Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania

Background: Trauma registries are vital to a well-organized trauma system. However, registries are non-existent in most low and middle-income countries, largely due to the difficulty of reliably capturing patient-level data. The aim of this thesis was to develop and implement a context appropriate standardised trauma form incorporating the World Health Organization Data Set for Injury, for both clinical documentation and use in a trauma registry. Methods: This mixed methods participatory action research utilised Susman and Evered's approach to develop and implement a standardised trauma form, using its five steps: diagnosis, action planning, intervention, evaluation and specifying learning. In the diagnosis phase, an assessment of baseline documentation was performed. In the action-planning phase, focus group discussion revealed the barriers and facilitators to completing documentation. Then, in the actiontaking phase, semi structured interviews, training of health care providers, and feedback enabled the development, review, pilot, and implementation of a standardised trauma form. In the evaluation phase, we compared the number and types of variables captured after the form was implemented to the baseline collection. Finally, we specified learning to inform the next steps in the amplification of the observed impact. Results: The diagnosis phase established that many injury variables were not captured routinely at the participating regional hospitals. Analysis of barriers and facilitators and feedback on perceptions of providers toward using standardised documentation informed the development, piloting, modification, training of providers and implementation of a context appropriate standardised trauma documentation form for clinical charting and data capture. Implementation of the standardised trauma form was associated with improved capture of injury variables from baseline pre-implementation (33.6%), during 30-days initial pilot (86.4%) and after seven months post implementation (96.3%). The providers reported the form was user-friendly, resulted in less time documenting, and served as a guide to managing trauma patients. Conclusions: Through participatory action research a contextually appropriate, standardised trauma documentation form was successfully developed and implemented, yielding marked improvement in the capture of essential injury variables. This model can serve as a working guide to other low- and middle-income countries seeking to establish sustainable national injury registries

Athari za valensia ya kitenzi katika usarufi wa miundo ya Kiswahili

Wasemaji wa lugha huzingatia aina tatu za kanuni za uzuifu madhubuti zinazofungamana na valensia ya kitenzi katika uundaji wa sentensi za Kiswahili. Katika mkabala huo basi, makala hii inatambuai kwamba kanuni husika hubainika kwa sababu baadhi ya vijenzi (hasa nomino) vikiondolewa au vikiongezwa kwenye uambajengo wa kisintaksia, miundo isiyofasilika huzalishwa. Uchanganuzi unaofanywa katika makala hii unaonesha kwamba ufasili hauwezekani iwapo taarifa za kutosha hazitawakilishwa kwa wasikilizaji au ikiwa taarifa zisizofaa zitashirikishwa kwenye sentensi. Aidha, makala hii inaonesha kwamba kanuni tatu za uzuifu madhubuti ambazo ni za kanuni ya uzuifu wa valensia moja, kanuni ya uzuifu wa valensia mbili na kanuni ya uzuifu wa valensia tatu huhusu idadi ya nomino zinazohitajika kwenye muundo kwa mujibu wa kitenzi kilichotumiwa

Resyllabification of Loan Words in Kalenjin Phonology

The description of syllable structure in the individual languages is important in realizing syllabic markedness which motivates re-syllabification in the recipient language. The paper threrefore is an analysis of re-syllabification of Kipsigis and Tugen loan words borrowed from Kiswahili langauge.  The paper also gives an overview of the syllable structure in Kipsigis and Tugen as the recepient languages and Kiswahili as the source language. Data analysis was guided by consonant vowel (C.V) phonological framework. The study found out that resyllabification is a morphophonological process during word formation in any given language. Keywords: Re-syllabification, Syllables, Loan words, Tugen, Kipsigi

Factors Affecting Acceptance, Adoption and Use of Online SNS by Seniors

The use of Online Social Networks is higher among the youth as compared to the use of the same by seniors in Kenya. Online social networking has the potential to enrich the lives of seniors by providing them with an easy way to stay in touch with friends and family. Software Engineers and designers are anxious to capture the needs of this demographic through this new channel. Yet very little is known about what influences seniors to use online social networks in relation to development and design of this online social networks.This study uses results from a pilot study conducted in some Universities in Kenya as well as theory and literature to identify and examine what key factors influence seniors to accept and use online social networks then map the factors to enhance an already existing model Unified Theory of Acceptance and Use of Technology (UTAUT) used to explain Acceptance and Use of technology. The enhanced model that emerged describes the key factors that influence acceptance and use. Specifically the model indicates that perceived privacy, security and trust, proclivity to give and get information, content of Online Social Networking Sites(SNS) are some of the key factors that influence seniors to use online social networks. The enhanced model is a first step of an ongoing research project that aims to provide software engineers and designers with the requirements of seniors in Online Social Networks. Keywords: Online Social Networks, Elderly, UTAUT, SNS, Online Social Networking Use and Acceptance

ANALYSIS OF GOVERNANCE CHALLENGES & ARCHIVEMENT IN GOVERNMENT OWNED PARASTATALS IN TANZANIA: A CASE STUDY OF TANZANIA NATIONAL PARKS AUTHORITY HEAD QUARTERS

The debate whether  good governance have contribution in the perfomance of state owned corporation  or as remidies for poor perfomance of corporation in Tanzania and many other parts of the world is still alive.This study undertook a case study approach in order to alayse the effectiveness of good governance principles in relation to state owned corporation archivements. The objectives were,to dentify governance challenges in publiccorporations with case study of TANAPA, To identify the achievements made by TANAPA in relation to Good Corporate Governance. To propose sustainable approaches in enhancing good corporate governance in TANAPA. The data was gathered through face to face interviews where 30 public leaders were involved. The finding revealed that  good governance has impacts on the perfomance & archivement, Tanapa has archived economicaly as well as socially resulted from good corporate governance, there is increase in revenue, and improved sustainable conservations.Different challenges includes poaching, corruption, conflict of intrest and in adequent transparency were also mentioned by respondents as the bottleneck for good govenance in TANAPA. Conclusively, there is need to enable anti corruption agency, instill COI mechanisim within TANAPA, improve transparency as well as accountabilty. Keywords: corporate governance, case study, governance principles, archivements &perfomance, governance challenges

Management of University research output in Digital era : a case of Strathmore University

Paper presented at Kenya Library Association (KLA) regional conference which was held at Nairobi Safari Club from 31st July-2nd August 2013Today scholarly information is being produced in digital format unlike few years ago when scholars used to present their work in a hard format.Kanyengo (2009) notes that creators of knowledge and publishers of knowledge and everyone who is involved in the production of knowledge prefer the electronic format.A lot of digital content is now being produced in the scholarly world and this has brought serious and pressing issues in the access, preservation an dissemination of the content. This paper will highlight Strathmore University’s experience in using institutional repository to manage their research output, the benefits and the challenges they faced.Today scholarly information is being produced in digital format unlike few years ago when scholars used to present their work in a hard format.Kanyengo (2009) notes that creators of knowledge and publishers of knowledge and everyone who is involved in the production of knowledge prefer the electronic format.A lot of digital content is now being produced in the scholarly world and this has brought serious and pressing issues in the access, preservation an dissemination of the content. This paper will highlight Strathmore University’s experience in using institutional repository to manage their research output, the benefits and the challenges they faced

Levels of selected toxic and essential elements in fish and oysters from Western Indian Ocean, Coast of Tanzania

Concentrations of toxic and essential elements in selected finfish and shellfish collected from Dar es Salaam and Tanga, Indian Ocean coast of Tanzania are presented. The elemental concentrations were determined using Energy Dispersive X-ray Fluorescence (EDXRF) spectrometer coupled with X-lab ProTM software. The mean concentrations of metals observed in finfish and shellfish collected from Tanga ranged from 3.40–5.75, 1.8–37.17, 3.5–7.1, 0.6–1.3, 0.53–0.73 and 16.80–96.70 mg kg–1 for As, Cu, Mn, Ni, Pb and Zn, respectively. For Dar es Salaam, the mean concentrations of metals ranged from 3.34–9.46, 2.90–30.53, 3.4–6.9, 0.7–1.0, 0.57–0.80 and 14.2–100.90 mg kg–1 for As, Cu, Mn, Ni, Pb and Zn, respectively. Thumbprint emperor showed the highest levels of Cu and Ni; octopus showed the highest values of As and Pb, while sardines showed the highest level of Mn. Oysters, used as pollution indicators in this study showed the highest elemental concentrations and exceeded their mean levels in finfish from Dar es Salaam by factors of 1.30, 7.15, 6.27, 2.72, 1.29 and 35.57 for As, Cu, Mn, Ni, Pb and Zn, respectively. In samples from Tanga, the metal concentrations in oysters were several times higher (3.76, 17.68, 1.12, 3.89, 1.88 and 66.92 for As, Cu, Mn, Ni, Pb and Zn) than in finfish, respectively. Based on metal concentrations in oysters, it can be concluded that coastal waters are contaminated with heavy metals. However, with an exception of arsenic and copper, the elemental levels in finfish are within the maximum permissible levels recommended by various international standards and guidelines. Keywords: Finfish, toxic elements, essential elements, pollution, EDXR

Non-traumatic chest pain in patients presenting to an urban emergency Department in sub Saharan Africa: a prospective cohort study in Tanzania.

BACKGROUND:Non-traumatic chest pain (NTCP) is a common reason for emergency department (ED) attendance in high-income countries, with the primary concern focused on life threatening cardiovascular diseases. There is general lack of data on aetiologies, diagnosis and management of NTPC in Sub Sahara African (SSA) countries. We aimed to describe evaluation, diagnosis and outcomes of adult patients presenting with NTCP to an urban ED in Tanzania. METHOD:This was a prospective observational cohort study of consecutive adult (≥18 years) patients presenting with non-traumatic chest pain to the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH) in Dar es salaam from September 2017 to April 2018. Structured case report form was used to collected demographics, clinical presentation, investigations, diagnosis, and EMD disposition and in hospital mortality. We determined frequency of NTCP among our patients, aetiologies, 24-h and 7-day in-hospital mortality, and predictors for mortality. RESULTS:We screened 29,495 adults attending EMD-MNH during the study and 389 (1.3%) presented with NTCP of these, 349 (90%) were enrolled. The median age was 45 (IQR 29-60) years and 177 (50.7%) were female. Overall, 69.1% patients received electrocardiography (ECG) in the EMD and 34.1% had a troponin test. Heart failure and pulmonary tuberculosis (PTB) were the leading hospital diagnoses (12.6% each), followed by chronic kidney disease (10%) and acute coronary syndrome (ACS) (9.6%). Total of 167 (48%) patients were admitted, and the 24-h and 7-day in-hospital mortality were 5 (3%) and 16 (9.6%) respectively. Univariate risk factors for mortality were a Glasgow Coma Scale of < 15 [RR = 3.4 (95%CI 3.2-23)], Acute Coronary Syndrome [RR = 5.7 (95% CI 1.7-11.8) and Troponin > 0.04 ng/ml [RR 2.9 (95%CI 1.2-7.3)]. Features distinguishing cardiovascular from other causes were: bradycardia [RR = 2.6 (95%CI 2.1-3.2)], heart beat awareness [RR = 2.3 (95%CI 1.7-3.2)] and history of diabetic mellitus [RR = 2.2 (95% CI 1.6-3.0)]. CONCLUSION:In this ED of SSA country, heart failure and pulmonary tuberculosis were the leading causes of NCTP, and ACS was present in 9.6%. NTCP in this setting carries high mortality, and ACS was the leading risk factor for death. ED providers in SSA must increasingly consider cardiovascular causes of NTCP

A conceptual model of heritage dimensions and agrotourism: Perspective of Nandi County in Kenya

Conceptual frameworks have previously been used to give a structure to research that essentially simplifies thinking and clarifies issues, while at the same time providing a common reference point. Agrotourism is fast emerging as a key player in the activation of rural economies. An understanding of the interplay between variables that may help sustain agrotourism no doubt provides an avenue through which the practice can be exploited. The aim of this paper is to develop a conceptual model that can explain the interrelationship between heritage dimensions and agrotourism. It envisages that such a model can provide the basis upon which researchers can investigate ways of exploiting the abundant heritage dimensions in Nandi County.Keywords: agrotourism, agrotourism model, conceptualisation, heritage dimension

How the House of Morgan Cooperated to Develop the Large-Cap US Multinational Corporation, 1895-1913

The following investigation is intended to determine how the large-cap US multinational corporation was further advanced during the pivotal years of 1895-1913 by a leading private unincorporated institution—House of Morgan. Historical review and assessment focused on the broader US society, government, monetary landscape, the House of Morgan, leading large cap US multinationals; looking at both the key organizations and underlying people in power. The report framework focuses upon the development of the US super structure within which all major companies work down to the way actual institutions organize economic assets in the form of a multinational corporation. Questions that have been considered include: how was business conducted globally with so little formal mechanisms in place, the importance of the various forms of capital for business, and the various roles politics played in business development. Other areas include how owners and managers were effectively separated, how these same companies were able to branch out its product offering and the importance of providing corporate incentives. The House of Morgan cooperated with leading merchant banks, governments, foundations in developing an over-arching environment that was better adapted to the realities of the recent agricultural, industrial, and transportation revolutions that had brought about an integrated world. To organize economic assets in a more efficient and stable manner, large-cap multinationals were the preferred alternative, with a wave of consolidation across industries, underpinned by the pristine Morgan name. Strong board presence, interlocking corporate representation, active role in strategic planning, and management selection ensured that not only were new corporations molded in the design of the House of Morgan but also that they would stay committed to the far-reaching objectives. The House of Morgan took on more than just a focus of increasing shareholder value. They were driven by lofty ambitions of providing comprehensive stability within society at large in a rapidly changing world. The partners of the House of Morgan families had for generations been at the vanguard for providing the highest level of leadership throughout society in areas including business, politics, finance, and religion. These leading families were instrumental in providing the backbone of American society including founding the US Republic, developing the most venerable education institutions, and providing a moral compass through religious revival movements. The House of Morgan would help bring about generally larger and more institutionalized solutions from preceding generations that were conducive for multinational corporations to operate within. This ranges from a US central bank, developing modern non-profits structure, and funding the transportation network making the world more integrated. In helping organize broader US society, the House of Morgan would interlock different subsystems, including finance, charity, and politics with business in promotion of a more harmonious, predictable and productive society. The House of Morgan development of leading US large-cap multinationals, including General Electric, International Harvester, International Mercantile Marine and US Steel illustrates how it not only provided for the macro landscape to operate within, but also developed the leading companies of the era