Isolation rates for Listeria monocytogenes and the other Listeria spp. typically improve when samples are enriched in more than one primary enrichment medium. This study evaluated the abilities of two primary enrichment media, University of Vermont-modified Listeria enrichment broth (UVM) and Listeria repair broth (LRB), to recover different ribotypes of Listeria spp. from raw meat and poultry samples. Forty-five paired 25-g retail samples of ground beef, pork sausage, ground turkey, and chicken (160 samples) underwent primary enrichment in UVM and LRB (30 degrees C for 24 h) followed by secondary enrichment in Fraser broth (35 degrees C for 24 and 40 h) and plating on modified Oxford agar. After 24 h of incubation of 35 degrees C, 608 Listeria colonies from selected positive samples were biochemically confirmed as L. monocytogenes (245 isolates), L innocua (276 isolates), and L. welshimeri (89 isolates) and then ribotyped with the automated Riboprinter microbial characterization system (E. I. du Pont de Nemours & Co., Inc.). Thirty-six different Listeria strains comprising 16 L. monocytogenes (including four known clinical ribotypes), 12 L. innocua, and 8 L. welshimeri ribotypes were identified from selected positive samples (15 samples of each product type; two UVM and two LRB isolates per sample). Twenty-six of 36(13 L. monocytogenes) ribotypes were detected with both UVM and LRB, whereas 3 of 36 (1 L. monocytogenes) and 7 of 36 (3 L. monocytogenes) Listeria ribotypes were observed with only UVM or LRB, respectively. Ground beef, pork sausage, ground turkey, and chicken yielded 22 (8 L. monocytogenes), 21 (12 L. monocytogenes), 20 (9 L. monocytogenes), and 19 (11 L. monocytogenes) different Listeria ribotypes, respectively, with some Listeria ribotypes confined to a particular product. More importantly, major differences in both the number and distribution of Listeria ribotypes, including previously recognized clinical and nonclinical ribotypes of L. monocytogenes, were observed when 10 UVM and 10 LRB isolates from five samples of each product were ribotyped. When a third set of six samples per product type was examined from which two Listeria isolates were obtained by using only one of the two primary enrichment media, UVM and LRB failed to detect L. monocytogenes (both clinical and nonclinical ribotypes) in two and four samples, respectively. These findings stress the importance of using more than one primary enrichment medium and picking a sufficient number of colonies per sample when attempting to isolate specific L. monocytogenes strains during investigations of food-borne listeriosis.

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Scenarios of past, present and intermediate future climates for Sondu River basin were analysed in this study to evaluate the potential changes in hydrologically relevant rainfall statistics that are likely to be observed by the middle of this century as a result of climate change. These climate scenarios were developed by applying dynamical downscaling of the relatively course resolution climate scenarios simulated by the fourth generation coupled Ocean-Atmosphere European Community Hamburg Model (ECHAM4) using the Providing Regional Climates for Impacts Studies (PRECIS) modelling system. The regional climate scenarios, which were available at a daily time-step and a spatial grid resolution of 0.5 over the Eastern Africa region, were matched to the Sondu river basin in the western region of Kenya. The possible hydrological impacts of climate change were assessed by applying the scenarios in a daily time-step hydrological model. The analysis of hydrologically relevant rainfall statistics focussed on determining changes in rainfall patterns and the likely hydrological implications to the basin. The results indicated that more rainfall is projected for the region in the immediate and intermediate future in form of increased seasonal rainfall during the December-January-February (DJF), March-April-May (MAM) and September-October-November (SON) seasons resulting from increased number of days of rainfall and higher probabilities of a wet day following a dry day in a month.

Scenarios of past, present and intermediate future climates for Sondu River basin were analysed in this study to evaluate the potential changes in hydrologically relevant rainfall statistics that are likely to be observed by the middle of this century as a result of climate change. These climate scenarios were developed by applying dynamical downscaling of the relatively course resolution climate scenarios simulated by the fourth generation coupled Ocean-Atmosphere European Community Hamburg Model (ECHAM4) using the Providing Regional Climates for Impacts Studies (PRECIS) modelling system. The regional climate scenarios, which were available at a daily time-step and a spatial grid resolution of 0.5˚ over the Eastern Africa region, were matched to the Sondu river basin in the western region of Kenya. The possible hydrological impacts of climate change were assessed by applying the scenarios in a daily time-step hydrological model. The analysis of hydrologically relevant rainfall statistics focussed on determining changes in rainfall patterns and the likely hydrological implications to the basin. The results indicated that more rainfall is projected for the region in the immediate and intermediate future in form of increased seasonal rainfall during the December-January-February (DJF), March-April-May (MAM) and September-October-November (SON) seasons resulting from increased number of days of rainfall and higher probabilities of a wet day following a dry day in a month. Based on these scenarios, the combination of the wetter antecedent conditions and the more rain days in a month will result in more surface runoff being generated which will not only have implications on the water balance but also the water quality in the basin.

Key Words: climate change, climate scenarios, climate modelling, climate downscaling, Sondu Basin, Kenya

The availability of water in the dryland regions is a function of climatic and land conditions, which determine the amount and distribution of atmospheric water and subsequent partitioning of that water into different hydrological components. Rainfall variability in the drylands affects water, food and livelihood security in the sensitive landscapes. For effective water resource management, it is important to quantify the effect of rainfall variability on the available water resource components to support food security, given that a majority of livelihoods in the drylands are dependent on rainfall. This study assessed rainfall variability and its effects on stream flows in the dryland regions of Turkana County in Northern Kenya. The Coefficient of Variation (CV), Standardised Precipitation Anomaly (SPA) and Mann-Kendal test approaches were used to determine variability and trends of rainfall. The Soil and Water Assessment Tool (SWAT), was employed to simulate hydrological components, including surface runoff, interflow, groundwater flow and the eventual water yield in the streams. The model simulations were driven by the Climate Hazards Group InfraRed Precipitation with Station CHIRPS and the Coordinated Regional Climate Downloading Experiment CORDEX projected rainfalls to establish the current and future water availability respectively. From the results, CV values ranging from 20 to 99% were obtained indicating that the region experiences moderate to high rainfall variability, often resulting in moderate to extreme floods and droughts in the area. The model simulations indicated that the stream-flows are increasing towards the 2020s decade compared to what was flowing in the 1980s decade, as observed between 1981 and 2020 using rainfall. This is probably a result of the increased rainfall observed in this region over the las four decades. Using Representative Concentration Pathways RCP 4.5 and RCP 8.5 projected rainfall scenarios, the model indicated that future stream flows will be higher than present. The findings show that, in the face of climate change scenarios, proper land management is required to promote water and food security in the drylands of sub-Saharan Africa in the future

Potential impacts of climate change on surface water yields over the Sondu River basin in the western region of Kenya were analysed using the Soil and Water Assessment Tool (SWAT) model with climate input data obtained from the fourth generation coupled Ocean-Atmosphere European Community Hamburg Model (ECHAM4) using the Providing Regional Climates for Impacts Studies (PRECIS) model. Daily time step regional climate scenarios at a spatial grid resolution of 0.44 Ëš over the Eastern Africa region were matched to the Sondu river basin and used to calibrate and validate the SWAT model. Analysis of historical and projected rainfall over the basin strongly indicated that the climate of the area will significantly change with wetter climates being experienced by 2030 and beyond. Projected monthly rainfall distribution shows increasing trends in the relatively dry DJF and SON seasons while showing decreasing trends in the relatively wet MAM and JJA seasons. Potential changes in water yields resulting from climate change were computed by comparing simulated yields under climate change scenarios with those simulated under baseline conditions.

Potential impacts of climate change on surface water yields over the Sondu River basin in the western region of Kenya were analysed using the Soil and Water Assessment Tool (SWAT) model with climate input data obtained from the fourth generation coupled Ocean-Atmosphere European Community Hamburg Model (ECHAM4) using the Providing Regional Climates for Impacts Studies (PRECIS) model. Daily time step regional climate scenarios at a spatial grid resolution of 0.44˚ over the Eastern Africa region were matched to the Sondu river basin and used to calibrate and validate the SWAT model. Analysis of historical and projected rainfall over the basin strongly indicated that the climate of the area will significantly change with wetter climates being experienced by 2030 and beyond. Projected monthly rainfall distribution shows increasing trends in the relatively dry DJF and SON seasons while showing decreasing trends in the relatively wet MAM and JJA seasons. Potential changes in water yields resulting from climate change were computed by comparing simulated yields under climate change scenarios with those simulated under baseline conditions.

There was evidence of substantial increases in water yields ranging between 88% and 110% of the baseline yields by 2030 and 2050 respectively. Although simulated water yields are subject to further verification from observed values, this study has provided useful information about potential changes in water yields as a result of climate change over the Sondu River basin and in similar basins in this region

Keywords: Simulated Impacts; Climate Change; Water Yields; Sondu Basin; Kenya

Objective: To assess malocclusion and orthodontic treatment needs among 12-15-year-olds in Moshi municipality, Tanzania.
Design: A cross-sectional study.
Setting: Moshi municipality, Tanzania.
Subjects: Two hundred and eighty nine randomly selected primary school children in Moshi municipality in the year 2003.
Results: Maxillary median diastema occurred in 20.1% of the children. Crowding and spacing in the incisor segments occurred in 41.2% and 28.4% respectively with significantly more crowding in males than in females (p = 0.009). Anterior irregularities occurred in 46% of the sample in the maxilla and 51.6% in the mandible. These irregularities were significantly more common in the females than in males in the maxilla and mandible (p=0.014, p=0.037 respectively). Reverse overjet was extremely rare (0.3%). Anterior openbite and antero-posterior molar relation discrepancies
occurred in 6.2% and 32.5% of the sample, respectively. Crowding, irregularities in the incisor segments and antero-posterior molar relation discrepancies were dominant malocclusion traits in this population. The sample mean DAI score was 24.6 points (CI 95% 23.86–25.36). There was no statistically significant gender difference of DAI scores (p = 0.473). About 65% of the subjects had either no need or had slight need for treatment whereas 35.3% were found with orthodontic treatment needs ranging from elective (21.5%), highly desirable (6.9%) to mandatory (6.9%). There was no significant gender difference in the categories of treatment need (p = 0.942). Unmet orthodontic treatment needs were present in this population with a very small proportion of
subjects exhibiting handicapping malocclusion.
Conclusion: The information from this study forms part of the basis not only for further research, but also for planning orthodontic care in this community where unmet orthodontic treatment needs are present.

Objective: To assess the prevalence of malocclusion in 12-15 - year-olds in Moshi, Tanzania.
Design: Cross-sectional study.
Setting: Moshi Municipality, Kilimanjaro region, Tanzania.
Subjects: Two hundred and eighty nine randomly selected primary school children (153 males and 136 females) had a clinical examination for malocclusion traits done.
Results: The overall prevalence of malocclusion was 97.6%. Angle’s Class II and III malocclusion occurred in 6.9% and 11% of the sample respectively. Crowding was encountered very frequently in both jaws, especially in the lower anterior segments. Anterior open bite occurred in 6.2% and the deep bite in 10.7% of the sample. There was no significant gender difference in either the overall prevalence of malocclusion or in the occurrence of the different occlusal traits.
Conclusion: It was noteworthy that some of the malocclusion traits recorded were relatively minor deviations from the normal occlusion. Hence the high prevalence of malocclusion did not necessarily imply a heavy burden of need and demand for orthodontic treatment.

Evolution in the field of Geographic Information Systems (GIS) has given rise to sophisticated scientific techniques for collection, analysis and visualization of location based data. These GIS analysis processes are used to reveal some critical patterns of occurrences. Due to inaccurate analysis and covering of insurance risks in Kenya, several companies have closed down prompting the Insurance Regulatory Authority (IRA) and Association of Kenyan Insurers (AKI) set up maximum and minimum premium rates on insurance risks. The set premiums discounts are given to the insured based on records of their annual claims. The main problem here is that the rates cover the entire nation without considering the distribution of risk in various regions. The objective of the paper is to show that GIS can be used to analyse and generate auto insurance risk territories for insurance companies from which an insurance rating model can be developed. We used GIS analysis methods such as inverse distance weighting (IDW) interpolation, data smoothing and clustering techniques and data on auto insurance accidents and crime, geo-coded police stations, roads, socio-economic, aerial and satellite imagery for Nairobi County. A risk territory map showing the distribution of auto insurance risk and other related maps were generated. A prescriptive insurance rating model was then developed that uses generated risk territories to calculate varying rates for auto insurance premiums rates for the respective regions. This research shows that GIS techniques can be used for better visualization of risk at a given location for accurate risk analysis and uptake.

This study aimed at assessing the response of maize crop to application of Tephrosia vogelii and Tithonia diversifolia biomass obtained six month-old fallows. The biomass were chopped into 5-cm long pieces and incorporated in the soil one week before planting maize. The natural fallow biomass was used as a control. These organic inputs were supplied with 20 kg phosphorus (P) /ha to attain P recommended rates. Shrub aboveground and litterfall biomass incorporation significantly (p=0.05) increased maize yield. Plots where above ground biomass was removed produced lower maize yield compared to those where the aboveground biomass was retained. Addition of 20 kg P/ha to soil together with the biomass increased maize yield by 40%. P in form of organic materials was insufficient to meet plant nutritional requirement. Residual effect of the biomass was low on the second and third subsequent crops. This may be due to the high rate of nutrient release during the biomass decomposition, the high crop nutrient uptake and also the nutrient losses through soil chemical and physical processes

An experiment including planted Tephrosia vogelii and Tithonia diversifolia fallow species and natural fallow was conducted at Maseno, Kenya, for assessing whether these fallows grown on a nutrient depleted land could produce sufficient green manure in six month period, whether their biomass retained on the same plots or transferred to continuously cropped plots with or without added P fertiliser could increase yield of consecutive maize crops and whether it is useful to regularly repeat these fallows on same plots. First fallow was established in randomized complete blocks with three replicates. At harvesting, biomass was recorded, then either incorporated in situ or transferred to continuous cropped plots split with and without added P fertiliser and monitored for the effect in improving consecutive maize crops. The second fallow was managed on this split plot design. The two-planted shrubs fallows produced more than 9 Mg total dry biomass and accumulated 154 to 234 kg N.ha-1, which were significantly higher compared to the production in the natural fallow. The shrubs were also superior to natural fallow for P accumulation (5-22 kg versus 2 kg.ha-1). The aboveground dry biomass harvested from planted T. vogelii and T. diversifolia and either incorporated in situ or transferred into continuously cropped plots increased maize yields by 2.5 folds compared to the unmanured crop, the control. Supplementing the organic materials with an additional 20 kg P inorganic fertilizer increased the 1st maize yield by about 40%. Productivity in the plots with T. vogelii or T. diversifolia aboveground biomass removal was low for the subsequent fallow and maize crops when compared to the performance in plots where biomass was incorporated. To achieve sustained yields of maize in depleted soils requires regular improved fallowing at least one season alternating with one season maize, and additional P inputs

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Two wetlands (Hyena and Nalogomon) in the Nairobi National Park were investigated by comparing plant composition in and around their immediate vicinity. The most common aquatic plant species in the Hyena wetland was Cyperus dives while in the Nalogomon wetland was Typha domingensis. The terrestrial vegetation surrounding Hyena wetland dominated by while that of surrounding Nalogomon wetland was the grass Hyparrhemia rufa. It was also noted that Hyena Dam waters were colonized by aquatic weeds, namely Gunnera perpensa, Enhydra fluctuans and Ludwigia abyssinica, that were absent in Nalogomon wetland waters. This could have been due to eutrophication of the waters of Hyena Dam as it originated from human settlements (city estates) outside the park boundary.

Selecting the right solid modeling software is a complex, multi-criteria decision making problem.
There are many issues a decision-maker needs to take into account, such as ease of learning,
educational materials built into the software, learning curve issues, performance of the software
for different solid modeling functions, operations and utilities, and cost. Beyond selecting the
right software, the decision-maker should also be concerned about (1) conceptual learning of the
solid modeling topics while “the right software” is being used, and (2) transfer of conceptual
learning between solid modelers. This is because a sound conceptual learning might increase the
probability of learning another solid modeling software in less time.

Accordingly this paper investigates the impact of icon recognition as an aid to transfer
conceptual learning between solid modelers. The investigation includes a review of the literature
on icon design and usage as it relates to solid modeling, in addition to an experiment in which
the icon recognition correctness and duration for over 20 operation icons were compared across
two modelers. The results shed light into the impact of icon designs on the transfer of learning
between solid modelers using the correct recognition counts as the transfer measure.

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Investments in faculty exchanges to build physician workforce capacity are increasing. Little attention has been paid to the expectations of host institution faculty and trainees. This prospective qualitative research study explored faculty and resident perspectives about guest faculty in paediatric departments in East Africa, asking (1) What are the benefits and challenges of hosting guest faculty, (2) What factors influence the effectiveness of faculty visits and (3) How do host institutions prepare for faculty visits?

Within the field of architecture, architects and scholars appear to have difficulty making sense of one another’s experience and the relationship between practice and research is often uneven and unclear. In addition, those who identify themselves as scholars of architecture tend to be closed in their academic spheres and vice versa for those who are practitioners. The professionals and scholars seem not to have adequate interchange and reconciliation of the profession. This has not helped much in developing a unifying framework for research and practice of architecture. The scholars and the practicing architect have yet to produce a comprehensive institutional framework capable of directing the profession toward the demonstrable improvement of the architectural practice; training and research. Survey is used as the research design. Questionnaires and interviews were used to collect data from archiects in practice and those in academia, students of architecture and educational administrators. The practicing architects were randomly sampled from the Board of Architects and Quantity Surveying (BORAQS) register. Forty practicing architects were selected. Twenty lecturers and fifty students were interviewed while four administrators were administered questionnaires. Qualitative techniques were used to analyze the responses from the field. This paper has unraveled the minimal relationship between scholars and professionals; the information flow between them and presented the way forward

Form making is one of the most important activities that the architect is engaged in when creating architecture. During the process of form making the architect expresses the individual perceptions of reality in tangible form, which is the symbolic form of architecture. When one observes the majority of built forms in the city of Nairobi they are more of an expression of Western culture than Kenyan culture. The individual perceptions of reality of Kenyan culture and nature are not well symbolized in most of the built forms. This has led to lack of a unifying architectonic style that defines and guides the Kenyan mordern architecture. Therefore, the purpose of this paper is to establish the extent to which the built forms in Nairobi portray the Kenyan cultural and natural forms through symbolism in their form making. A sample of 21 buildings constructed between 1960 and 2011 in the City of Nairobi were studied. Data was collected using interviews and observation techniques. Qualitative methods were used to analyse the data. Out of the 21 sampled buildings, only 40% seemed to be inspired by Kenyan culture and nature in their built forms. The study recommends that the architects in Kenya create architectural forms that are inspired by natural environment, traditions and cultural values of the local communities. It is only out of this that the symbolic architectural forms in Kenya can be realised

Taylor & Francis UK: DOI: 10.1080/17452007.2018.1489212

The Kenyan Maasai traditional built form in Kajiado District is changing. It is being replaced by the newly developed homesteads and houses which are inadequately planned, designed and lacking in symbolism. The latter are inconsistent with social arrangements and cultural needs of the contemporary Maasai lifestyle. It was the hypothesis of this study that the culture of the Maasai influences the architecture of their built forms. Multiple research tools were used in the collection of data. These included Observation, Focus Group Discussion, Questionnaires and Interviews. Among the techniques used in analysing the data are the chi-square statistics and qualitative analytical procedures based on the material collected through cluster sampling of 92 homesteads which were presented graphically. It is clear that the architectural conditions of Maasai buildings are a result of culture change variables identified as occupation, religion, rituals, education, family set-up and land tenure which have consistently evolved cultural values such as social status, independence, privacy and sedentary lifestyle. The study concludes that, in view of the changed culture of the maasai, the new built form is satifactory in the incorporating the emerging architectural design concepts such as nuclear family house, linearity, divisibility and permanence in response to emerging spaces and artifacts. These concepts symbolise the changing Maasai culture in the built form.

Historically, it has been observed that people's settlements tend to change with their changing cultural values. Societies in early and rapid transition offer rich laboratories for the testing of this observation. The Maasai of Kenya are such a group that in a relatively short period have undergone revolutionary transformation as a casual observation may reveal. This paper investigates whether there is any relationship between their new built forms and their current cultural values. Using a number of identified culture – change variables including land tenure, education, religion, occupation, and rite of passage, the paper analyses what impact changes in these variables has on the Maasai settlements. It clearly reveals that as these variables change due to contacts with western-based modernity, the settlements have undergone noticeable transformation. For example, change of land tenure from communal to individual leads to permanent settlements. While exposure through education, religion and occupation leads to a change in the spatial organisation of the dwelling and the use of new building materials. These insights are a useful background to any policy matters regarding housing that respects the cultures of the people. They are indications of what can be considered as a transitional architecture as communities struggle to modernise.

The objective of the study was to determine the efficacy of chloroquine in pregnant women with Plasmodium falciparum parasitemia at therapeutic doses of 25 mg/kg body weight divided over 3 days. METHODS: Three-hundred pregnant women in Kilifi Hospital at the coast of Kenya were screened for malaria parasitemia using Giemsa stained thick blood smears. In vivo and in vitro parasite sensitivity to chloroquine was determined. RESULTS: P. falciparum infections were present in 65 (22%) of 300 pregnant women. The in vivo tests showed that 46% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels. The in vitro tests showed a resistance rate of 35%. CONCLUSIONS: A large proportion of pregnant women with malaria do not respond to chloroquine therapy and alternative drugs are required

Information and Communication Technologies (ICTs) mean different things to different people; there is little informed discussion on what ICTs actually are; how they are evolving and converging, where they might be going and what the implications are for their further use in poverty reduction. This paper explores the various definitions and conceptualizations of ICTs with a view to arriving at a working definition and conceptualization of ICTs in our attempt to suggest the requirements of a framework for the utilization of ICTs for poverty reduction. To work towards the framework, various definitions and dimensions of poverty are explored and poverty reduction efforts using the capability approach are considered. Lastly, a framework for the utilization of ICTs for poverty reduction is suggested.

In the last number of years, many have looked to ICTs to enable the reduction of poverty. A lot of resources have been expended by international organizations, donors and governments in ICT4D and ICT-for-poverty reduction initiatives. The results have been mixed with many of the initiatives having negligible or negative.
Many explanations for this have been given but some have suggested that the way that the projects are carried out is problematic. One of the approaches that have had great promise for development and poverty reduction is Amartya Sen’s Capability Approach (CA). This paper uses the approach to define poverty, poverty reduction and specify a framework for conceptualizing, designing, developing and evaluating poverty reduction initiatives. CA is deliberately incomplete and requires a lot of information to make it operational. Alkire’s has specified a framework for operationalizing CA for poverty reduction. This paper uses that framework to specify a framework for poverty reduction using ICTs. In acknowledgement of the importance of agency in CA, the proposed framework the central role played by the poor community in the conception and design of the project. It lays out the process of the design and implementation of the project and the role the poor community plays, while specifying the roles of the different players in the project.

1.1. The ability of the dik-dik antelope to survive while drinking saline solutions was tested in controlled laboratory experiments by providing drinking water containing up to 0.5 M NaCl.2.2. Fluid intake increased from 230.5 ml/day when fresh water was offered to a maximum of 373.9 ml/day when 0.3 M NaCl solution was offered.3.3. At concentrations higher than 0.3 M animals lost weight, were anorexic and developed diarrhoea.4.4. It is concluded that the dik-dik antelope will probably tolerate drinking water containing 0.24 M NaCl.

Studies in HIV-1-infected infants and HIV-1-exposed, uninfected infants link early cytomegalovirus (CMV) acquisition with growth delay and cognitive impairment. We investigated maternal valacyclovir to delay infant acquisition of CMV.

Herpes simplex virus type 2 (HSV-2) suppression has been shown to reduce HIV-1 disease progression in non-pregnant women and men, but effects on pregnant and postpartum women have not been described.

Herpes simplex virus-2 (HSV-2) suppression with acyclovir or valacyclovir reduces HIV-1 viral RNA levels; one hypothesis is that HSV-2 suppression reduces immune activation. We measured T cell immune activation markers among women participating in a randomized placebo-controlled trial of valacyclovir to reduce HIV-1 RNA levels among pregnant women. Although valacyclovir was associated with lower HIV-1 RNA levels, the distribution of both CD4(+) and CD8(+) CD38(+)HLA-DR(+) T cells was not different among women taking valacyclovir when compared to women taking placebo. Further study is needed to understand the mechanism of HIV-1 RNA reduction following herpes suppression among those coinfected with HIV-1 and HSV-2.

Depot medroxyprogesterone acetate (DMPA) is associated with HIV acquisition. We studied changes in vaginal microbiota and inflammatory milieu after DMPA initiation.

Herpes simplex virus type 2 (HSV-2) suppression has been shown to reduce HIV-1 disease progression in non-pregnant women and men, but effects on pregnant and postpartum women have not been described.

Herpes simplex virus-2 (HSV-2) suppression with acyclovir or valacyclovir reduces HIV-1 viral RNA levels; one hypothesis is that HSV-2 suppression reduces immune activation. We measured T cell immune activation markers among women participating in a randomized placebo-controlled trial of valacyclovir to reduce HIV-1 RNA levels among pregnant women. Although valacyclovir was associated with lower HIV-1 RNA levels, the distribution of both CD4(+) and CD8(+) CD38(+)HLA-DR(+) T cells was not different among women taking valacyclovir when compared to women taking placebo. Further study is needed to understand the mechanism of HIV-1 RNA reduction following herpes suppression among those coinfected with HIV-1 and HSV-2.

This study sought to determine nutrition knowledge and its association with practices in management of stage 5 chronic
kidney disease (CKD) among renal adult patients in Kenyatta National Hospital. A cross-sectional analytical design was used to
facilitate collection of qualitative and quantitative data and enable identification of associations between variables. Cochran formula
was used to calculate a sample of 110 respondents. A research administered questionnaire with closed ended questions was used to
collect information. Descriptive statistics such as frequency and percentage were used to describe demographic and socio-economic
characteristics of the population. Inferential statistics were done using chi square with an alpha of 0.05 to test association between
independent and dependent variables. Most participants had moderate knowledge levels whereas more than half of the participants
(66%) indicated poor nutrition management practices of their condition. There was significant association between period on dialysis
in months and practices in management of stage 5 chronic kidney disease. Knowledge on importance of diet in management of stage 5
CKD (<0.001), moderation of fluid intake (<0.001), reduction in salt/ sodium intake (<0.001), and moderation in protein intake
(<0.004) were significantly associated with nutritional management practices of stage 5 CKD. The study concluded that Knowledge
levels were low in identifying foods rich in phosphorus, calcium and fat soluble vitamins. Practice scores were also poor despite
moderate nutrition knowledge levels. Patients’ knowledge on nutrition management of their condition may be achieved through
frequent and consistent nutrition education and counseling including follow ups.
Key Terms: Knowledge, Practice, chronic kidney disease, nutrition management

The study was conducted from 30th May 2006 - July 3rd 2006 at Kenyatta and Pumwani hospitals in Kenya. The aim was to determine the socio-economic and cultural factors that influence women's reproductive health decision making. It was cross-sectional and descriptive study on a sample size of 384 subjects. A semi structured questionnaire and focus group discussion on 3 groups of eight mothers each was used. The study revealed that age, marital status, level of education and employment status influences women's reproductive health decision making. The main cultural factors found to influence women's reproductive health decision making were; FGM, wife inheritance, sex of baby (preference for boys) and dowry. The conclusions arrived at was that majority of women are participating in their own reproductive health decision making though many need to be given education on different areas of reproductive health to encourage informed decision making. It was recommended that education opportunities for women on reproductive health issues be given more emphasis.

The study was conducted from 30th May 2006 - July 3rd 2006 at Kenyatta and Pumwani hospitals in Kenya. The aim was to determine the socio-economic and cultural factors that influence women's reproductive health decision making. It was cross-sectional and descriptive study on a sample size of 384 subjects. A semi structured questionnaire and focus group discussion on 3 groups of eight mothers each was used. The study revealed that age, marital status, level of education and employment status influences women's reproductive health decision making. The main cultural factors found to influence women's reproductive health decision making were; FGM, wife inheritance, sex of baby (preference for boys) and dowry. The conclusions arrived at was that majority of women are participating in their own reproductive health decision making though many need to be given education on different areas of reproductive health to encourage informed decision making. It was recommended that education opportunities for women on reproductive health issues be given more emphasis.

The study was conducted from 30th May 2006 - July 3rd 2006 at Kenyatta and Pumwani hospitals in Kenya. The aim was to determine the socio-economic and cultural factors that influence women's reproductive health decision making. It was cross-sectional and descriptive study on a sample size of 384 subjects. A semi structured questionnaire and focus group discussion on 3 groups of eight mothers each was used. The study revealed that age, marital status, level of education and employment status influences women's reproductive health decision making. The main cultural factors found to influence women's reproductive health decision making were; FGM, wife inheritance, sex of baby (preference for boys) and dowry. The conclusions arrived at was that majority of women are participating in their own reproductive health decision making though many need to be given education on different areas of reproductive health to encourage informed decision making. It was recommended that education opportunities for women on reproductive health issues be given more emphasis.

Bacteriophage 1N2-2 infects a narrow range of alkaliphilic bacterial strains phylogenetically
related to the family Idiomarinacea [1]. Both phage and host bacterium were isolated from alkaline
and saline waters of Lake Nakuru, a soda lake of Kenya’s Great Rift Valley. Virion structures
including capsids must tolerate extreme alkaline environments of pH 10 and above. The phage is
morphologically and genetically related to lambdoid viruses of the family Siphoviridae (Fig. 1B)[1].
Genomic analysis revealed that 1N2-2 genes are organized in functional modules. Capsid
morphogenesis genes are homologous both in order and predicted amino acid sequence to the
corresponding genes of the coliphage HK97 (Fig. 1A )[2]. Like many dsDNA viruses, HK97
assembles multiple subunits of a single gene product into a protocapsid around a transient
protein-scaffolding core that is subsequently cleaved by a protease at the time of DNA packaging
triggering expansion and stabilization of the mature capsid [3]. 1N2-2, like HK97, lacks an
independent capsid scaffolding gene but rather, as we have inferred, the N-terminal 110 residues of
the major head protein (MHP) encoded by gene 10 probably assume a coiled-coil folding typical of
scaffolding proteins.
We cloned the 1N2-2 gene 10 MHP sequence into a pQE-Tri-system plasmid (Qiagen) and have
expressed a 46-kDa MHP protein in Escherichia coli strain SG19003 (Qiagen) that can be
precipitated by 8% PEG treatment in ice and low speed centrifugation (Fig. 1C and 1E).
Transmission electron microscopy (TEM) analysis shows the presence of virus-like particles (VLP)
of similar size and shape as empty proheads of naturally formed 1N2-2 (Fig. 1B). Alternatively,
the 3’ end of the gene 10 in the pQE vector was modified to eliminate the stop codon allowing in
frame translation of ten additional codons including eight histidine residues at the C-terminus of
MHP (MHP-his). Based on a Swiss-model prediction of the 1N2-2 MHP protein sequence using
the structure of phage HK97 MHP as template (PDB 1OHG)[4] we inferred that the C-terminus and
its additional modifications would be located on the surface of the recombinant capsid allowing the
purification of fully assembled capsids with Ni-NTA affinity chromatography (data not shown).
SDS-PAGE analysis and UAc-stained protein samples visualized by TEM show that MHP-his
expressed in E. coli is a protein of 46.5 kDa (Fig. 1E) that can assemble into VLPs, possibly
proheads of 46 nm in diameter (Fig. 1D). Other non-closed structures that are seen in the sample are
presumably incomplete capsids (Fig 1 C and 1D). We are currently investigating whether capsid
morphogenesis including incomplete structures and proheads produced from the expression plasmid
in E. coli differ from natural capsid morphogenesis in the alkaliphilic host of 1N2-2. We are
formulating capsid assembly buffers to produce fully closed stable VLP in vitro. We conclude that the Φ1N2-2 MHP protein, either intact or with histidineresidues at the C-terminus, is sufficient to produce VLP in theabsence of other virally-encoded proteins. Weexpectthe MHP C-terminus can be used to
display antigens on the prohead surface while modifications of the N-terminus may be used for
packaging antigens internally providing a versatile VLP platform for vaccine development and
other nanomedicine applications.

A novel triple co-culture model of the human airway barrier was designed to simulate the cellular part of the air–blood barrier of the respiratory tract represented by macrophages, epithelial cells, and dendritic cells. When epithelial cells (A549 cells) were grown on filter inserts with pores of 3.0 m in diameter in a two-chamber system, they formed monolayers with polarization into apical and basolateral domains. The epithelial cell cultures were then supplemented with human blood monocyte–derived macrophages and dendritic cells on the apical and basal aspect, respectively. The single-cell cultures as well as the triple co-cultures were characterized in terms of a number of typical features, for example, morphology of cell types, integrity of epithelial layer, and expression of specific cell surface markers (CD14 for macrophages and CD86 for dendritic cells). The interplay of epithelial cells with macrophages and dendritic cells during the uptake of polystyrene particles (1 m in diameter) was investigated with confocal laser scanning and conventional transmission electron microscopy. Particles were found in all three cell types, although dendritic cells were not directly exposed to the particles. More investigations are needed to understand the translocation pathway

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Throughout sub-Saharan Africa, there is resistance to changing sexual behavior despite survey data indicating high levels of knowledge about HIV transmission patterns and high-risk behavior. Previous explanations for this paradox emphasize indigenous cultural models. An alternative explanation is that, due to a strong natural selection for sexual gratification, individuals evoke the evolved trait of selfdeception to continue practicing high-risk sexual behavior. This alternative is tested using survey data from an Ariaal community in Marsabit District, northern Kenya. Results indicate that respondents make highly accurate self-assessments of HIV risk, negating the concept of self-deception in this study. These results are discussed within the larger context of the applicability of evolutionary theory to the AIDS pandemic.

This report examines the semantic structure of Terminologia Anatomica, taking one page as an example. The focus of analysis is the meaning imparted to an anatomical term by virtue of its location within the structured list. Terminologia's structure, expressed through hierarchies of headings, varied typographical styles, indentations, and an alphanumeric code, implies specific relationships among the terms embedded in the list. Together, terms and relationships can potentially capture essential elements of anatomical knowledge. The analysis focuses on these knowledge elements and evaluates the consistency and logic in their representation. Most critical of these elements are class inclusion and part-whole relationships. Since these are implied, rather than explicitly modeled, by Terminologia, the use of the term list is limited to those who have some knowledge of anatomy; computer programs are excluded from navigating through the terminology. Assuring consistency in the explicit representation of anatomical relationships would facilitate adoption of Terminologia as the anatomical standard by the various controlled medical terminology (CMT) projects. These projects are motivated by the need to computerize the patient record, and their aim is to generate machine-understandable representations of biomedical concepts, including anatomy. Because of the lack of a consistent and explicit representation of anatomy, each of these CMTs has generated its own anatomy model. None of these models is compatible with any other, yet each is consistent with textbook descriptions of anatomy. The analysis of the semantic structure of Terminologia Anatomica leads to some suggestions for enhancing the term list in ways that would facilitate its adoption as the standard for anatomical knowledge representation in biomedical informatics.

Description
In this study the synergistic and catalytic properties of a novel nano-composite cathode material of nominal composition Li(M)xMn2-xO4 (M = Pt-Au; x # 0.2) has been explored. Li(PtAu)xMn2-xO4 nanomaterial for use in lithium-ion batteries (LIB) was synthesized by incorporation of the Pt-Au (1:1) nanoparticles onto the spinel phase LiMn2O4. Ultra-low scan rate (0.01 mV s−1) cyclic voltammetry of the cathode material in 1 M LiPF6 (in 1:1 EC:DMC), showed four sets of redox peaks, which reflect the typical redox process of the active material in the spinel structure due to lithium intercalation and deintercalation. The Li/Li(PtAu)0.02Mn1.98O4 cell had less polarization as it effectively accommodates the structural transformation during Li+ ion charge and discharge. The Li(PtAu)0.02Mn1.98O4 cathode showed an increase in discharge currents densities with an exchange current density, i0, value of 2.8 × 10−4 A cm−2 …

Choline acetyltransferase (EC 2.3.1.6) catalyzes the biosynthesis of acetylcholine according to the following chemical equation: acetyl-CoA + choline in equilibrium to acetylcholine + CoA. In addition to nervous tissue, primate placenta is the only other animal source which contains appreciable acetylcholine and its biosynthetic enzyme. Human brain caudate nucleus and human placental choline acetyltransferase were purified to electrophoretic homogeneity using ion-exchange and blue dextran-Sepharose affinity chromatography. The molecular weights determined by Sephadex G-150 gel filtration and sodium dodecyl sulfate gel electrophoresis are 67000 plus or minus 3000. N-Ethylmaleimide, p-chloromercuribenzoate, and dithiobis(2-nitrobenzoic acid) inhibit the enzyme. Dithiothreitol reverses the inhibition produced by the latter two reagents. The pKa of the group associated with N-ethylmaleimide inhibition is 8.6 plus or minus 0.3. A chemically competent acetyl-thioenzyme is isolable by Sephadex gel filtration. The enzymes from the brain and placenta are thus far physically and biochemically indistinguishable.

Early sexual partnerships place young women in sub-Saharan Africa at high risk for HIV. Few studies have examined both individual- and partnership-level characteristics of sexual relationships among adolescent girls. A cross-sectional survey of sexual history and partnerships was conducted among 761 adolescent girls aged 15-19 years in Nairobi, Kenya. Rapid HIV testing was conducted and correlates of HIV infection were determined using multivariate logistic regression. The HIV prevalence was 7% and seropositive adolescents had a younger age at sexual debut (P < 0.01), more sexual partners in 12 months (P = 0.03), and were more likely to report transactional or non-consensual sex (P < 0.01). Girls who reported not knowing their partner's HIV status were 14 times as likely to be HIV-seropositive than girls who knew their partner's status (adjusted odds ratio: 14.2 [1.8, 109.3]). Public health messages to promote HIV testing and disclosure within partnerships could reduce sexual risk behaviours and HIV transmission among adolescents.

Early sexual partnerships place young women in sub-Saharan Africa at high risk for HIV. Few studies have examined both individual- and partnership-level characteristics of sexual relationships among adolescent girls. A cross-sectional survey of sexual history and partnerships was conducted among 761 adolescent girls aged 15–19 years in Nairobi, Kenya. Rapid HIV testing was conducted and correlates of HIV infection were determined using multivariate logistic regression. The HIV prevalence was 7% and seropositive adolescents had a younger age at sexual debut (P < 0.01), more sexual partners in 12 months (P = 0.03), and were more likely to report transactional or non-consensual sex (P < 0.01). Girls who reported not knowing their partner’s HIV status were 14 times as likely to be HIV-seropositive than girls who knew their partner’s status (adjusted odds ratio: 14.2 [1.8, 109.3]). Public health messages to promote HIV testing and disclosure within partnerships could reduce sexual risk behaviours and HIV transmission among adolescents.

Our study aimed to assess adult women's knowledge of human papillomavirus (HPV) and cervical cancer, and characterize their attitudes towards potential screening and prevention strategies.

Early sexual partnerships place young women in sub-Saharan Africa at high risk for HIV. Few studies have examined both individual- and partnership-level characteristics of sexual relationships among adolescent girls. A cross-sectional survey of sexual history and partnerships was conducted among 761 adolescent girls aged 15-19 years in Nairobi, Kenya. Rapid HIV testing was conducted and correlates of HIV infection were determined using multivariate logistic regression. The HIV prevalence was 7% and seropositive adolescents had a younger age at sexual debut (P < 0.01), more sexual partners in 12 months (P = 0.03), and were more likely to report transactional or non-consensual sex (P < 0.01). Girls who reported not knowing their partner's HIV status were 14 times as likely to be HIV-seropositive than girls who knew their partner's status (adjusted odds ratio: 14.2 [1.8, 109.3]). Public health messages to promote HIV testing and disclosure within partnerships could reduce sexual risk behaviours and HIV transmission among adolescents.

Our study aimed to assess adult women's knowledge of human papillomavirus (HPV) and cervical cancer, and characterize their attitudes towards potential screening and prevention strategies.

The effect of insulin treatment on the rate of decline of plasma glucose concentration was determined in nine patients with hyperosmolar hyperglycemic nonketosis [HHNK; mean plasma glucose, 999 +/- 59 (+/- SEM) mg/dl] and in six normal subjects rendered hyperglycemic by a combined infusion of somatostatin and glucose (mean plasma glucose, 653 +/- 28 mg/dl). Both the fractional glucose turnover and the half-time of the fall in plasma glucose during low dose (5-10 U/h) insulin treatment were reduced 10-fold (P less than 0.001) in the diabetic patients compared with the hyperglycemic normal subjects. In the hyperosmolar patients, the mean glucose clearance during insulin treatment was only 7% that in the normal subjects (P less than 0.001). The rate of plasma glucose decline in our hyperosmolar patients after hydration and insulin administration was 80 +/- 7 mg/dl X h. This decline is comparable to the results reported in other series, although in striking contrast to the 508 +/- 32 mg/dl X h decline in normal subjects (P less than 0.001). Our findings do not support the clinical impression that HHNK patients are insulin sensitive. We conclude that marked resistance to infused insulin delays the correction of hyperglycemia during treatment of HHNK and suggest that resistance to the normal basal insulin levels encountered in some HHNK patients may contribute in part to the development of the hyperosmolar state.