Urbanization, ethnicity and cardiovascular risk in a population in transition in Nakuru, Kenya: a population-based survey.

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among older people in Africa. This study aimed to investigate the relationship of urbanization and ethnicity with CVD risk markers in Kenya. METHODS: A cross-sectional population-based survey was carried out in Nakuru Kenya in 2007-2008. 100 clusters of 50 people aged ≥ 50 years were selected by probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Participants were interviewed by nurses to collect socio-demographic and lifestyle information. Nurses measured blood pressure, height, weight and waist and hip circumference. A random finger-prick blood sample was taken to measure glucose and cholesterol levels.Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mm Hg, or diastolic blood pressure (DBP) ≥ 90 mm Hg or current use of antihypertensive medication; Diabetes as reported current medication or diet control for diabetes or random blood glucose level ≥ 11.1 mmol/L; High cholesterol as random blood cholesterol level ≥ 5.2 mmol/L; and Obesity as Body Mass Index (BMI)≥ 30 kg/m2. RESULTS: 5010 eligible subjects were selected, of whom 4396 (88%) were examined. There was a high prevalence of hypertension (50.1%, 47.5-52.6%), obesity (13.0%, 11.7-14.5%), diabetes (6.6%, 5.6-7.7%) and high cholesterol (21.1%, 18.6-23.9). Hypertension, diabetes and obesity were more common in urban compared to rural groups and the elevated prevalence generally persisted after adjustment for socio-demographic, lifestyle, obesity and cardiovascular risk markers. There was also a higher prevalence of hypertension, obesity, diabetes and high cholesterol among Kikuyus compared to Kalenjins, even after multivariate adjustment. CVD risk markers were clustered both across the district and within individuals. Few people received treatment for hypertension (15%), while the majority of cases with diabetes received treatment (68%). CONCLUSIONS: CVD risk markers are common in Kenya, particularly in urban areas. Exploring differences in CVD risk markers between ethnic groups may help to elucidate the epidemiology of these conditions

Learning for the Future: Exploring Effective Characteristics of Sustainability Leadership Programs in Higher Education

In response to global environmental, economic, and social issues, universities and colleges have begun to create and expand leadership courses and programs that aspire to foster sustainability change agents. This literature review explores these courses and programs in greater detail and identifies the characteristics they share. In doing so, it maintains a common focus on education that is collaborative, experiential, and transformative while providing examples of effective pedagogies, skills, and learning outcomes that support these themes. This review contributes to emerging research on best practices for sustainability education and can potentially provide insights for sustainability educators, researchers, and students at the post-secondary level

Prevalence and predictors of refractive error and spectacle coverage in Nakuru, Kenya: a cross-sectional, population-based study.

A cross-sectional study was undertaken in Nakuru, Kenya to assess the prevalence of refractive error and the spectacle coverage in a population aged ≥50 years. Of the 5,010 subjects who were eligible, 4,414 underwent examination (response rate 88.1 %). LogMAR visual acuity was assessed in all participants and refractive error was measured in both eyes using a Topcon auto refractor RM8800. Detailed interviews were undertaken and ownership of spectacles was assessed. Refractive error was responsible for 51.7 % of overall visual impairment (VI), 85.3 % (n = 191) of subjects with mild VI, 42.7 % (n = 152) of subjects with moderate VI, 16.7 % (n = 3) of subjects with severe VI and no cases of blindness. Myopia was more common than hyperopia affecting 59.5 % of those with refractive error compared to 27.4 % for hyperopia. High myopia (+5.0 DS). Of those who needed distance spectacles (spectacle coverage), 25.5 % owned spectacles. In conclusion, the oldest, most poor and least educated are most likely to have no spectacles and they should be specifically targeted when refractive services are put in place

Evaluating the Effects of Curing Methods on BCSA Cement Concrete

BCSA cement is a type of cement that makes concrete set up much quicker than typical portland cement concrete. BCSA cement concrete also has a much higher compressive strength than that of portland cement concrete. This study was conducted to determine the effect of different curing conditions on the compressive strength of BCSA cement concrete

The Effects of Autonomous Motivation and Implementation Planning on Dietary Goal Adherence Among Personal Training Clients

Personal Fitness Trainers working within their scope of practice are in a unique position to encourage client adherence to dietary changes that are aligned with the Dietary Guidelines for Americans (DGA). Some research shows that the quality of an individual’s motivation may play a role in goal success, and that implementation planning may be an effective goal adherence promotion strategy for those with autonomous motivation. However, little is known regarding this relationship between type of motivation, implementation planning, and goal adherence among personal training clients interested in improving their dietary habits. This 6-week mixed methods study sought out female personal training clients at a public comprehensive university who were interested in improving their dietary habits (n=19). All participants were presented with information about the DGA and asked to set a daily dietary goal to bring their diet in tighter alignment with those guidelines. They were asked to rate their source of motivation for the goal as either autonomous or controlled. Participants were randomly assigned to one of two groups: Control group (C), or (2) Implementation Planning group (IP) both of which tracked goal adherence and reasons for non-adherence on a daily basis. In addition, IP participated in weekly implementation planning sessions. Results suggested that participants adhered to their self-selected daily dietary goals approximately 62% of the time, irrespective of group assignment. No significant correlation was found between the source of motivation, implementation planning, and adherence, although the small sample size makes it difficult to determine whether the lack of correlation was valid or due to low statistical power. In conclusion, more research needs to be conducted to determine what factors influence successful dietary change

The Level of Commitment of Intrinsic Religiosity and Relational Aggression In Middle-Aged Women

The study examined the relationship between the level of commitment to intrinsic religiosity and the role of relational aggression in the lives of middle-aged women. Research has shown that middle-aged women participate in relational aggression, but few studies have investigated it. The causes and methods of prevention in relational aggression are something to be considered, and a first step is examining risk and protective factors. Is intrinsic religiosity a protective or risk factor for participating as an instigator in relational aggression? Does intrinsic religiosity actually buffer the negative effects associated with victimization in relational aggression? Based on research that previously examined the relationship between religiosity and prosociality, I hypothesized that women who are more intrinsically religious will be less likely to participate in relational aggression. Based on research surrounding the benefits of religion to well-being, I also hypothesized that more intrinsically religious women will feel less victimized by aggression than women who are less intrinsically religious

Global Performance Testing, Simulation, and Optimization of a 6-MW Annular Floating Offshore Wind Turbine Hull

Floating offshore wind turbine (FOWT) hull technologies are evolving rapidly with many technically viable designs. However, a commercially dominant architecture has yet to emerge. This thesis presents a methodology for evaluation of the hydrodynamic performance of an annular FOWT hull. This hull shows significant promise from a manufacturing and installation standpoint, but limited performance data exists. This thesis will provide ample documentation on scale model testing of an annular FOWT hull as well as the corresponding numerical validation approach and opportunities for design improvement. The first portion of this work involves testing a 1/100th-scale model in the Harold Alfond Wind Wave Ocean Engineering Laboratory at the University of Maine’s Advanced Structures and Composites Center followed by an investigation of wave-induced motion using ANSYS AQWA, a commercial hydrodynamic software. The experimental and numerical results are compared to determine the ability of ANSYS AQWA to simulate the response of an annular FOWT hull, which here implies that the hull contains a moonpool. The wave-only performance of the annular hull is also compared to experimental data obtained for other baseline FOWT hulls. In addition to quantifying a baseline hull, this thesis will also explore modifications in the annular geometry to further explore the design space in an effort to find a more optimal annular hull configuration for use in FOWT applications

Effects of Classroom Relationships Between Students and Teachers on Emotional Development of Elementary School Students

Today, the current education system does not foster the emotional development of elementary school students. As a consequence, this affects student’s emotional development. Through the use of literature review, interview of a teacher, anonymous survey with five teachers and twenty-six elementary school students, this senior capstone research examines the effects of classroom relationships between students and teachers on the emotional development of elementary school students. The results indicate that classroom relationship does in fact foster the development of student emotional skills

Prevalence of age-related macular degeneration in Nakuru, Kenya: a cross-sectional population-based study.

BACKGROUND: Diseases of the posterior segment of the eye, including age-related macular degeneration (AMD), have recently been recognised as the leading or second leading cause of blindness in several African countries. However, prevalence of AMD alone has not been assessed. We hypothesized that AMD is an important cause of visual impairment among elderly people in Nakuru, Kenya, and therefore sought to assess the prevalence and predictors of AMD in a diverse adult Kenyan population. METHODS AND FINDINGS: In a population-based cross-sectional survey in the Nakuru District of Kenya, 100 clusters of 50 people 50 y of age or older were selected by probability-proportional-to-size sampling between 26 January 2007 and 11 November 2008. Households within clusters were selected through compact segment sampling. All participants underwent a standardised interview and comprehensive eye examination, including dilated slit lamp examination by an ophthalmologist and digital retinal photography. Images were graded for the presence and severity of AMD lesions following a modified version of the International Classification and Grading System for Age-Related Maculopathy. Comparison was made between slit lamp biomicroscopy (SLB) and photographic grading. Of 4,381 participants, fundus photographs were gradable for 3,304 persons (75.4%), and SLB was completed for 4,312 (98%). Early and late AMD prevalence were 11.2% and 1.2%, respectively, among participants graded on images. Prevalence of AMD by SLB was 6.7% and 0.7% for early and late AMD, respectively. SLB underdiagnosed AMD relative to photographic grading by a factor of 1.7. After controlling for age, women had a higher prevalence of early AMD than men (odds ratio 1.5; 95% CI, 1.2-1.9). Overall prevalence rose significantly with each decade of age. We estimate that, in Kenya, 283,900 to 362,800 people 50 y and older have early AMD and 25,200 to 50,500 have late AMD, based on population estimates in 2007. CONCLUSIONS: AMD is an important cause of visual impairment and blindness in Kenya. Greater availability of low vision services and ophthalmologist training in diagnosis and treatment of AMD would be appropriate next steps. Please see later in the article for the Editors' Summary