Solutions for f(R) gravity coupled with electromagnetic field

In the presence of external, linear / nonlinear electromagnetic fields we integrate f(R) \sim R+2{\alpha}\surd(R+const.) gravity equations. In contrast to their Einsteinian cousins the obtained black holes are non-asymptotically flat with a deficit angle. In proper limits we obtain from our general solution the global monopole solution in f(R) gravity. The scale symmetry breaking term adopted as the nonlinear electromagnetic source adjusts the sign of the mass of the resulting black hole to be physical.Comment: 7 pages no figure, final version for publication in European Physical Journal

Identifying and quantifying initial post-discharge needs for clinical review of sick, newborns in Kenya based on a large multi-site, retrospective cohort study

BackgroundProgress in neonatal care has resulted in a 51% decrease in global neonatal mortality rates from 1990 to 2017. Enhanced survival will put pressure on health care systems to provide appropriate post-discharge, follow-up care but the scale of need for such care is poorly defined.MethodsWe conducted a retrospective cohort study of newborns discharged from 23 public hospital neonatal units (NBUs) in Kenya between January 2018 and June 2023 to identify initial follow-up needs. We first determined pragmatic follow-up categories based on survivors’ clinical conditions and morbidities. We then used individual phenotypes of individual babies to assign them to needing one or more forms of specialized clinical follow-up. We use descriptive statistics to estimate proportions of those with specific needs and patterns of need.FindingsAmong 136,249/159,792 (85.3%) neonates discharged, around one-third (33%) were low birth weight (<2,500 g), and a similar 33.4% were preterm (<37 weeks). We estimated 131,351 initial episodes of follow-up would be needed across nine distinct follow-up categories: general pediatrics, nutrition, growth & development (40.4%), auditory screening (38.8%), ophthalmology for retinopathy of prematurity (9.6%), neurology (8.0%), occupational therapy (1.3%), specialized nutrition (0.9%), surgery (0.8%), cardiology (0.2%), and pulmonary (<0.1%). Most neonates met the criteria for two (52.3%, 28,733), followed by three (39.6%, 21,738) and one follow-up episodes (5.6%, 3,098). In addition to prematurity and very low birth weight (≤1,500 g), severe infections with extended gentamicin treatment, severe jaundice managed with phototherapy, and hypoxic-ischemic encephalopathy (HIE) contributed substantially to the pattern of need for post-discharge follow-up.ConclusionsAlmost half of surviving NBU infants have multiple specialty post-discharge follow-up needs. More urgent attention needs to be focused on healthcare planning now to guide strategies to address the varied medical and developmental needs that we outline in resource-constrained contexts like Kenya

Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality

BackgroundReports on hypothermia from high-burden countries like Kenya amongst sick newborns often include few centers or relatively small sample sizes.ObjectivesThis study endeavored to describe: (i) the burden of hypothermia on admission across 21 newborn units in Kenya, (ii) any trend in prevalence of hypothermia over time, (iii) factors associated with hypothermia at admission, and (iv) hypothermia's association with inpatient neonatal mortality.MethodsA retrospective cohort study was conducted from January 2020 to March 2023, focusing on small and sick newborns admitted in 21 NBUs. The primary and secondary outcome measures were the prevalence of hypothermia at admission and mortality during the index admission, respectively. An ordinal logistic regression model was used to estimate the relationship between selected factors and the outcomes cold stress (36.0°C–36.4°C) and hypothermia (<36.0°C). Factors associated with neonatal mortality, including hypothermia defined as body temperature below 36.0°C, were also explored using logistic regression.ResultsA total of 58,804 newborns from newborn units in 21 study hospitals were included in the analysis. Out of these, 47,999 (82%) had their admission temperature recorded and 8,391 (17.5%) had hypothermia. Hypothermia prevalence decreased over the study period while admission temperature documentation increased. Significant associations were found between low birthweight and very low (0–3) APGAR scores with hypothermia at admission. Odds of hypothermia reduced as ambient temperature and month of participation in the Clinical Information Network (a collaborative learning health platform for healthcare improvement) increased. Hypothermia at admission was associated with 35% (OR 1.35, 95% CI 1.22, 1.50) increase in odds of neonatal inpatient death.ConclusionsA substantial proportion of newborns are admitted with hypothermia, indicating a breakdown in warm chain protocols after birth and intra-hospital transport that increases odds of mortality. Urgent implementation of rigorous warm chain protocols, particularly for low-birth-weight babies, is crucial to protect these vulnerable newborns from the detrimental effects of hypothermia

Effect environmental activities on the financial performance of small and medium sized companies in Kenya

This study therefore seeks to analyze the effect of annual cost of environmental activities on the financial performance of small and medium sized enterprises in Kenya. The study is anchored on triple bottom line model and stakeholders’ and corporate social responsibility theories. A descriptive study design has been adopted in order to observe and make inferences on the effect of corporate social activities spending of firm financial performance. The study targets a population of 100 top performing medium sized companies in Kenya because of their rank as best financial performers in the country and their involvement in corporate social responsibility activities. Secondary data was collected by use of data collection form and the data was obtained from annual financial reports for years ending 2014 to 2018. Data was edited, coded and analysed using descriptive and inferential statistics. Results were presented in form of tables and graphs. The study will enable the owners of small and medium sized enterprises to understand the resultant effect of corporate social responsibility on financial performance of small and medium enterprises. It will also aid decision makers to make informed decisions about planning of sustainable objectives and allocation of resources towards achievement of those objectives. Using results from random effects model, revealed annual cost of environmental activities by Small and Medium Sized Enterprises in Kenya can be used to predict the outcome of return on investment as a measure of the SMEs financial performance. When amount spent annually on environmental activities is increased by 1 unit, return on investment also decreases by -5.6109 units with other variables kept constant. This indicated that amount spent annu

THE EFFECT OF ADOPTION OF INTEGRATED FINANCIAL MANAGEMENT INFORMATION SYSTEMS ON THE SUSTAINABILITY OF NGOs IN NAIROBI COUNTY

This study aimed at establishing the effect of adoption of integrated financial management systems on the sustainability of Non-Governmental Organizations in Nairobi County. The study was guided by the resource based view theory and was anchored on a positivist paradigm philosophy. The study employed descriptive research design. Out of a target population of 1000 senior project managers and chief executives, a sample of 285 was obtained using stratified random sampling. Primary data was collected from sampled officers using structured questionnaires, while secondary data was obtained from the audited financial statements of the NGOs and publications by the NGO coordination board. 172 questionnaires were found to be satisfactorily completed for analysis yielding a 60.35% response rate. The data collected was analyzed using descriptive and inferential statistics and it was presented in tables and charts. Statistical Package for Social Scientists (SPSS) was used for data handling and analysis. The descriptive statistics included frequencies, percentages, means and modes, while modelling and inferential statistics included regression and Correlation analysis, Chi square tests and Analysis of Variance (ANOVA). Normality of the response variable (NGO sustainability) data was confirmed using the Shapiro-Wilks test. The study showed that adoption of IFMIS have significant effect on NGO sustainability more so on current ratio and survival ratio. The study concluded that the adoption of IFMIS had enhanced the effectiveness and efficiency in the running of NGOs in Nairobi County and made significant contribution towards managerial support, reduced the data processing costs, reduced possibilities of misappropriation of funds and facilitated remote access which was necessary for effective monitoring and evaluation. The study recommended that the NGOs should be encouraged to adopt the IFMIS in order to improve their efficiency and effectiveness in financial management and financial reporting which is critical factor to the NGO growth and sustainability

An Assessment of the Role of Credit Reference Bureau in Influencing Customer Credit Access in Mitigating Against Credit Default in Commercial Banks in Kenya

The study examined the role of Credit Reference Bureau (CRB) in influencing customer credit access in mitigating default risk among commercial banks in Kenya. The study was based on the theories of Adverse Selection and Hazard. The study used a Causal-Comparative descriptive survey design. The target population of the study consisted of all the 43 licensed commercial banks in Kenya and the three licensed credit reference bureaus in Kenya under the Banking Act. The researcher used a census of all commercial bank headquarters bank managers and the three headquarters credit reference bureau managers. To collect primary data, the researcher used questionnaires. Secondary data were collected from CBK loan books and CBK annual Bank supervisory reports. Data was analysed using SPSS and results presented using graphical systems. The researcher used descriptive statistics, which included the mean, median standard deviation and range to show the default rate. The inferential statistical tests comprised correlation, ANOVA regression and Chi-square analysis to test hypothesis. P -values yielded were less than 0.05, which indicated that the role played by Credit Revenue Bureau in influencing customer access to credit and mitigation of Credit Default Rate was significant among commercial banks in Keny

Role of Credit Reference Bureau in Influencing Customer Repayment Behaviour in Mitigating against Credit Default among Commercial Banks in Kenya

The study examined the role of Credit Reference Bureau (CRB) in influencing customer repayment behaviour in militating against credit default in commercial banks in Kenya. The study was based on the Information asymmetry theory Theory. The study used a Causal-Comparative descriptive survey design in evaluating the role of CRB in influencing customer repayment behaviour in mitigating against credit default in commercial banks in Kenya. The target population of the study consisted of all the 43 licensed commercial banks in Kenya under the Banking Act. The researcher used a census of all the 43 commercial banks in Kenya. Primary data was collected using questionnaires. Secondary data was obtained from CBK loan books and CBK annual Bank supervisory reports. Data was analysed using SPSS and results presented using graphs and tables .The researcher used descriptive statistics and inferential statistics. Inferential statistics comprised correlation, regression and Chi-square. The conclusion was that CRB plays a significant role in customer repayment behaviour in Mitigating against credit default in commercial banks in Kenya

Role of Social Health Insurance towards Universal Health Coverage for East African Community: An Analytical Review

Background: Social Health Insurance (SHI), a health financing model for Universal Health Coverage (UHC), is an organizational mechanism for raising and pooling funds to finance health services, along with tax-financing, private health insurance, community health insurance and others. Objective: To analyze successful experiences, lessons learnt and best practices among selected middle income countries in the efforts of the East African Community member states to attain UHC through SHI. Methods: A 11-year (2009-2019) electronic peer-reviewed articles that met eligibility criteria were collated. PubMed, Medline and Google Scholar search engine. Only papers published in English from the 9 countries (Thailand, Philippines, Colombia, Ghana, Kenya, Tanzania, Uganda, Rwanda and Burundi) were reviewed. A Scoping review methodology was used to improve data validity. Results: A total of 9649 papers were extracted from the databases. 17 studies met all inclusion criteria; Colombia (1) Thailand (2), Philippines (2) Kenya (4) and Ghana (8).11 studies were case control studies, 2 mixed methods, 2 qualitative and 2 systematic reviews. UHC index and indicators were higher in UHC successful countries compared to the EAC countries. Most papers in Ghana discussed a significant progress towards UHC through political stewardship, quality of care, significant expansion of population coverage and financial risk protection with their National Health Insurance though equity, sustainability and enrolment were some of the challenges. Successes of Thailand and Philippines were as a result of political commitment and goodwill, subsidies, increasing funding, adoption of general tax-financed for UHC, access to PHC, quality through accreditation system and earmarked revenue source. In Kenya, progress was made by introduction of civil servants’ schemes, subsidies and expansion of benefit packages while struggling with purchasing reforms, equity, efficiency and sustainability