This study was done at Machakos District Hospital in the Eastern province of Kenya between May and August 2007.Aim was to find out the role of hormonal contraceptives in HIV infection among antennal mothers. Analytical cross- sectional study design was used. Methodology. The sample size consisted of 144 antenatal mothers visiting the MCH clinic for PMTCT services among other services. The simple random sampling technique included every 8th antenatal mother visiting the PMTCT clinic who had no history of consisted condom use. All antenatal mothers who had not used condoms consistedly both contraceptive and non-contraceptive users who fell in the sampling frame acted as study subjects. This was on condition that they consented to participate in the study. A self

Mentorship programs are offered to support students in program completion, confidence building and transitioning to further education or the work force. However mentoring relationships have been faced by challenges such as inadequate knowledge and negative attitude. This study aimed at evaluating knowledge, attitude and perceived benefits on mentorship among the nursing students in Kenyan universities. The study was conducted in September, 2009.  A descriptive cross sectional survey  used both qualitative and quantitative methods to gather information. The study participants were students from University of Nairobi (U.O.N) and Kenya Methodist University (K.E.M.U). A sample of 188 students was selected from a total population of 403 in both universities. The data were coded, entered and analyzed using statistical package for social sciences (SPSS). Presentation of data was done in form of descriptive statistics, frequency distribution and graphs. Pearsons chi square tests were used to compare the two groups. The tests level of significance was set at 5%. Results showed that there was a significance difference between mentorship programmes in the two institutions ( χ 2= 17.02,  d.f=1 , p < 0.001)           . Fourty four (72%) of the students at K.E.M.U felt that the program had positive impact on students

The study sought to establish the factors affecting the diploma graduates performance in the Nursing registration examination. Necessitated by poor performance recorded in recent years, this study was aimed at seeking to establish the reasons why. This was a descriptive study. Quantitative data was collected using self-administered semi structured questionnaires from 75 KRCHN graduates working at Kenyatta National Hospital. The study areas were purposively selected and the study subjects selected through simple random sampling. Qualitative data was collected using a study from lecturers

Necessitated by poor performance recorded in recent years, this descriptive study sought to establish the impact of students and teacher characteristics on performance in the Nursing registration examination. The study combined both qualitative and quantitative methods. Quantitative data was collected using self-administered semi structured questionnaires from 75 KRCHN graduates working at Kenyatta National Hospital. The study areas were purposively selected and the study subjects selected through simple random sampling. Qualitative data was collected using a study guide from lecturers

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Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

 Prof. Anna Karani on - Authentic Leadership focus on impact of integrity so that leadership is better prepared to face the toughest challenges, inspire transparency and trust. It requires building in mind the customers served. Behaviour change is essential for long term growth and it avoids peripheral vision. Focused leadership identifies the missing link, addresses priority issues and information that is accurate, complete, economical, flexible, reliable, simple, timely, and verifiable. Nurses have a purpose, a destiny and need to accomplish things. They are trained to make a difference in peoples

 The  research evaluated clinical training provided by the academic institutions that offer Bachelor of Science in Nursing (BScN) program. The purpose of the study was to describe the adequacy of clinical training and the graduates preparedness for nursing practice. The study was conducted from Sept. 2008 to March 2010. Design was cross sectional using questionnaires and focus group interviews (FGI) methods to collect data. The sample comprised of 232 subjects including pre-service BScN graduates and nursing supervisors at four teaching and referral hospitals in Kenya. Results revealed that clinical training provided by academic institutions was adequate but quality of training varied widely among the training institutions. The conclusion was that clinical training provided by BScN programs in Kenya was of high quality. The study recommends that urgent attention was required by nurse educators to address identified gaps in clinical training especially clinical instruction and supervision.   

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

This paper reports the detailed results of a study of the impact of the Health Workers for Change (HWFC) workshop series on clients' perceptions of health services, relationships within the health centre and relations between the health facility and the district health system. The study was carried out in three stages: baseline, intervention and evaluation over a period of 20 months. Data, both qualitative and quantitative, were collected at three levels: client, facility and system. Results indicate that relations between health workers and clients improved a great deal after the intervention while those between the facility and the system remained to a large extent unchanged. The paper concludes that, with external support and help, especially from the health system level, health workers can work towards improving health services and their job satisfaction, which can lead to better health worker-client relations.

The study was conducted to investigate the clinical Competence of Bachelor of Science Nursing graduates working at Kenyatta National Hospital in March 2011. The objective was to assess the perceptions of graduate nurses about the nursing profession and the implications on the development of BScN undergraduates from the University of Nairobi and other Universities with a view to improving their perception about the profession  through continuing education and curriculum review. It was a cross sectional study with a sample size of 50 nurses, total population selected on purpose. A supervised questionnaire and focus group discussion tools were used for data collection.  The findings indicated that majority of the Bachelor of Science Nursing graduates

The old nurse was there during the colonial  era. They were trained mainly by missionaries who were Christians. Therefore, they had the discipline and the Christian foundation principles. The joy of a Christian institution like Kijabe is that it still has that foundation. So all is not lost. We have to make sure that the lost PASSION, LOVE & CARE are back in the nursing profession. We have to restore that passion. That idea or feeling

A leader is one who has the  Vision to see, Faith to believe, Will to learn, Humility to serve, Courage to do, Resilience to rise up in times of knock downs. What  is leadership? The ability to get things done through people.  What challenges have you encountered in leadership as you work? How have you overcome these challenges? What sets you apart from everybody else? What is it that you do differently from the nurse of to-day? It is your leadership. The way you do things for the community you serve. The commitment to serve selflessly. The way you are disciplined. It is not just money.  We all want to learn how to become more effective leaders in providing health care to the  community. We have to prepare for many challenges with the advanced technology, rapid development, and fast changing health systems, emerging diseases, rising poverty, hard economic times, changing social systems, Education , political , environment, climate among many others that affect the communities we serve. Facing Today

 Media resources are critical component in teaching and learning process. Studies indicate that media resources provide the substitute for direct learning experiences during instruction and enable educators to present the learners with the requisite experience necessary for the acquisition of appropriate knowledge, skills and attitudes.The researchers set out to explore the philosophical, psychological and educational basis that provides guidelines on the development of media resources in the effective education and training of health professionals. Methodology was a historical critique of information from books, journals,magazines and internet on media resources in Medical education.  The findings indicate that the process of media resources development and administration is highly creative venture according to Mason (1977).plan, prepare, present, preview and follow up activities after use of equipment. Therefore educators must be able to demonstrate these issues when developing and administering them. 

Authentic Leadership focus on impact of integrity so that leadership is better prepared to face the toughest challenges, inspire transparency and trust. It requires building in mind the customers served. Behaviour change is essential for long term growth and it avoids peripheral vision. Focused leadership identifies the missing link, addresses priority issues and information that is accurate, complete, economical, flexible, reliable, simple, timely, and verifiable. Nurses have a purpose, a destiny and need to accomplish things. They are trained to make a difference in peoples

Electrical power supply in Sub Saharan Africa (SSA) is expensive and very low, and most families have no chance of accessing clean lighting and cooking power. Off grid systems are the best viable solution in SSA and wind energy has a potential. However, the components …

This paper reports the detailed results of a study of the impact of the Health Workers for Change (HWFC) workshop series on clients' perceptions of health services, relationships within the health centre and relations between the health facility and the district health system. The study was carried out in three stages: baseline, intervention and evaluation over a period of 20 months. Data, both qualitative and quantitative, were collected at three levels: client, facility and system. Results indicate that relations between health workers and clients improved a great deal after the intervention while those between the facility and the system remained to a large extent unchanged. The paper concludes that, with external support and help, especially from the health system level, health workers can work towards improving health services and their job satisfaction, which can lead to better health worker-client relations.

Health care professionals are absorbed daily in the practices of their professional areas of specialization. Medical Educators,  spend their time catering to the educational needs of all health care professionals, whatever their specialization. A recent area of concern in the medical education curricula has been the inclusion of the topic

Health care professionals are absorbed daily in the practices of their professional areas of specialization. Pediatricians, for example spend most of their time catering to the needs of children, while nurses, pharmacists and dentists in their own areas. Medical Educators, however, spend their time catering to the educational needs of all health care professionals, whatever their specialization. A recent area of concern in the medical education curricula has been the inclusion of the topic

Health care professionals are absorbed daily in the practices of their professional areas of specialization. Pediatricians, for example spend most of their time catering to the needs of children, while nurses, pharmacists and dentists in their own areas. Medical Educators, however, spend their time catering to the educational needs of all health care professionals, whatever their specialization. A recent area of concern in the medical education curricula has been the inclusion of the topic

This paper is based on narrative performances collected in research by students of the University of Nairobi under the guidance of their lecturers. The fieldwork was conducted in February 2005 among nomadic communities in northern Kenya. The main thrust of the paper is to explore how Magdalene, a woman narrator, subverts the dominant masculine ideology inherent in the structure and orientation of oral narratives. The paper identifies the discrete and subtle ways in which the narrator seeks to undermine the manifest inclination of oral narratives towards male dominance. Considering that oral literature is a crucial tool in shaping the world view of a community (especially children), and bearing in mind that women artists perform many of the oral narratives, the imperceptible but subversive potential of such narration becomes even clearer.

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

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Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

This paper reports the detailed results of a study of the impact of the Health Workers for Change (HWFC) workshop series on clients' perceptions of health services, relationships within the health centre and relations between the health facility and the district health system. The study was carried out in three stages: baseline, intervention and evaluation over a period of 20 months. Data, both qualitative and quantitative, were collected at three levels: client, facility and system. Results indicate that relations between health workers and clients improved a great deal after the intervention while those between the facility and the system remained to a large extent unchanged. The paper concludes that, with external support and help, especially from the health system level, health workers can work towards improving health services and their job satisfaction, which can lead to better health worker-client relations.

Background: Utrasound  technology continues advancing in techniques and diagnosis. It remains a field of specialists where nurses and other health workers are uneducated on it. Objectives: Determine pattern of ultrasound findings in ectopic pregnancy, involvement of nursing staff, determine medical education implications.Design: Retrospective, prospective and on-going study over 8 year period. Focus group discussions with nursing and medical education analysts. Setting: Memorial Hospital Eldoret, Kenya.Participants - 81 patients with ectopic pregnancy diagnosed by ultrasound.Results: Age range 19-39 years - 34.6% Unruptured ectopic pregnancy - 44.5%, Ruptured 43.2%, chronic leaking 2.3%.Conclusion: Ultrasound aids diagnosis and can grade type of pregnancy. Need to demystify science to nurses, clinical officers and other health workers.Recommendation: Medical education to include ultrasound to existing curriculaspecifying roles by health workers. Use participatory teaching methods for ultrasound technology. 

Description
Adsorption of crystal violet (CV) dye from aqueous solution using dried bark powder of mangrove species Rhizophora mucronata was studied. Characterization of adsorbent was done using FTIR and SEM. Batch experiment was carried out to examine the viability of using mangrove bark for adsorption of CV dye from aqueous solutions under different process conditions. The result revealed that removal of CV increased with contact time, adsorbent dose, initial dye concentration and decreased with increased particle size and ionic strength. pH 7 was the optimum pH for CV dye removal. The adsorption equilibrium for CV dye by Rhizophora mucronata stem-bark was attained within 60 min with removal efficacy of up to 99.8%. Pseudo-second-order kinetic model was best used to describe sorption kinetics while Freundlich isotherm model was appropriate for describing adsorption isotherm. The results demonstrated …

This paper builds a case for a reconsideration of Kenya’s legislation that relates to cultural and societal heritage resources management by briefly revisiting the circumstances that informed the enactment of the related laws. We present the view that existing legislation has tended to serve corporate, multinational and foreign interests at the expense of local and national interests, and that although these Acts may have somewhat served the country in the past, the legislations have turned the cultural heritage management in Kenya into a lame duck framework of abstractions of policy matters, that are irrelevant and unresponsive to changing local and international circumstances. We highlight contradictions between and within varied Acts, and offer suggestions for remedy that are geared toward the development of a cultural management policy with local ownership and universal compatibility.

Background: Alot of research work has been carried out to determine the effectiveness of using atraumatic restorative treatment (ART) in the management of dental caries, but there are still unresolved issues surrounding the use of the technique particularly in very large carious lesions.
Objective: To determine the current survival rates of multi-surface ARTrestorations placed in the primary dentition and any consequences to the restored tooth after premature loss of the restoration.
Study selection: Using a set of specific key words, a Pubmed/Medline search was carried out to retrieve all publications on ARTrestorations placed in primary teeth in the period January 2000 to December 2011. Only publications whose studies had multi-surface ARTrestorations as an item of study were retrieved and relevant data extracted.
Data synthesis: Twelve studies contained in 12 publications fulfilled the selection criteria and were included in the study. The selected publications were analysed by the author to establish the study follow-up period and the survival rate of the multi-surface ARTrestorations for the different follow-up periods. Further information was adduced on any other effects of restoration on the tooth after premature loss of the restoration.
Results: The search findings indicated that the survival rate for most of the multi-surface restorations were generally very low. Further, there were indications that even after the premature loss of the ARTrestorations, most of the affected teeth survived for the period of the study with a number of them having shown no signs of secondary caries or associated dental abscessees.
Conclusion: While the survival rates of multi-surface ARTrestorations in the studies documenetd in the review were low, the ART restorations appeared to provide some beneficial effects to the retention-longevity of the restored tooth even after their premature loss.

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Precis: Simulation-based surgical education shows a positive, immediate, and sustained impact on core surgical skill competency in trabeculectomy among resident ophthalmologists in training.

Purpose: To measure the impact of trabeculectomy, surgical simulation training on core surgical skill competency in resident ophthalmologists.

Materials and methods: This is a post hoc analysis of the GLAucoma Simulated Surgery trial, which is a multicenter, multinational randomized controlled trial. Resident ophthalmologists from 6 training centers in sub-Saharan Africa (in Kenya, Uganda, Tanzania, Zimbabwe, and South Africa) were recruited according to the inclusion criteria of having performed zero surgical trabeculectomies and assisted in <5. Participants were randomly assigned to intervention and control arms using allocation concealment. The intervention was a 1-week intensive trabeculectomy surgical simulation course. Outcome measures were mean surgical competency scores in 8 key trabeculectomy surgical skills (scleral incision, scleral flap, releasable suturing, conjunctival suturing, sclerostomy, tissue handling, fluidity, and speed), using a validated scoring tool.

Results: Forty-nine residents were included in the intention-to-treat analysis. Baseline characteristics were balanced between arms. Median baseline surgical competency scores were 2.88/16 [interquartile range (IQR): 1.75-4.17] and 3.25/16 (IQR: 1.83-4.75) in the intervention and control arms, respectively. At primary intervention, median scores increased to 11.67/16 (IQR: 9.58-12.63) and this effect was maintained at 3 months and 1 year ( P =0.0001). Maximum competency scores at primary intervention were achieved in the core trabeculectomy skills of releasable suturing (n=17, 74%), scleral flap formation (n=16, 70%), and scleral incision (n=15, 65%) compared with scores at baseline.

Conclusions: This study demonstrates the positive impact of intensive simulation-based surgical education on core trabeculectomy skill development. The rapid and sustained effect of resident skill acquisition pose strong arguments for its formal integration into ophthalmic surgical education.

The platinum drug, cisplatin, is considered as among the most successful medications in cancer treatment. However, due to its inherent toxicity and resistance limitations, research into other metal-based non-platinum anticancer medications with diverse mechanisms of action remains an active field. In this regard, copper complexes feature among non-platinum compounds which have shown promising potential as effective anticancer drugs. Moreover, the interesting discovery that cancer cells can alter their copper homeostatic processes to develop resistance to platinum-based treatments leads to sugges- tions that some copper compounds can indeed re-sensitize cancer cells to these drugs. In this work, we review copper and copper complexes bearing dithiocarbamate ligands which have shown promising results as anticancer agents. Dithiocarbamate ligands act as effective ionophores to convey the com- plexes of interest into cells thereby influencing the metal homeostatic balance and inducing apoptosis through various mechanisms. We focus on copper homeostasis in mammalian cells and on our current understanding of copper dysregulation in cancer and recent therapeutic breakthroughs using copper coordination complexes as anticancer drugs. We also discuss the molecular foundation of the mecha- isms underlying their anticancer action. The opportunities that exist in research for these compounds and their potential as anticancer agents, especially when coupled with ligands such as dithiocarbamates, are also reviewed.

Abstract

Chromium (Cr) is among the heavy metals that are added to automotive paints to provide protection against corrosion and reflective properties. However, exposure to hexavalent chromium Cr(VI), which is the toxic form of Cr is associated with adverse health effects such as lung cancer. The study, therefore, assessed Cr levels in the automotive paints commonly used by spray painters in informal settings in Nairobi City. Chromium concentrations were determined in triplicates in the three sets of automotive paint samples in red, blue and green colours. The same samples were also used for the determination of lead content and the findings of the study were published elsewhere. The automotive paint samples were procured from 8 formal and informal retail stores. The Cr concentrations was also analyzed using Atomic Absorption Spectrophotometry. The mean ± standard deviation (SD) of Cr levels obtained from informal retail shops ranged from 120.5±10.6 to 2771.9±35.6 parts per million (ppm). On the contrary, those from the formal retail stores were significantly lower (p < 0.05), and were in the range of 39.3±7.0 to 461.9±11.1 ppm. The Cr levels in automotive paints varied greatly across different colours and retail shops. Substantial levels were observed in almost all paint samples purchased from the informal retail shops except one retail shop. The elevated Cr levels in various colours of automotive paints used by spray painters in the informal sector call for a comprehensive assessment of Cr in these settings along with health-driven policies to address related health impacts.

Keywords:Chromium-based paints automotive repair spray painting retail stores

Lead (Pb) is added to automotive paints to prevent corrosion on metallic surfaces, for decorative colours, and for reflective properties to heighten visibility, and enhanced drying time, and durability. However, there are substitutes for all of these applications and Pb is highly toxic to human health and the environment. Through concerted efforts, leaded gasoline was phased out and currently, the focus is on lead-based paints. Leaded automotive paint used for spray painting activities often conducted in close proximity to human habitation raises public health concerns over possible exposure. This study was therefore undertaken to assess Pb levels in automotive paints frequently used by informal spray painters. A total of thirty-two (n = 32) cans of automotive paints were purchased in 4 sets of red, blue, green and white colours from eight formal and informal retail shops. Lead levels in the paint samples were analyzed in triplicates using Atomic Absorption Spectrophotometry. All the automotive paints from the informal retail shops had Pb levels that ranged from 220 to 2740 ppm, and exceeded the regulatory limit of 90 ppm. The blue paint from the informal store had the highest Pb levels which were 30 times of the set limit. On the contrary, the paints from the formal stores had significantly (p < 0.05) lower Pb levels that ranged from 80.7 to 580 ppm than those of the informal stores. Although only one paint sample from the former retail shop had Pb levels within the limit. In general, the elevated Pb levels in automotive paints that are used in an unregulated environment are potential sources of exposure and environmental contamination. The study urgently calls for enforcement of the regulatory limits and comprehensive Pb exposure assessments in this sector.

The World Health Organization predicts that 90.0% of the 2.3 million people who die annually due to water-borne diseases come from developing countries. At the same time fluorosis occurrence in the world's geological fluoride belts has left many people maimed due to drinking highly fluoridated water. This work reports on the use of molasses in making carbon-activated diatomaceous earth waste (DE-waste) ceramic membranes with improved mechanical strength and water purification efficiency. The fabricated diatomaceous membranes were soaked in molasses for 24.0 h and fired at 600.0 for 3.0 h. The carbon-activated membranes were used to filter water contaminated with Escherichia coli, Rotavirus, and sodium fluoride. The activated carbon obtained in this work had a bulk density of 450.0 kg/m3 and it reduced the porosity of the DE-waste membranes by 18.0%. The activated carbon improved the modulus of rupture (MOR) of the DE-waste membrane by 47.8% and the average pore size of the active DE-waste membrane was 50.0 nm. The filtration process was found to be dependent on the contaminant's size, concentration, and the external pressure applied to the water during the filtration process. The filtration efficiency of > 99.9 in E. coli was dependent on concentration and pressure. Membranes reported efficiency of 97.1% and 98.9% in deflouridation and Rotavirus filtration. Thus, molasses is potential material in fabrication of water membranes

Wild fruits contribute significantly to food security, thus becoming an important global discussion. This study evaluated the physicochemical and nutritional properties of Syzygium cumini (L.) Skeels fruits from two microclimates in Kenya as essential contributors to the human diet. Analysis was done using standard methodologies including the use of inductively coupled plasma - optical emission spectrometer for elemental analysis and high-pressure liquid chromatography for the determination of Vitamin C. The T-test showed significant differences in the fruit breadth, pH, total ash, sodium, calcium, manganese, copper, and zinc. The Pearson correlation matrix showed a small positive association between total soluble solids and titratable acidity with altitude, a medium positive correlation with rainfall, and a strong positive correlation between sunshine and skin colour intensity. Larger fruits contained substantial amounts of protein and crude fiber with a significant increase in energy values in fruits with high crude fat and carbohydrates, all correlating positively with the microclimate conditions; altitude, and rainfall. This study exemplifies the potential of Syzygium cumini as an alternative feed supplement to strengthen food security. It provides information on the variation of the physicochemical and nutritional composition of the fruits with climatic conditions, for the industries to employ the best strategies in obtaining marketable products