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Sinclair J.,John Muir Medical Center | Otieno E.,UJAMAA Africa | Mulinge M.,United States International University Africa | Kapphahn C.,Stanford University | Golden N.H.,Stanford University
Journal of Adolescent Health | Year: 2013

Purpose: To determine the effect of a standardized 6-week self-defense program on the incidence of sexual assault in adolescent high school girls in an urban slum in Nairobi, Kenya. Methods: Population-based survey of 522 high school girls in the Korogocho-Kariobangi locations in Nairobi, Kenya, at baseline and 10 months later. Subjects were assigned by school attended to either a "No Means No Worldwide" self-defense course (eight schools; N = 402) or to a life-skills class (two schools; N = 120). Both the intervention and the life-skills classes were taught in the schools by trained instructors. Participants were administered the same survey at baseline and follow-up. Results: A total of 522 girls (mean age, 16.7 ± 1.5 years; range, 14-21 years) completed surveys at baseline, and 489 at 10-month follow-up. At baseline, 24.5% reported sexual assault in the prior year, with the majority (90%) reporting assault by someone known to them (boyfriend, 52%; relative, 17%; neighbor, 15%; teacher or pastor, 6%). In the self-defense intervention group, the incidence of sexual assault decreased from 24.6% at baseline to 9.2% at follow-up (p <.001), in contrast to the control group, in which the incidence remained unchanged (24.2% at baseline and 23.1% at follow-up; p =.10). Over half the girls in the intervention group reported having used the self-defense skills to avert sexual assault in the year after the training. Rates of disclosure increased in the intervention group, but not in controls. Conclusions: A standardized 6-week self-defense program is effective in reducing the incidence of sexual assault in slum-dwelling high school girls in Nairobi, Kenya. © 2013 Society for Adolescent Health and Medicine. All rights reserved.

Campagne P.,United States International University Africa | Smouse P.E.,Rutgers University | Pasquet R.,University Paris - Sud | Silvain J.-F.,University Paris - Sud | And 2 more authors.
Evolutionary Applications | Year: 2016

Transgenic crops expressing Bacillus thuringiensis (Bt) toxins have been widely and successfully deployed for the control of target pests, while allowing a substantial reduction in insecticide use. The evolution of resistance (a heritable decrease in susceptibility to Bt toxins) can pose a threat to sustained control of target pests, but a high-dose refuge (HDR) management strategy has been key to delaying countervailing evolution of Bt resistance. The HDR strategy relies on the mating frequency between susceptible and resistant individuals, so either partial dominance of resistant alleles or nonrandom mating in the pest population itself could elevate the pace of resistance evolution. Using classic Wright-Fisher genetic models, we investigated the impact of deviations from standard refuge model assumptions on resistance evolution in the pest populations. We show that when Bt selection is strong, even deviations from random mating and/or strictly recessive resistance that are below the threshold of detection can yield dramatic increases in the pace of resistance evolution. Resistance evolution is hastened whenever the order of magnitude of model violations exceeds the initial frequency of resistant alleles. We also show that the existence of a fitness cost for resistant individuals on the refuge crop cannot easily overcome the effect of violated HDR assumptions. We propose a parametrically explicit framework that enables both comparison of various field situations and model inference. Using this model, we propose novel empiric estimators of the pace of resistance evolution (and time to loss of control), whose simple calculation relies on the observed change in resistance allele frequency. © 2015 The Authors. Evolutionary Applications published by John Wiley & Sons Ltd..

Macharia J.,United States International University Africa | Nyakwende E.,North West University South Africa
Asian Journal of Information Technology | Year: 2010

Universities round the world are transitioning to innovative and better e-mail systems with the aim of attaining improved student output and interaction than ever before. Studies have shown that this expectation usually fails since technology deployment does not necessarily lead to utilization for improved learning and teaching. To understand this failure in enhancement of student productivity and learning outcomes, this study investigates the factors in students learning that affect the adoption and diffusion of e-mail in institutions of higher learning. This was done by modelling the relationships between variables that influence e-mail use and learning, using Technology Acceptance Model (TAM). This study sampled 1092 male and female responses via a cross-sectional survey instrument. The sample drew from public and private universities students using e-mail systems in their universities in Kenya. The results show that voluntariness influences the diffusion of e-mail and its use and consequently students learning. Further Perceived Usefulness (PU), Perceived Ease of Use (PEOU) and Perceived enjoyment of e-mail systems are related to their use. The contribution of thisstudy lies in positing e-mail effects on student learning can improve if vendors develop user friendly and easy to use e-mail systems. This can minimize variations in e-mail use and consequently leverage e-mail usage as a tool that enhances student learning in an educational setup. © Medwell Journals, 2010.

Kirigia J.M.,World Health Organization | Muthuri R.D.K.,United States International University Africa | Nabyonga-Orem J.,World Health Organization | Kirigia D.G.,KEMRI Wellcome Trust Research Programme
BMC Public Health | Year: 2015

Background: Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is "by 2030, end preventable deaths of new-borns and children under 5 years of age". There is urgent need for increased advocacy among governments, the private sector and development partners to provide the resources needed to build resilient national health systems to deliver an integrated package of people-centred interventions to end preventable child morbidity and mortality and other structures to address all the basic needs for a healthy population. The specific objective of this study was to estimate expected/future productivity losses from child deaths in the WHO African Region in 2013 for use in advocacy for increased investments in child health services and other basic services that address children's welfare. Methods: A cost-of-illness method was used to estimate future non-health GDP losses related to child deaths. Future non-health GDP losses were discounted at 3 %. The analysis was undertaken with the countries categorized under three income groups: Group 1 consisted of nine high and upper middle income countries, Group 2 of 13 lower middle income countries, and Group 3 of 25 low income countries. One-way sensitivity analysis at 5 % and 10 % discount rates assessed the impact of the expected non-health GDP loss. Results: The discounted value of future non-health GDP loss due to the deaths of children under 5 years old in 2013 will be in the order of Int$ 150.3 billion. Approximately 27.3 % of the loss will be borne by Group 1 countries, 47.1 % by Group 2 and 25.7 % by Group 3. The average non-health GDP lost per child death will be Int$ 174 310 for Group 1, Int$ 57 584 for Group 2 and Int$ 25 508 for Group 3. Conclusions: It is estimated that the African Region will incur a loss of approximately 6 % of its non-health GDP from the future years of life lost among the 2 976 000 child deaths that occurred in 2013. Therefore, countries and development partners should in solidarity sustainably provide the resources essential to build resilient national health systems and systems to address the determinants of health and meet the other basic needs such as for clothing, education, food, shelter, sanitation and clean water to end preventable child morbidity and mortality. © 2015 Kirigia et al.

Sarnquist C.,Stanford University | Omondi B.,UJAMAA Africa | Sinclair J.,John Muir Medical Center | Sinclair J.,UJAMAA United States of America | And 4 more authors.
Pediatrics | Year: 2014

BACKGROUND AND OBJECTIVE: Sexual assault is a major cause of injury, unplanned pregnancy, HIV infection, and mental health problems worldwide. In parts of sub-Saharan Africa, sexual assault has reached epidemic proportions. This study evaluated the efficacy of an empowerment and self-defense intervention for adolescent girls to decrease the incidence of sexual assault and harassment in Nairobi's large informal settlements. METHODS: A prospective cohort of 1978 adolescents from 4 neighborhoods near Nairobi were taught empowerment, deescalation, and selfdefense skills in six 2-hour sessions. The standard-of-care (SOC) group (n = 428) received a life skills class. Self-reported, anonymous survey data were collected at baseline and 10.5 months after intervention. RESULTS: Annual sexual assault rates decreased from 17.9/100 personyears at baseline to 11.1 at follow-up (rate ratio = 1.61; 95% confidence interval [CI], 1.26-1.86; P , .001); there was no significant change in the SOC group (14.3 to 14.0, rate ratio = 1.02; 95% CI, 0.67-1.57, P = .92). Sexual assault disclosure in the intervention group increased from 56% to 75% (P = .006), compared with a constant incidence of disclosure (53%) in the SOC group. The majority (52.3%) of adolescents in the intervention group reported using skills learned to stop an assault. CONCLUSIONS: This intervention decreased sexual assault rates among adolescent girls in Kenya. The intervention was also associated with an increase in the disclosure of assaults, thereby enabling survivors to seek care and support and possibly leading to the identification and prosecution of perpetrators. This model should be adaptable to other settings both in Africa and globally. Copyright © 2014 by the American Academy of Pediatrics.

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