Child Survival, Poverty and Policy Options from DHS Surveys in Kenya: 1993-2003

This paper analyses multidimensional aspects of child poverty in Kenya. We carry out poverty and inequality comparisons for child survival and also use the parametric survival model to explain childhood mortality using DHS data. The results of poverty comparisons show that: children with the lowest probability of survival are from households with the lowest level of assets; and poverty orderings for child survival by assets are robust to the choice of the poverty line and to the measure of wellbeing. Inequality analysis suggests that there is less mortality inequality among children facing mortality than children who are better off. The survival model results show that child and maternal characteristics, and household assets are important correlates of childhood mortality. The results further show that health care services are crucial for child survival. Policy simulations suggest that there is potential for making some progress in reducing mortality, but the ERS and MDG targets cannot be achieved.Child survival, multidimensional poverty, inequality, stochastic dominance, childhood mortality, asset index, Kenya

THE DETERMINANTS OF FINANCIAL PERFORMANCE IN GENERAL INSURANCE COMPANIES IN KENYA

The contribution of the general insurance industry in Kenya to the gross domestic product is at 2.08%. This is low and hence the need to establish factors that can influence improved performance of some of the key players – the general insurance companies. The study was therefore to establish the factors that affect the profitability of general insurers in Kenya. The study employed multiple linear regression, with return on assets as the dependent variable, and considered all the general insurance companies in Kenya for the period 2009-2012. Profitabilitywas positively related to leverage, equity capital, management competence index and negatively related to sizeand ownership structure. The study did not find a relationship between performance and retention ratio, liquidity, underwriting risk and age. The study recommends that for general insurers in Kenya to perform better they should increase leverage, equity capital and quality of staff

Ohio CCRCs in the Economic Downturn

This report examines how the economic downturn affected consumer opinions about choosing a CCRC and how the CCRCs in Ohio made adjustments in response to declining numbers of prospective residents. One hundred-sixty five Ohio CCRCs are included in the survey results

Implementation of the 2008 Ohio Nursing Home Family Satisfaction Survey : Final Report

In 2008, the Scripps Gerontology Center conducted the third bi-annual nursing home family satisfaction survey under a contract to the Ohio Department of Aging. Refinements to the survey instrument showed continued high reliability of domain areas and the instrument as a whole. Changes in instructions to families, and a number of processes were changed this year that resulted in fewer family and facility calls requesting assistance from the toll-free hotline. Comparisons of 2006 and 2008 responses show some significant improvements statewide, with more items showing statewide averages of 90 and above. The family satisfaction survey is one important component of the comprehensive nursing home information shown on the Ohio Long-Term Care Consumer Guide (www.ltcohio.org)

Implementation of the 2010 Ohio Nursing Home Family Satisfaction Survey : Final Report

In 2010, the Scripps Gerontology Center conducted the fifth biennial Ohio Nursing Home Family Satisfaction Survey under a contract to the Ohio Department of Aging. This year the survey had the largest number of family response ever, with 97% of facilities participating and nearly 30,000 involved family and friends responding. An online version of the family survey was also made available for the first time. The report includes information about the survey process, psychometric analysis of the survey, and recommendations for future implementation of the family survey. The family satisfaction survey is one important component of the comprehensive nursing home information shown on the Ohio Long-Term Care Consumer Guide (www.ltcohio.org). Overall scores are also used as a quality component of Ohio's nursing home Medicaid reimbursement formula

Implementation of the 2010 Ohio Nursing Home Family Satisfaction Survey: Final Reportf

In 2010, the Scripps Gerontology Center conducted the fifth biennial Ohio Nursing Home Family Satisfaction Survey under a contract to the Ohio Department of Aging. This year the survey had the largest number of family response ever, with 97% of facilities participating and nearly 30,000 involved family and friends responding. An online version of the family survey was also made available for the first time. The report includes information about the survey process, psychometric analysis of the survey, and recommendations for future implementation of the family survey. The family satisfaction survey is one important component of the comprehensive nursing home information shown on the Ohio Long-Term Care Consumer Guide (www.ltcohio.org). Overall scores are also used as a quality component of Ohio's nursing home Medicaid reimbursement formula

A system for profiling the IXPs in a region and monitoring their growth: spotlight at the internet frontier

This work aims at designing and implementing a system able to profile and help manage the set of Internet eXchange Points (IXPs) in an Internet region. As part of the Internet Society's strategy to help monitor and understand the evolution of IXPs in a particular region, a route-collector data analyzer tool was developed before being deployed and tested in AfriNIC. In fact, traffic localization efforts in the African peering ecosystem would be more sustained, and their efficacy assessed if they were supported by a platform, which evaluates and reports in real time about their impact on the Internet. We, thus, built the “African” Route-collectors Data Analyzer (ARDA), an open source web platform for analyzing publicly available routing information collected since 2005, by local route-collectors. ARDA evaluates predefined metrics that picture the status of the interconnection at local, national, and regional levels. It shows that a small proportion of AfriNIC ASes (roughly 17%) are peering in the region. Through them, 58% of all African networks are visible at one IXP or more. These have been static from April to September 2017, and even February 2018, underlining the need for increased efforts to improve local interconnectivity. We show how ARDA can help detect the impact of policies on the growth of local IXPs or continually provide the community with up-to-date empirical data on the evolution of the IXP substrate. Given its features, this tool will be a helpful compass for stakeholders in the quest for better traffic localization and new interconnection opportunities in the targeted region.This work was partially funded by the Internet Society (ISOC). Support to this work was also provided by IMDEA Networks Institute, the National Science Foundation (NSF) CNS-1414177, and NSF OAC-1724853.We are grateful to Nishal Goburdhan and Dibya Khatiwada for their technical support as well as to The African IXP Association (Af-IX), Packet Clearing House (PCH), and Hisham Ibrahim for their cooperation.Publicad

A Comparative Study of Modified and Unmodified Algae (Pediastrum boryanum) for Removal of Lead, Cadmium and Copper in Contaminated Water

The presence of heavy metals in water is of concern due to the risk toxicity. Thus there is need for their removal for the safety of consumers. Methods applied for removal of heavy metals include adsorption, membrane filtration and co-precipitation. However, studies have revealed adsorption is highly effective technique. Most adsorbents are expensive or require extensive processing before use and hence need to explore for possible sources of inexpensive adsorbents. This research work investigated the use an algal biomass (pediastrum boryanum) as an adsorbent for removal of Lead, Cadmium and Copper in waste water in its raw and modified forms. The samples were characterized with FTIR and was confirmed a successful modification with tetramethylethlynediamine (TMEDA). Sorption parameters were optimized and the material was finally applied on real water samples. It was found that the sorption was best at lower pH values (4.2-6.8). Sorption kinetics was very high as more that 90% of the metals were removed from the solution within 30 minutes. The adsorption of copper fitted into the Langmuir adsorption isotherm indicating a monolayer binding mechanism. Cadmium and lead fitted best the Freundlich adsorption mechanism. Sorption of lead and cadmium was of pseudo-second order kinetics, confirming a multisite interaction whereas copper was pseudo-first order indicating a single site adsorption. The adsorption capacity did not improve upon modification but the stability of the material was improved and secondary pollution of leaching colour was alleviated. This implies that the modified material is suitable for application on the removal of metals from water

Comparison of equations for estimating glomerular filtration rate in screening for chronic kidney disease in asymptomatic black Africans: A cross sectional study

Background: Several equations have been developed to estimate glomerular filtration rate (eGFR). The common equations used were derived from populations predominantly comprised of Caucasians with chronic kidney disease (CKD). Some of the equations provide a correction factor for African-Americans due to their relatively increased muscle mass and this has been extrapolated to black Africans. Studies carried out in Africa in patients with CKD suggest that using this correction factor for the black African race may not be appropriate. However, these studies were not carried out in healthy individuals and as such the extrapolation of the findings to an asymptomatic black African population is questionable. We sought to compare the proportion of asymptomatic black Africans reported as having reduced eGFR using various eGFR equations. We further compared the association between known risk factors for CKD with eGFR determined using the different equations. Methods: We used participant and laboratory data collected as part of a global reference interval study conducted by the Committee of Reference Intervals and Decision Limits (C-RIDL) under the International Federation of Clinical Chemistry (IFCC). Serum creatinine values were used to calculate eGFR using the Cockcroft-Gault (CG), re-expressed 4 variable modified diet in renal disease (4v–MDRD), full age spectrum (FAS) and chronic kidney disease epidemiology collaboration equations (CKD-EPI). CKD classification based on eGFR was determined for every participant. Results: A total of 533 participants were included comprising 273 (51.2%) females. The 4v–MDRD equation without correction for race classified the least number of participants (61.7%) as having an eGFR equivalent to CKD stage G1 compared to 93.6% for CKD-EPI with correction for race. Only age had a statistically significant linear association with eGFR across all equations after performing multiple regression analysis. The multiple correlation coefficients for CKD risk factors were higher for CKD-EPI determined eGFRs. Conclusions: This study found that eGFR determined using CKD-EPI equations better correlated with a prediction model that included risk factors for CKD and classified fewer asymptomatic black Africans as having a reduced eGFR compared to 4v–MDRD, FAS and CG corrected for body surface area

Assessment of Patient Satisfaction with Nursing Care at a Large Public Referral Hospital in Kenya

Patient satisfaction with nursing care is known to predict patient outcomes. Nursing care offered by the largest single technical group in any hospital, is known to often determine the overall quality of care offered. This study hence examined the extent to which patients at a Referral hospital in Western Kenya are satisfied with the nursing care they receive. A cross sectional exit survey of discharged patients using a self-administered patient questionnaire was used. 274 patients participated, of which 65.6% were female. 94.1% had formal education with 59.1% reporting that this was their maiden visit to the hospital. Overall, 87% of patients felt satisfied with nursing care received. Most (81.8%) of the patients interviewed felt they had been promptly attended to, with a further 71.6% rating the nurses as competent and knowledgeable in their clinical care. The ward in which the patient had been admitted and the number of days a patient had spent in hospital were found to be significantly associated with reporting of overall satisfaction with nursing care (p=0.037 & 0.03 respectively). Since nursing care is determinant of patient outcomes during hospitalization, clinical care administrators should often emphasize on the Nurses’ technical competence and interpersonal relationships throughout patient care. Prompt quality nursing care should be prioritized to match with patient expectations in each hospital units and ensure patient satisfaction through reduction of length of stay in hospital. Key words: Assessment, patient satisfaction, nursing car