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A Critical Re-Examination Of Kenya’s Approaches To Threats To Her Territorial Integrity
No full textTerritorial integrity is an important aspect for states. It is the main concern in the national interest, security and peace for states. The concern of most states is to protect their territorial integrity as it ensures their place in International Relations. Territorial threat is an issue and concern for many states. The main source of territorial threat for most states in the international system is border demarcation mostly caused by colonialism. Other threats include; shared natural resource, ethnic communities living across international boundaries, insurgency and secessionist movements. In Africa most territorial disputes are a result of the scramble and partitioning of African countries during the Conference of Berlin. The dynamic and complexities of territorial issue in Africa makes this research worthwhile. The objective of this study was to re-examine Kenya‘s approaches in dealing with threats to her territorial integrity. This research study had three main research objectives; to indentify the major threats to Kenya‘s territorial integrity, identify the approaches that Kenya has used in dealing with those threats and how Kenya has been able to defend her territorial integrity of not. The research critically examined the approaches Kenya has used, looking at the pros and cons of those approaches. The theory of Realism and its concepts was applied to the study to evaluate the importance the protection of territorial integrity by Kenya, the concept of conflict and war in state national interest. The research employed both qualitative and quantitative research approach, Non – Probability sampling which is Purposive sampling method. The study used primary methods and secondary method of data collection was used. This study found out that major threats to the country‘s territorial integrity are border demarcation issues such as the Maritime dispute with Somalia, Migingo Island and Ilemi Triangle disputes. Other disputes included terror attacks, refugees and piracy. The study also established that Kenya approaches in dealing with threats to her territorial integrity have been effective although it is faced with a lot of challenges. Diplomatic approaches have had but a few successes in the dispute over Migingo Island with Uganda and the Illemi Triangle dispute with South Sudan. It has failed with the Somalia dispute that was later forwarded to the International Court of Justice (ICJ). In the end both the diplomatic and judicial approaches in dealing with threats to Kenya‘s territorial integrity are important. Finally, from the analysis, this study recommends that Kenya should ensure to employ the best approach in dealing with threats to her territorial integrity such as participating in good faith, adoption of non aggressive approaches to foster peace and use regional organizations in trying solving the threats to her territorial integrity if bilateral negotiations fail
Baseline Highly Sensitive Troponin T And Outcome Prediction In Adults With Acute Coronary Syndrome Treated At The Aga Khan University Hospital-Kenya
No full textBackground: WHO (2017) report indicates that (CVD) is a major concern worldwide and accounts for approximately 10% mortality and 30% morbidity and nearly half of all these deaths are due to ACS. ACS is divided into ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina. The term acute myocardial infarction (AMI) is used in reference to STEMI and NSTEMI and develops when there is an imbalance between demand in oxygen and supply in the heart muscle. Cardiac troponin assays have evolved over the years and is marked with significant improvement in analytical sensitivity that has enabled the measurement of very low concentrations of Troponin as seen in healthy individuals that was previously not possible. Data on the utility of HsTnT assays is scarce from the African continent. The time from onset of symptoms to initial troponin testing impacts on the baseline levels and is an important consideration when interpreting the evolution of troponin levels.
Objectives: We wanted to determine if baseline HsTnT is a useful predictor of in-hospital mortality among patients with ACS seen at AKUH-N. We also wanted to determine the relationship between known risk factors for CVD and baseline HsTnT levels. Finally, we wanted to determine the association of time to presentation on baseline hsTnT levels.
Methods: A cross sectional study Design looking at clinical and laboratory data for patients diagnosed with ACS at the AKUH-N between January 2012 to December 2013. The data was retrieved from the hospital information system and chart reviews where necessary.
Results: 196 patients were in the final analysis. Patients included were 29 - 89 years. 44% had a diagnosis of STEMI, about 40% had NSTEMI diagnoses and 16% diagnosed with unstable
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ungina (UA). 16.8% had normal baseline troponin T levels while 83.2%had elevated baseline troponin T levels. Duration of symptom onset to presentation in patients with STEMI was 1-3 hrs 66.7% while for NSTEMI/UA majority took more than 24hrs to present 70.1%. 12 (6.1%, 95% CI: 2.8%-9.5%) died while in hospital and 24 (12.2%, 95% CI: 7.7%- 16.8%) died after discharge. Troponin T level was found to have no statistically significant effect (RR=1.00, 95% CI 0.99-1.00) on the risk of mortality among ACS patients at 0.05 level of significance. CVD risk factors as well as baseline hsTnT levels had no statistically significant effect on the risk of mortality among ACS patients.
Conclusion : Even though there was no sufficient evidence to conclude that baseline hsTnT was a statistically significant predictor of mortality in this study, previous studies indicates that in patients with ACS, hsTnT levels provides useful prognostic information and permits early identification of patients with increased risk of mortality. (Reichlin, T et al 2009)
Influence Of Political-Legal Environment On Foreign Market Entry Strategies Among Multinationals Corporations In Kenya
No full textThe study examined the influence of the political-legal environment on international
business entry strategies among multinationals in Kenya. The study was anchored on two
theories, namely, international product life cycle theory and environmental dependency
theory. A descriptive research design was utilized in the study. The survey covered 44
multinationals corporations with offices in Nairobi County. A census was conducted in the
investigation since the focus population was small and manageable. For each of the
company, only one managing director, one business development manager and one legal
manager were picked randomly. Questionnaires with closed-ended questions were
administered directly to the respondents. The data was analyzed using descriptive and
inferential statistics. The descriptive statistics entailed the frequencies, mean and standard
deviation, while inferential statistics comprised of the correlation and the regression
analysis. Analysis of variance was utilized to determine whether the overall model was
statistically significant. The findings of the study established that the political environment
factors that affected the foreign market entry strategies in large extent were election cycles,
politician’s involvement, the political risk and predictability, level of democracy,
embezzlement of funds, the graft level, political traditions, political structure and taking of
bribes. Besides the study found that the legal factors that affected the foreign market entry
strategies among multinationals corporations to a large extent were liberation in
management, levels of consumer protection, economic regulation on price ceiling,
licensing requirements, competition regulation, export subsidies, trade tariffs, import
quotas and level of taxes. Additionally, The study revealed that foreign entry strategies
used in large extent were direct exporting, indirect exporting, investment franchising,
management franchising, provision of managerial expertise, hiring of the management
company, cooperation with another business, separate joint venture, licensing of copyright
and trade secrets and licensing of trademarks. The correlation results showed that the
political environment and legal environment were positively and significantly associated
with foreign market entry strategies. The study concluded that the political environment
and legal environment were positively and significantly related to foreign market entry
strategies. The study recommended that multinational corporations in Kenya be granted
democracy in their leadership style and not dictated on who be involved in the
management. The study also recommended that politicians should distance themselves
from interfering with the operations of the business and government to establish policies
and regulations to protect companies from the interference from the influential people in
the country. The study also recommended that other multinational corporations aiming to
expand their business in different countries can also adapt those strategies of cooperation
with another company, separate joint venture and direct exporting since they were the most
used by the multinational corporations in Kenya
Multiple Disease Resistance and Agronomic Performance of Inter-racial Beans Developed Through Marker-assisted Gamete Selection
No full textCommon bean (Phaseolus vulgaris L.) is the most important legume crop and the main source of dietary protein for urban and rural populations in Eastern and Central Africa. However, its productivity in this region is among the lowest in the world due to the presence of many biotic and abiotic production limiting factors. Diseases and pests are the most economically important biotic stresses. Although several diseases attack common bean, angular leaf spot, anthracnose, common bacterial blight, bean common mosaic virus and the root roots are the most damaging leading to substantial economic losses. Breeding for multiple resistance is the most practical, cost-effective and sustainable approach to cope with production limiting biotic factors since there is no additional investment by farmers. Broadening the genetic base of existing commercial cultivars through inter-racial crosses provides a unique opportunity for effective selection of improved progeny with better agronomic potential. This study was a continuation of a marker-assisted gamete selection programme initiated by the University of Nairobi Legume Breeding Research Programme in 2009 to determine whether this breeding procedure was effective in pyramiding genes for resistance to bean major diseases in Eastern Africa into susceptible, but popular, large- and small-seeded bean varieties. The specific objectives of this study were to: i) Determine the agronomic potential of 16 inter-racial and inter-gene pool populations and select the most promising small- and medium-seeded lines; ii) Determine yield stability and genotype x environment interactions of elite lines, and iii) Validate F1.8 elite lines for multiple resistance to root rots, common bacterial blight, angular leaf spot, bean common mosaic virus and anthracnose using natural epiphytotics and artificial inoculations.
For the first objective, 16 populations were advanced from F1.3 to F1.5 generation at Kabete Field Station of the University of Nairobi between 2013 and 2016. The F1.6 generation was subsequently evaluated at Mwea Research Station of the Kenya Agricultural and Livestock Research Organization (KALRO). Data were collected on seed yield and yield related parameters. The field disease score for target diseases was recorded using the CIAT standard system for bean germplasm evaluation. GenStat 15th edition software was used for analysis of variance (ANOVA) using generalized linear additive model. Fisher’s Least Significant Difference (LSD) test was used for mean separation. Results on agronomic performance revealed significant differences for seed yield among populations, commercial checks and donor parents
(P<0.05). Although the performance of the populations was not consistent over generations and across sites, crosses involving the commercial variety KATB9 were generally high yielding and superior for most agronomic traits. Population KMA13-32 (KATB9 x Mex54 / G2333 // RWR719 / BRB191) with a mean seed yield of 2,844 kg ha-1, out-yielded all the other populations, commercial varieties and donor parents used as checks. The number of pods per plant (r=0.85***) and the seed yield per plant (r=0.97***) were the most positively correlated to seed yield per ha, suggesting that these two traits can be used as indirect selection criteria for grain yield. Inter-racial populations showed low to moderate infection levels in all the generations (1.0 to 5.0) while commercial checks were moderate to highly susceptible to most of the pathogens (3.1 to 9.0). From the F1.6 generation, 92 progeny rows from single plant selections belonging to five market classes (19 small reds, 12 pintos, 13 red kidneys, 16 red mottled and 32 mixed colors) were selected for further testing.
For the second objective, 92 F1.7 lines representing five major market classes were evaluated in three locations (Mwea, Kabete and Tigoni) representing low, medium and high altitude agro-ecological conditions. Data were collected on seedling emergence rate, plant vigor, days to flowering, flower color, growth habit, days to maturity, number of pods per plant, number of seeds per pod, 100-seed mass, seed yield and the harvest index. Prevalent diseases were assessed using the CIAT standard system for bean germplasm evaluation. In addition to ANOVA, the AMMI (additive main-effects and multiplicative interaction) model was used to separate the additive variance from the G x E interaction and to determine the stability of the genotypes across locations using the PCA scores (IPCA1 and IPCA2) and the AMMI stability values (ASV). G x E effects were significant (P<0.05) for all the traits and market classes implying that the tested lines responded differently to variation in agro-ecological conditions, resulting in inconsistent ranking of genotypes across the three sites. The high altitude Tigoni site (2,130 masl) with a mean grain yield of 4,010.2 kg ha-1 was the most favorable environment for common bean cultivation, while the low altitude Mwea site (1,150 masl) with a mean yield of 771.6 kg ha-1 was the lowest yielding environment. AMMI analyses showed that seed yield varied significantly (P<0.001) among genotypes and test sites regardless of the market class. The red kidney market class had the best mean yield (2,299.5 kg ha-1) while the lowest seed yield (1,599.3 kg ha-1) was recorded on mixed color market class. The three major factors (genotype, environment, and G x E) contributed the most to the yield variability (87.8%) regardless of the
market class. Of these, environment factors were largest source of variability (74.2%). The interaction between the genotype and environment was high for the small reds and the mixed colors (17.6% and 26.7%, respectively) suggesting that tested lines were not stable and should, therefore, be selected and recommended to specific environments. From ASV, the higher yielding lines were also the most unstable across sites. Among tested lines, only KMA13-22-21 and KMA13-29-21 combined high yield potential and wider adaptation across the three agro-ecological conditions.
For the third objective on multiple disease resistance validation, pathogens were isolated from diseased bean plants from various parts of central Kenya, multiplied on appropriate media and used to inoculate the elite high yielding lines previously identified using the AMMI model. Data on disease incidence and severity were collected at 14th, 21st and 28th days after inoculation using 1-9 CIAT scale. ANOVA and AUDPC (Area Under Disease Progression Curve) were used for data analysis. Results showed that five of the 26 elite lines possessed multiple resistance to five pathogens; eight genotypes were resistant to four pathogens; nine genotypes were resistant to three pathogens; three possessed resistance to two pathogens and one was resistant to one pathogen. However, there were no significant correlations in the reaction of tested genotypes to the seven diseases (angular leaf spot, bean common mosaic virus, common bacterial blight, anthracnose, Pythium root rot, Fusarium root rot and Rhizoctonia root rot) used in this study, except the significant correlation (P<0.05) existing between the reaction of genotypes to bean common mosaic virus and the angular leaf spot (r=0.39*). This suggested that resistance genes for those pathogens were inherited independently.
The presence of transgressive genotypes combining high yield potential (with a mean grain yield advantage of 17.5% over parental cultivars), stability across locations and high resistance to major diseases confirmed the effectiveness of inter-racial crosses and marker-assisted gamete selection for common bean improvement.
Keywords: Gene pyramiding, market class, Phaseolus vulgaris, stability analysis, yield potentia
Patterns Of Clinical Presentation, Treatment Modalities And Outcomes In Children Under 5 Years With Acute Kidney Injury At Kenyatta National Hospital
No full textAcute kidney injury (AKI) is a multifaceted ailment with clinical signs showing from minor dysfunction of the kidney to total malfunction of the kidney completely. The disorder is a type of emergency which is common in children who visit pediatric emergency units. It is a syndrome of diverse etiology characterized by fast decline of the functioning of the kidney resulting in accumulation of harmful nitrogenous wastes in the body and accumulation of extracellular fluid volume as well as electrolyte imbalance. No studies on the management and outcome of AKI in the children population in Kenya.
To establish the patterns of clinical presentation, treatment modalities and outcomes in children under 5 years with acute kidney injury at Kenyatta National Hospital
The study used a prospective research design that used quantitative approach to determine the patterns of clinical presentation, treatment modalities and their immediate outcome of children under five admitted with AKI in Kenyatta National Hospital (KNH). Stratified and Convenience sampling was used to recruit a total of 120 children with AKI admitted in pediatrics department KNH. The information was filled in the structured questionnaire. Quantitative data was analyzed using SPSS computer package, version 23. Normally distributed variables were reported as means with standard deviations and compared by Student's t test.
Assessment of parents/caregiver socio-demographic identified that, 96.7% were female , 41.2% secondary level education, 43.9% self-employed and 40% earning between Ksh. 10,001 and 20,000. The biographic characteristics of children, 50.4% were female,72% stay with their parents and 51.2% were firstborns. The common clinical presentation found in children included decrease in urine volume (69%), nausea (49.6%), shortness of breath (46.3%) and seizures (36.7%). In medication only clinical intervention, 75% fully recovered, 20.6% were at end-stage renal disease and 4.4% died. Peritoneal dialysis and medication intervention had 92.9% fully recovered, 5% were at end-stage renal disease and 2.1% died. There was statistically significant association in both medication and peritoneal dialysis and medication based on the clinical parameters ( Creatinine, Urea, Na, K+) (p<0.05).
Substantial number of children were put on medication only treatment modality compared to combined therapy. This is despite combined therapy showing a better outcome than medication only intervention. This underscores the need to implement combined therapy as the first modality in the treatment of children with acute kidney injury. In addition, to adopt improved mechanisms for early detection of AKI among children to guarantee improved clinical outcomes .a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Effectiveness of Alternative Dispute Resolution Mechanism (Adr) in Case Backlog Management in Kenyan Judicial System: Focus on Milimani High Court Commercial Division.
No full textKenyan Judiciary continues to register high number of cases. This has resulted in huge backlog,
which has overstretched existing human resource and physical facilities. Despite introduction of
ADR mechanisms as measure to reduce case backlog, the effects of the ADR is yet to be realized.
This study has an objective of finding reason for continued rise in cases being filed in Court despite
the fact that there exists ADR mechanisms anchored in the Kenyan Constitution of 2010. This
study also considered theories on managing case backlog, reliability of ADR and reliability of
litigation to underpin effectiveness of ADR in this study. The study collected data through desk
research, interview and records from the Deputy Registrar commercial division and performance
management and Measurement directorate. Among the selected respondents to interview
questions were the Deputy registrar of Milimani High court of commercial Division, a member of
the Chartered Institute of Arbitrators, lawyers, and a senior officer Kenya Revenue Authority. All
the institutions and persons targeted for the interview had crucial and reliable information that
builds on testing the hypotheses of the study. The perceptions of the selected audiences were also
critical in understanding credibility of the current ADR system
The Prevalence, Severity And Pattern Of Head Injury Among Motorcycle Crash Victims At Kenyatta National Hospital
No full textIntroduction. Motorcycles represent the most dangerous form of motorized transportation,
and their increased use has been associated with a rise in motorcycle related crashes. In last
decade, Kenya witnessed an explosion of motorcycle numbers and a concomitant increase in
motorcycle crash-related deaths and injuries has been noted. Head injury is the main cause of
death, severe morbidity and long-term disability among motorcyclists. However, few hospital
based studies have been conducted to evaluate the prevalence and severity of motorcycle
crash related-head injuries (MCR-HIs) and none has determined the pattern of head injuries
in this patient population in Kenya.
Objectives. This study aimed to determine the burden, evaluate severity and describe the
pattern of MCR-HIs at Kenyatta National Hospital (KNH). The rate of helmet use among
MCR-HI patients was also estimated. The desired outcome is prevention and reduction of
motorcycle crash related head injuries, mortality and disability among motorcyclists in
Kenya.
Methodology. Sixty consecutive patients with motorcycle accident related head injury seen
between 5th December, 2017 and 28th February, 2018 were prospectively studied using a predesigned
questionnaire. Data analysis was done using Statistical Package for Social Sciences
(SPSS) version 21.0 software.
Results. Head injury was present in 30.3% (n=60) of the patients with motorcycle crash
injury (MCI) who presented to KNH during the study period. MCR-HI represented 25.0% of
the total head injuries attended during the same period. Motorcycle operators (37, 61.7%)
formed the largest proportion of patients with MCR-HI. Fifty-five (91.7%) subjects were
male and the mean age was 29.4 years (SD 14.4 years, range 4 to 67 years), with majority
(21, 35.0%) falling in the age group 20 – 29 years. More than two-thirds (44, 73.3%) of the
patients were in the economically active age group (i.e. 20 - 49 years). There was a
significant proportion of children younger than 10 years (8, 13.3%) and these made up 61.5%
of the pedestrians. Motorcycle-vehicle collision (21, 35.0%) was the most common accident
type. Thirty-nine (65.9%) of the patients had mild head injury, while seven (11.7%) and
fourteen (23.3%) incurred moderate and severe head injury, respectively. Intracranial
UNIVERSITY OF NAIROBI
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haemorrhage (42, 70.0%) was the most common craniocerebral injury type, with cerebral
contusions (36, 63.2%) constituting the majority. Scalp injury (34, 56.4%), and skull fracture
(31, 51.7%) were the other significant injuries. There was a notable low helmet use rate (11,
23.4%) among motorcyclists with MCR-HI, which was worse among passengers (1, 10.0%).
Helmet use reduced the rate of severe head injury, scalp injury, skull fracture and extradural
hematoma. However, helmets were not protective against cerebral contusions. Limb injuries
represented the most common non-craniocerebral injury associated with MCR-HI.
Conclusion. MCR-HI is an important public health problem in Kenya. Being a preventable
injury, every effort is needed to eradicate it. Helmet use among motorcyclists with MCR-HI
is low, especially amongst passengers. Though protective against head injury, the helmet’s
efficacy has significant limitations. Therefore, measures to prevent MCR-HIs should not
promote helmet use in isolation. Effective prevention efforts must, instead, be more holistic
to include promotion of safe riding habits and behaviour, as well as enforcement of road
traffic regulations.
Limitations. This study has the following important limiting factors; small sample size,
recall bias, single-site study, and pre-hospital deaths.a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Prevalence of Substance Use Among Undergraduate Medical Students at the University of Nairobi
No full textIntroduction: There is a growing and worrying trend in the prevalence of substance use disorders among medical students globally. This substance use not only interferes with learning, which is a major concern considering the cognitive and psychological impact on the student, it also impacts on the medical students’ future careers as practicing physicians this has longstanding implications that could have on patients. There is paucity of local studies done and published from this particular demographic in Kenya to assess the trend among medical students.
Objective: The broad objective. To determine the prevalence of substance use among undergraduate medical students in the University of Nairobi.
Methods: This was a cross-sectional study of 387 undergraduate medical students in the University of Nairobi using proportional sampling. Data was collected via self-administered The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and researcher designed socio-demographic questionnaire. SPSS for windows version 25 was used for data analysis. Frequencies, proportions and Fishers’ exact test was used.
Results: A total of 387 students participated recruited. Prevalence of substance use was 43.7% [95% CI: 38.7%-48.7%], the substance with highest use were Alcohol 39.6%, cannabis 24.7%, cigarette 17%. Cannabis was associated with the most frequent use and the substance with the highest risk of harmful use. The greatest influencing factor to start substance use was curiosity and peer pressure 78.4%.a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Factors Influencing The Performance Of Public Mixed Day Secondary Schools In Kenya: A Case Of Likuyani Constituency
No full textThis study aimed at determining the factors affecting the performance of public mixed
day secondary schools in Kenya. Challenges facing these schools have persistently
controlled their outcome over the years. The inability of students to compete favorably
with those in boarding schools continue to raise concern over the rating process.
Managing such schools require knowledge and recognition of the specific underlying
factors in the region. With an increasing number of students enrolling into mixed day
schools across the country, the government policies on financial support has proven
inadequate in many schools. In Likuyani constituency, for example, 24 public secondary
mixed day schools are hampered by poor performance due to lack of adequate facilities
and learning material. Moreover, poverty has led to a significant number of potential
students dropping out school to cater for their basic needs and families. The increasing
gap between rural public mixed day schools and the urban developed boarding schools
prompted the researcher to survey the issues experienced at the lower level. For this
reason, the study investigated the factors relating to the poor performance of the public
mixed day schools. It was guided by the following objectives; determining the role of
leadership styles, assessing the influence of availability of resources, evaluating the role
played by community participation, and establishing the impact of parental socioeconomic
factors towards the performance of public secondary mixed day schools in
Kenya. The study was based on the following theories; the theory of Education
production function and the continuous improvement theory. The research used a
descriptive design. Primary data was collected using questionnaires distributed to the
school management in different schools within the constitution. The data collected was
analyzed using descriptive design. The findings showed that; leadership styles, resources,
and parental socio-economic factors had a significant effect on the performance of public
secondary schools. Community participation had a moderate impact on the dependent
variable. It, therefore, recommends local government action and further research form
future scholars
Influence Market Entry Strategies on Performance of Foreign Fast Food Firms in Nairobi County Kenya
No full textToday’s business environment is dynamic, complex and continually changing hence whichever market entry strategies global companies setting up in a country decide to use must be the most effective and efficient strategy. Fast food business is booming in Kenya attracting both international and local brands making Kenyan consumers to be more and more international. The middle class group in Kenya is growing and as result it attracts international investors to invest in fast food restaurants within the country. The objective of the study was to examine the influence of market entry strategy on performance of foreign fast food firms in Nairobi County Kenya. The study used descriptive cross-sectional survey. The population for this study was 15 foreign fast food firms in Nairobi Kenya. Primary data was used in which questionnaire was adopted. This study was based on primary data that was collected through the questionnaire method. The results revealed that strategic alliance, foreign direct investment and joint venture and franchising influence firm performance at moderate extent while licensing influence firm performance at great extent. The study concludes further that strategic alliance, foreign direct investment and joint venture and franchising influence firm performance at moderate extent. The study recommends that government should come up with laws and policies to ensure proper regulation and governance of the fast food industry in Kenya. This will lay down the guidelines to be followed by the players in the industry to create fair competition practices. The study suggested that other research studies should be done on other multinational companies that adopted market entry strategies and firm performance such as those in the FMCG and in oil sector