Literary scholars in Kenya have recognised that oral literature is a cultural heritage worth preserving and accessing. To this end, they have used traditional information to good effect. In today

No abstract available.

No abstract available

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

No abstract available.

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

No abstract available

One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.

PMID: 2591328 [PubMed - indexed for MEDLINE]

One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.

PMID: 2591328 [PubMed - indexed for MEDLINE]

BACKGROUND: There is indirect evidence that HIV-1 exposure does not inevitably lead to persistent infection. Heterogeneity in susceptibility to infection could be due to protective immunity. The objective of this study was to find out whether in highly HIV-1-exposed populations some individuals are resistant to infection. METHODS: We did an observational cohort study of incident HIV-1 infection-among 424 initially HIV-1-seronegative prostitutes in Nairobi, Kenya, between 1985 and 1994. 239 women seroconverted to HIV-1 during the study period. Exponential, Weibull, and mixture survival models were used to examine the effect of the duration of follow-up on incidence of HIV-1 infection. The influence of the duration of exposure to HIV-1 through prostitution on seroconversion risk was examined by Cox proportional hazards modelling, with control for other known or suspected risk factors for incident HIV-1 infection. HIV-1 PCR with env, nef, and vif gene primers was done on 43 persistently seronegative prostitutes who remained seronegative after 3 or more years of follow-up. FINDINGS: Modelling of the time to HIV-1 seroconversion showed that the incidence of HIV-1 seroconversion decreased with increasing duration of exposure, which indicates that there is heterogeneity in HIV-1 susceptibility or acquired immunity to HIV-1. Each weighted year of exposure through prostitution resulted in a 1.2-fold reduction in HIV-1 seroconversion risk (hazard ratio 0.83 [95% CI 0.79-0.88], p < 0.0001). Analyses of epidemiological and laboratory data, show that persistent seronegativity is not explained by seronegative HIV-1 infection or by differences in risk factors for HIV-1 infection such as safer sexual behaviours or the incidence of other sexually transmitted infections. Interpretation: We conclude that a small proportion of highly exposed individuals, who may have natural protective immunity to HIV-1, are resistant to HIV-1. PIP: A cohort study conducted in 1985-94 among 424 prostitutes from Nairobi, Kenya, who were initially human immunodeficiency virus (HIV)-1 seronegative, tended to provide support for the observation that some individuals in highly exposed populations may be resistant to infection. During the 10-year study period, 239 of these women seroconverted. The overall HIV-1 incidence was 42/100 person-years. After the first 2 years of follow up, in which the majority of seroconversions occurred, HIV-1 prevalence reached a plateau and then began a steep decline. To determine whether the risk of HIV-1 infection declined over time as a result of the selection of resistance, incidence rates among women with less than 3 years' versus more than 3 years' duration of prostitution were compared for 1989-93. An increasing protective effect for each seronegative year of exposure was observed. The estimated cumulative protective effect for women practicing prostitution from 1984-93 and remaining seronegative, compared to women who entered prostitution in 1994, was over 100-fold. To rule out the possibility that the decrease in seroconversion with duration of exposure reflected differences in sexual behavior or immunity to sexually transmitted diseases that facilitate HIV transmission, Cox proportional hazards modelling was performed. The weighted duration of prostitution was independently associated with a decreased risk of seroconversion. Each weighted year of exposure resulted in a 1.2-fold decrease in risk. Women who seroconverted were more likely to report 1 or more regular partners and to use condoms with these partners than their counterparts who remained seronegative. Elucidation of the protective mechanisms and the factors mediating the development of immunity against HIV-1 could be important to HIV-1 vaccine research.

ABSTRACT: Several strategies are employed in management of insect pests. Among these, chemical control is a priority to most farming communities where pest incidences occur while other existing options such as biological control are rarely considered. In coffee farming agro ecosystems, there are indigenous biological control agents such as the predacious phytoseiid mites, Euseius kenyae (Swirski and Ragusa) that have the potential to manage secondary pests like coffee thrips, Diarthrothrips coffeae Williams. This study was conducted to assess the population dynamics of E. kenyae and D. coffeae as well as theirinteractions under coffee agro ecosystems where various soil fertilizer sources and selective insecticides were applied as treatments. The populations of both E. kenyae and D. coffeae fluctuated during the three years study period. The E. kenyae suppressed the population of D. coffeae under various treated coffee blocks. There was negative correlation between E. kenyae and D. coffeae in year 2006 and 2008 where the increasing population of E. kenyae decreased that of D. coffeae. In year 2007, positive correlation between E. kenyae and D. coffeae was observed in some of the treatments where increased population of D. coffeae caused an increased population of E. kenyae. Euseius kenyae managed to contain the D. coffeae population to below economical injury levels (1-2 thrips per leaf) during the three years under the various coffee agro ecosystems. The use of chlorpyrifos never affected E. kenyae. Their survival and increased in number under chlorpyrifos treated coffee blocks indicated the development of resistance by the population of E. kenyae, hence the possibility of using them as a component in an Integrated Pest Management strategy in coffee.

ABSTRACT: Several strategies are employed in management of insect pests. Among these, chemical control is a priority to most farming communities where pest incidences occur while other existing options such as biological control are rarely considered. In coffee farming agro ecosystems, there are indigenous biological control agents such as the predacious phytoseiid mites, Euseius kenyae (Swirski and Ragusa) that have the potential to manage secondary pests like coffee thrips, Diarthrothrips coffeae Williams. This study was conducted to assess the population dynamics of E. kenyae and D. coffeae as well as theirinteractions under coffee agro ecosystems where various soil fertilizer sources and selective insecticides were applied as treatments. The populations of both E. kenyae and D. coffeae fluctuated during the three years study period. The E. kenyae suppressed the population of D. coffeae under various treated coffee blocks. There was negative correlation between E. kenyae and D. coffeae in year 2006 and 2008 where the increasing population of E. kenyae decreased that of D. coffeae. In year 2007, positive correlation between E. kenyae and D. coffeae was observed in some of the treatments where increased population of D. coffeae caused an increased population of E. kenyae. Euseius kenyae managed to contain the D. coffeae population to below economical injury levels (1-2 thrips per leaf) during the three years under the various coffee agro ecosystems. The use of chlorpyrifos never affected E. kenyae. Their survival and increased in number under chlorpyrifos treated coffee blocks indicated the development of resistance by the population of E. kenyae, hence the possibility of using them as a component in an Integrated Pest Management strategy in coffee.

HIV-infected patients face a greater risk of developing malignant disease. The most commonly reported neoplasms of the head and neck region include Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL). There is also an increased risk of oral squamous cell carcinoma (SCC). A descriptive cross-sectional study including HIV-infected patients with neoplastic and non-neoplastic lesions was conducted. Of the 200 participants, 116 (58%) were male and 84 (42%) female with an age range of 18-61 years (mean 37 years). The females were significantly younger (mean 33 years) than the males (mean 37 years) (t test; 2.57; P<0.05 [0.001]). The prevalence of neoplastic lesions in this study was 27%; 37 (68%) patients had KS, 9 (17%) had SCC, 7 (13%) had NHL and 1 (2%) had Burkitt's lymphoma. More females than males presented with lesions of KS and SCC compared with NHL. The youngest patient presented with SCC at 18 years (mean 35.7 years), followed by KS at 23 years (mean 36.3 years) and NHL at 33 years (mean 43.9 years). Most study participants (97%) were in stage III/IV of the disease and the remaining 3% in stage II. In this study, the most common malignant neoplasms were KS, SCC and NHL, manifesting in a younger age group than in the non-HIV group of patients.

BACKGROUND: In Kenya many patients exposed to the HIV infection present with orofacial lesions as the primary manifestations of the disease and only a few studies have been performed to document this observation. OBJECTIVE: To clinically evaluate and document the range and pattern of oral lesions in a group of hospitalised patients with HIV-infection. DESIGN: A prospective study. SETTING: Coast Province General Hospital in Mombasa, Kenya, which is the main referral institution serving a population of approximately two million people. METHODS: Examination of all the cases included in the study was performed according to the WHO criteria. Both male and female patients aged 16 years and above were selected. The criterion of recruitment was based on a suspicion of immunosuppression, the presence of oral manifestations and the willingness to participate in the study. Prior to the examination each patient had undergone counselling followed by two consecutive screening tests using the ELISA technique. Where indicated incisional biopsy was performed to confirm the clinical diagnosis of the relevant lesions. In collaboration with the medical team, treatment was administered as per the needs of the patient in terms of anti-fungals, antivirals or topical cortisteroids. RESULTS: Of the 61 cases, 25(41%) were males and 36(59%) females with an age range of 19 to 65 years (mean = 34.7 years). While all the cases had periodontal disease, over 80% had candidiasis of the hyperplastic, erythematous and pseudomembraneous types. Lymphadenopathy and angular cheilitis were each diagnosed in 27.9% of the cases; while oral Kaposi's sarcoma was seen in 13% of the patients. Other conditions seen included persistent oral ulceration (11.5%), oral hairy leukopLakia and herpes zoster each constituting 4.9%; herpes simplex, mucosal hyperpigmentation, parotomegaly and facial palsy each comprised six per cent and oral warts seen in one case. In accordance with the pattern and prevalence of oral manifestations in our study, the results were largely consistent with those documented elsewhere. CONCLUSION: For the alleviation of the morbidity arising from the commonly occurring lesions, early detection is mandatory. Furthermore, documentation of the varied regional patterns of occurrence of these lesions may aid in the rational application of the emerging treatments.

Four new naphthohydroquinones, named busseihydroquinones A−D (1−4), along with a known homoprenylated dihydronaphthoquinone (5), were isolated from the CH2Cl2/MeOH (1:1) extract of the roots of Pentas bussei. Although the genus Pentas is frequently used by traditional healers for the treatment of malaria, only marginal activities against the chloroquine-sensitive (D6) and the chloroquineresistant (W2) strains of Plasmodium falciparum were observed for the crude root extract and the isolated constituents of this plant.

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

Due to the increasing degradation of the natural business enterprises’ environmental commitment has become an
important variable in most of today’s competitive business environment. This is because activities of most
enterprises are the main causes of environmental degradation which in turn impact on the sustainability of their
performance. This study looks at the specific business environmental practices and initiatives and how they
impact on their sustainability. The overall objective of the study was to establish the impact of environmental
initiatives on business sustainability around Lake Naivasha. The study design was descriptive survey in order to
pick behaviors which needed to be mitigated for purposes of business sustainability. Purposive random sampling
was used from the target population which comprised of farming, hospitality and fishing sectors. Discriminant
analysis was used to analyze the data and the key findings of the study show that business sustainability depends
mainly on the current environmental practices and initiatives that have been put in place. The study recommends
that business associations be at the frontline in regulating activities by their members in order to achieve
sustainability.

Kenya Literature Bureau, Nairobi, Kenya. (Kibera F.N. Ed.)

n/a

The El Niño event in 2015/2016 was one of the strongest since at least 1950. Through surveys and interviews with key informants, we found businesses in the capital cities of Zambia, Botswana and Kenya experienced major disruption to their activities from El Niño related hydroelectric load shedding, water supply disruption and flooding, respectively. Yet, during the 2015/2016 El Niño, fluctuations in precipitation were not extreme considering the strength of the El Niño event. Results therefore highlight that even fairly moderate precipitation anomalies can contribute to major disruption to economic activity. Addressing the risk of disruption – and supporting the private sector to adapt – is a development priority.

The El Niño event in 2015/2016 was one of the strongest since at least 1950. Through surveys and interviews with key informants, we found businesses in the capital cities of Zambia, Botswana and Kenya experienced major disruption to their activities from El Niño related hydroelectric load shedding, water supply disruption and flooding, respectively. Yet, during the 2015/2016 El Niño, fluctuations in precipitation were not extreme considering the strength of the El Niño event. Results therefore highlight that even fairly moderate precipitation anomalies can contribute to major disruption to economic activity. Addressing the risk of disruption – and supporting the private sector to adapt – is a development priority.

Firms’ performance differs from firm to firm in the same industry with some firms achieving higher
levels of performance than others which can be connected to the type of competitive strategies a
firm adopts. The never-ending changes today calls for firms to continuously monitor their business
environment with a view to creating strategies that will make them different from their competitors
and improve their corporate image in the eyes of their customers. The study sought to determine
how business environment and corporate image affect the relationship between competitive
strategies and the performance of large manufacturing firms in Kenya. It was guided by positivist
philosophy and a cross-sectional descriptive survey. The target population was large
manufacturing firms in Kenya where a structured questionnaire was utilized to collect data.
Regression analysis was used to test the hypotheses. The study found that the joint influence of
competitive strategies, business environment and corporate image on performance of large
manufacturing firms in Kenya was statistically significant. Manufacturing firms should adopt
competitive strategies in response to business environment and craft strategies to enable them
position themselves better than competitor. The firms can indirectly improve performance by
maintaining a good corporate image also.

The author illustrates how qualitative data from open-ended interviews, pile sorts, and triad sorts can be used to test quantitatively for intracultural variation in norms. Specifically, the author tests whether Gusii men and women in the Suneka Division of Kisii District in southwest Kenya have developed a common set of standards in response to symptoms of malaria. In this small sample, the focus is on internal, rather than external, validity. While the findings about Gusii responses to malaria are not generalizable beyond the village where the data were collected, the method described may be used to study cultural similarities across socioeconomic, gender, and other groups.

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the Cly to Portland cement produced good binders for mass concre and plaster work,particularly for low cost housin

BACKGROUND:

Many burns are preventable but there is no published local prospective data on the epidemiological pattern of burns that would form the basis of care and formulation of burn prevention strategies.

OBJECTIVES:

To determine the epidemiological pattern of burns and assess the awareness of burn risk and preventive measures among patients admitted at Kenyatta National Hospital (KNH) with burns.

DESIGN:

Cross-sectional study.

SETTING:

Kenyatta National Hospital.

PATIENTS:

One hundred and nine consecutive burn patients admitted at Kenyatta National Hospital.

RESULTS:

The mean age was 14.4 years (median 7.0, range 0.2-66 years). Mean total body surface area burned (TBSA) was 22.3% (median 13.0, range 1-95%). Children under five years were 48.6% with more scalds compared to adults. Open flames burns, involvement of accelerants and assault were prominent among adults. Education level above primary school was associated with higher risk awareness compared with primary level education or below.

CONCLUSION:

The pattern of burns noted resembles other reported series but the role of accelerants and assault appears enhanced in this study. Public education campaigns aimed at burns reduction could be tailored to the educational level of target population.

Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an aggressive B-cell non-Hodgkin's lymphoma, characterized by a high degree of proliferation of the malignant cells and deregulation of the c-MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of B-cell lymphoma, unclassificable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma, now listed in the updated WHO classification. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

This research sought to establish the existence of the bull and bear market at the Nairobi Securities Exchange. The bull market is experienced when the prices of securities are in an upward trend while the Bear market is experienced when the prices of securities are in a downward trend. Bull and bear market can be traced back to the time of Charles Dow when he made analysis of trends in the stock market. The current and potential investors do not have any form of reference when making investment decisions, they will therefore benefit from this research since they will confirm which months are prone to the bull and bear markets and therefore not dispose their stocks in panic and also know the best time to purchase shares respectively. The Government will also benefit from it since it will be able to create a conducive environment for investment in the stock exchange and also for taxation purposes. It will also be useful to the Capital Markets Authority which is the main regulator of the Nairobi Securities Exchange since they will establish the genuine bull and bear market. The research was entirely based on secondary data from stocks of the year 2006. The research design was historical since it was dealing with issues that had occurred. Some fifteen out of the fifty two equities of companies trading in the Nairobi Securities Exchange were analyzed. Stratified and purposive samplings were used to select the fifteen companies. The data was analysed using percentages, mean, standard deviation and correlation coefficients. The findings confirmed that all the sampled stocks experienced both the bull and bear market. January, February and March were the months when most stocks experienced the bear market while August to November were the months when the majority of stocks experienced bull market. The study recommends the licensing of more stock brokers by CMA and also a further research into the role of stock brokers in influencing stock prices in the secondary market.

{

OBJECTIVE: To assess the clinical outcome of successful percutaneous transluminal coronary angioplasty (PTCA) in patients with poor ventricular function. METHODS: Analysis of angiographic, echocardiographic and clinical records of patients with severe LV dysfunction who underwent PTCA from January 1, 1995 to December 31, 1997 was undertaken. Forty-one patients aged 63+/-10 years, 36 men, all with significant coronary artery disease and impaired LV function (fractional shortening, FS<or=20%) were identified. Patients' data before and after angioplasty were analyzed. RESULTS: Post PTCA: angiographic success was 95.2%. Major complications occurred in 19.5% and hospital mortality was 2.7%. At 6 months after PTCA:LV fractional shortening (FS) increased from 15.9+/-3.4% to 19.6+/-6.6%

{

OBJECTIVE: To assess the clinical outcome of successful percutaneous transluminal coronary angioplasty (PTCA) in patients with poor ventricular function. METHODS: Analysis of angiographic, echocardiographic and clinical records of patients with severe LV dysfunction who underwent PTCA from January 1, 1995 to December 31, 1997 was undertaken. Forty-one patients aged 63+/-10 years, 36 men, all with significant coronary artery disease and impaired LV function (fractional shortening, FS<or=20%) were identified. Patients' data before and after angioplasty were analyzed. RESULTS: Post PTCA: angiographic success was 95.2%. Major complications occurred in 19.5% and hospital mortality was 2.7%. At 6 months after PTCA:LV fractional shortening (FS) increased from 15.9+/-3.4% to 19.6+/-6.6%

Grammatical Framework (GF) is a multilingual parsing and generation framework. In this paper, we describe the development of the Swahili Resource Grammar, a first in extending GF’s coverage with a Bantu language. The paper details the linguistic detail and considerations that have to be addressed whilst defining the grammars. The paper also describes an end-user application that uses the developed grammars to achieve multilinguality.

Mike English and colleagues argue that as efforts are made towards achieving universal health coverage it is also important to build capacity to develop regionally relevant evidence to improve healthcare.

Achieving universal coverage that supports high-quality care will require that health systems are designed to integrate the delivery of health services with the generation of new knowledge about the effectiveness of these services.
System strengthening and research will need to be better integrated to achieve this in low- and middle-income countries (LMIC) so that changes in coverage, quality, and impact are measured, costs are contained, and health systems are responsive to users’ needs and concerns.
In high-income countries, learning health systems (LHS) are emerging to meet similar needs. The LHS vision aspires to engage policy makers, researchers, service providers, and patients in learning that uses and strengthens routinely collected data to conduct pragmatic, contextually appropriate research, promote rapid adoption of findings to improve quality and outcomes, and promote continuous learning.
Although there are significant challenges, we should begin to develop LHS in LMIC for their immediate and longer term benefits and to avoid having to retrofit health systems with the capability to promote learning at a later date and even greater cost.
A global coalition on how to build LHS effectively that shares accumulating learning could enable such a strategy.

The success of any project is determined mainly by the effectiveness of the procedure used and by the efficiency of the organizational tools employed. Building and construction projects in general are particularly very sensitive to the nature of the organizational structure of the implementation team. This is so because many different, autonomous and fragmented institutions are brought together to combine their various expertise with a comon objective of producing a structure to the satisfaction of the client. It is the efficiency of combining their various activities that generally determines the success of the project. In Kenya, many reports have continued to appear in the local newspapers, professional journals and even meetings have been held by the respective institutions on accusations and counter accusations on the performance of government building contracts. The concern has been raised by a few cases of delayed projects which are likely be the tip of the iceberg, because nobody has come up with an emperical data to prove their side of the argument. Among other methods of measuring contract performance are cost and time, the success which contributes to yet another measure-client satisfaction The aim of this study is to establish whether or not the performance of government building contracts in terms of cost and time was poor in the period 1967 - 1981.~ This is done by use of a statistical technique - regression and correlation analysis as programmed in Statistical Package for Social Sciences (SPSS)• It is shown that majority of government building contracts suffer cost and time overruns. Time overruns are more frequent than cost overruns and the two are not related. Big projects have been shown to be more prone to both time and cost overruns than the smaller ones although delays have been found to bear no relationship to contract sizes.

Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science.

Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science.

Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap between evidence-based health interventions and actual practice in health service settings. It is essential for health care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by training professionals in implementation science. With support from the Medical Education Partnership Initiative, the University of Nairobi has developed a training program to build local capacity for implementation science.

Background: Health care systems in sub-Saharan Africa, and globally, grapple with the problem of closing the gap
between evidence-based health interventions and actual practice in health service settings. It is essential for health
care systems, especially in low-resource settings, to increase capacity to implement evidence-based practices, by
training professionals in implementation science. With support from the Medical Education Partnership Initiative,
the University of Nairobi has developed a training program to build local capacity for implementation science.
Methods: This paper describes how the University of Nairobi leveraged resources from the Medical Education
Partnership to develop an institutional program that provides training and mentoring in implementation science,
builds relationships between researchers and implementers, and identifies local research priorities for
implementation science.
Results: The curriculum content includes core material in implemerjjation science theory, methods, and experiences.
The program adopts a team mentoring and supervision approach, in which fellows are matched with mentors at the
University of Nairobi and partnering institutions University of Washington, Seattle, and University of Maryland,
Baltimore. A survey of program participants showed a high degree satisfaction with most aspects of the program,
including the content, duration, and attachment sites. A key strength of the fellowship program is the partnership
approach, which leverages innovative use of information technology to offer diverse perspectives, and a team model
for mentorship and supervision.
Conclusions: As health care systems and training institutions seek new approaches to increase capacity in
implementation science, the University of Nairobi Implementation Science Fellowship program can be a model
for health educators and administrators who wish to develop their program and curricula.
Keywords: Implementation science, Training, Fellowship program

This paper examines the budgetary practices in private and mission hospitals. The aim is to shed some light on the human behaviour including other activities during budgeting. This research was based on a survey of all private and mission hospitals in Nairobi. Two additional hospitals were included in the study from the environs. Budgeting reflects a conscious effort to plan for certain desirable results and controls to maximise the chances of achieving those results in a company. In a typical private sector, budgeting is a collective and closely coordinated exercise in which each activity is systematically related to the other since the sector is profit motivated. Future planning needs to recognize that sustainable health service provision cannot be achieved by the government health sector alone and active involvement of stakeholders is required. Typically, in the governmental sector, health services are financed primarily through the revenue collected from fees and insurance premiums charged to service users. The main contribution of this paper is to highlight the involvement of senior staff in the budget planning, problems faced during the budgeting process and the effectiveness of the budgeting process. In addition, it guides on possible solutions to problems faced by the organisations.

This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.