the inclusion criteria. A number of the studies included in this review utilized the same data to measure the incidence of post-operative trichiasis and other poor outcomes over different follow-up periods. Overall, a review of the included studies revealed a pattern of high incidence of post-operative trichiasis and other poor outcomes ranging from 2.3 at 6 weeks to 65% at 7 years. This incidence varied by type of study design, surgical procedure and technique used as well as the follow up period among other factors

Obesity and obesity-related markers associated with breast and colorectal cancer occurence and mortality

Indiana University-Purdue University Indianapolis (IUPUI)Purpose: Obesity is a growing public health problem and the second most preventable cause of death in the US. Obesity has been linked as a risk factor for several cancers. However, there are limited studies that have examined the roles of metabolic syndrome (MetS) and C-reactive protein (CRP), as well as change in body composition from early adulthood to late adulthood on the risk of cancer. The overall objective of this dissertation was to determine the association of obesity and obesity-related markers with breast and colorectal cancer occurrence and mortality. Methods: Three datasets were used. The first study used 4,500 asymptomatic adults who were surveyed during a colorectal cancer screening study. The second study was based on the National Health and Nutrition Examination Survey (NHANES) 2005-2010. The dataset had 172 breast cancer survivors and 2,000 women without breast cancer. The last manuscript resulted from the NHANES follow-up study (NHANES III). A total of 120 cancer deaths from breast and colorectal deaths were identified from 10,103 women aged 18 years or older. Results: Overall, obesity and obesity related markers were associated with breast and colorectal cancer occurrence and mortality. BMI change and WC change were positively associated with increased risk of advanced colorectal neoplasia (AN). WC measures (both static and dynamic) were generally a better predictor of AN compared to BMI. In the second study involving breast cancer survivors, neither MetS nor CRP were associated with having a breast cancer diagnosis. Also, none of the individual components of MetS (WC, Triglycerides, HDL, fasting blood glucose and blood pressure) were associated with a breast cancer diagnosis. In the last study, MetS was associated with increased risk of mortality from obesity-related cancers. In addition, all components of MetS, except dyslipidemia, were associated with increased risk of mortality for the obesity-related cancers. Conclusion: Obesity expressed in terms of BMI and WC, or their change, MetS and CRP are important factors in regard to the occurrence, survivorship and mortality of breast and colorectal cancer. The results of this research underscore the importance of maintaining a healthy weight

Effects of Dramatization on Learning of the English Language in Meru County, Kenya

The study sought to find out the effects of dramatization on learning of the English Language, among high school students and its influence on learner achievement. The target population of the study was 4,400 students, 45 headteachers, 720 teachers and 16 Directorate Quality Assurance officers from the Ministry of Education Science and Technology. Data was qualitative and quantitative in nature and was collected using questionnaires, interviews and test scores. Data was analyzed using IBM SPSS which is an acronym for (statistical package for social sciences software) and descriptive statistics. The analyzed data was presented in tables of frequencies and percentages. The study established that when dramatic features were used in learning the English Language, learner achievement was improved. The study explored the significance of drama and the communicative approach, teachers and student attitude towards drama, drama and learning of the English Language and drama and the micro-skills in learning the English Language. Other factors were dramatized poetry used in learning the English Language, dramatization and secondary curriculum, dramatization and performance of the English Language and Bloom’s taxonomy anddramatization in learning the English Language. Key Words: effects, dramatization, learning and English Language

Associations of Muscle Mass and Strength with All-Cause Mortality among US Older Adults

INTRODUCTION: Recent studies suggested that muscle mass and muscle strength may independently or synergistically affect aging-related health outcomes in older adults; however, prospective data on mortality in the general population are sparse. METHODS: We aimed to prospectively examine individual and joint associations of low muscle mass and low muscle strength with all-cause mortality in a nationally representative sample. This study included 4449 participants age 50 yr and older from the National Health and Nutrition Examination Survey 1999 to 2002 with public use 2011 linked mortality files. Weighted multivariable logistic regression models were adjusted for age, sex, race, body mass index (BMI), smoking, alcohol use, education, leisure time physical activity, sedentary time, and comorbid diseases. RESULTS: Overall, the prevalence of low muscle mass was 23.1% defined by appendicular lean mass (ALM) and 17.0% defined by ALM/BMI, and the prevalence of low muscle strength was 19.4%. In the joint analyses, all-cause mortality was significantly higher among individuals with low muscle strength, whether they had low muscle mass (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.27-3.24 for ALM; OR, 2.53; 95% CI, 1.64-3.88 for ALM/BMI) or not (OR, 2.66; 95% CI, 1.53-4.62 for ALM; OR, 2.17; 95% CI, 1.29-3.64 for ALM/BMI). In addition, the significant associations between low muscle strength and all-cause mortality persisted across different levels of metabolic syndrome, sedentary time, and LTPA. CONCLUSIONS: Low muscle strength was independently associated with elevated risk of all-cause mortality, regardless of muscle mass, metabolic syndrome, sedentary time, or LTPA among US older adults, indicating the importance of muscle strength in predicting aging-related health outcomes in older adults

Soybean farm-saved seed viability and vigor as influenced by agro-ecological conditions of Meru South Sub-County, Kenya

Objective: The experiment was conducted with the aim of assessing the soybean farm-saved seed viability and vigor as influenced by agro-ecological conditions of Meru South Sub-County, Kenya.Methodology and results: Within one month of harvest, soybean farm-saved-seed was randomly sampled from 30 households in February 2013 from areas representative of agro-ecological zones Upper Midlands II (Ann. Mean temp. (18.2-20.60C); Upper Midlands III (19.2-20.60C; Lower Midlands III (20.9-22.90C) and Lower Midlands IV (21-240C). Standard germination, electrical conductivity and moisture content tests were done according to ISTA rules (2007). Analysis of Variance was done using SAS (9.2) and means separated using LSD. Results revealed that seed moisture was lowest in the warmer LM4 (6.3%) than in the cooler LM3 (8%); UM3 (8.4%) and UM2 (10%). In addition, soybean seed from the cooler agro-ecologies - UM2 (94%), UM3 (86.6%) and LM3 (99.5%) had significantly higher germination than seed from the lower warmer LM4 (57%). Similarly, seed vigor was highest in the cooler UM2 (41.7 C/cm/g), UM3 (45.8C/cm/g) and LM3 (31.6C/cm/g) as shown by reduced seed leachates; indicative of better integrity of seed membranes than seed from the warmer LM4 (79.1C/cm/g). In addition, there was a strong negative correlation between electrical conductivity and germination, showing a faster deterioration due to leakage of electrolytes.Conclusions and applications of findings: The soybean farm-saved seed germination and vigor were significantly influenced by agro-ecological conditions. Considering that seed moisture content in the lower warmer agro-ecologies was significantly lower than those from higher cooler agro-ecologies the observed seed deterioration was attributable to the higher temperatures characteristic of lower altitudes agro-ecologies. Therefore, since the farm saved seed viability and vigor was better retained in the cooler higher agroecological zones (UM2, UM3 and LM3) of Meru South Sub-County, farmers should source better quality soybean seed from these areas. The results validate the need for ecological zoning of suitable areas for the production of high quality soybean seed in Kenya.Keywords: soybean farm-saved seed, agro-ecological zones, seed germination and vigo

PEPFAR Public Health Evaluation - Care and Support - Phase 2 Kenya

Phase 2 consisted of a longitudinal cohort study to measure patient-reported outcomes of care and support, a costing survey, and qualitative interviews to understand patient and carer experiences

Intra-urban variation of intimate partner violence against women and men in Kenya: Evidence from the 2014 Kenya Demographic and Health Survey

Although urban areas are diverse and urban inequities are well documented, surveys commonly differentiate intimate partner violence (IPV) rates only by urban versus rural residence. This study compared rates of current IPV victimization among women and men by urban residence (informal and formal settlements). Data from the 2014 Kenya Demographic and Health Survey, consisting of an ever-married sample of 1,613 women (age 15-49 years) and 1,321 men (age 15-54), were analyzed. Multilevel logistic regression was applied to female and male data separately to quantify the associations between residence and any current IPV while controlling for regional variation and other factors. Results show gendered patterns of intra-urban variation in IPV occurrence, with the greatest burden of IPV identified among women in informal settlements (across all types of violence). Unadjusted analyses suggest residing in informal settlements is associated with any current IPV against women, but not men, compared with their counterparts in formal urban settlements. This correlation is not statistically significant when adjusting for women’s education level in multivariate analysis. In addition, reporting father beat mother, use of current physical violence against partner, partner’s alcohol use, and marital status are associated with any current IPV against women and men. IPV gets marginal attention in urban violence and urban health research and our results highlight the importance of spatially disaggregate IPV data – beyond the rural-urban divide – to inform policy and programming. Future research may utilize intersectional and syndemic approaches to investigate the complexity of IPV and clustering with other forms of violence and other health issues in different urban settings, especially among marginalized residents in informal urban settings

Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya

Background: Diabetes and hypertension pose a significant socio-economic burden in developing countries such as Kenya, where financial risk-protection mechanisms remain inadequate. This proves to be a great barrier towards achieving universal health care in such settings unless mechanisms are put in place to ensure greater access and affordability to non-communicable disease (NCD) management services. Aim: This article aims to examine outpatient management services costs for patients with diabetes and hypertension attending public primary healthcare facilities. Setting: The study was conducted in Busia and Trans-Nzoia counties in Western Kenya in facilities supported by the PIC4C project, between August 2020 and December 2020. Methods: This cross-sectional survey included 719 adult participants. Structured interviewer-administered questionnaires were used to collect information on healthcare-seeking behaviour and associated costs. The annual direct and indirect costs borne by patients were computed by disease type and level of healthcare facility visited. Results: Patients with both diabetes and hypertension incurred higher annual costs (KES 13 149) compared to those with either diabetes (KES 8408) or hypertension (KES 7458). Patients attending dispensaries and other public healthcare facilities incurred less direct costs compared to those who visited private clinics. Furthermore, a higher proportionate catastrophic healthcare expenditure of 41.83% was noted among uninsured patients. Conclusion: Despite this study being conducted in facilities that had an ongoing NCDs care project that increased access to subsidised medication, we still reported a substantially high cost of managing diabetes and hypertension among patients attending primary healthcare facilities in Western Kenya, with a greater burden among those with comorbidities. Contribution: Evidenced by the results that there is enormous financial burden borne by patients with chronic diseases such as hypertension and diabetes; we recommend that universal healthcare coverage that offers comprehensive care for NCDs be urgently rolled out alongside strengthening of lower-level public healthcare systems