An Assessment of the Challenges Facing Implementation of Guidance and Counselling Programme in Public Secondary Schools: A Case of Lugari Subcounty, Kakamega County, Kenya

Students studying in public secondary schools in Kakamega County, Lugari Sub-County have a range of challenges, which include, deteriorating academic performance, drug and substance abuse, low self-esteem and socially unacceptable behaviour such as destruction of school property, among others. These problems exist despite the fact that guidance and counselling programmes were established in Kenyan public Secondary Schools in 1970s. This study carried out an assessment on the challenges facing implementation of guidance and counselling programme in public Secondary Schools in Lugari Sub-County. The study employed descriptive survey research design. The target population was 21 principals, 42 Guidance and Counselling teachers, as well as, 336 teachers in public Secondary Schools in Lugari Sub-County, making a total of 399 subjects. The sample size was composed of 30% of the total target population which was 120 subjects. The 120 subjects were comprised of 6 principals, 12 guidance and counselling teachers and 102 public secondary school teachers from the study area. A pilot study was carried out on the instruments in two Secondary Schools using test/retest method, with a two weeks’ interval between the tests, to enable assessment of both validity and reliability of the data collection instruments. Simple random sampling was used to select 30% of the principals. However, purposeful sampling was used to select the 30% of the guidance and counselling teachers. Simple random sampling, purposeful, as well as, stratified random sampling were used to select teachers from the schools where the principals were drawn. Stratified sampling was necessary because teachers were selected with respect to their populations in the respective six schools. Data was analyzed using descriptive statistics. Results were presented, using frequency distributions, percentages and narratives for qualitative results. The study established that principals’ support to the G&C departments was minimal as principals gave less weight to the departments. It was also observed that schools had G&C departments but most lacked teachers with G&C skills. The study recommends that: school principals should provide G&C teachers maximum support so as to ensure that discipline is maintained through counselling in the secondary schools. Teachers should take in-service courses and short seminars in G&C, especially those who had not received formal training in G&C. Keywords: Guidance and counselling, principals’ support, guidance and counselling teachers’ qualifications and training. DOI: 10.7176/JEP/11-32-16 Publication date: November 30th 202

Use of the Physician Orders for Scope of Treatment Program in Indiana Nursing Homes

OBJECTIVES: To assess the use of the Indiana Physician Orders for Scope of Treatment (POST) form to record nursing home (NH) resident treatment preferences and associated practices. DESIGN: Survey. SETTING: Indiana NHs. PARTICIPANTS: Staff responsible for advance care planning in 535 NHs. MEASUREMENTS: Survey about use of the Indiana POST, related policies, and educational activities. METHODS: NHs were contacted by telephone or email. Nonresponders were sent a brief postcard survey. RESULTS: Ninety-one percent (n=486) of Indiana NHs participated, and 79% had experience with POST. Of the 65% of NHs that complete POST with residents, 46% reported that half or more residents had a POST form. POST was most often completed at the time of admission (68%). Only 52% of participants were aware of an existing facility policy regarding use of POST; 80% reported general staff education on POST. In the 172 NHs not using POST, reasons for not using it included unfamiliarity with the tool (23%) and lack of facility policies (21%). CONCLUSION: Almost 3 years after a grassroots campaign to introduce the voluntary Indiana POST program, a majority of NHs were using POST to support resident care. Areas for improvement include creating policies on POST for all NHs, training staff on POST conversations, and considering processes that may enhance the POST conversation, such as finding an optimal time to engage in conversations about treatment preferences other than a potentially rushed admission process

Georgia Library Association - Technical Services Interest Group

Published in Georgia Library Quarterl

Paleomagnetism and Tectonic Significance of Albian and Cenomanian Turbidites, Ochoco Basin, Mitchell Inlier, Central Oregon

Understanding continental growth and convergent margin dynamics associated with terrane accretion and modification of the Cordilleran margin of North America is prevented by conflicts in paleogeographic models for major terranes, oceanic plates, and the North American margin. We present new paleomagnetic data suggesting that the Blue Mountains superterrane, located at an inboard portion of the Cordilleran margin, has undergone substantial northward translation and clockwise rotation relative to North America since mid-Cretaceous time. Positive baked-contact, conglomerate, and fold tests, provide evidence that the magnetization of these rocks dates from their deposition. These results yield a mean direction of D = 10.8°, I = 58.5°, k = 127, α95 = 4.1°, and N = 11. Comparison of magnetic inclinations and magnetic fabrics shows no evidence for inclination error. A paleolatitude of 39.2° +4.8°/−4.3°N is obtained, indicating a paleolatitude anomaly of 15.9° ± 4.1° (northward translation of 1760 ± 460 km) and CW rotation of 37° ± 7.3° with respect to North America since circa 93 Ma. Application of an ad hoc 5° inclination error yields translation of 1200 ± 460 km. Through comparison with other units in the western Cordillera we infer that the Mitchell Inlier was located adjacent to the Sierra Nevada arc during mid-Cretaceous time and that the Blue Mountains province may correlate with the Intermontane superterrane in British Columbia. Other interpretations, such as large inclination errors or an independent displacement history for the Mitchell Inlier, are possible but unlikely. More work is needed to fully test these hypotheses and resolve major questions of Cordilleran tectonics

Reply to Correspondence: is the strength of association between indicators of dietary quality and the nutritional status of children being underestimated?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102165/1/mcn12107.pd

Problemáticas éticas y legales en la salud reproductiva : responsabilidades en los servicios de salud y objeción de conciencia•

Texto traducido y reproducido con autorización de la Federación Internacional de Ginecología y Obstetricia (FIGO): Cook, R. J., Arango Olaya, M, Dickens, B.M., "Healthcare responsibilities and conscientious objection" Intemational Joumal of Gynecology and Obstetrics 2009; 104(3):249-252.A lo largo de las últimas cuatro décadas progresivamente las leyes contra el aborto han ido siendo liberalizadas por diferentes cuerpos legislativos democráticamente responsables y por altas cortes de muchos países, respondiendo a la evolución en la protección legal de los derechos humanos. Dicho movimiento no es universal. De hecho, muchos cuerpos legislativos y cortes han aprobado medidas más restrictivas del aborto. No obstante, la tendencia general ha sido hacia la atenuación de leyes históricamente proscriptoras. Esta liberalización es especialmente evidente en las democracias de tipo occidental. Sin embargo, paradójicamente, muchos países que han emergido de la dominación colonial a la independencia, logrando la autodeterminación política y económica, conservan las leyes restrictivas al aborto impuestas por los poderes occidentales antiguamente coloniales, quienes desde entonces han liberalizado su propia legislación al respecto, de conformidad con los principios de derechos humanos que respetan el derecho de las mujeres a la vida, la salud y la autodeterminació

Mosquitoes Inoculate High Doses of West Nile Virus as They Probe and Feed on Live Hosts

West Nile virus (WNV) is transmitted to vertebrate hosts by mosquitoes as they take a blood meal. The amount of WNV inoculated by mosquitoes as they feed on a live host is not known. Previous estimates of the amount of WNV inoculated by mosquitoes (101.2–104.3 PFU) were based on in vitro assays that do not allow mosquitoes to probe or feed naturally. Here, we developed an in vivo assay to determine the amount of WNV inoculated by mosquitoes as they probe and feed on peripheral tissues of a mouse or chick. Using our assay, we recovered approximately one-third of a known amount of virus inoculated into mouse tissues. Accounting for unrecovered virus, mean and median doses of WNV inoculated by four mosquito species were 104.3 PFU and 105.0 PFU for Culex tarsalis, 105.9 PFU and 106.1 PFU for Cx. pipiens, 104.7 PFU and 104.7 PFU for Aedes japonicus, and 103.6 PFU and 103.4 PFU for Ae. triseriatus. In a direct comparison, in vivo estimates of the viral dose inoculated by Cx. tarsalis were approximately 600 times greater than estimates obtained by an in vitro capillary tube transmission assay. Virus did not disperse rapidly, as >99% of the virus was recovered from the section fed or probed upon by the mosquito. Furthermore, 76% (22/29) of mosquitoes inoculated a small amount of virus (∼102 PFU) directly into the blood while feeding. Direct introduction of virus into the blood may alter viral tropism, lead to earlier development of viremia, and cause low rates of infection in co-feeding mosquitoes. Our data demonstrate that mosquitoes inoculate high doses of WNV extravascularly and low doses intravascularly while probing and feeding on a live host. Accurate estimates of the viral dose inoculated by mosquitoes are critical in order to administer appropriate inoculation doses to animals in vaccine, host competence, and pathogenesis studies

Attributable costs of enterococcal bloodstream infections in a nonsurgical hospital cohort

BACKGROUND: Vancomycin-resistant enterococcal (VRE) bloodstream infections (BSI) are associated with increased morbidity and mortality. OBJECTIVE: To determine the attributable costs of vancomycin-sensitive (VSE) and VRE BSI and the independent impact of vancomycin-resistance on hospital costs. METHODS: A retrospective cohort study was conducted of 21,154 non-surgical patients admitted to an academic medical center between 2002 and 2003. Using administrative data, attributable hospital costs (inflation adjusted to $2007) and length of stay were estimated with multivariate generalized least squares (GLS) models and propensity score matched-pairs. RESULTS: The cohort included 182 VSE and 94 VRE BSI cases. After adjustment for demographics, comorbidities, procedures, non-enterococcal BSI, and early mortality, the attributable costs of VSE BSI were$2,250 (95% confidence interval [CI], $1,758–$2,880) in the standard GLS model and $2,023 (95$1,588–$2,575) in the propensity-score weighted GLS model and the attributable costs of VRE BSI were$4,479 (95% CI, $3,500–$5,732) in the standard GLS model and $4,036 (95$3,170–$5,140) in the propensity-score weighted GLS model. The median of the difference in costs between matched-pairs was$5,282 ($2,042–$8,043) for VSE BSI and $9,949 (95$1,579–$24,693) for VRE BSI. The attributable costs of vancomycin-resistance were$1,713 (95% CI, $1,338–$2,192) in the standard GLS model and $1,546 (95$1,214–$1,968) in the propensity-score weighted GLS model. Attributable length of stay ranged from 1.1–2.2 days for VSE BSI and 2.2–3.5 days for VRE BSI cases. CONCLUSIONS: VSE and VRE BSI were independently associated with hospital costs and length of stay. Vancomycin-resistance was associated with increased costs

Visual Narratives: Exploring the Impacts of Tourism Development in Placencia, Belize

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156219/2/napa12135_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156219/1/napa12135.pd

Glucagon receptor family in GtoPdb v.2023.1

The glucagon family of receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on the Glucagon receptor family [165]) are activated by the endogenous peptide (27-44 aa) hormones glucagon, glucagon-like peptide 1, glucagon-like peptide 2, glucose-dependent insulinotropic polypeptide (also known as gastric inhibitory polypeptide), GHRH and secretin. One common precursor (GCG) generates glucagon, glucagon-like peptide 1 and glucagon-like peptide 2 peptides [121]. For a recent review on the current understanding of the structures of GLP-1 and GLP-1R, the molecular basis of their interaction, and the associated signaling events see de Graaf et al., 2016 [90]