The antifeedant activities of the Erythrina alkaloids from the seeds, seed pods and flowers of Erythrina latissima were investigated in laboratory dual-choice bioassays using third-instar Spodoptera littoralis (Boisduval) larvae. The new compound (+)-11β-methoxy-10-oxoerysotramidine (1) from the flowers, showed potent dose dependant activity at concentration>= 500 pm while (+)-10, 11-dioxoerysotramidine (2) also new from the flowers showed potent dose dependant activity at concentration>= 100 ppm. Three known compounds (+)-erysotrine,(+)-erysotramidine,(+)-erythraline,(+)-11β-hydroxyerysotramidine showed potent dose dependant antifeedant activity at concentrations>= 100 ppm while (+)-10, 11-dioxoerysotrine and (+)-11 b-hydroxyerysotramidine also a known compounds showed potent dose dependant antifeedant activity at concentrations>= 100 ppm.

The antifeedant activities of the Erythrina alkaloids from the seeds, seed pods and flowers of Erythrina latissima were investigated in laboratory dual-choice bioassays using third-instar Spodoptera littoralis (Boisduval) larvae. The new compound (+)-11β-methoxy-10-oxoerysotramidine (1) from the flowers, showed potent dose dependant activity at concentration 500≥ ppm while (+)-10, 11-dioxoerysotramidine (2) also new from the flowers showed potent dose dependant activity at concentration 100≥ ppm. Three known compounds (+)-erysotrine,(+)-erysotramidine,(+)-erythraline,(+)-11β-hydroxyerysotramidine showed potent dose dependant antifeedant activity at concentrations 100≥ ppm while (+)-10, 11-dioxoerysotrine and (+)-11βhydroxyerysotramidine also a known compounds showed potent dose dependant antifeedant activity at concentrations 300≥ ppm. Three known compounds (+)-11β-methoxyerysotramidine,(+)-8-oxoerythraline and (+)-15 (16) β-D-glucoerysodine showed no appreciable change in antifeedant activity with concentration change.

The teaching of English using the Integrated Approach at secondary school has been an issue of concern to both Linguists and Literary Scholars as well as Educators for quite some time now due to poor performance of students in KCSE , coupled with their inability to communicate effectively in English. This research study investigated factors that influence the implementation of the Integrated English Curriculum in public secondary schools in Kanduyi Division of Bungoma District. Using a descriptive survey research design , the study had two objectives and two corresponding research questions. This paper discusses the said research study and its findings , key of which was that the training that English teachers received at pre-service level does not much the requirements of teaching Integrated English in public secondary schools. Thus , the need for the Kenya Institute of Education (KIE) to liaise with teacher training colleges and Schools of Education in the universities to ensure there is harmony between pre-service teacher training programmes for teachers of Integrated English and the implementation of the curriculum in secondary schools. This will empower them to be better placed in implementing the curriculum with competence and confidence.

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Objective
To describe the presentation and surgical care of patients managed for cleft lips and palates during a surgical outreach program..
Study design
A five year retrospective chart study of the patients operated on between January 2005 to the 31st December 2009 in selected hospitals in Kenya.
Setting
Smile train-facilitated surgical outreach programs at the following hospitals: St Elizabeth Mission Hospital Mukumu, St Francis Mission Hospital, Mwiki, Embu Provincial General hospital , Isiolo District Hospital.and Alupe Subdistrict Hospital.
Subjects
One hundred and sixty three patients with cleft lips and palates.
Results
The male female ratio was 1.3 to 1. Left unilateral cleft lip was the most common malformation (34.6% of the patients) with modified Millards repair the most frequent surgical procedure. More than 30% of the patients operated on had attained their fifth birthday. There were eight complications for every 100 procedures. Palatal fistulae were the most common complications.
Conclusion
The overall pattern of deformity encountered and the morbidity profile correlate with other studies. There is need to intensify more outreach programs to capture younger patients and address the backlog of cleft cases in the community.

This paper discusses the research that was carried out in order to determine the extent of teachers' involvement in instructional supervision and its effects on KCSE performance in Gucha-South District. The purpose of the research was to establish whether there existed a significant correlation between teacher involvement in instructional supervision and students' performance in KCSE. Using a descriptive survey research design , data were collected from 266 teachers in 13 secondary schools and 8 Quality Assurance Officers. Data were collected using a variety of techniques and analyzed using appropriate descriptive statistics. A major finding of the research is that schools where teachers' involvement in supervision was higher registered better grades in the Kenya Certificate of Secondary Examination.

The module as a whole is designed to provide both the student and the lecturer/professor with a descriptive account of the content of planning and its application to education and national development. it is divided into four sections. Section One comprises of the first six lectures of the unit and is intended to introduce the learner to the study of educational planning. Lecture 1 deals with the general concept of planning ; its characteristics and scope. The concept of planning as applied to education is described in Lecture 2 and Lecture 3 deals with the concept of modelling in educational planning. Lecture 4 discusses the historical background and rationale for educational planning while the social and psychological factors affecting educational planning are dealt with in Lecture 5 and the final lecture in this section discusses the process of educational planning.
Section Two covers three lectures which , taken together intend to introduce the learner to methodologies of educational planning with particular reference to developing countries , that is the Social Demand Approach covered in in Lecture 7 ; the Labour Requirements Approach covered in Lecture 8 and the Cost/benefit Analysis Approach covered in Lecture 9.
Section Three has three broad lectures , which give some highlights on the need to plan for changes in the educational system. They focus on the issues of efficiency and equity as a measure of the success of an educational system.
Section Four has three lectures dealing with population , education and national development. Apart from considering demographic factors and how they affect educational planning , we also examine matters dealing with the location of schools.

Ever since Professor G.D. Killam of the University of Guelph edited The
Writings of East and Central Africa (1984),and the conferences that lead
to the changes in the English syllabi of Secondary Schools, nothing has
brought the writers,booksellers,librarians,literary critics,journalists,and
intellectual property lawyers of the region together more than book fairs
which take place annually in Harare, Zimbabwe, and Nairobi, Kenya.
Names like Ali A. Mazrui, Njabulo Ndebele, Ngugi wa Thiong’o, David
Rubadiri, Charles Mungoshi, Chenjerai Hove, Micere Githae Mugo,
which one sees on book covers suddenly stick into one’s mind as one
meets their owners at either the Zimbabwe or Nairobi International
Book Fairs.
During the years under review (2000–4), Jared Angira, the internationally
known Kenyan poet and chairman of the Kenya Organization
of Writers Association (KOWA) could be seen with Dr. Jack Mapanje,
the famous Malawian linguist and poet, at the international book fair
almost every day. At the meetings of the National Book Development
Council of Kenya,one met the stakeholders in the book production and
book marketing industry meeting under the aegis of the East African
Book Development Association (EABDA),a consortium comprising of
the National Book Development Councils of Kenya, Uganda, and
Tanzania. As constituent bodies,these councils and the organizers of the
book fairs in Nairobi and Harare argue that the challenges facing all the
stakeholders of the books is the fight against the monster of illiteracy. A
nation that has to operate satisfactorily in the twenty-first century has to
be a reading nation. It must celebrate the book.

Decline in quality education has become one of the major challenges facing the education sector as the government tries to widen access to basic education. To address these challenges , the major thrust has been to develop feasible policies , objectives , strategies , programmes and activities to guide the development of the sector. For instance , the strategies proposed by MPET for primary education included increasing access and participation as well as raising relevance and quality. However , the quality of education cannot be improved without improving the teacher. Consequently , many primary school teachers went back to school and enrolled in degree courses at universities.This paper discusses the attempt to assess the extent to which the teachers who enrolled in the B.Ed.(Arts) programme of the University of Nairobi have been able to expand their knowledge and pedagogical skills in different subjects. Can these teachers contribute to improved efficiency and effectiveness with respect to the provision and delivery of education? In what ways have they contributed to increased quality in education at the primary school level?

Planners attempting to influence the course of a country's educational development can expect to confront a wide variety of problems which are sometimes difficult to formalize. Many of these challenges involve the most significant decisions in determining an effective sectoral growth strategy. Examples that come readily to mind for higher education include an assessment of the optimal level of resources to be devoted to research and extension activities , estimated rates of return , demand-adapted education policies , employment promotion of programmes as well as fostering marketable occupational capacities particularly of young people.
This paper tries to describe and analyze educational policy formation , planning and implementation in higher education showing its contribution to the socio-economic transformation of Kenya. The central proposition in this paper is that educational endeavour - whether conceived as an activity of colonizing powers or as the unfolding of the aspirations of the African peoples - has shown itself as an important vehicle for the transformation of society. Thus , the process of educational policy formation is necessarily an exercise in social learning whereby technical expertise is required to establish information requirements and the parameters of reasonable choice. Nevertheless , this analysis must be embedded in a process of social dialogue , negotiation and learning.

According to the Education Sector Report (2007 : 12) the primary school completion rate (PCR) has grown from 52.5% in 2001 to 67.4% in 2005. The primary net enrollment rate (NER) similarly increased from 82.1% in 2004 to 83.2% in 2005. This is a clear indicator that nationally , Kenya is yet to achieve full participation rates because there are gaps between NER and PCR worth assessing. This paper discusses a research study whose purpose was to unearth the factors influencing participation rates in public primary schools in Rangwe Division of Homa-Bay District in Kenya. Using a descriptive survey research design , in which data were collected and analyzed from 20 head-teachers , 20 class teachers and 100 pupils by means of questionnaires , interviews and direct observation; it was established that provincial differences in terms of poverty index , persistent drought , insecurity , cultural and religious beliefs , have a bearing on primary schooling , hence creating complexity in achieving 100% primary school participation rates by province , district or division. It was also observed that processes undertaken by school adminstrators and QASO officials in ensuring that teaching and learning is provided according to required standards played a major role in influencing participation rates in public primary schools in Rangwe Division.

Decentralization of teacher recruitment in Kenya was as a result of World Bank/IMF policies which support projects that guarantee direct net economic returns by productivity and indirect returns or externalities. The projects are also expected to meet the private demand for education and inter-regional distribution (Psacharapoulos & Woodhall , 1985; and Psacharapoulos , 1994) These strategies that have been successful elsewhere are not necessarily appropriate for Kenya. Any meaningful interventions in Kenya ought to be based on research data from within the country's education system. These paper , thus , discusses a research study that set out to assess the implications of decentralizing teacher recruitment for secondary schools to the Boards of Governors in Kisumu District. The research study analyzed data gathered from head-teachers who are secretaries to the recruitment panels , seniour education officials and trade union officials at the district. Data were collected through questionnaires , interviews and document study and were analyzed using descriptive statistics. The findings indicate that decentralization reduces the workload at the Teachers' Service Commission headquarters while also satisfying the staffing needs of the schools. However , the respondents were dissatisfied with current staffing trends and were in agreement that the recruitment panel members' capacity be enhanced to enable them carry out the tasks bestowed upon them effectively and efficiently.. Thus , decentralization of teacher recruitment should not take place when institutional capacity is weak , democratic institutions are fragile and resources are scarce.

This paper discusses the research study that was carried out in an effort to assess the effectiveness of the Teachers' Service Commission in maintaining a balanced teaching force in all secondary schools in Kenya. The research had two main hypotheses : Ho1 : Teachers are equitably distributed in all provinces in Kenya ; and Ho2 : Teacher related factors have an impact on the role of the Commission in teacher distribution. The analysis of the data revealed that there are disparities in teacher distribution between subject areas and regions. These disparities can be viewed as indicators of potential ineffectiveness in the Teachers' Service Commission's role in maintaining a balanced teaching force at the secondary school level.

Ever since Professor G.D. Killam of the University of Guelph edited The
Writings of East and Central Africa (1984),and the conferences that lead
to the changes in the English syllabi of Secondary Schools, nothing has
brought the writers,booksellers,librarians,literary critics,journalists,and
intellectual property lawyers of the region together more than book fairs
which take place annually in Harare, Zimbabwe, and Nairobi, Kenya.
Names like Ali A. Mazrui, Njabulo Ndebele, Ngugi wa Thiong’o, David
Rubadiri, Charles Mungoshi, Chenjerai Hove, Micere Githae Mugo,
which one sees on book covers suddenly stick into one’s mind as one
meets their owners at either the Zimbabwe or Nairobi International
Book Fairs.
During the years under review (2000–4), Jared Angira, the internationally
known Kenyan poet and chairman of the Kenya Organization
of Writers Association (KOWA) could be seen with Dr. Jack Mapanje,
the famous Malawian linguist and poet, at the international book fair
almost every day. At the meetings of the National Book Development
Council of Kenya,one met the stakeholders in the book production and
book marketing industry meeting under the aegis of the East African
Book Development Association (EABDA),a consortium comprising of
the National Book Development Councils of Kenya, Uganda, and
Tanzania. As constituent bodies,these councils and the organizers of the
book fairs in Nairobi and Harare argue that the challenges facing all the
stakeholders of the books is the fight against the monster of illiteracy. A
nation that has to operate satisfactorily in the twenty-first century has to
be a reading nation. It must celebrate the book.

This paper discusses the research that was carried out to assess the usefulness of the educational solutions that were adopted to respond to government policy of enhancing entrepreneurial development. The main arguement of the thesis is that entrepreneurs are not always born , they can be made and developed through appropriate education and training. The purpose of the study was to determine whether there is a causal relationship between entrepreneurial development and education using the Entrepreneural Development Unit (EDU) of the Kenya Institute of Management (KIM) as an illustrative case. Taking the conceptual perspective that human capital formation is an essential process to the socio-economic development of nations , the study had five objectives and three research questions. It was a qualitative study looking at a single institution as an illustrative case of a policy intervention to enhance entrepreneurship. The study used the poisson process of the stochastic family of models to assess the contribution of education to entrepreneural development. The sample size for the study included 50 EDU graduates sampled using cluster sampling techniques such as area sampling and systematic list sampling ; 10 government officials , 15 trainers and other staff from KIM and 2 officials from the sponsoring body - all of whom were purposively sampled because they were viewed as information-rich cases. Questionnaires , interviews , observation checklists and document study were the instruments that were used to collect data.

The development of the distance mode of teacher training can be characterized as an attempt to resolve the conflict between aspiration for more education by an ever increasing number of Kenyans and the need to broaden the base of high level human resources for national development and that of resource constraint - both human and financial. This paper discusses a research study that was carried out to establish the factors influencing the demand for the Bachelor of Education (B.Ed.) Arts Degree Programme by Distance Learning mode at the University of Nairobi. It was a descriptive survey and had seven objectives and seven hypotheses to test. The target population for the research study comprised all the students enrolled in the B.Ed. (Arts) programme of the University of Nairobi who were studying through the distance learning mode. Through stratified random sampling , the study focused on the 2002 cohort that was undergoing part six semester in the School of Continuing and Distance Education. Chi square tests were used to analyze the relationship between demand for distance learning considered as a dependent variable and the independent variables of gender , age , income level , admission criteria , employment status and source of finance. A 0.1 level of significance was used to determine the acceptance level in all the hypotheses.

BACKGROUND: Variations in position of the vermiform appendix considerably changes clinical findings. Retrocaecal appendicitis presents with slightly different clinical features from those of classical appendicitis associated with a normally sited appendix. K-sign looks for the presence of tenderness on posterior abdominal wall in the retrocaecal and paracolic appendicitis. This is the first case report of this kind in the literature. The K-sign has been named, as a mark of respect, after the region of origin of this sign, Kashmir, so called as "Kashmir Sign". The sign being present in view of inflamed appendix crossing above its non palpable position above iliac crest on the posterior abdominal wall and the tenderness is by irritation of posterior peritoneum. CASE PRESENTATION: The author is reporting a case series of four patients in whom a K-sign, a clinical sign, was elicited and found positive on the posterior abdominal wall for presence of tenderness in a specific area bound by the 12th rib superiorly, spine medially, lateral margin of posterior abdominal wall laterally and iliac crest inferiorly and was found to be present in three retrocaecal and one paracolic appendicitis. Each case had tenderness in this specific area on posterior abdominal wall. All had appendectomy and having histopathological evidence of appendicitis. CONCLUSION: K-sign can be useful in diagnosis of retrocaecal and paracolic appendicitis. Significance of K-sign being in view of difficulty in diagnosis of retrocaecal appendicitis and its subsequent complications.

Experiments were carried out to determine the effects of friction stir welding on microstructure and properties of recycled Aluminum 6061 alloy, whose alloy content varied from that of primary alloy. The alloy was processed at tool speed and feed ranges of 530 rev/min–1320 rev/min and 40 mm/min–100 mm/min respectively. Microstructure examination; tensile test and Vickers microhardness evaluation were carried out. Microstructure of the alloy was in four zones including: base metal, heat affected zone, thermo-mechanically affected zone and stirred zone. Average grain size of unprocessed material was 93 μm. Processing the alloy at 530 rev/min and 100 mm/min resulted in grains of average size 93 μm, 183 μm and 7 μm; in base metal, heat affected zone and stirred zone respectively. Tensile failure occurred in heat affected zone; that was exposed to high heat. The alloy hardness decreased to a minimum in heat affected zone, followed by a brief rise in thermo-mechanically affected zone, to another maximum in stirred zone. Processed zone hardness was inversely proportional to tool speed and directly proportional to feed rate. Increase in the speed and decrease in feed, increased heat which deteriorated the properties.

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CVD is a common killer in both the Western world and the developing world. It is a multifactorial disease that is influenced by many environmental and genetic factors. Although public health advice to date has been principally in the form of prescribed population-based recommendations, this approach has been surprisingly unsuccessful in reducing CVD risk. This outcome may be explained, in part, by the extreme variability in response to dietary manipulations between individuals and interactions between diet and an individual's genetic background, which are defined by the term 'nutrigenetics'. The shift towards personalised nutritional advice is a very attractive proposition. In principle an individual could be genotyped and given dietary advice specifically tailored to their genetic make-up. Evidence-based research into interactions between fixed genetic variants, nutrient intake and biomarkers of CVD risk is increasing, but still limited. The present paper will review the evidence for interactions between dietary fat and three common polymorphisms in the apoE, apoAI and PPARgamma genes. Increased knowledge of how these and other genes influence dietary response should increase the understanding of personalised nutrition. While targeted dietary advice may have considerable potential for reducing CVD risk, the ethical issues associated with its routine use need careful consideration.

Introduction: Human Respiratory Syncytial Virus is the leading viral cause of bronchiolitis and pneumonia in children and infants. Amongst adults, the elderly and the immuno-compromised are also at risk of severe RSV. RSV is classified into two genetically distinct groups: RSV A and RSV B. In the case of RSV A, 11 genotypes have been reported to date. Amongst these are three new variants (NA1, NA2 and ON1). Appearance of new genotypes has been accompanied by rapid spread and near replacement of existing variants. There is need to constantly re-examine the nature of genotypic changes amongst circulating viruses. Objective: To assess the geographic distribution and genotypic diversity of RSV A in outpatients presenting with Influenza-Like-Illness from 2007 and 2010 across Kenya.Methods: Nasopharyngeal (NP) swabs were obtained from subjects ≥2 months of age presenting with fever ≥38ºC and cough or sore throat at district hospitals under surveillance across 5 regions of Kenya. RNA was extracted from the NP samples and screened using multiplex real-time RT-PCR. A 490bp fragment of the RSVA G-gene was amplified by nested RT-PCR and nucleotide sequencing carried out using the Sanger dideoxy termination method. The sequences were analyzed using a suite of bioinformatics software. Results: 159 NP samples were positive for RSV A, of which, 130 were genotyped; 21 (16%) were GA5, 39 (30%) GA2, 66 (50%) NA1, 1 GA1 and 3 (2%) GA2 variants closely related to NA2. GA2 and NA1 genotypes were identified in the highlands from 2007 – 2010. In 2009, NA1 was highest in Nairobi and Coast regions (11; 17%). GA2 genotype was highest in Northeastern (8; 21%) and was most prevalent in 2009 (44%). The Western region had the highest prevalence of GA5 in 2008 (6; 29%). Conclusion: Five genotypes were in circulation across the country in 2007 and of these NA1 genotype increased dominance year by year and spread to all the regions by 2009. These data provide insight into the dynamics of persistence of RSV strains within a national geographical area.

Invasive diagnostic and therapeutic techniques are increasingly applied to the fetus. It is not known if the fetus feels pain during such procedures, but the fetus does mount significant stress hormonal and circulatory changes in response to these from 18-20 weeks. Perinatal stress may have long-term neurodevelopmental implications. During open fetal surgery, maternal general anaesthesia provides fetal anaesthesia. However, in closed procedures, fetal analgesia presents difficulties. The optimal drug, dose, and route of administration remain to be determined.

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OBJECTIVES: While it is well established that delivery by elective caesarean section is less stressful for the fetus than normal vaginal delivery, little attention has been paid to the effect on the baby of an assisted delivery. STUDY DESIGN: We examined cortisol levels in venous cord blood from seven babies born by forceps, 10 by ventouse extraction, 28 by unassisted normal vaginal delivery, and 12 born by elective caesarean. Paired maternal bloods were taken immediately after delivery. RESULTS: Cord blood cortisol values were significantly different in the different groups (one-way ANOVA, P < 0.0001). The forceps group had the highest values and the caesarean group the lowest; both were different from the normal vaginal delivery group (P=0.019 and P=0.046, respectively). There was no effect of length of labour, or method of pain relief on cortisol levels. Maternal values were similar in the different groups, confirming that the differences observed derived from the fetus. CONCLUSIONS: There is increasing evidence that the stress experienced by the fetus or neonate can have long-term effects on the function of the hypothalamic-pituitary-adrenal axis in later life. We speculate that the stress caused by some assisted deliveries may contribute to this.

BACKGROUND: Fetal exposure to testosterone has been implicated in programming childhood behaviour, but little is known about the determinants of fetal testosterone concentrations. AIMS: To investigate the relation between fetal testosterone and maternal and fetal cortisol. METHODS: Clinically indicated blood samples taken from 44 human fetuses (mean gestational age 27 weeks, range 15-38), together with paired maternal samples, were analysed for testosterone and cortisol concentrations. RESULTS: Male fetuses had significantly higher concentrations of testosterone than females. Female but not male fetal concentrations rose significantly with gestational age. Fetal testosterone correlated positively with both fetal cortisol and maternal testosterone concentrations. Multiple regression showed that maternal testosterone and fetal cortisol were independently correlated with fetal plasma testosterone in both sexes. CONCLUSION: Unlike the norm in the adult, where testosterone production is often inhibited by cortisol, in the fetus there is a positive link between the two.

BACKGROUND: Multiple micronutrient supplementation of Nepalese women during pregnancy is associated with a significant increase in birth weight. OBJECTIVE: We tested the hypothesis that improved birth weight in infants of mothers supplemented with micronutrients is associated with a decrease in inflammatory responses and an increase in the production of T helper 1 cells and T helper 2 cells. DESIGN: The study was embedded in a randomized controlled trial of 15 micronutrients, compared with iron-folate supplementation (control), given during pregnancy with the aim of increasing birth weight. Blood samples were collected at 32 wk of gestation, 12-20 wk after supplementation began, for the measurement of inflammatory markers. Breast-milk samples were collected 1 mo after delivery for the measurement of the ratio of milk sodium to potassium (milk Na:K). In an opportunistically selected subgroup of 70 women, mitogen-stimulated cytokine production was measured ex vivo in whole blood. RESULTS: Blood eosinophils; plasma concentrations of the acute phase reactants C-reactive protein, alpha(1)-acid glycoprotein (AGP), neopterin, and ferritin; milk Na:K; and the production of interleukin (IL) 10, IL-4, interferon gamma, and tumor necrosis factor alpha in whole blood did not differ significantly between the supplemented and control groups. Plasma C-reactive protein and AGP were higher in women who had a preterm delivery, and AGP was higher in women who delivered a low-birth-weight term infant than in women who delivered a normal-birth-weight term infant. CONCLUSIONS: The results indicate an association between systemic inflammation in late pregnancy and compromised delivery outcome in Nepalese women but do not support the hypothesis that multiple micronutrient supplementation changes cytokine production or inflammatory markers.

{ Paired fetal and maternal samples were obtained, at fetal blood sampling and intrauterine transfusion, to study hypothalamic-pituitary-adrenal stress responses. This confirmed that the fetus mounts an hypothalamic-pituitary-adrenal stress response to transfusion via the intrahepatic vein, which involves piercing the fetal trunk, but not to transfusion via the placental cord insertion [mean cortisol response via intrahepatic vein delta = 52.6 nmol/L, 95% CI (25.3-79.9)

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{ OBJECTIVE: To investigate the effects on maternal micronutrient status and infant growth of the increased maize prices that resulted from the southern African drought of 2001-2002. DESIGN: Longitudinal cohort study. SETTING: A maternal and child health clinic in Lusaka, Zambia. SUBJECTS: Maternal and infant health and nutrition data and maternal plasma were being collected for a study of breast-feeding and postpartum health. Samples and data were analysed according to whether they were collected before (June to December 2001), during (January 2002 to April 2003) or after (May 2003 to January 2004) the period of increased maize price. Season and maternal HIV status were controlled for in analyses. RESULTS: Maize price increases were associated with decreased maternal plasma vitamin A during pregnancy (P = 0.028) and vitamin E postpartum (P = 0.042), with the lowest values among samples collected after May 2003 (vitamin A: 0.96 micromol l(-1), 95% confidence interval (CI) 0.84-1.09

Coronary heart disease (CHD) is the leading cause of mortality in Western societies, affecting about one third of the population before their seventieth year. Over the past decades modifiable risk factors of CHD have been identified, including smoking and diet. These factors when altered can have a significant impact on an individuals' risk of developing CHD, their overall health and quality of life. There is strong evidence suggesting that dietary intake of plant foods rich in fibre and polyphenolic compounds, effectively lowers the risk of developing CHD. However, the efficacy of these foods often appears to be greater than the sum of their recognised biologically active parts. Here we discuss the hypothesis that beneficial metabolic and vascular effects of dietary fibre and plant polyphenols are due to an up regulation of the colon-systemic metabolic axis by these compounds. Fibres and many polyphenols are converted into biologically active compounds by the colonic microbiota. This microbiota imparts great metabolic versatility and dynamism, with many of their reductive or hydrolytic activities appearing complementary to oxidative or conjugative human metabolism. Understanding these microbial activities is central to determining the role of different dietary components in preventing or beneficially impacting on the impaired lipid metabolism and vascular dysfunction that typifies CHD and type II diabetes. This approach lays the foundation for rational selection of health promoting foods, rational target driven design of functional foods, and provides an essential thus-far, overlooked, dynamic to our understanding of how foods recognised as "healthy" impact on the human metabonome.

BACKGROUND: Human respiratory syncytial virus (HRSV) is a major cause of severe viral acute respiratory illness and contributes significantly to severe pneumonia cases in Africa. Little is known about its spatial-temporal distribution as defined by its genetic diversity. METHODS: A retrospective study conducted utilizing archived nasopharyngeal specimens from patients attending outpatient clinics in hospitals located in five demographically and climatically distinct regions of Kenya; Coast, Western, Highlands, Eastern and Nairobi. The viral total RNA was extracted and tested using multiplex real time RT-PCR (reverse transcriptase polymerase chain reaction). A segment of the G-gene was amplified using one-step RT-PCR and sequenced by Sanger di-deoxy method. Bayesian analysis of phylogeny was utilized and subsequently median joining methods for haplotype network reconstruction. RESULTS: Three genotypes of HRSVA were detected; GA5 (14.0%), GA2 (33.1%), and NA1 (52.9%). HRSVA prevalence varied by location from 33% to 13.2% in the Highlands and the Eastern regions respectively. The mean nucleotide diversity (Pi[$π$]) varied by genotype: highest of 0.018 for GA5 and lowest of 0.005 for NA1. A total of 58 haplotypes were identified (GA5 10; GA2 20; NA1 28). These haplotypes were introduced into the population locally by single haplotypes and additional subsidiary seeds amongst the GA2 and the NA1 haplotypes. CONCLUSIONS: HRSVA was found across all the regions throughout the study period and comprised three genotypes; GA5, GA2, and NA1 genotypes. The genotypes were disproportionately distributed across the regions with GA5 gradually increasing toward the Western zones and decreasing toward the Eastern zones of the country.

BACKGROUND: Bacterial vaginosis (BV) is common and has been associated with increased HIV-1 susceptibility. The objective of this study was to identify risk factors for BV in African women at high risk for acquiring HIV-1. METHODS: We conducted a prospective study among 151 HIV-1-seronegative Kenyan female sex workers. Nonpregnant women were eligible if they did not have symptoms of abnormal vaginal itching or discharge at the time of enrollment. At monthly follow-up, a vaginal examination and laboratory testing for genital tract infections were performed. Multivariate Andersen-Gill proportional hazards analysis was used to identify correlates of BV. RESULTS: Participants completed a median of 378 (interquartile range 350-412) days of follow-up. Compared with women reporting no vaginal washing, those who reported vaginal washing 1 to 14 [adjusted hazard ratio (aHR) 1.29, 95% confidence interval (CI) 0.88-1.89], 15 to 28 (aHR 1.60, 95% CI 0.98-2.61), and >28 times/wk (aHR 2.39, 95% CI 1.35-4.23) were at increased risk of BV. Higher BV incidence was also associated with the use of cloth for intravaginal cleansing (aHR 1.48, 95% CI 1.06-2.08) and with recent unprotected intercourse (aHR 1.75, 95% CI 1.47-2.08). Women using depot medroxyprogesterone acetate contraception were at lower risk for BV (aHR 0.59, 95% CI 0.48-0.73). CONCLUSIONS: Vaginal washing and unprotected intercourse were associated with increased risk of BV. These findings could help to inform the development of novel vaginal health approaches for HIV-1 risk reduction in women.

Invasive diagnostic and therapeutic techniques are increasingly applied to the fetus. It is not known if the fetus feels pain during such procedures, but the fetus does mount significant stress hormonal and circulatory changes in response to these from 18-20 weeks. Perinatal stress may have long-term neurodevelopmental implications. During open fetal surgery, maternal general anaesthesia provides fetal anaesthesia. However, in closed procedures, fetal analgesia presents difficulties. The optimal drug, dose, and route of administration remain to be determined.

BACKGROUND: Whether the fetus can experience pain remains controversial. During the last half of pregnancy, the neuroanatomic connections for nociception are in place, and the human fetus mounts sizable stress responses to physical insults. Analgesia has been recommended for intrauterine procedures or late termination, but without evidence that it works. The authors investigated whether fentanyl ablates the fetal stress response to needling using the model of delayed interval sampling during intrahepatic vein blood sampling and transfusion in alloimmunized fetuses undergoing intravascular transfusion between 20 and 35 weeks. METHODS: Intravenous fentanyl (10 microg/kg estimated fetal weight x 1.25 placental correction) was given once at intrahepatic vein transfusion in 16 fetuses, and changes (posttransfusion - pretransfusion) in beta endorphin, cortisol, and middle cerebral artery pulsatility index were compared with intrahepatic vein transfusions without fentanyl and with control transfusions at the placental cord insertion. RESULTS: Fentanyl reduced the beta endorphin (mean difference in changes, -70.3 pg/ml; 95% confidence interval, -121 to -19.2; P = 0.02) and middle cerebral artery pulsatility index response (mean difference, 0.65; 95% confidence interval, 0.26-1.04; P = 0.03), but not the cortisol response (mean difference, -10.9 ng/ml, 95% confidence interval, -24.7 to 2.9; P = 0.11) in fetuses who had paired intrahepatic vein transfusions with and without fentanyl. Comparison with control fetuses transfused without fentanyl indicated that the beta endorphin and cerebral Doppler response to intrahepatic vein transfusion with fentanyl approached that of nonstressful placental cord transfusions. CONCLUSIONS: The authors conclude that intravenous fentanyl attenuates the fetal stress response to intrahepatic vein needling.

{ OBJECTIVES: To study the effect of acute stress, caused by intrauterine needling at the intrahepatic vein (IHV), on fetal plasma concentrations of corticotrophin releasing hormone (CRH), and to compare paired fetal and maternal samples for CRH concentration to determine the extent of their joint control. DESIGN: Venous blood samples were obtained from fetuses (gestational age 17-38 weeks) undergoing fetal blood sampling (n = 29) or intrauterine transfusion (n = 17) through either the IHV or the placental cord insertion (PCI). SETTING: The Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, London, UK. PATIENTS: Pregnant women undergoing clinically indicated fetal blood sampling or intrauterine blood/platelet transfusion. RESULTS: Fetal plasma cortisol increased with intrahepatic vein transfusion (mean (SD) cortisol response Delta64.7 (54.5) nmol/l; p < 0.0001

Subclinical mastitis, defined as raised milk sodium/potassium (Na/K) ratio, is associated with poor infant growth and, among HIV-infected women, with increased milk HIV viral load. We conducted a longitudinal cohort study in Lusaka, Zambia, in order to investigate the relative importance of several potential causes of subclinical mastitis: maternal infection, micronutrient deficiencies and poor lactation practice. Women (198 HIV-infected, 189 HIV-uninfected) were recruited at 34 weeks' gestation and followed up to 16 weeks postpartum for collection of information on their health, their infant's health, infant growth and infant feeding practices. Milk samples were collected from each breast at 11 postpartum visits and blood at recruitment and 6 weeks postpartum. The geometric mean milk Na/K ratio and the proportion of women with Na/K ratio > 1.0 in one or both breasts were significantly higher among HIV-infected than among uninfected women. Other factors associated with the higher mean Na/K ratio in univariable analyses were primiparity, high maternal alpha(1)-acid glycoprotein (AGP) at 6 weeks, maternal overall morbidity and specific breast symptoms, preterm delivery, low infant weight or length, infant thrush and non-exclusive breast feeding. In multivariable analyses, primiparity, preterm delivery, breast symptoms, HIV status and raised AGP were associated with the raised Na/K ratio. Thus the main factors associated with subclinical mastitis that are amenable to intervention are poor maternal overall health and breast health. The impact of improved postpartum health care, especially management of maternal infections and especially in primiparous women, on the prevalence of subclinical mastitis and its consequences requires investigation.

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Small and medium scale foundry enterprises occupy an important position in the economic growth and development in our societies. They are the main force behind a large number of innovations and contribute significantly to the nation’s growth through employment creation, investments and exports. Their contribution to poverty reduction and wealth creation is enormous. This study investigated the aluminium scrap recycling practices through a survey of 45 foundry enterprises in Kenya; and evaluated the effectiveness of scrap segregation, melt cleanliness and post cast processing in reducing failures of load bearing products using commonly used cylinder head scrap. Survey data was acquired through a questionnaire, onsite observations and individual interviews with the foundry men. Three alloys were developed from carefully segregated cylinder head scrap; which include BA (base alloy), BA + 0.6%Fe and BA + 0.6%Fe + 0.3%Mn. Analysis of microstructure and mechanical properties was done on as cast and T6 heat treated alloys. The foundries involved in the survey were classified into ‘‘jua kali’’(micro), small, medium and large enterprises based on capital investment, number of employees, volume of castings produced and level of technology. It was found that ‘‘jua kali’’ enterprises were majority at 44%. Their operations were limited by low capital base, low level technology and inadequate skills; forcing them to operate below 40% capacity. Further, the approaches adopted for sorting scrap were found to lead to unpredictable chemical composition and uncertainties in mechanical performance. Use of alloying additives to adjust the alloy chemistry and improve properties of load bearing castings was utilized by 10% of the enterprises. This resulted in production of low quality and unreliable castings. BA had composition similar to that of parent cylinder head alloys. A small increase of Fe by 0.2 % as an inclusion in the as cast alloy, resulted in a drop of strength and ductility by 7 and 20 % respectively. Mn mitigated the harmful effects of Fe by increasing strength and ductility by 5 and 12 % respectively. T6 heat treatment of as cast alloy improved the strength and decreased ductility by 40 and 18 % respectively. It was shown that sorting separately the aluminium scrap component by component, observation of melt cleanliness, use of additives, and post cast processing can yield good mechanical performance of the resulting alloy. International market requirements have set quality standards, which local foundries must fulfill through adoption of scrap segregation, casting and melt control procedures in order to ensure high quality products.

ABSTRACT
This research was conducted to asses the possibilities
and limitations in flavouring of the cultured
milk product "mala" by preparations from fruits
available in Kenya. Experiments were therefore
carried out to:
- determine the sucrose and fruit pulp or juice
levels in mala most acceptable to Kenyans and
the comparative acceptability of different fruit
based flavours;
- optimise the viscosity of mala flavoured with
fruit juices;
devise simple means for preparation and preservation
of fruit-sugar mixes for aromatising and
sweetening mala;
- assess the storage quality of mala flavoured
with selected fruit-suga~ mixes.
Samples of the cultured milk product mala
flavoured with different fruits at varying fruit
and sugar levels were tested for acceptability by
adult Kenyans. Pulps of mango, banana and strawberry,
passion fruit juice and pineapple juice
together with its pieces were used to flavour
mala. For the various fruit-sugar preparations the
optimum flavouring effect was obtained with the
following combinations:-
(xii)
Mango: 18% pulp and 12% sucrose
Passion fruit: 12% juice and 10% sucrose
Banana: 18% pulp and 10% sucrose
Strawberry: 20% pulp and 12% sucrose
Pineapple: 16% pieces and juice and 10%
sucrose.
When various quality characteristics of mala
flavoured with different fruit-sugar combinations at
their optimum were compared, mala with mango pulp and
with passion fruit juice respectively, had the best
appearance; those flavoured with mango and strawberry
pulp respectively were the most preferred for
taste; mala flavoured with mango pulp had the best
consistency. Seeds in strawberry mala were found
objectionable. The same applied to specks and high
t viscosity of mala flavoured with banana pulp. The
viscosity of mala flavoured with passion fruit juice
was considered low. Odour hedonics for all the malas
did not differ.
When 0.164% pectin and 0.9% gelatine respectively,
were added the viscosity of the mala flavoured
with optimum passion fruit juice-sugar mlX
was improved to that of the control/original mala.
Sodium caseinate (17.9% dry matter) added at the rate
of 0.6% on dry matter basis to the milk prior to
acidification had the same balancing effect.
Raising the temperature of fruit-sugar mixes
(xiii)
to 75°C, hot filling immediately after removal of
bottles from boiling water and cooling to ambient
proved adequate to preserve the mixes without refrigeration
for one month. Banana pulp without heat
treatment however had to be preserved by freezing.
The possible levels of 330-500 ppm sorbic acid on
fruit part, considering that the flavoured mala
should not exceed 50 ppm, can protect the product from
infections if not used immediately after opening.
Unflavoured mala and mala flavoured with
different preparations became unacceptable when yeast
and mould counts were of the order of 107/ml. At
the same storage temperature unflavoured mala or
mala flavoured with different fruit preparations
attained these counts after varying storage periods
although the initial yeast and mould counts were
approximately the same. Unflavoured mala, mala
flavoured with pineapple preparation and mala
flavoured with banana pulp attained the counts after
more than 6 days, 6 days and 4 days storage at 25°C,
respectively. The type of fruit preparation added
determined the yeast and mould growth and thereby the
keeping quality of the product at a given temperatuLe.
Sorbic acid at 200 ppm of the final product
prolonged the storage period of mala flavoured with
passion fruit juice sugar mix from 6 to 8 days at
15°C by slowing down the initial proliferation of
(xiv)
yeasts and moulds. Mala flavoured with fruit preparations
other than passion fruit juice showed a
decrease of pH and viscosity and an increase of
titrable acidity over the storage period. On the
other hand mala flavoured with passion fruit juice
showed an increase in pH, a decrease in titrable
acidity and a constant viscosity over the storage
period. The latter may be due to the hydrocolloids
added to improve the viscosity of the product.

This paper presents comparative qualitative and quantitative evidence from rural Kenya and Madagascar in an attempt to untangle the causality behind persistent poverty. We find striking differences in welfare dynamics depending on whether one uses total income, including stochastic terms and inevitable measurement error, or the predictable, structural component of income based on a household's asset holdings. Our results suggest the existence of multiple dynamic asset and structural income equilibria, consistent with the poverty traps hypothesis. Furthermore, we find supporting evidence of locally increasing returns to assets and of risk management behaviour consistent with poor households' defence of a critical asset threshold through asset smoothing.

Maize is the key food crop in Kenya, with estimated production (1998) of 3 million tons of which about 40% are marketed. The Government strictly controlled all aspects of maize marketing until 1986 when gradual liberalisation started and this was completed in 1995. The objective of this study is to assess the degree of policy implementation and the impact of liberalisation of maize marketing on stakeholders between 1989 and 1999. The method of the study included review of available literature, conduct of interviews with stakeholders and the authors’ personal observations of maize marketing activities. Results indicate that liberalisation was implemented without the formation of alternative marketing institutions. Also, maize prices fluctuated substantially according to competitive market forces with limited moderating effects from the Government through open market interventions and import tariffs. But soon the rules of regional and worldwide trading organisations will render this impossible. Private sector participation at all levels in the marketing system increased substantially. There is easy maize flow and supplies to all parts of Kenya. One recommended intervention is to form maize farmer-based institutions for the marketing of maize, provision of maize market information and credit. Further studies should assess the impact of liberalisation and continued regulation of maize imports on producers and consumers.

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

Department of Human Anatomy, University of Nairobi, Kenya. Despite extensive investigation, pain cannot always be adequately diagnosed or cured. Subsequently, the management of pain can be daunting. The diagnosis of pain, however, is crucial to its effective management because of the grave influence that pain has on the quality of life. The biggest drawback in the management of pain is the lack of understanding, on the part of the practitioner, of the peripheral and central modulation of pain. The objective of this paper is to briefly review the current concepts in the recognition of and classification of pain, with emphasis on orofacial pain. PMID: 8033773 [PubMed - indexed for MEDLINE]

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.