Adult BMI change and risk of Breast Cancer: National Health and Nutrition Examination Survey (NHANES) 2005-2010

OBJECTIVE: Breast cancer is the second leading cause of cancer mortality among women in the developed world. This study assessed the association between occurrence of breast cancer and body mass index (BMI) change from age 25 to age closest to breast cancer diagnosis while exploring the modifying effects of demographic variables. METHODS: The National Health and Nutrition Examination Survey data were used. Women included were ≥50 years, not pregnant and without a diagnosis of any cancer but breast. The total sample included 2895 women (172 with breast cancer and 2723 controls with no breast cancer diagnosis). Multivariate logistic regression was used to estimate the OR and 95 % CIs and interaction evaluated by including an interaction term in the model. RESULTS: Women whose BMI increased from normal or overweight to obese compared to those who remained at a normal BMI were found to have a 2 times higher odds (OR = 2.1; 95 % CI 1.11-3.79) of developing breast cancer. No significant association was observed for women who increased to overweight. However, a more pronounced association was observed in non-Hispanic black women (OR = 6.6; 95 % CI 1.68-25.86) and a significant association observed when they increased from normal to overweight (OR = 4.2; 95 % CI 1.02-17.75). CONCLUSIONS: Becoming obese after age 25 is associated with increased risk of breast cancer in women over 50 years old, with non-Hispanic black women being at greatest risk

Integrating ICT with education: using computer games to enhance learning mathematics at undergraduate level

Integration of ICT in the education sector is a desired trend globally. Where it has been adopted, it contributes significantly to increased access to education for all (EFA). This research seeks to look into ways in which computer games as ICT tools can be used to enhance and promote quality teaching and learning; particularly in creating and sustaining interest in the teaching and learning of Functions, a topic taught in mathematics coursessuch as Discrete Mathematics, Real Analysis and Calculus, among others. At Jomo Kenyatta University of Agriculture and Technology (JKUAT) in Kenya, the topic is introduced to students of Mathematics and those of Computer Science in first year Discrete Mathematics. A computer game was developed using Full Professional Adobe Acrobat 9 Pro. The game isdesigned in five levels in line with the progression of functions subject content. A minimum score of 60% for each level was built in the game to ensure the player has a good grip of the content for a certain level before moving on to the next level, thus contributing to guided revision of the level with fun. After game development, it was availed to ten first year Bachelor of Science in Mathematics students taking discreet Mathematics course at the Taita Taveta Campus of JKUAT. The students were in their second semester academic year 2009/2010. Analysis of end of the  semester examinations results show that students who played the game had better performance than their counterparts who had not. Recommendations for further work as advancement of this research is development of a more advanced game in terms of adaptation of the game for use in teaching and learning other Mathematics topics considered to be boring, or difficulty or both and ultimately for purposes of promoting universal quality of university teaching.&nbsp

Evidence for over-dispersion in the distribution of clinical malaria episodes in children.

BACKGROUND: It may be assumed that patterns of clinical malaria in children of similar age under the same level of exposure would follow a Poisson distribution with no over-dispersion. Longitudinal studies that have been conducted over many years suggest that some children may experience more episodes of clinical malaria than would be expected. The aim of this study was to identify this group of children and investigate possible causes for this increased susceptibility. METHODOLOGY AND PRINCIPAL FINDINGS: Using Poisson regression, we chose a group of children whom we designated as 'more susceptible' to malaria from 373 children under 10 years of age who were followed up for between 3 to 5 years from 1998-2003. About 21% of the children were categorized as 'more susceptible' and although they contributed only 23% of the person-time of follow-up, they experienced 55% of total clinical malaria episodes. Children that were parasite negative at all cross-sectional survey were less likely to belong to this group [AOR = 0.09, (95% CI: 0.14-0.61), p = 0.001]. CONCLUSIONS AND SIGNIFICANCE: The pattern of clinical malaria episodes follows a negative binomial distribution. Use of lack of a clinical malaria episode in a certain time period as endpoints for intervention or immunological studies may not adequately distinguish groups who are more or less immune. It may be useful in such studies, in addition to the usual endpoint of the time to first episode, to include end points which take into account the total number of clinical episodes experienced per child

Physical and sexual abuse in orphaned compared to non-orphaned children in sub-Saharan Africa: A systematic review and meta-analysis

This systematic review assessed the quantitative literature to determine whether orphans are more likely to experience physical and/or sexual abuse compared to non-orphans in sub-Saharan Africa (SSA). It also evaluated the quality of evidence and identified research gaps. Our search identified 10 studies, all published after 2005, from Zimbabwe, South Africa, Kenya and Uganda. The studies consisted of a total 17,336 participants (51% female and 58% non-orphans). Of those classified as orphans (n = 7,315), 73% were single orphans, and 27% were double orphans. The majority of single orphans were paternal orphans (74%). Quality assessment revealed significant variability in the quality of the studies, although most scored higher for general design than dimensions specific to the domain of orphans and abuse. Combined estimates of data suggested that, compared to non-orphans, orphans are not more likely to experience physical abuse (combined OR = 0.96, 95% CI [0.79, 1.16]) or sexual abuse (combined OR = 1.25, 95% CI [0.88, 1.78]). These data suggest that orphans are not systematically at higher risk of experiencing physical or sexual abuse compared to non-orphans in sub-Saharan Africa. However, because of inconsistent quality of data and reporting, these findings should be interpreted with caution. Several recommendations are made for improving data quality and reporting consistency on this important issue

Influence of Prices on Market Participation Decisions of Indigenous Poultry Farmers in Four Districts of Eastern Province, Kenya

Over 70% of the domesticated birds in Kenya are indigenous chicken (IC) providing meat and table eggs. They are frequently raised through the free range, backyard production system. Small flock sizes are characteristic of this production system and often, sales are mainly at the farmgate. Although IC production possesses enormous potential at livelihood improvement, marketing systems are undefined and variable. The influence of prices on market engagement has frequently been assumed. A study of 68 farmers conducted in Machakos, Kibwezi, Nzaui and Mwala District in 2008 revealed that 70% of all IC sales were conducted at the farmgate while only 19% of the sales were at the local market. This study also investigates the probability of market participation by employing a binary logistic regression model. The results suggests that while farmers complain of poor farm gate prices for indigenous chicken offered by middlemen, low volumes are an important drawback to market participation

Mammography Adherence in African-American Women: Results of a Randomized Controlled Trial

BACKGROUND: Breast cancer is the second leading cause of cancer mortality among women in the developed world. Mammography screening is especially important for African-Americans because they experience a greater mortality (OR = 1.38) than Caucasians despite having a lower incidence of breast cancer. PURPOSE: The purpose of this study was to compare the effects of two interventions with usual care on mammography adherence among African-American women. METHODS: A subsample of African-American women (n = 244) aged 41-65 years who had not had a mammogram in the last 15 months and no history of breast cancer was randomly assigned to receive (1) mailed interactive DVD, (2) computer-tailored telephone counseling, or (3) usual care. RESULTS: The DVD intervention was five times more effective than usual care for promoting mammography screening at 6 months follow-up among women who earned less than $30,000 (OR = 5.3). Compared to usual care, neither the DVD nor phone produced significant effects for women with household incomes >$30,000. CONCLUSION: Use of a mailed DVD for low-income African-American women may be an effective way to increase mammography adherence

Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver-child dyads enrolled in the study, children's mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child's knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5-2.1), better WHO disease stage (OR 2.5, 95% CI 1.4-4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1-3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes