The Mediating Influence of Employee Behaviour on the Relationship Between Strategic Planning and Competitive Advantage of Large Manufacturing Firms in Kenya

Several studies have been carried out in the past to find out how strategic planning and competitive advantage are connected and the causes of differences in competitive advantage among firms. Scholars have argued that competitive advantage can emanate from either internal or external sources and is usually in several forms which include; valuable resources, the position held within the industry, position within the marketplace, operating at lower costs than rival firms, differentiation, capabilities and dynamic capabilities. The debate on what causes differences in competitive advantage is still on. This study sought to establish the mediating influence of employee behaviour on the relationship between strategic planning and competitive advantage of large manufacturing firms in Kenya. The study was underpinned by the competitive advantage typology of Michael Porter, the resource-based theory, dynamic capabilities theory, and goal-setting theory. The study used a positivist research paradigm and a cross-sectional survey design. This was a census study from 124 large manufacturing firms in Kenya. Out of the 124 firms, data on strategic planning, employee behaviour and competitive advantage was collected from 122 of the firms representing a response rate of 98.4%. The data was interpreted using a 5-point Likert type questionnaire. The data received was analysed using both descriptive and inferential statistics. Reliability tests returned an average Cronbach Alpha Value for the three variables that is strategic planning, employee behaviour and competitive advantage, of 0.86. Hypotheses were tested using both simple and multivariate regression analysis as well as hierarchical analysis for mediation. The findings indicate that overall strategic planning has a statistically significant influence on competitive advantage and that employee behaviour mediates completely the relationship between strategic planning and competitive advantage (R2=0.751, p-value<0.05). The study concluded that the relationship between strategic planning and competitive advantage is completely mediated by employee behaviour. The study further recommended that employees’ behaviour should be strategically aligned to the goals and objectives set in the strategic plan and that they should be committed fully to the ideals of the firm in order for the firm to attain and sustain its competitive advantage position. Keywords: strategic planning, competitive advantage employee behaviour, lower costs, differentiation, capabilities, dynamic capabilities DOI: 10.7176/EJBM/11-8-01 Publication date:March 31st 201

Assisted partner notification services to augment HIV testing and linkage to care in Kenya: study protocol for a cluster randomized trial

Background: HIV case-finding and linkage to care are critical for control of HIV transmission. In Kenya, >50% of seropositive individuals are unaware of their status. Assisted partner notification is a public health strategy that provides HIV testing to individuals with sexual exposure to HIV and are at risk of infection and disease. This parallel, cluster-randomized controlled trial will evaluate the effectiveness, cost-effectiveness, and feasibility of implementing HIV assisted partner notification services at HIV testing sites (clusters) in Kenya. Methods/design Eighteen sites were selected among health facilities in Kenya with well-established, high-volume HIV testing programs, to reflect diverse communities and health-care settings. Restricted randomization was used to balance site characteristics between study arms (n = 9 per arm). Sixty individuals testing HIV positive (‘index partners’) will be enrolled per site (inclusion criteria: ≥18 years, positive HIV test at a study site, willing to disclose sexual partners, and never enrolled for HIV care; exclusion criteria: pregnancy or high risk of intimate partner violence). Index partners provide names and contact information for all sexual partners in the past 3 years. At intervention sites, study staff immediately contact sexual partners to notify them of exposure, offer HIV testing, and link to care if HIV seropositive. At control sites, passive partner referral is performed according to national guidelines, and assisted partner notification is delayed by 6 weeks. Primary outcomes, assessed 6 weeks after index partner enrollment and analyzed at the cluster level, are the number of partners accepting HIV testing and number of HIV infections diagnosed and linked to care per index partner. Secondary outcomes are the incremental cost-effectiveness of partner notification and the costs of identifying >1 partner per index case. Participants are closely monitored for adverse outcomes, particularly intimate partner violence. The study is unblinded due to practical limitations. Discussion This rigorously designed trial will inform policy decisions regarding implementation of HIV partner notification services in Kenya, with possible application to other parts of sub-Saharan Africa. Examination of effectiveness and cost-effectiveness in diverse settings will enable targeted application and define best practices. Trial registration ClinicalTrials.gov NCT01616420

Biomolecular simulations: From dynamics and mechanisms to computational assays of biological activity

Biomolecular simulation is increasingly central to understanding and designing biological molecules and their interactions. Detailed, physics‐based simulation methods are demonstrating rapidly growing impact in areas as diverse as biocatalysis, drug delivery, biomaterials, biotechnology, and drug design. Simulations offer the potential of uniquely detailed, atomic‐level insight into mechanisms, dynamics, and processes, as well as increasingly accurate predictions of molecular properties. Simulations can now be used as computational assays of biological activity, for example, in predictions of drug resistance. Methodological and algorithmic developments, combined with advances in computational hardware, are transforming the scope and range of calculations. Different types of methods are required for different types of problem. Accurate methods and extensive simulations promise quantitative comparison with experiments across biochemistry. Atomistic simulations can now access experimentally relevant timescales for large systems, leading to a fertile interplay of experiment and theory and offering unprecedented opportunities for validating and developing models. Coarse‐grained methods allow studies on larger length‐ and timescales, and theoretical developments are bringing electronic structure calculations into new regimes. Multiscale methods are another key focus for development, combining different levels of theory to increase accuracy, aiming to connect chemical and molecular changes to macroscopic observables. In this review, we outline biomolecular simulation methods and highlight examples of its application to investigate questions in biology. This article is categorized under: Molecular and Statistical Mechanics > Molecular Dynamics and Monte‐Carlo Methods Structure and Mechanism > Computational Biochemistry and Biophysics Molecular and Statistical Mechanics > Free Energy Method

The use of written guides to empower breast cancer survivors in their management of chronic pain:A realist evaluation

OBJECTIVE: Many breast cancer survivors experience long-term complaints following treatment, such as pain, which are often not addressed in a sufficient way. To empower survivors in talking about their pain and related complaints and in searching for appropriate support when needed, we developed two written guides. With this study, we aimed to pilot test the guides and gain insight into the implementation process and influencing mechanisms through the perspective of a realist evaluation.METHODS: Nine survivors were interviewed at two time points (i.e., post-intervention and at three-month follow-up). The data were thematically analysed and categorized into a context-implementation-mechanisms-outcomes hypothesis.RESULTS: The guides empowered the participants to discuss pain with medical specialists and initiate support-seeking behaviour through underlying mechanisms such as awareness, acknowledgment, hope, reduced isolation, and motivation. Nonetheless, mechanisms and outcomes differed according to a survivor's unique context.CONCLUSION: Written guides can offer a feasible way to empower survivors in their management of chronic pain. However, a one-size-fits-all approach is not desirable and other strategies might be necessary.PRACTICE IMPLICATIONS: It is pivotal to engage survivors as well as professionals in adopting new interventions. As such, the role of nurses in introducing and endorsing the guides should be further explored

Prevalence and risk factors associated with Ehrlichia infections in smallholder dairy cattle in Nairobi City County, Kenya

Background and Aim: Ehrlichiosis caused by Ehrlichia ruminantium is a tick-borne disease of great economic importance in cattle production worldwide. Despite its economic impact, limited knowledge is available on its epidemiology in Africa, including Kenya. Suspected cases of E. ruminantium infections have been reported in the recent past to the University of Nairobi's Veterinary Hospital, prompting the need to investigate their possible re-emergence. Therefore, this study was aimed at determining the prevalence of E. ruminantium among smallholder dairy cattle in Nairobi City County and to assess potential risk factors. This knowledge may guide the development of appropriate control strategies of ehrlichiosis, subsequently reducing associated losses. Materials and Methods: A total of 107 smallholder dairy farms from Nairobi City County were recruited for the study. Blood samples were collected from 314 apparently healthy dairy cattle, and Giemsa-stained blood smears were screened under the microscope for Ehrlichia species. A commercial antigen enzyme-linked immunosorbent assay (ELISA) kit was then used to confirm the presence of the infections in serum samples. A pre-tested questionnaire was used to collect data on management practices that may be potential risk factors. A univariate and mixed-effects logistic regression was then used to determine significant risk factors. Results: On microscopy, 79.3% (249/314) of the sampled animals had Ehrlichia-like inclusion bodies in white blood cells, though only 18.6% (95% confidence interval [CI] 14.2-23.0) of these were confirmed to be E. ruminantium on ELISA. A farm-level prevalence of 35.5% (95% CI 27.0-45.3) was reported. Female-headed households (p=0.013), farms in Langata region (p=0.027), cleaning of cowsheds fortnightly (p=0.019), and roofing of cowshed (p=0.022) were factors significantly associated with E. ruminantium infections. Conclusion: There is a relatively high prevalence of E. ruminantium infections in apparently healthy cattle in smallholder dairy farms in this area, warranting control measures. It is critical to improve animal welfare-related factors, such as cowshed cleaning and roofing, as well as the strategic location of farms, especially, since reservoirs may reduce infection levels in the farms, in relation to wildlife. However, since Ehrlichia-like inclusion bodies other than those of E. ruminantium were observed in this study, there is a need to investigate further these factors and the possibility of other Ehrlichia species infecting cattle in the study area

Genetic diversity of symbiotic bacteria nodulating common bean (Phaseolus vulgaris) in western Kenya.

Biological nitrogen fixation (BNF) in legumes plays a critical role in improving soil fertility. Despite this vital role, there is limited information on the genetic diversity and BNF of bacteria nodulating common bean (Phaseolus vulgaris L.). This study evaluated the genetic diversity and symbiotic nitrogen fixation of bacteria nodulating common bean in soils of Western Kenya. The genetic diversity was determined using 16S rRNA gene partial sequences while BNF was estimated in a greenhouse experiment. The sequences of the native isolates were closely affiliated with members from the genera Pantoea, Klebsiella, Rhizobium, Enterobacter and Bacillus. These results show that apart from rhizobia, there are non-rhizobial strains in the nodules of common bean. The symbiotic efficiency (SE) of native isolates varied and exhibited comparable or superior BNF compared to the local commercial inoculants (CIAT 899 and Strain 446). Isolates (MMUST 003 [KP027691], MMUST 004 [KP027687], MMUST 005 [KP027688], KSM 001 [KP027682], KSM 002 [KP027680], KSM 003 [KP027683] and KSM 005 [KP027685]) recorded equal or significantly higher SE (p < 0.05) compared to N supplemented treatments. The results demonstrate the presence of genetic diversity of native bacteria nodulating bean that are effective in N fixation. These elite bacterial strains should be exploited as candidates for the development of Phaseolus vulgaris inoculants

Prevalence of Ticks Infesting Dairy Cattle and the Pathogens They Harbour in Smallholder Farms in Peri-Urban Areas of Nairobi, Kenya

This study aimed at determining the tick species infesting dairy cattle in Nairobi, Kenya, and the pathogens they harbour. While ticks are well-known vectors of major bacterial pathogens of both veterinary importance and public health importance, few studies have investigated the range of the tick species and the associated pathogens, especially present in unique dairy production systems, which compromise animal welfare, such as those in peri-urban areas. A cross-sectional study was undertaken involving 314 randomly selected dairy cattle in 109 smallholder farms. Each animal was examined for attached ticks followed by morphological tick identification at the species level. Genomic DNA was extracted from each of the ticks, and 16S rDNA gene was amplified for pathogen identification. Sequencing of the amplicons and subsequent BLASTn analysis, multiple sequence alignment, and phylogenetic reconstruction were performed to confirm the species of the pathogens. Sixty-six (21.0%) of the cattle examined had ticks. A total of 94 adult ticks were found on the cattle, and of these, 63 (67.0%), 18 (19.1%), and 13 (13.8%) were in the genera Rhipicephalus, Amblyomma, and Hyalomma, respectively. Twelve tick species in Rhipicephalus genus and two in Amblyomma and Hyalomma genera were identified. Although Rh. decoloratus was the most prevalent tick (24.5% (23/94)), the emerging Rh. microplus (6.4% (6/94)) was also identified. The DNA of Rickettsia was detected in the ticks, with Rickettsia conorii in H. rufipes and A. variegatum, and Rickettsia aeschlimannii in Rh. microplus and H. rufipes, while Ehrlichia ruminantium and E. canis were in A. variegatum. In conclusion, the study reported a wide range of tick species present in the study area including Rhipicephalus microplus, which is an emerging tick species in parts of Kenya. The ticks harboured DNA of Rickettsia and Ehrlichia, highlighting possible animal and human health concerns. Hence, effective tick control strategies remain paramount to prevent potential diseases associated with the harboured pathogens

HIV partner services in Kenya: a cost and budget impact analysis study

Abstract Background The elicitation of contact information, notification and testing of sex partners of HIV infected patients (aPS), is an effective HIV testing strategy in low-income settings but may not necessarily be affordable. We applied WHO guidelines and the International Society for Pharmaco-economics and Outcomes Research (ISPOR) guidelines to conduct cost and budget impact analyses, respectively, of aPS compared to current practice of HIV testing services (HTS) in Kisumu County, Kenya. Methods Using study data and time motion studies, we constructed an Excel-based tool to estimate costs and the budget impact of aPS. Cost data were collected from selected facilities in Kisumu County. We report the annual total and unit costs of HTS, incremental total and unit costs for aPS, and the budget impact of scaling up aPS over a 5-year horizon. We also considered a task-shifted scenario that used community health workers (CHWs) rather than facility based health workers and conducted sensitivity analyses assuming different rates of scale up of aPS. Results The average unit costs for HIV testing among HIV-infected index clients was US$25.36 per client and US$ 17.86 per client using nurses and CHWs, respectively. The average incremental costs for providing enhanced aPS in Kisumu County were US$1,092,161 and US$ 753,547 per year, using nurses and CHWs, respectively. The average incremental cost of scaling up aPS over a five period was 45% higher when using nurses compared to using CHWs (US$5,460,837 and US$ 3,767,738 respectively). Over the five years, the upper-bound budget impact of nurse-model was US$1,767,863, 63$ 1,258,854, which was 71.2% lower than the nurse-based model. The budget impact was sensitive to the level of aPS coverage and ranged from US$28,547 for 30$ 1,267,603 for 80% coverage using nurses in 2018. Conclusion Scaling aPS using nurses has minimal budget impact but not cost-saving over a five-year period. Targeting aPS to newly-diagnosed index cases and task-shifting to community health workers is recommended