Stewardship Practices in Kenya with Proposed Solutions

Problem Although the Seventh-day Adventist church in Kenya has over three hundred thousand believers, the annual statistical reports indicate that its return of tithes and offerings does not correspond with its large membership. This study was undertaken to survey its giving patterns so as to discover possible weaknesses, to find ways of overcoming such weaknesses, and to promote faithful stewardship. Method To create a better concept of the stewardship of tithes and offerings an attempt was made to examine how tithes and offerings were practiced during the Old Testament era, intertestamental period, New Testament period, and by Ellen G. White. Also, an attempt was made to investigate the current pattern of giving. Three questionnaires were drafted and sent to Kenya to help determine the factors affecting the unfaithfulness of tithes and offerings. Based on the analysis of these questionnaires, solutions are proposed for possible improvement. These solutions are informed by the current literature on the stewardship of tithes and offerings, the researcher\u27s understanding of the biblical teaching of tithes and offerings, and his personal experience as a minister in the country under study. Results The study shows that the Bible does teach about the stewardship of tithes and offerings. God has always called upon His people to render their tithes and offerings so as to provide for His work on earth. Scripture and historical literature witness to the practices of tithing and freewill offerings from the Old Testament period, through the intertestamental and New Testament era. These sources give no information in this area regarding the Babylonian exile. Significantly, Ellen G. White makes it clear that the stewardship of tithes and offerings still applies to the present generation. She called for God\u27s people to continue supporting His work on earth by way of their tithes and offerings. It was her understanding that if all God\u27s children gave their tithes and offerings faithfully, there would be enough funds to provide ministry for God\u27s work on earth. Unfortunately, the SDA Church in Kenya does not have sufficient funds to provide for its ministries due to the unfaithfulness of some members in returning their tithes and offerings. The study reveals that, due to a number of factors, a significant number of church members return no tithes and offerings. A number of the factors have to do with the pastor\u27s lack of skills and tools needed to teach/preach on the subject of tithes and offerings. Conclusions The study reveals that several factors must be dealt with to effect the faithful return of tithes and offerings in East African Union. The most immediate way to strengthen the finances of the SDA Church in East African Union might lie in a calculated effort by both the leaders and pastors to instruct their members as to what constitutes tithes and offerings. In addition, an accurate account of how money is spent and a program to visit church members are likely to yield good results. Second, the leaders should pay immediate attention to the factors that affect the pastors\u27 ability to minister effectively. An effort should be made to provide the pastors with the skills and tools needed for their work, such as sufficient traveling allowance, stewardship material, and less churches. Moreover, the pastors\u27 theological training needs immediate attention. Third, all concerned need to work together for the sake of God\u27s work in East African Union

Performance of a new pulse contour method for continuous cardiac output monitoring: validation in critically ill patients

Background A new calibrated pulse wave analysis method (VolumeView™/EV1000™, Edwards Lifesciences, Irvine, CA, USA) has been developed to continuously monitor cardiac output (CO). The aim of this study was to compare the performance of the VolumeView method, and of the PiCCO2™ pulse contour method (Pulsion Medical Systems, Munich, Germany), with reference transpulmonary thermodilution (TPTD) CO measurements. Methods This was a prospective, multicentre observational study performed in the surgical and interdisciplinary intensive care units of four tertiary hospitals. Seventy-two critically ill patients were monitored with a central venous catheter, and a thermistor-tipped femoral arterial VolumeView™ catheter connected to the EV1000™ monitor. After initial calibration by TPTD CO was continuously assessed using the VolumeView-CCO software (CCOVolumeView) during a 72 h period. TPTD was performed in order to obtain reference CO values (COREF). TPTD and arterial wave signals were transmitted to a PiCCO2™ monitor in order to obtain CCOPiCCO values. CCOVolumeView and CCOPiCCO were recorded over a 5 min interval before assessment of COTPTD. Bland-Altman analysis, %errors, and concordance (trend analysis) were calculated. Results A total of 338 matched sets of data were available for comparison. Bias for CCOVolumeView−COREF was −0.07 litre min−1 and for CCOPiCCO-COREF +0.03 litre min−1. Corresponding limits of agreement were 2.00 and 2.48 litre min−1 (P<0.01), %errors 29 and 37%, respectively. Trending capabilities were comparable for both techniques. Conclusions The performance of the new VolumeView™-CCO method is as reliable as the PiCCO2™-CCO pulse wave analysis in critically ill patients. However, an improved precision was observed with the VolumeView™ technique. Clinicaltrials.gov identifier NCT0140504

Machine Learning Research Trends in Africa: A 30 Years Overview with Bibliometric Analysis Review

In this paper, a critical bibliometric analysis study is conducted, coupled with an extensive literature survey on recent developments and associated applications in machine learning research with a perspective on Africa. The presented bibliometric analysis study consists of 2761 machine learning-related documents, of which 98% were articles with at least 482 citations published in 903 journals during the past 30 years. Furthermore, the collated documents were retrieved from the Science Citation Index EXPANDED, comprising research publications from 54 African countries between 1993 and 2021. The bibliometric study shows the visualization of the current landscape and future trends in machine learning research and its application to facilitate future collaborative research and knowledge exchange among authors from different research institutions scattered across the African continent

Comment on Morse et al. A Universal Pharmacokinetic Model for Dexmedetomidine in Children and Adults. J. Clin. Med. 2020, 9, 3480

We read with interest the recently published manuscript [...]

Comparison of renal region, cerebral and peripheral oxygenation for predicting postoperative renal impairment after CABG

Patients undergoing coronary artery bypass grafting (CABG) are at risk of developing postoperative renal impairment, amongst others caused by renal ischemia and hypoxia. Intra-operative monitoring of renal region tissue oxygenation (SrtO(2)) might be a useful tool to detect renal hypoxia and predict postoperative renal impairment. Therefore, the aim of this study was to assess the ability of intra-operative SrtO(2) to predict postoperative renal impairment, defined as an increase of serum creatinine concentrations of > 10% from individual baseline, and compare this with the predictive abilities of peripheral and cerebral tissue oxygenation (SptO(2) and SctO(2), respectively) and renal specific tissue deoxygenation. Forty-one patients undergoing elective CABG were included. Near-infrared spectroscopy (NIRS) was used to measure renal region, peripheral (thenar muscle) and cerebral tissue oxygenation during surgery. Renal region specific tissue deoxygenation was defined as a proportionally larger decrease in SrtO(2) than SptO(2). ROC analyses were used to compare predictive abilities. We did not observe an association between tissue oxygenation measured in the renal region and cerebral oxygenation and postoperative renal impairment in this small retrospective study. In contrast, SptO(2) decrease > 10% from baseline was a reasonable predictor with an AUROC of 0.767 (95%CI 0.619 to 0.14; p = 0.010). Tissue oxygenation of the renal region, although non-invasively and continuously available, cannot be used in adults to predict postoperative renal impairment after CABG. Instead, peripheral tissue deoxygenation was able to predict postoperative renal impairment, suggesting that SptO(2) provides a better indication of 'general' tissue oxygenation status. Registered at ClinicalTrials.gov: NCT01347827, first submitted April 27, 2011

Prospective clinical validation of the Eleveld propofol pharmacokinetic-pharmacodynamic model in general anaesthesia

BACKGROUND: Target-controlled infusion (TCI) systems incorporating pharmacokinetic (PK) or PK-pharmacodynamic (PK-PD) models can be used to facilitate drug administration. Existing models were developed using data from select populations, the use of which is, strictly speaking, limited to these populations. Recently a propofol PK-PD model was developed for a broad population range. The aim of the study was to prospectively validate this model in children, adults, older subjects, and obese adults undergoing general anaesthesia. METHODS: The 25 subjects included in each of four groups were stratified by age and weight. Subjects received propofol through TCI with the Eleveld model, titrated to a bispectral index (BIS) of 40-60. Arterial blood samples were collected at 5, 10, 20, 30, 40, and 60 min after the start of propofol infusion, and every 30 min thereafter, to a maximum of 10 samples. BIS was recorded continuously. Predictive performance was assessed using the Varvel criteria. RESULTS: For PK, the Eleveld model showed a bias < ±20% in children, adults, and obese adults, but a greater bias (-27%) in older subjects. Precision was <30% in all groups. For PD, the bias and wobble were <5 BIS units and the precision was close to 10 BIS units in all groups. Anaesthetists were able to achieve intraoperative BIS values of 40-60 using effect-site target concentrations about 85-140% of the age-adjusted Ce50. CONCLUSIONS: The Eleveld propofol PK-PD model showed predictive precision <30% for arterial plasma concentrations and BIS predictions with a low (population) bias when used in TCI in clinical anaesthesia practice

Clinical validation of pharmacokinetic/pharmacodynamic models for propofol infusion. Response to Br J Anaesth 2021:126: e172-4

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