Dignity, Life-Affirming Advocacy and Compassionate Solidarity

In “Special Issue: Overcoming Violence against Women and Children” in the Journal of Theology for Southern Africa (No. 114, Nov. 2002), the guest editors Tinyiko Sam Maluleke and Sarojini Nadar wrote: Given the great cloud and intricate network of witnesses and conspirators who subscribe to the covenant of death, standing up against this covenant of death and violence is costly. It often results in the isolation and rejection of those who dare to speak. Therefore, the voices of those who dare to stand up against the covenant are often like voices in the wilderness (7). In this essay, I will focus on the lessons I learned from a few strategies and tactics to covenant with dignity and life to uphold Ubuntu. I will draw inspiration from my mothers in faith who one hundred years ago in Kenya shielded the dignity of Gĩkũyũ girls and women against female genital mutilation and other dignity and life-denying cultural practices and beliefs, which are contrary to Ubuntu and the sustaining of life. I will conclude with a summary of collective actions I have taken with the women and men who have been my professional companions in my work as an ordained minister of word and sacrament with the Presbyterian Church of East Africa

Pattern of major surgery among the elderly and aged patients seen in Kampala, Uganda

A cross sectional descriptive prospective study was conducted at three of  Kampala's tnain hospitals with the aim of determining the pattern of major surgery among the  elderly and aged patients over a six months period from 1" July to 31" December  1999. In the study, patients aged between 65 and 74 years were regarded as elderly while those aged 75 years and above were considered aged. A total of 196 patients  were included in the study. There were 152 (75.5%)males  and 46 (23.5%) females (M: F=3:1). More elderly patients than the aged were operated on. Only 25.3% of the emergencies. Operations on the  gastrointestinal tract were the commonest and   accounted for 36.9% of cases, followed by surgery of the genitourinary (30.8%) and cardiovascular (13.1%) systems. In 63% of cases, the operations were palliative. Wound sepsis was the commonest postoperative complication and accounted for  17.8% of all complications. There were 19 deaths, an overall mortality rate of 9.6%. Thirteen (68.4%) of all deaths occurred after operations on the gastrointestinal tract. The mean hospital stay was 11.6 days for both the elderly and aged. Both the short and long term outcome of both emergency and elective operations were good. The study confirmed that age should not be a contraindication to surgery

Will Small-Scale Dairy Producers in Kenya Disappear Due to Economies of Scale in Production?

There is growing policy concern regarding the competitiveness of small-scale livestock production in the wake of the contemporary livestock revolution in many developing countries. In Kenya, this debate has focused on economies of scale and the undue influence of policy distortions on promoting the scaling up of dairy farms. This paper seeks to investigate economies of scale in Kenyan dairy in terms of relative profit efficiency at different levels of output, and identify policy and technology options to help small-scale farmers develop solutions to the challenges of competition. Data were collected from 204 dairy producers of different farm sizes in rural Kiambu and Thika, and urban Nairobi districts and a stochastic frontier model approach was used to analyze the determinants of profitability and inefficiency. Unit profitability per farm ranged between US$0.13 - US$0.16 per liter of milk with no significant variation across scales of farm. However, at all given levels of scale of farm, inefficiency significantly contributed to variability in profitability across farms. Scale had no significant effect on efficiency, confirming the relative competitiveness of small-scale dairy producers. Dairy farmers with commercial poultry achieved higher relative profit efficiency as poultry waste was fed to cattle. Rural location relative to Nairobi also increased efficiency. Linking rural areas and major market centre with good roads, strengthening of farmers' co-operative societies and exploring use of cheaper raw materials in the manufacture of concentrate feeds may strengthen the competitive position small dairy farms versus large ones.Dairy Production, Stochastic Production Frontier, Efficiency, Profitability, Livestock Production/Industries, C21, Q12,

SPATIAL ANALYSIS OF SOIL FERTILITY MANAGEMENT USING INTEGRATED HOUSEHOLD AND GIS DATA FROM SMALLHOLDER KENYAN FARMS

Although soil fertility is recognized as a primary constraint to agricultural production in developing countries, use of fertilizer in Sub-Saharan Africa is declining. Smallholder farmers still rely heavily on livestock manure for soil fertility management. To explore the determinants of soil fertility management practices, including both the use of cattle manure and inorganic fertilizer, data are used from a sample of 3,330 geo-referenced farm households across Central and Western Kenya. A bivariate probit model is applied to jointly examine the use of the two technologies. Particular attention is given to measures of location related to market access and agroclimate, which in the adoption literature have typically been addressed using crude proxies. To avoid such proxies, GIS-derived variables are integrated into the household decision model. Their use also allows the spatial prediction of uptake based on parameter estimates. The results show clearly the derived-demand nature of soil fertility services, based on markets for farm outputs. They also illustrate that supply of manure for soil fertility amendments is conditioned by demand for livestock products, especially milk. The integration of GIS-derived variables is shown to better estimate the effects of location than the usual measures employed, and offers scope to wider use in technology adoption research.spatial analysis, soil fertility, market access, technology adoption., Farm Management, Land Economics/Use, Q12, Q16,

Gestational Diabetes Mellitus and Risk of Childhood Overweight and Obesity in Offspring: A Systematic Review

We systematically reviewed research examining the association between gestational diabetes (GDM) and childhood overweight and obesity. We identified studies from three sources: (1) a PubMed search of articles published between January 1990–January 2011, (2) reference lists of publications from the PubMed search, and (3) reference lists of review articles. We included studies that examined GDM separately from pregestational diabetes and childhood overweight or obesity defined as BMI > 85th or 95th percentile. A total of 12 studies were included in the systematic review. Crude odds ratios for the relationship between GDM and childhood overweight or obesity ranged from 0.7 to 6.3; in 8 studies, the associations were not statistically significant. In only 3 studies were results adjusted for any confounders; in the 2 that adjusted for prepregnancy obesity, the GDM and childhood overweight or obesity associations were attenuated and not statistically significant after adjustment. This paper demonstrates inconsistent evidence of an association between GDM and offspring overweight and obesity due to the methodological limitations of existing studies. Recommendations for future research are presented, which address methodological challenges

Power-Law Distributions in a Two-sided Market and Net Neutrality

"Net neutrality" often refers to the policy dictating that an Internet service provider (ISP) cannot charge content providers (CPs) for delivering their content to consumers. Many past quantitative models designed to determine whether net neutrality is a good idea have been rather equivocal in their conclusions. Here we propose a very simple two-sided market model, in which the types of the consumers and the CPs are {\em power-law distributed} --- a kind of distribution known to often arise precisely in connection with Internet-related phenomena. We derive mostly analytical, closed-form results for several regimes: (a) Net neutrality, (b) social optimum, (c) maximum revenue by the ISP, or (d) maximum ISP revenue under quality differentiation. One unexpected conclusion is that (a) and (b) will differ significantly, unless average CP productivity is very high

The extent of and factors associated with self-reported overdose and self-reported receipt of naloxone among people who inject drugs (PWID) in England, Wales and Northern Ireland.

BACKGROUND: Overdose is a major cause of death among PWID, and for opioid overdoses naloxone administration can reduce harm. However, globally there is limited national level data on the extent of non-fatal overdose and naloxone uptake. The first national level data on the extent of self-reported overdose and self-reported receipt of naloxone among UK PWID, providing a baseline to monitor the impact of the recent policy change regarding naloxone availability, is presented. METHODS: Data on self-reported overdose and receipt of naloxone during the preceding year for 2013-2014 from a national survey of PWID was analysed. Participants who reported injecting during the preceding year were included. RESULTS: Participants (3850) were predominantly male (75%); mean age was 36 years. The most commonly injected drugs were: heroin (91%), crack (45%) and amphetamine (29%). 15% (591) reported overdosing during the preceding year. There were no differences in the proportion reporting overdose by age or gender, but overdose was more common among those who: injected multiple drugs; recently ceased addiction treatment; injected with used needles/syringes; ever had transactional sex; had used a sexual health clinic or emergency department and lived in Wales or Northern Ireland. Among those reporting an overdose during the preceding year, a third reported two to four overdoses and 7.5% five or more overdoses; half reported receiving naloxone. Those reporting naloxone receipt in the preceding year were more likely to: live in Wales or Northern Ireland; ever received used needles/syringes; ever been imprisoned; and less likely to have injected two drug types. CONCLUSION: These data provide a baseline for monitoring the impact of the 2015 UK policy change to improve take-home naloxone access. Interventions tackling overdose should promote naloxone awareness and access, and target those who; are poly-drug injectors, have ceased treatment, share needles/syringes and whose drug use links to sexual activity

Evaluation of resistance reaction of maize germplasm to common foliar diseases in Kenya

Use of resistance varieties is the most practical method of managing crop diseases. There is a great variation in terms of resistance reaction to diseases among the various maize germplasm and with the liberization of seed market, the sector has witnessed proliferation of massive introduction of new varieties whose reaction to diseases cannot be ascertained. This study was conducted to evaluate the reaction of maize varieties to northern leaf blight (NLB), common maize rust, gray leaf spot (GLS) and maize streak disease (MSD). The experiment was conducted at Kabete Field Station, University of Nairobi for two seasons namely short rains and long rains. The germplasm was bought from the commercial seed stockists and the landraces obtained from KARI Katumani and from farmers. The diseases were assessed by monitoring and scoring for disease incidence and severity. The appropriate scoring keys were used for determination of disease severity. All the varieties showed symptoms of the four diseases in both seasons but the intensity of the diseases differed significantly among the different varieties. Disease incidence was highest for common rust with a mean of 14.29% for the variety DH04, while disease incidence was highest (19.21%) for northern leaf blight in season two for Kinyanya which is a landrace. Gray leaf spot and the common smuts had the lowest mean incidence ranging from 0 to 0.25% for common smut and 0 to 2.6% for gray leaf spot. Season two had comparatively higher disease incidence means compared to season one. Meteorological data showed that season two had more rains and this explains the reasons behind this. Though all the varieties screened were found to be affected by the diseases to various levels, the varieties displayed significant differences in the disease incidence and severity. This shows that use of resistance varieties should be considered in the management of maize diseases. Focus should also be on pyramiding genes for resistance in the breeding programmes to develop varieties with multiple resistance to different diseases. Key words: Disease incidence and severity, disease score, symptoms, varietie

Factors influencing cervical cancer screening in a Kenyan Health Facility: a mixed qualitative and quantitative study

Background: Cervical cancer is the commonest cause of cancer-related morbidity and mortality among women in developing countries in sub-Saharan Africa. Screening for cervical cancer among HIV infected women is crucial as they are more at risk of developing the disease and progressing faster once infected with Human Papilloma Virus (HPV).Methods: We aimed to determine the factors affecting the utilization of cervical cancer screening among HIV infected women above 18 years of age at Kenyatta National Hospital by conducting a cross-sectional mixed quantitative and qualitative methods study. Descriptive and inferential analysis was carried out on quantitative data to determine significant associations with cervical cancer utilization. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising.Results: Three hundred and twenty eight of the total 387 women enrolled reported they had been advised by their health providers to go for screening. However, only 179 (46%) reported cervical cancer screening.  Women were more likely to report cervical cancer screening if recommendation by a staff was made (p <0.001), and prior to joining KNH CCC (p <0.001). Qualitatively the main barrier to screening included fear of screening due to concerns about excessive pain or bleeding, lack of proper communication on screening procedures and long waiting timeConclusions: The utilization of cervical cancer screening services was low despite high rates of health care recommendation. The women were more likely to utilize the service if recommendation from the health care worker was made, and if they had ever screened before