Prevalence of Under Nutrition and Its Effects on Response to Malaria Treatments Among Children Under Five Years at Ahero and Homa Bay Hospitals, Western Kenya

Nutritional status of a person with malaria infection is thought to contribute to host treatment outcome. Limited studies have investigated the association despite the widespread concern with nutrition in malaria endemic areas. We evaluated the impact of under nutrition on the treatment outcome by Artemether Lumefantrine and Clindamycin plus Quinine. Sample of 384 children aged below five years diagnosed with uncomplicated Plasmodium falciparum malaria, were randomized to receive Clindamycin plus quinine or Artemether-lumefantrine (AL) for treatment. The children were followed up for 28 days to monitor body weight and height, clinical and parasitological parameters of treatment response.Outcomes included parasite clearance at days 2 and 3 and risk of recurrent parasitemia after 28 days of follow-up. Prevalence of underweight was 6 % (n=23) and stunting was 12% (n=45). Body weight increased over the 28 day follow up period. The initial mean weight was 13.03kg while the mean weight on day 28 was 13.7kg.The proportion of children with stunting was comparable between the female and male children: 40% verse 60%, p=0.06. Generally, the prevalence of underweight was comparable between the treatment arms (p=0.08). Similarly, the prevalence of stunting was not significantly different between the treatment arms (p=0.34). Cure rate was high in the Artemether group (96.5%) compared to the Clindamycin group (44.2%). Children who were underweight were 0.69 times less likely to be cured compared to those who were not underweight, but this difference was not significantly different from that of children were had no underweight (p = 0.429). Treatment outcomes were known for 43 of the 45 (95.6%) children with stunting. Overall, stunted children were 1.15 times more likely to be cured compared with children who were not stunted, but this difference was not statistically significant (p=0.704). No association between under nutrition (underweight and stunting) and treatment outcome was observed.  Further research is suggested on the impact of under nutrition on response to malaria treatment using Artemether Lumefantrine alone on children less than five years. Ministry of health and other policy makers may formulate guidelines to improve management of children with malaria taking into consideration their nutritional status, and to integrate nutrition in malaria programmes

STUDY OF FOOD SECURITY THROUGH FOOD WASTE AND LOSS CONTROL MECHANISM IN KENYA

Food waste within the hospitality’s restaurant operations contribute immensely to the global food wastes, and studies reveal that it contributes 45% of wastes through food preparation and production processes, 21% through food spoilage as a result of poor storage and 34% through food leavers as observed from customer plates. Further, research confirms that food wastage has directly resulted in the starvation of over 842 million people, with over 1.3 billion tons documented as food wastages, while substantial amounts of this food waste and losses taking place within the larger hospitality restaurant’s operations. The factors influencing these food waste generation included; the type of service, the type of food served, the expected and actual numbers of customers, the season and the food service organization, which are addressed by this study in an attempt to propose ways of reducing food waste and losses, and hence promoting food security. The study narrows down to the prevention solutions approach, which was employed on the basis of; menu design, portion choices and customized dishes, use of smaller plates during service, procuring optimized quantities, proper application of product specifications, and employment of waste tracking and analytics methodologies, which when appropriately applied in the restaurant food operations business will significantly reduce food waste and losses, and by extension global food insecurity

THE TIPPING CONSEQUENCE ON HOSPITALITY’S RESTAURANT FOOD AND BEVERAGE SERVICE RESPONSIVENESS IN KISUMU COUNTY - KENYA

Purpose of study: The purpose of this study was to investigate the tipping consequence of restaurant food service responsiveness. Methodology: The study employed a descriptive survey approach within Kisumu County in Kenya, with a focus on classified hotel restaurant (dependent). A simple random sampling methodology was applied in the selection of restaurant clients, with a sample size of 384 respondents. Main Findings: According to the study, tipping was found to have an effect on foodservice responsiveness (P ˂ 0.05), and thus a clear indication that foodservice responsiveness is dependent on tipping within classified dependent restaurants in Kisumu County, Kenya. Limitations: The study captured dependent restaurants in star-rated hotels within Kisumu County. Therefore, the results of the study may be applied with caution outside the scope of the study. Social Implications: Since its inception, tipping has been thought of as an incentive towards quality food service provision, hence customer satisfaction and retention. However, tipping has had a negative influence on foodservice responsiveness and therefore a compromise on food service quality, customer satisfaction and retention. Originality: There is insufficient literature on the topic, although with a handful on the relationship between service quality and tipping. This study will, therefore, fill the gap and used as a benchmark for other studies within not only the hospitality industry but the entire service industry. As a result, the study will be utilized both in policy and practice

A CUSTOMER-EMPLOYEE ENCOUNTER: A REVIEW OF CUSTOMER QUALITY CONTROL ON RESTAURANT FOOD SERVICE

Purpose of the Study: The purpose of this study review was to fill the literature gap into the customer quality control on restaurant food and beverage service, with the objective of identifying customer quality control methodologies within the hospitality’s food and beverage operations. Methodology: For purposes of carrying out the study review, the concept of customer employees encounter in the process of not only creating and offering goods and services but also the quality control aspect, and the various methodologies in doing so were considered and reviewed. The study employed a meta-analysis in gathering, analyzing, presentation and discussion of the study results. Main Findings: The study review findings reveal that hospitality organizations are facing a drift from the conventional restaurant standard operating procedures in reference to foodservice quality control with the customer taking a central position in the production and presentation of food services. Limitations: This is a study review and therefore the study findings were arrived at in consideration of mainly secondary sources. Some studies are traditionally region and/ or country-specific and therefore much caution is needed when generalizing the study findings. Social implications: There is a myriad of ways through which restaurant food service quality control can be integrated into the customer employee service encounter. They reviewed three main methodologies in this study review may provide the best tools not only for quality control function but also build confidence among the customer base, thus yielding customer satisfaction and retention on the one hand, while creating business sustainability on the other hand. Originality: This study will, therefore, help the hospitality restaurant business to appreciate the role of customers in the process of quality services provision, thus enable organizations to achieve a strategic business competitive position

Localization in Strongly Chaotic Systems

We show that, in the semiclassical limit and whenever the elements of the Hamiltonian matrix are random enough, the eigenvectors of strongly chaotic time-independent systems in ordered bases can on average be exponentially localized across the energy shell and decay faster than exponentially outside the energy shell. Typically however, matrix elements are strongly correlated leading to deviations from such behavior.Comment: RevTeX, 5 pages + 3 postscript figures, submitted to Phys. Rev. Let

Infectious disease testing of UK-bound refugees: a population-based, cross-sectional study

Background: The UK, like a number of other countries, has a refugee resettlement programme. External factors, such as higher prevalence of infectious diseases in the country of origin and circumstances of travel, are likely to increase the infectious disease risk of refugees, but published data is scarce. The International Organization for Migration carries out and collates data on standardised pre-entry health assessments (HA), including testing for infectious diseases, on all UK refugee applicants as part of the resettlement programme. From this data, we report the yield of selected infectious diseases (tuberculosis (TB), HIV, syphilis, hepatitis B and hepatitis C) and key risk factors with the aim of informing public health policy. Methods: We examined a large cohort of refugees (n = 18,418) who underwent a comprehensive pre-entry HA between March 2013 and August 2017. We calculated yields of infectious diseases stratified by nationality and compared these with published (mostly WHO) estimates. We assessed factors associated with case positivity in univariable and multivariable logistic regression analysis. Results: The number of refugees included in the analysis varied by disease (range 8506–9759). Overall yields were notably high for hepatitis B (188 cases; 2.04%, 95% CI 1.77–2.35%), while yields were below 1% for active TB (9 cases; 92 per 100,000, 48–177), HIV (31 cases; 0.4%, 0.3–0.5%), syphilis (23 cases; 0.24%, 0.15–0.36%) and hepatitis C (38 cases; 0.41%, 0.30–0.57%), and varied widely by nationality. In multivariable analysis, sub-Saharan African nationality was a risk factor for several infections (HIV: OR 51.72, 20.67–129.39; syphilis: OR 4.24, 1.21–24.82; hepatitis B: OR 4.37, 2.91–6.41). Hepatitis B (OR 2.23, 1.05–4.76) and hepatitis C (OR 5.19, 1.70–15.88) were associated with history of blood transfusion. Syphilis (OR 3.27, 1.07–9.95) was associated with history of torture, whereas HIV (OR 1521.54, 342.76–6754.23) and hepatitis B (OR 7.65, 2.33–25.18) were associated with sexually transmitted infection. Syphilis was associated with HIV (OR 10.27, 1.30–81.40). Conclusions: Testing refugees in an overseas setting through a systematic HA identified patients with a range of infectious diseases. Our results reflect similar patterns found in other programmes and indicate that the yields for infectious diseases vary by region and nationality. This information may help in designing a more targeted approach to testing, which has already started in the UK programme. Further work is needed to refine how best to identify infections in refugees, taking these factors into account

The Essential Interactions in Oxides and Spectral Weight Transfer in Doped Manganites

We calculate the value of the Fr\"ohlich electron-phonon interaction in manganites, cuprates, and some other charge-transfer insulators and show that this interaction is much stronger than any relevant magnetic interaction. A polaron shift due to the Fr\"ohlich interaction, which is about 1 eV, suggests that carriers in those systems are small (bi)polarons at all temperatures and doping levels, in agreement with the oxygen isotope effect and other data. An opposite conclusion, recently suggested in the literature, is shown to be incorrect. The frequency and temperature dependence of the optical conductivity of ferromagnetic manganites is explained within the framework of the bipolaron theory.Comment: 6 pages, REVTeX 3.1 with 3 eps-figures. Journal versio

The Costs of Implementing Vaccination With the RTS,S Malaria Vaccine in Five Sub-Saharan African Countries.

Background. The World Health Organization has recommended pilot implementation of a candidate vaccine against malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of the expanded program on immunization at all levels in each country were interviewed on the resources required for implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach setting. Results. The costs per FVC ranged from US$25 (Burkina Faso) to US$37 (Kenya) assuming a vaccine price of US$5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the countries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose in outreach settings raised the costs, mostly fuel, per FVC by less than US$1 regardless of the country. Conclusions. This study provides relevant information for donors and decision makers about the cost of implementing RTS,S. Variations within and across countries are important and the unknown future price per dose and wastage rate for this candidate vaccine adds substantially to the uncertainty about the actual costs of implementation