Search results for: Cyrus Ndungu Kimani

Authors: Hasanzadeh Mehran

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The Cyrus Cylinder, which is a baked clay tablet, was written in 539 BC by order of the Achaemenid king Cyrus. This clay tablet contains orders and is considered a historical document of the humanitarian behaviour of the victorious army during the conquest of Babylon. Some believe that these laws are the first declaration of human rights in the ancient world. After the conquest of Babylon, Cyrus created laws that had never been seen anywhere in history. For this reason, in this article it has been tried to mention the human aspects and the reasons and grounds for the formation of such laws at that time. The origin of the creation of these progressive and humanitarian laws in the Cyrus cylinder should be sought in the cultural roots of civilization and his social and individual teachings.

Keywords: Iran, cyrus, cyrus cylinder, human rights

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Authors: Allan Kiptanui Kimisto, Geoffrey Odhiambo Ongondo, Anastasia Wairimu Muia, Cyrus Ndungu Kimani

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The major challenge to proper sewage sludge treatment processes is the poor understanding of sludge microbiome diversities. This study applied the whole-genome. shotgun metagenomics technique to profile the microbial composition of sewage sludge in two active digestion lagoons at the Nyeri-Kangemi Wastewater Treatment Plant in Nyeri County, Kenya. Total microbial community DNA was extracted from samples using the available ZymoBIOMICS™ DNA Miniprep Kit and sequenced using Shotgun metagenomics. Samples were analyzed using MG-RAST software (Project ID: mgp100988), which allowed for comparing taxonomic diversity before β-diversities studies for Bacteria, Archaea and Eukaryotes. The study identified 57 phyla, 145 classes, 301 orders, 506 families, 963 genera, and 1980 species. Bacteria dominated the microbes and comprised 28 species, 51 classes, 110 orders, 243 families, 597 genera, and 1518 species. The Bacteroides(6.77%) were dominant, followed by Acinetobacter(1.44%) belonging to the Gammaproteobacteria and Acidororax (1.36%), Bacillus (1.24%) and Clostridium (1.02%) belonging to Betaproteobacteria. Archaea recorded 5 phyla, 13 classes, 19 orders, 29 families, 60 genera,and87 species, with the dominant genera being Methanospirillum (16.01%), methanosarcina (15.70%), and Methanoregula(14.80%) and Methanosaeta (8.74%), Methanosphaerula(5.48%) and Methanobrevibacter(5.03%) being the subdominant group. The eukaryotes were the least in abundance and comprised 24 phyla, 81 classes, 301 orders, 506 families, 963 genera, and 980 species. Arabidopsis (4.91%) and Caenorhabditis (4.81%) dominated the eukaryotes, while Dityostelium (3.63%) and Drosophila(2.08%) were the subdominant genera. All these microbes play distinct roles in the anaerobic treatment process of sewage sludge. The local sludge microbial composition and abundance variations may be due to age difference differences between the two digestion lagoons in operation at the plant and the different degradation rales played by the taxa. The information presented in this study can help in the genetic manipulation or formulation of optimal microbial ratios to improve their effectiveness in sewage sludge treatment. This study recommends further research on how the different taxa respond to environmental changes over time and space.

Keywords: shotgun metagenomics, sludge, bacteria, archaea, eukaryotes

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Authors: Seyedeh-Fariba Jahanbin, Hasan Yusefzadeh, Bahram Nabilou, Cyrus Alinia, Cyrus Alinia

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Background: Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran’s general public, the cost-efectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting. Methods: We have measured this cost-efectiveness threshold with the participation of 2854 individuals from fve provinces, each representing an income quintile, using a modifed Time Trade-Of-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire. Results: Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confrmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts. Conclusions: In the health system of Iran, any intervention that is with the incremental cost-efectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-efective.

Keywords: willingness to Pay, QALY, chained-approach, cost-efectiveness threshold, Iran

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Authors: Ezekiel Mwangi, Stephen Kimani, Agnes Mindila

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Usability is one of the key factors that determine the success or failure of any WebGIS (technology normally applied on the internet to analyze and present spatial data on the Internet). However, not all the usability attributes have the same impact on usability. It is, therefore, necessary to prioritize WebGIS usability elements and determine the ones that are more crucial to the success of the WebGIS. This research aims to identify the main elements of WebGIS usability, investigate the order of importance and priority of the usability elements of WebGIS, and propose a WebGIS development framework that incorporates the prioritization of the usability elements. This will be achieved through a literature review. The outcome of this research will help usability specialists and WebGIS developers in determining specific usability elements that should be accorded more emphasis during the design and development of WebGIS.

Keywords: framework, prioritization, usability, WebGIS

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Authors: Edwin Njoroge Kimani, Alan M. Munyao

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Despite Kenya’s status as a regional economic powerhouse, it struggles with economic shocks that expose the consumers. This, however, seems not to affect major cooperates such as those in the telecommunication and energy sectors. Through their operations, they have not only been able to fluctuate prices at will but also they have been accused of curtailing their rivals from penetrating the market. This study, through literature review of the legal and institutional framework, reports and publications interrogates the law and uncovers the following; i) failings of the legal framework to define market dominance and abuse of such positions, ii) the participation of the state, iii) the inertia of the government to prosecute corporations that abuse their market dominance, iv) the role of the state as a market player and as a regulator through the Competition Authority of Kenya. This study concludes that the market distortion is as a result of weak legal and institutional framework as well as conflict of interest by the government. Not much has been researched in the field of competition law the greater East Africa. This research is intended to form part of the growing research in the field and inform legal reform.

Keywords: competition law, economic power, dominance, Kenya

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Authors: Phumlani Msomi, Patrick Nonjola, Patrick Ndungu, James Ramontja

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A series of quaternized poly (2.6 dimethyl – 1.4 phenylene oxide)/ polysulfone (QPPO/PSF) blend anion exchange membrane (AEM) were successfully fabricated and characterized for methanol alkaline fuel cell application. Zinc Oxide (ZnO) nanoparticles were introduced in the polymer matrix to enhance the intrinsic properties of the AEM. To confirm successful fabrication, FT-IR spectroscopy and nuclear magnetic resonance (¹H NMR and HMBC ¹⁵N NMR) were used. The membrane properties were enhanced by the addition of ZnO nanoparticles. The addition of ZnO nanoparticles resulted to a higher ion exchange capacity (IEC) of 3.72 mmol.g⁻¹and a 30-fold ion conductivity (IC) increase of the nanocomposite due to no (zero (0)) methanol permeability at 30 °C and increased water uptake. The QPPO/PSF/2% ZnO composite retained over 80 % of its initial IC when evaluated for alkaline stability at room temperature. The maximum power output reached for the membrane electrode assembly (MEA) constructed with QPPO/PSF/2%ZnO is 69 mW.cm⁻², which is about three times more than the parent QPPO membrane. The above results indicate that QPPO/PSF-ZnO is a good candidate as an anion exchange membrane for fuel cell application.

Keywords: anion exchange membrane, fuel cell, zinc oxide, nanocomposite

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Authors: L. M. Ombaka, R. S. Oosthuizen, P. G. Ndungu, V. O. Nyamori

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Understanding the role of nitrogen species on the catalytic properties of nitrogen-doped carbon nanotubes (N-CNTs) as catalysts supports is critical as nitrogen species influence the support’s properties. To evaluate the influence of pyrrolic nitrogen on the physicochemical properties and catalytic activity of N-CNTs supported Pd (Pd/N-CNTs); N-CNTs containing varying pyrrolic contents were synthesized. The catalysts were characterised by the use of transmission electron microscope (TEM), scanning electron microscope, X-ray photoelectron spectroscopy (XPS), X-ray diffraction, Fourier transform infrared spectroscopy, and temperature programmed reduction. TEM analysis showed that the Pd nanoparticles were mainly located along the defect sites on N-CNTs. XPS analysis revealed that the abundance of Pd0 decreased while that of Pd2+ increased as the quantity of pyrrolic nitrogen increased. The increase of Pd2+ species was accredited to the formation of stable Pd-N coordination complexes which prevented further reduction of Pd2+ to Pd0 during synthesis. The formed Pd-N complexes increased the stability and dispersion of Pd2+ nanoparticles. The selective hydrogenation of nitrobenzophenone to aminobenzophenone over Pd/N-CNTs was compared to that of Pd on carbon nanotubes (Pd/CNTs). Pd/N-CNTs showed a higher catalytic activity and selectivity compared with Pd/CNTs. Pyrrolic nitrogen functional groups significantly promoted the selectivity towards aminobenzophenone formation.

Keywords: pyrrolic N-CNTs, hydrogenation reactions, chemical vapour deposition technique

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Authors: Carolyne Ndungu, Wesley Too, Diana Kassaman

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Diabetes is a global public health problem with an increasing morbidity and mortality rate across the globe. It is reported that 422 million people worldwide have diabetes with type 2 diabetes more common in people of African descent. Whilst prevalence of diabetes is four times more than it was in the last three decades, making it the world's ninth greatest cause of mortality, treatment of complications resulting from poor glycemic control is still high, contributing to poverty level in sub-Saharan. Poor treatment adherence has also been identified as a major contributing factor poor glycemic control among diabetic patients and still remains a significant challenge especially among patients living in rural Kenya. This study therefore seeks to identify gaps, barriers and challenges towards medication non-adherence among diabetic patients on follow-up at Kiambu County Referral Hospital, Kenya. Methods: A cross- sectional descriptive study was carried out at Gatundu Level five Hospital in Kiambu County. The study population consisted of adult patients with type two diabetes mellitus (T2DM) on follow up, at the Diabetes clinic between the month of June to July 2022. Systematic sampling of 200 participants was carried out. Ethical approvals from relevant authorities were done and ethical aspects of the study were also observed. Data analysis is ongoing using logistic regression analysis. Results, recommendations -contribution of this study will be highlighted within the next one month.

Keywords: adherence, diabetes, medication, Kenya

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Authors: Cyrus Addy, Venkata Sriram Siddhardh Nadendla, Kwame Awuah-Offei

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Surface robots in modern underground mine rescue operations suffer from several limitations in enabling a prompt self-rescue. Therefore, the possibility of designing and deploying in-mine robots to expedite miner self-rescue can have a transformative impact on miner safety. These in-mine robots for miner self-rescue can be envisioned to carry out diverse tasks such as object detection, autonomous navigation, and payload delivery. Specifically, this paper investigates the challenges in the design of object detection algorithms for in-mine robots using thermal images, especially to detect people in real-time. A total of 125 thermal images were collected in the Missouri S&T Experimental Mine with the help of student volunteers using the FLIR TG 297 infrared camera, which were pre-processed into training and validation datasets with 100 and 25 images, respectively. Three state-of-the-art, pre-trained real-time object detection models, namely YOLOv5, YOLO-FIRI, and YOLOv8, were considered and re-trained using transfer learning techniques on the training dataset. On the validation dataset, the re-trained YOLOv8 outperforms the re-trained versions of both YOLOv5, and YOLO-FIRI.

Keywords: miner self-rescue, object detection, underground mine, YOLO

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Authors: P. F. Msomi, P. T. Nonjola, P. G. Ndungu, J. Ramontja

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In view of the projected global energy demand and increasing levels of greenhouse gases and pollutants issues have inspired an intense search for alternative new energy technologies, which will provide clean, low cost and environmentally friendly solutions to meet the end user requirements. Alkaline anion exchange membrane fuel cells (AAEMFC) have been recognized as ideal candidates for the generation of such clean energy for future stationary and mobile applications due to their many advantages. The key component of the AAEMFC is the anion exchange membrane (AEM). In this report, a series of quaternized poly (2.6 dimethyl – 1.4 phenylene oxide)/ polysulfone (QPPO/PSF) blend anionic exchange membranes (AEM) were successfully fabricated and characterized for alkaline fuel cell application. Zinc Oxide (ZnO) nanoparticles were introduced in the polymer matrix to enhance the intrinsic properties of the AEM. The characteristic properties of the QPPO/PSF and QPPO/PSF-ZnO blend membrane were investigated with X-ray diffraction (XRD), thermogravimetric analysis (TGA) scanning electron microscope (SEM) and contact angle (CA). To confirm successful quaternisation, FT-IR spectroscopy and proton nuclear magnetic resonance (1H NMR) were used. Other properties such as ion exchange capacity (IEC), water uptake, contact angle and ion conductivity (IC) were also undertaken to check if the prepared nanocomposite materials are suitable for fuel cell application. The membrane intrinsic properties were found to be enhanced by the addition of ZnO nanoparticles. The addition of ZnO nanoparticles resulted to a highest IEC of 3.72 mmol/g and a 30-fold IC increase of the nanocomposite due to its lower methanol permeability. The above results indicate that QPPO/PSF-ZnO is a good candidate for AAEMFC application.

Keywords: anion exchange membrane, fuel cell, zinc oxide nanoparticle, nanocomposite

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Authors: Y. Jeon, A. Bissessur, J. Lin, P. Ndungu

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Most transformers employ the usage of cellulose paper, which has been chemically modified through the Kraft process that acts as an effective insulator. Cellulose ageing and oil degradation are directly linked to fouling of the transformer and accumulation of large quantities of waste insulating paper. In addition to technical difficulties, this proves costly for power utilities to deal with. Currently there are no cost effective method for the rejuvenation of cellulose paper that has been documented nor proposed, since renewal of used insulating paper is implemented as the best option. This study proposes and contrasts different rejuvenation methods of accelerated aged cellulose insulating paper by chemical and bio-bleaching processes. Of the three bleaching methods investigated, two are, conventional chlorine-based sodium hypochlorite (m/v), and chlorine-free hydrogen peroxide (v/v), whilst the third is a bio-bleaching technique that uses a bacterium isolate, Acinetobacter strain V2. Through chemical bleaching, varying the strengths of the bleaching reagents at 0.3 %, 0.6 %, 0.9 %, 1.2 %, 1.5 % and 1.8 % over 4 hrs. were analyzed. Bio-bleaching implemented a bacterium isolate, Acinetobacter strain V2, to bleach the aged Kraft paper over 4 hrs. The determination of the amount of alpha cellulose, degree of polymerization and viscosity carried out on Kraft-cellulose insulating paper before and after bleaching. Overall the investigated techniques of chemical and bio-bleaching were successful and effective in treating degraded and accelerated aged Kraft-cellulose insulating paper, however, to varying extents. Optimum conditions for chemical bleaching were attained at bleaching strengths of 1.2 % (m/v) NaOCl and 1.5 % (v/v) H2O2 yielding alpha cellulose contents of 82.4 % and 80.7 % and degree of polymerizations of 613 and 616 respectively. Bio-bleaching using Acinetobacter strain V2 proved to be the superior technique with alpha cellulose levels of 89.0 % and a degree of polymerization of 620. Chemical bleaching techniques require careful and controlled clean-up treatments as it is chlorine and hydrogen peroxide based while bio-bleaching is an extremely eco-friendly technique.

Keywords: alpha cellulose, bio-bleaching, degree of polymerization, Kraft-cellulose insulating paper, transformer, viscosity

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Authors: Masita Mokeira, Kimani Rita, Obonyo Brian, Kwenda Kennedy, Mugambi Purity, Kirui Joan, Chomba Eric, Orwa Daniel, Waiganjo Peter

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Rugby is a highly intense and physical game requiring speed and strength. The need for physical fitness therefore cannot be over-emphasized. Sports are no longer about lifting weights so as to build muscle. Most professional teams are investing much more in the sport in terms of time, equipment and other resources. To play competitively, Kenyan players may therefore need to complement their ‘home-grown’ and sometimes ad-hoc training and nutrition regimes with carefully measured strength and conditioning, diet, nutrition, and supplementation. Nokia Research Center and University of Nairobi conducted an exploratory study on needs and behaviours surrounding sports in Africa. Rugby being one sport that is gaining ground in Kenya was selected as the main focus. The end goal of the research was to identify areas where mobile technology could be used to address gaps, challenges and/or unmet needs. Themes such as information gap, social culture, growth, and development, revenue flow, and technology adoption among others emerged about the sport. From the growth and development theme, it was clear that as rugby continues to grow in the country, teams, coaches, and players are employing interesting techniques both in training and playing. Though some of these techniques are indeed scientific, those employing them are sometimes not fully aware of their scientific basis. A further case study on sports science in rugby in Kenya focusing on physical fitness and nutrition revealed interesting findings. This paper discusses findings on emerging adoption of techniques in managing physiological and nutritional needs of rugby players across different levels of rugby in Kenya namely high school, club and national levels.

Keywords: rugby, nutrition, physiological needs, sports science

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Authors: Sofya Komarova, Frashia Ndungu, Alessia Gavazzoli, Roberta Mineo

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Modern society requires people to be flexible and to develop innovative solutions to unexpected situations. Creativity refers to the “interaction among aptitude, process, and the environment by which an individual or group produces a perceptible product that is both novel and useful as defined within a social context”. It allows humans to produce novel ideas, generate new solutions, and express themselves uniquely. Only a few scientific studies have examined group dynamics' influence on individuals' creativity. There exist some gaps in the research on creative thinking, such as the fact that collaborative effort frequently results in the enhanced production of new information and knowledge. Therefore, it is critical to evaluate creativity via social settings. The study aimed at exploring the group dynamics of young adults in small group settings and the influence of these dynamics on their creativity. The study included 30 participants aged 20 to 25 who were attending university after completing a bachelor's degree. The participants were divided into groups of three, in gender homogenous and heterogeneous groups. The groups’ creative task was tied to the Lego mosaic created for the Scintillae laboratory at the Reggio Children Foundation. Group dynamics were operationalized into patterns of behaviors classified into three major categories: 1) Social Interactions, 2) Play, and 3) Distraction. Data were collected through audio and video recording and observation. The qualitative data were converted into quantitative data using the observational coding system; then, they were analyzed, revealing correlations between behaviors using median points and averages. For each participant and group, the percentages of represented behavior signals were computed. The findings revealed a link between social interaction, creative thinking, and creative activities. Other findings revealed that the more intense the social interaction, the lower the amount of creativity demonstrated. This study bridges the research gap between group dynamics and creativity. The approach calls for further research on the relationship between creativity and social interaction.

Keywords: group dynamics, creative thinking, creative action, social interactions, group play

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Authors: Pui Hong Chung, Wing Chi Ho, Jun Li, Cyrus Leung, Ek Yeoh

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Background: Cigarette smoking is associated with poor tuberculosis (TB) outcomes in terms of progression of active TB, relapse of TB and TB-related mortality, but the association with latent tuberculosis infection (LTBI) is unclear. The systematic review conducted aimed at studying the association between active smoking and LTBI, and likelihood of dose-response relationship. Methods: Two independent reviewers searched three electronic databases comprising PudMed, Medline by EBSCOHOST, ExcerptaMedica Database (EMBASE), from inception up to 31st Dec 2015 for studies reporting data on current smoking and the LTBI with tuberculin skin test (TST) or interferon-γ release assays (IGRAs) results, comparing the odds ratios (ORs) of outcome measure of TST or IGRAs among current smokers with 95% confidence intervals (CI). Results: Seven studies were identified, including six cross-sectional studies and one longitudinal cohort study. The outcome measures from three studies were in TST, three studies in IGRAs and one for both tests. For TST, OR ranging from 1.39 to 3.40 (95% CI) with all studies shown positive association between cigarette smoking and LTBI. For IGRAs, OR ranging from 0.47 to 1.89 (95% CI) with one study shown the negative association that might be related to impaired interferon-gamma production in immunosuppressive persons. One identified study demonstrated positive dose-response relationship in TST result. Conclusions: Cigarette smoking is likely to be a risk factor of LTBI. There is the important implication for TB and tobacco control program to halt TB by empowering public health policy. Further study is also needed to provide more evidence of the dose-response model/relationship.

Keywords: latent tuberculosis infection, systematic review, active smoking, model

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Authors: Md. Ehsan, Cyrus Ashok Arupratan Atis

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Significantly lower cost, bulk availability, absence of identification color additives and relative ease of mixing with fuels have made gas-field condensates a lucrative option as adulterant for gasoline in Bangladesh. Widespread adulteration of fuels with gas-field condensates being a problem existing mainly in developing countries like Bangladesh, Nigeria etc., research works regarding the effect of such fuel adulteration are very limited. Since the properties of the gas-field condensate vary widely depending on geographical location, studies need to be based on local condensate feeds. This study quantitatively evaluates the effects of blending of gas-field condensates with gasoline(octane) in terms of - fuel properties, engine performance and exhaust emission. Condensate samples collected from Kailashtila gas field were blended with octane, ranging from 30% to 75% by volume. However for blends with above 60% condensate, cold starting of engine became difficult. Investigation revealed that the condensate samples had significantly higher distillation temperatures compared to octane, but were not far different in terms of heating value and carbon residues. Engine tests showed Kailashtila blends performing quite similar to octane in terms of power and thermal efficiency. No noticeable knocking was observed from in-cylinder pressure traces. For all the gasoline-condensate blends the test engine ran with relatively leaner air-fuel mixture delivering slightly lower CO emissions but HC and NOx emissions were similar to octane. Road trials of a test vehicle in real traffic condition and on a standard gradient using 50%(v/v) gasoline-condensate blend were also carried out. The test vehicle did not exhibit any noticeable difference in drivability compared to octane.

Keywords: condensates, engine performance, fuel adulteration, gasoline-condensate blends

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Authors: John M. Kimani, Joseph K. N. Kuria, Stephen G. Kiama

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The spiny mouse (Acomys species) is a precocial rodent that has emerged as an interesting mammal model for various organ regeneration studies due to its remarkable ability to restore all tissues in punched ear holes and injured skin. There is a scarcity of information regarding neonatal and postnatal skin development in precocial mammals in comparison to other close relatives in the altricial-precocial spectrum. The varying developmental degrees of neonates and how they relate to adults are the focus of this study. The study compares neonatal characteristics and postnatal skin development in Acomys Percival to its close relative Lophuromys zena (Lophuromys flavipunctatus group) in the Deomyinae subfamily to establish their neonatal maturity status and growth pattern. Breeding colonies of A. percivali, L. zena and Mus musculus were established. The off-springs postnatal stages of structural dorsal and auricular skin development were studied where manifesting external features established through gross examination were used to unravel histogenesis of skin in neonates and aged groups. Skin specimens from the different rodents showed striking differences between the neonatal and aged groups. Moreover, the skin structure also exhibited considerable inter-species differences at the same postnatal time points but followed similar development patterns to maturity. The integument of the newborn A. Percival was the most advanced in development compared to the in-between nidicolous semi-precocial young of L. zena with a rapid postnatal development pattern and the altricial M. musculus, where most maturation of the integumentary system occurred in a prolonged postnatal period. We then utilized a 4-mm ear punch assay to compare the ability to replace auricular tissue and the rate of pinnal hole closure. L. zena closed the pinnal hole at a faster rate compared A. percivali. Taken together, our findings support the conclusion that neonatal maturity status and developmental patterns are not directly related to regenerative ability. This study deepens the understanding of skin morphogenesis across developmental, regenerative and evolutionary levels in mammals.

Keywords: altricial, intermediate, precocial, skin development, regeneration

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Authors: Ghulamhossein Nezami

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Civilizations based in Iran, especially in the south, have always realized the all-around importance of the Persian Sea and for various reasons, have paid full attention to it. The first of these was the pre-Aryan government, Ilam in the coastal province of Sharihum and the city of Lian (now the port of Bushehr) in terms of trade, defense and religion. With the establishment of the Achaemenids on the entire plateau of Iran to the center of Persia, they created several communication routes from Parseh to the shores of the Persian Gulf, which ended in the present Bushehr province. This coastal area was extended by a road in the coastal plain to the more southern parts of the ports of Ausinze - according to Ptolemy the port of Siraf before the Sassanids - and Epstane and Hormozia in the present-day Strait of Hormuz. Meanwhile, the ancient city of Temukknana, whose new historical documents testify to its extraordinary importance in the Achaemenid period, especially Darius I of the Achaemenids, from a strategic position with the coastal areas, the coasts and on the other hand with the gamers, the political center. - Achaemenid administration, had. New archeological evidence, research, and excavations show that both the famous Achaemenid kings and courtiers paid special attention to Tamukknana. The discovery of a tomb and three Achaemenid palaces from before the reign of Cyrus to Xerxes in this region showed the importance of the strategic, security-defense and commercial position of this region, extraordinary for the Achaemenids. Therefore, the city of Temukkana in the Dashtestan region of present-day Bushehr province became an important Achaemenid center on the Persian Gulf coast and became the political-economic center of gravity of the Achaemenids and the regulator of communication networks on the Persian Gulf coast. This event showed that the Achaemenids attached importance to their economic goals and oversight of their vast territory by the Persian Gulf. Methods: Book resources and field study.

Keywords: Achaemenids, Bushehr, Persian Gulf, Tamukkana

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Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

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Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

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Authors: Kushal Patel, Manasa Dittakavi, Cyrus Falsafi, Gretchen Lovett

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Rural America has seen a surge in opioid addiction rates and overdose deaths in recent years, becoming a significant public health crisis. This may be due to a variety of factors, such as lack of access to healthcare or other economic and social factors that can contribute to addiction such as poverty, unemployment, and social isolation. As the opioid epidemic has disproportionately affected rural communities, pregnant women in these areas may be highly susceptible and face additional difficulties in facing the appropriate care they need. Opioid use disorder has many negative effects on prenatal infants. These include changes in their microbiome, mental health, neurodevelopment and cognition. These can affect how the child performs in various activities in life and how they interact with others. It has been demonstrated that using cognitive behavioral therapy improves not just pain-related results but also mobility, quality of life, disability, and mood outcomes. This indicates that cognitive behavioral therapy (CBT) may be a useful therapeutic strategy for enhancing general health and wellbeing in people with opioid use problems. In terms of treating psychiatric diseases, CBT carries fewer dangers than opioids. One study that illustrates the potential for CBT to promote a reduction in opioid use disorder used self-reported drug use patterns 6 months prior to and during their pregnancy. At the beginning of the study, participants reported an average of 3.78 drug or alcohol use days in the previous 28 days, which decreased to 1.63 days after treatment. The study also found a decrease in depression scores, as measured by IDS scores, from 23.9 to 17.1 at the end of treatment. These and other results show that CBT can have meaningful impacts on pregnant women in Rural America who struggle with an opioid use disorder. This project has been approved by the West Virginia School of Osteopathic Medicine- Office of Research and Sponsored Programs and deemed non-research scholarly work.

Keywords: appalachia, CBT, opiods, pregnancy

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Authors: Pui Hong Chung, Cyrus Leung, Jun Li, Kin On Kwok, Ek Yeoh

Abstract:

Introduction: Studies for TB control in intermediate tuberculosis burden countries (IBCs) comprise a relatively small proportion in TB control literature, as compared to the effort put in high and low burden counterparts. It currently lacks of consensus in the optimal weapons and strategies we can use to combat TB in IBCs; guidelines of TB control are inadequate and thus posing a great obstacle in eliminating TB in these countries. To fill-in the research and services gap, we need to summarize the findings of the effort in this regard and to seek consensus in terms of policy making for TB control, we have devised a series of scoping and Delphi studies for these purposes. Method: The scoping and Delphi studies are conducted in parallel to feed information for each other. Before the Delphi iterations, we have invited three local experts in TB control in Hong Kong to participate in the pre-assessment round of the Delphi study to comments on the validity, relevance, and clarity of the Delphi questionnaire. Result: Two scoping studies, regarding LTBI control in health care workers in IBCs and TB control in elderly of IBCs respectively, have been conducted. The result of these two studies is used as the foundation for developing the Delphi questionnaire, which tapped on seven areas of question, namely: characteristics of IBCs, adequacy of research and services in LTBI control in IBCs, importance and feasibility of interventions for TB control and prevention in hospital, screening and treatment of LTBI in community, reasons of refusal to/ default from LTBI treatment, medical adherence of LTBI treatment, and importance and feasibility of interventions for TB control and prevention in elderly in IBCs. The local experts also commented on the two scoping studies conducted, thus act as the sixth phase of expert consultation in Arksey and O’Malley framework of scoping studies, to either nourish the scope and strategies used in these studies or to supplement ideas for further scoping or systematic review studies. In the subsequent stage, an international expert panel, comprised of 15 to 20 experts from IBCs in Western Pacific Region, will be recruited to join the two-round anonymous Delphi iterations. Four categories of TB control experts, namely clinicians, policy makers, microbiologists/ laboratory personnel, and public health clinicians will be our target groups. A consensus level of 80% is used to determine the achievement of consensus on particular issues. Key messages: 1. Scoping review and Delphi method are useful to identify gaps and then achieve consensus in research. 2. Lots of resources are put in the high burden countries now. However, the usually neglected intermediate-burden countries with TB is an indispensable part for achieving the ambitious WHO End TB 2035 target.

Keywords: dephi questionnaire, tuberculosis, WHO, latent TB infection

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