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The rise of influencer marketing and its implications on Kenyan legacy media houses\u27 revenues
Full text linkThe growth of social media influencers popularity has substantially disrupted traditional media and advertising landscapes, redefining audience engagement, brand marketing strategies, and revenue streams for legacy media houses. This study investigates the implications of influencer marketing on Kenyan legacy media, exploring shifts in audience preferences, financial impacts, and factors influencing advertisers toward influencer marketing. Building on the disruptive innovation theory and qualitative data from interviews with media professionals, influencers, advertisers, and audiences, the study reveals a fundamental shift in content consumption and advertising dynamics. Findings show that social media influencers thrive in direct audience engagement, authenticity, and niche targeting, catering especially to younger audiences. These qualities contrast with traditional media’s structured, credibility-focused approach, which, while trusted for regulated and fact-checked content, struggles to compete with the relatability and flexibility of influencer-led campaigns. Advertisers are reallocating budgets from legacy media to influencers due to the cost-effectiveness, measurable ROI, and personalized appeal of influencer marketing. This trend has resulted in significant revenue declines for Kenyan media houses, further compounded by audience fragmentation and shifting content preferences. The study highlights the need for legacy media to innovate by adopting hybrid models, leveraging digital platforms, and exploring collaborations with influencers to remain competitive. Recommendations for advertisers include enhancing data-driven campaigns and partnering with culturally attuned influencers. Policymakers are urged to establish regulatory frameworks to ensure fair competition and preserve journalistic integrity. The research adds to understanding the challenges presented by digital disruption and offers practical strategies for stakeholders to maneuver the evolving media and advertising ecosystem. Further studies are proposed to explore standardized metrics for influencer marketing ROI, long-term impacts on journalism, and collaborative opportunities between influencers and traditional media
Customized on-site professional development: Empowering a primary math teacher to teach mental math skills
No full textIn today’s rapidly evolving educational landscape, efforts to drive change or improvement in education, whether through educational reforms or school improvement plans, underscore the critical importance of professional development. Accordingly, this study aimed to support a primary school math teacher in teaching mental math skills to class 5 students in a low-cost private school in Karachi, Pakistan. The study employed action research and focused on customized professional development with on-site support and collaborative teaching opportunities. The process of data collection in this study entailed three stages: reconnaissance, intervention and post-intervention. In the reconnaissance stage, the data were collected through classroom observations, semi-structured interviews, mental math tasks, and document analyses to explore the existing perceptions and practices of the teacher towards teaching and learning of mental math skills. Based on the findings from the reconnaissance, an intervention was designed to provide the teacher with one-on-one support to develop her understanding of content and pedagogy related to mental math skills. The intervention stage included working sessions, demonstration of lessons, and opportunities for reflection. A collaborative teaching approach was adopted to help the teacher connect theoretical concepts with real classroom situations. In the post-intervention stage, the data were gathered through classroom observation and semi-structured interview of the participant teacher. The findings indicated that in low-cost private schools, assigning teachers to subjects beyond their area of expertise presents considerable challenges, including gaps in content knowledge and pedagogical skills, and underscores the critical need for targeted, context-responsive professional development support. The study emphasized the value of context-specific and customized on-site professional development, reflective practices, and collaborative support in empowering teachers to overcome challenges and improve instructional quality of teaching of mental math. These results highlight the need for professional development models tailored to address the unique challenges of resource-constrained educational settings
Prognostic accuracy of clinical markers of postpartum bleeding in predicting maternal mortality or severe morbidity: A WHO individual participant data meta-analysis
No full textBackground: Postpartum haemorrhage (excessive bleeding after birth) is a leading cause of maternal mortality and morbidity worldwide. However, there is no global consensus on which clinical markers best define excessive bleeding or reliably predict adverse maternal outcomes. The aim of this study was to assess the prognostic accuracy of clinical markers of postpartum bleeding in predicting maternal mortality or severe morbidity.Methods: In this individual participant data meta-analysis, eligible datasets were identified through a global call for data issued by WHO and systematic searches of PubMed, MEDLINE, Embase, the Cochrane Library, and WHO trial registries (from database inception to Nov 6, 2024). Studies were eligible if they included at least 200 participants with objectively measured blood loss or other clinical markers of haemodynamic instability, and reported at least one clinical outcome of interest. Individual participant data were requested for all eligible studies. For each dataset, we computed the prognostic accuracy of each clinical marker to predict a composite outcome of maternal mortality or severe morbidity (blood transfusion, surgical interventions, or admission to intensive care unit). Five clinical markers were assessed: measured blood loss, pulse rate, systolic blood pressure, diastolic blood pressure, and shock index. Results were meta-analysed through two-level mixed-effects logistic regression models, with a bivariate normal model used to generate summary accuracy estimates. Clinical marker and threshold selections were informed by a WHO expert consensus process, which placed emphasis on maximising prognostic sensitivity (preferably \u3e80%) over prognostic specificity (preferably ≥50%). This meta-analysis was registered on PROSPERO (CRD420251034918).Findings: We identified 33 potentially eligible datasets and successfully obtained and analysed full data for 12 datasets, comprising 312 151 women. At the conventional threshold of 500 mL, measured blood loss had a summary prognostic sensitivity of 75·7% (95% CI 60·3-86·4) and specificity of 81·4% (95% CI 70·7-88·8) for predicting the composite outcome. The preferred sensitivity threshold was reached at 300 mL (83·9% [95% CI 72·8-91·1]), although at the expense of reduced specificity (54·8% [95% CI 38·0-70·5]). Prognostic performance improved with a decision rule that combined the use of either blood loss thresholds less than 500 mL (≥300 mL to ≥450 mL) and any abnormal haemodynamic sign (pulse rate \u3e100 beats per min, systolic blood pressure \u3c 100 mm Hg, diastolic blood pressure \u3c 60 mm Hg, or shock index \u3e1·0) or 500 mL or more of blood loss, with sensitivities ranging from 86·9% to 87·9% and specificities from 66·6% to 76·1%.Interpretation: Measured blood loss below the conventional threshold, combined with abnormal haemodynamic signs, accurately predicts women at risk of death or life-threatening complications from postpartum bleeding and could support earlier postpartum haemorrhage diagnosis and treatment
Rethinking environmental sustainability in intensive care medicine: A call for global collaboration for mutual learning
No full textGender-Responsive Reporting and Communication Curriculum
Full text linkThis curriculum, developed in collaboration with media organisations, women’s professional associations, and civil society groups in East Africa, provides a structured approach to teaching gender-responsive reporting and communication. Covering concepts such as gender analysis, gender-based violence, media representation, and emerging issues including climate change and artificial intelligence, it aims to strengthen journalism education and practice by fostering inclusivity, equality, and balanced reportinghttps://ecommons.aku.edu/aku-prospectuses/1006/thumbnail.jp
Association of health knowledge with adoption of heart healthy behaviours: A cross-cohort analysis using data from the PURE Study
No full textAims: This study aims to assess aspects of health knowledge: i) awareness of health effect of tobacco smoking and ii) awareness of preventive actions for heart disease and stroke, and their relationships with adoption of heart healthy behaviours (smoking cessation and utilisation of antihypertensive treatment). Methods: In this multi-cohort study, we recruited adults aged 35 to 70 years from 21 countries. Data on health effects of tobacco smoking (10 questions) and health actions to prevent heart disease or stroke (11 questions) were collected at baseline. Logistic regression analyses were used to examine the relationship with the outcomes of smoking cessation and use of antihypertensive treatment adjusting for adjusting for possible confounders. Results: Of the 12,962 included in the descriptive analysis, 50.0% were female, 42.9% had no or primary education, and 53.3 % were residing in low or lower middle-income country. Among current and former smokers, having knowledge of health effect of tobacco smoking on heart disease [Adjusted Odds Ratio (aOR): 1.70, 95% CI: 1.19, 2.43)], stroke (1.41, 1.08,1.86), and on heart disease in non-smokers exposed to others smoking (1.40, 1.06,1.86) were significantly and positively associated with smoking cessation compared to those who were not aware of health effects. Knowledge of the importance of reducing dietary salt aOR 1.62 (1.23,2.13), dietary fat aOR 1.56 (1.17,2.08) and exercising more aOR 1.48 (1.22,1.80) to prevent heart disease or stroke were positively associated with taking anti-hypertensive medication compared to those who were not aware of preventative actions. Conclusion: This study reinforces that better health knowledge shapes adoption of heart healthy behaviours such as smoking cessation and taking anti-hypertensive treatment even after accounting for baseline education and wealth
Hepatitis C virus cascade of care among adults in Sindh province, Pakistan: Findings from 2019-2020 household sero-survey
No full textPakistan has the largest national burden of hepatitis C virus (HCV) infections (9.8 million). High levels of testing and treatment are needed to achieve HCV elimination, but little data exists on this in Pakistan. A household sero-survey from Sindh province (2019-2020) collected self-reported data from adults on previous HCV testing and treatment, and undertook HCV-antibody (HCV-Ab) testing of participants (2988 children (\u3c 18) and 3684 adults) and HCV-RNA testing of HCV-Ab positive individuals. We determined the self-reported HCV cascade-of-care among adults ever eligible for HCV treatment, defined as either having a past infection (HCV-Ab positive and HCV-RNA negative) with self-reported treatment history or current infection (HCV-RNA positive). We assessed factors associated with self-reporting ever being HCV-tested using multi-variable logistic regression. Overall, 10.8% (397/3684) of adults tested HCV Ab-positive in the sero-survey, of which 80.9% (321/397) had a HCV-RNA test result. Of adults defined as ever treatment eligible (n = 232), 40.9% (95/232) reported a previous HCV test and 91.2% (87/95) reported testing positive. Of these, HCV treatment was reported by 69.0% (60/87) and 46.7% (28/60) of treated individuals tested HCV-RNA-negative. Overall, 25.9% (60/232) of treatment-eligible adults reported being treated. The regression analysis suggested that males, older adults (\u3e25 years), and adults with a secondary or higher education level were more likely to have ever been tested for HCV, as were individuals with a family history of hepatitis, received HBV vaccination or that had various risk factors linked to HCV transmission (e.g., blood transfusion, having tattoo/acupuncture, hospitalisation or therapeutic injection (s) history). The cascade-of-care for HCV needs improving to eliminate HCV in Pakistan, especially among younger adults, women and people with low education levels
Targeting triglycerides: The rise of apolipoprotein C3 and angiopoietin-like protein 3 inhibitors
No full textHypertriglyceridemia has been proposed as a risk factor for atherosclerotic cardiovascular disease (ASCVD). Triglycerides (TG) are viewed as a marker for remnant cholesterol in triglyceride-rich lipoproteins, as this remnant cholesterol has been identified as a causal risk factor for ASCVD. The limited number of effective treatments for elevated TG has fueled the search for novel pharmacotherapy options, and multiple medication classes are being explored. Apolipoprotein C3 (APOC3) and angiopoietin-like protein 3 (ANGPTL3) are among the most promising targets. Several novel agents utilizing these pathways, including olezarsen, plozasiran, and zodasiran, are currently under development for the management of elevated TG, with olezarsen approved in 2024 for the management of familial chylomicronemia syndrome. This comprehensive review provides updated insights into the development of novel hypertriglyceridemia treatments
Predictors of 30-day mortality in major lower limb amputations: Insights from a five-year retrospective study in a South Asian LMIC
No full textBackground: Major lower limb amputation (MLLA) is a life-saving procedure with significant morbidity and mortality. The objectives of this study were to determine the incidence of 30-day mortality, perioperative complications, and predictive risk factors of mortality in MLLA patients.Methods: This retrospective cohort study included patients undergoing MLLA at The Aga Khan University Hospital, Pakistan, from January 2018 to December 2022. Data was collected using chart reviews and analyzed via Stata 15. Demographic, clinical, and procedural variables were examined. Predictive factors for 30-day mortality were assessed using Firth logistic regression.Results: Among 286 patients, the mean age was 49.4 ± 20.9 years, and 79.4% were male. The leading indications for MLLA were diabetic foot (43.4%) and trauma (23.8%). Thirty-day mortality was 6.6%. Most deaths occurred in patients with diabetic foot (68.4%), chronic kidney disease (31.6%), or ischemic heart disease (36.8%). Below-knee amputation accounted for 68.4% of cases. Postoperative infections (11.2%) and stump necrosis (4.2%) were the most common complications. Multivariable analysis identified chronic kidney disease (OR: 3.613; 95% CI: 1.112-11.739; p = 0.033) and postoperative local wound infection (OR: 3.416; 95% CI: 1.036-11.267; p = 0.044) as significant predictors of 30-day mortality in this cohort.Conclusion: MLLA is associated with considerable short-term mortality, particularly among patients with chronic kidney disease and postoperative surgical site infections. These findings emphasize the need for proactive identification of high-risk individuals, optimization of comorbid conditions, especially renal function, and strengthening perioperative infection control practices to improve patient outcomes in resource-limited settings