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Search Results: 1 - 10 of 89590 matches for " Mary W. Kuria "
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Alcohol dependence: Does the composition of the available beverages promote it?  [PDF]
Mary W. Kuria, Yvonne Olando
Open Journal of Psychiatry (OJPsych) , 2012, DOI: 10.4236/ojpsych.2012.24042
Abstract: Affordability and availability of alcohol are factors that have been associated with alcohol dependence. Ethanol content in the alcoholic beverages is an important determinant in alcohol dependence. Quality control of alcoholic beverages available in the market is important in safeguarding the health of alcohol consumers. Few studies in Kenya have determined the chemical composition of alcohol used by the study participants. Objective: To determine the chemical composition of alcoholic beverages used by a group of alcohol dependent study participants. Design: The study was a clinical trial with pre and post measurements. Method: The CIDI and WHO-ASSIST were administered to 188 alcohol-dependent persons at intake and after six months. A researcher-designed socio demographic questionnaire was also administered at intake. Alcohol beverages were randomly collected from the location of the study area and their chemical composition analyzed using gas chromatography. Results: The mean AUDIT score of the participant was 28.6 for male and 26.6 for females. Three of the alcohol samples collected was illicit brews collected while 11 were licit. Four out of the eleven licit brews had ethanol levels that did not complied with the set government standards. Conclusion: Illicit brews with high ethanol content are available in the Kenyan market, while some of the manufacturers of the licit brew do not comply with government set content recommendations.
Factors associated with relapse and remission of alcohol dependent persons after community based treatment  [PDF]
Mary Wangari Kuria
Open Journal of Psychiatry (OJPsych) , 2013, DOI: 10.4236/ojpsych.2013.32025

Knowledge of factors associated with relapse and remission after treatment for alcohol dependence enables the clinician to offer better individualized treatment. It also enables the clinician to predict which patients are likely to relapse and therefore offer appropriate and effective treatment to prevent relapse. Objective: This study sought to determine the factors associated with remission and relapse in a group of alcohol dependent persons undergoing Community Based Detoxification and Rehabilitation of alcohol dependent persons. Method: One hundred and eighty eight (188) persons with Alcohol Use Disorder Identification Test (AUDIT) positive were subjected to outpatient detoxification for 10 days using a pair of ampoules of high potency Vitamin B and C intravenously daily for 3 consecutive days, diazepam 5 mg and carbamazepine 200 mg for 5 and 10 consecutive nights respectively on an outpatient basis. The participants were visited twice a week (at home) by the community based health workers and reviewed once a week by the principal investigator and attended a bimonthly group therapy session conducted in groups of 20 s as part of the rehabilitation process. The groups were converted to self-help groups after 4 months to generate income for the participants. Results: Factors significantly associated with relapse to alcohol use included severity of alcohol use and craving for alcohol at intake and the age of onset of alcohol drinking. Further there was a statistically significant predictive value in the mean score of alcohol related problems in the community based group (health, social, financial and legal). Conclusion: Identifying factors that are associated with relapse after alcohol dependence treatment is likely to improve the effectiveness of treatment and prevent relapse in persons at risk.

The Prevalence of Depression among Family Caregivers of Children with Intellectual Disability in a Rural Setting in Kenya
Margaret Njeri Mbugua,Mary W. Kuria,David M. Ndetei
International Journal of Family Medicine , 2011, DOI: 10.1155/2011/534513
Abstract: Caregivers of children with intellectual disability have a great responsibility that may be stressful. The psychological well-being of the care giver may affect the quality of care given to children with intellectual disability. Objective. The objective of the study was to determine the risk of depression in caregivers of children with intellectual disability. Setting. The study was conducted at Gachie Catholic Parish, Archdiocese of Nairobi (Kenya). Design. Cross sectional, descriptive study. Method. The study was conducted among 114 caregivers registered at the Gachie Parish program (in Kenya) for the intellectual disabled children. A researcher-designed social demographic questionnaire and the Beck depression inventory were administered to those that met the inclusion criteria. Results. Seventy-nine percent (79%) of the caregivers were at risk of clinical depression. Conclusion. Majority of the caregivers of children with intellectual disability were at risk of developing clinical depression. 1. Introduction There is an increased demand on the care givers of children with developmental disability [1] especially when it is intellectual in nature. Intellectual disability is associated with poor communication, academic and social skills that make the child more dependent on the caregiver than the normal child. In the past (in Kenya), the extended family would be available to provide care to an intellectually disabled child easing the burden of care expected from the nuclear family. However, in recent times, there is a shift from extended family to nuclear family. In addition, over the past 2 decades, family units have become smaller [2] and the rate of marriage break down has increased [3]. Though the magnitude of the responsibility depends on the level of intellectual disability, it is greater for those in small nuclear families. It is also important to note that the economic situation in Kenya dictates that people work long hours with little pay especially if they are in nonskilled employment. This coupled with the fact that there are few institutions or organizations that school or take care of the intellectually disabled makes the role of caregivers enormous. The caregivers are usually the mother of the child, elderly family members, or the unemployed members of the family. Such people do not normally plan to be caregivers [4] but find the need unavoidable. In addition, the caregivers do not receive preparation for this role, and, in the process of engaging in the same, they later on find it very demanding [4]. Unlike other carers, the caregiver may
The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence
Mary W. Kuria,David M. Ndetei,Isodore S. Obot,Lincoln I. Khasakhala
ISRN Psychiatry , 2012, DOI: 10.5402/2012/482802
The prevalence of mental disorders in adults in different level general medical facilities in Kenya: a cross-sectional study
David M Ndetei, Lincoln I Khasakhala, Mary W Kuria, Victoria N Mutiso, Francisca A Ongecha-Owuor, Donald A Kokonya
Annals of General Psychiatry , 2009, DOI: 10.1186/1744-859x-8-1
Abstract: This was a descriptive cross-sectional study conducted in 10 health facilities. All the patients in psychiatric wards and clinics were excluded. Stratified and systematic sampling methods were used. Informed consent was obtained from all study participants. Data were collected over a 4-week period in November 2005 using various psychiatric instruments for adults. Descriptive statistics were generated using SPSS V. 11.5.A total of 2,770 male and female inpatients and outpatients participated in the study. In all, 42% of the subjects had symptoms of mild and severe depression. Only 114 (4.1%) subjects had a file or working diagnosis of a psychiatric condition, which included bipolar mood disorder, schizophrenia, psychosis and depression.The 4.1% clinician detection rate for mental disorders means that most psychiatric disorders in general medical facilities remain undiagnosed and thus, unmanaged. This calls for improved diagnostic practices in general medical facilities in Kenya and in other similar countries.Mental disorders are more common in medical than in community settings [1], and some studies report that up to 40% of the patients in general medical and surgical wards are depressed and require treatment [2,3]. This level exceeds the 20 to 25% prevalence rates reported in studies carried out in general outpatient facilities in Kenya [4,5]. The most frequent diagnoses of mental illnesses made in general hospital settings are depression, substance abuse, neurotic stress-related and anxiety disorders, [6] and these are more frequently associated with chronic medical conditions [7-9]. However, since most patients present at health facilities with medical rather than psychiatric complaints, these diagnoses may be missed especially if the levels of somatic symptoms are elevated [10]. This is especially so considering that some chronic medical illnesses and psychiatric disorders may produce similar somatic symptoms [11]. Conversely, almost 60% of psychiatric patients h
The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence
Mary W. Kuria,David M. Ndetei,Isodore S. Obot,Lincoln I. Khasakhala,Betty M. Bagaka,Margaret N. Mbugua,Judy Kamau
ISRN Psychiatry , 2012, DOI: 10.5402/2012/482802
Abstract: The presence of depression in alcohol-dependent persons is likely to influence treatment process and outcomes. Identification of depression is important though not every depressed alcohol-dependent person requires treatment with antidepressants. Understanding the association between depression and alcohol dependence is essential for proper management of alcohol dependence. Objectives. To determine the prevalence of depression among alcohol-dependent persons before and after alcohol detoxification and rehabilitation. Design. Clinical trial with pre-/postmeasurements. Method. The CIDI and WHO-ASSIST were administered to 188 alcohol-dependent persons at intake and after six months. A researcher-designed sociodemographic questionnaire was also administered at intake. Results. The prevalence of depression among alcohol-dependent persons is high (63.8%) with a significant association between depression and the mean AUDIT score. At posttest, depressed participants had a statistically significant craving for alcohol. Conclusion. Alcohol dependence is associated with major depression. 1. Introduction The prevalence of comorbidity of depression and alcohol use disorders (AUD) has been demonstrated in a number of researches [1–4]. Depression in an alcohol-dependent person has been reported to not only lower the resolve to resisting alcohol use, but may also lead to use of alcohol to relive the depressive symptoms [5, 6]. It is important to understand the significance of cooccurrence of depression and alcohol use disorders since this may explain why majority of cases relapse after treatment for alcohol dependence [5, 6]. In addition it may explain why antidepressants have been shown to moderately benefit patients with both depression and alcohol use disorders [7]. In Kenya a study by Ndetei et al. showed that there was positive correlation between major depressive illness, panic disorder, and alcohol abuse among patients admitted at the main referral psychiatric hospital [8]. Although the cooccurrence of depression and alcohol use disorders has been confirmed by several studies, the relationship between the two disorders has been difficult to describe [9]. This cooccurrence is at prevalence rate of 16%–68% [10]. Studies have attempted to differentiate between depressed and nondepressed alcohol-dependent persons with particular focus on the participant’s level of alcohol dependence, demographic characteristics, or illness-related variables. It has been shown that depression is more related to the current alcohol drinking episode than lifetime diagnosis of depression
A Web-Based Pilot Implementation of the Africanized Land Administration Domain Model for Kenya—A Case Study of Nyeri County  [PDF]
David Kuria, Moses Ngigi, Caroline Gikwa, Charles Mundia, Mary Macharia
Journal of Geographic Information System (JGIS) , 2016, DOI: 10.4236/jgis.2016.82016
Abstract: Kenya has amassed a wealth of paper based land information records collected over the duration of more than a century. The National Land Commission (NLC) having the mandate to develop a National Land Information Management System (NLIMS) for Kenya partnered with the Dedan Kimathi University of Technology on a project to develop a pilot LIMS for Nyeri County. A pilot Land Administration System (LAS) has been developed in this work and utilizes an Africanized Land Administration Domain Model (A-LADM) fitted to the Kenyan context. Various processes involved in land administration that required to be automated were identified. Informed by the numbers of applications made for the change of User service, it was picked as the first workflow to be automated. The key outputs of this work were the A-LADM and pilot LAS. The pilot solution uses a webcentric solution, with the data stored and managed centrally from a PostGIS database backend, using the Python Django framework to implement the server side and client side frontend. This solution demonstrates the importance of automating processes and supporting standards based software development. Stakeholder participation is key when implementing systems and 2 workshops are held to capture requirements and validate the developed solution.
Complex Post Traumatic Stress Disorder (PTSD) in Defilement: Case Report  [PDF]
D. A. Kokonya, W. M. Kuria, F. A. Ong’echa, J. M. Mburu, D. M. Ndetei
Open Journal of Psychiatry (OJPsych) , 2014, DOI: 10.4236/ojpsych.2014.43023

We report a case of the debilitating and lifelong complex post traumatic stress disorder. Data on rape/defilement-related complex post traumatic stress disorder (PTSD) is rare due to low reporting rates and misdiagnosis in Kenya. Childhood complex PTSD is compounded by its symptomatic overlap with rape trauma syndrome (RTS) and attention deficit hyperactivity disorder (ADHD). This case demonstrated the difficulties involved in making the correct diagnosis while at the same time it brought to the fore clearly the features of complex PTSD as opposed to ordinary PTSD. Strengths in management depended on making appropriate diagnosis based on concerted efforts by clinicians, comprehensive care, team work, sensitivity to age and sex, winning trust of the child and the care taker among others and bearing in mind the in-ward handling of the trauma by the rape/defilement victims. This case shared a lot with other cases of complex PTSD in its presentation, course of illness, diagnosis and response to management protocol instituted yielding positive results. Using the lessons learnt from this case, her response was satisfactory based on her improved social and occupational functioning. The patient continues to respond well to treatment to date, bearing in mind that her presentation and age within a dysfunctional family background did not offer good prognosis, especially if the management and social support system will not be steadfast and innovative.

Use of insecticide-treated clothes for personal protection against malaria: a community trial
Elizabeth W Kimani, John M Vulule, Isabel W Kuria, Fredrick Mugisha
Malaria Journal , 2006, DOI: 10.1186/1475-2875-5-63
Abstract: This study was done in Dadaab refugee camps, North Eastern Province Kenya between April and August 2002, and involved a total of 198 participants, all refugees of Somali origin. The participants were selected through multi-stage cluster sampling. Half of the participants (treatment group) had their personal clothes worn on a daily basis (Diras, Saris, Jalbaabs, Ma'awis and shirts) and their bedding (sheets and blankets) treated with insecticide (permethrin). The other half (comparison group) had their clothes treated with placebo (plain water). Indoor mosquito density was determined from twelve households belonging to the participants; six in the treatment block and six in the comparison block. During pre-test and post-test, laboratory analysis of blood samples was done, indoor mosquito density determined and questionnaires administered. Using STATA statistical package, tests for significant difference between the two groups were conducted.Use of ITCs reduced both malaria infection rates and indoor mosquito density significantly. The odds of malaria infection in the intervention group were reduced by about 70 percent. The idea of using ITCs for malaria infection control was easily accepted among the refugees and they considered it beneficial. No side effects related to use of the ITCs were observed from the participants.The use of ITCs reduces malaria infection rate and has potential as an appropriate method of malaria control. It is recommended, therefore, that this strategy be considered for use among poor communities like slum dwellers and other underprivileged communities, such as street children and refugees, especially during an influx to malaria-prone regions. Further research on cost-effectiveness and sustainability of this strategy is worthwhile.Malaria is the world's most prevalent vector borne disease. Each year 300 to 500 million clinical cases of malaria occur and at least 1 million people die of malaria each year [1]. About 90 percent of all malaria de
Effect of Age at Harvest and Manure or Fertilizer Application on Quality of Vicia villosa Roth
T.P. Lanyasunya,H.R. Wang,W.O. Ayako,D.M. Kuria
Agricultural Journal , 2013,
Abstract: This study was conducted in Kenya over 15 weeks to determine the effect of manure or fertilizer application on quality of Vicia villosa Roth. After field preparation, 60 plots of 2x2 m2 size were then demarcated and divided into 5 similar units comprising of 4 blocks of 3 plots each and independently allotted to 3 treatments in a Randomized Complete Block (RCB) design. Treatments were: T1-control (No fertilizer), T2 and T3 received beef cattle manure and fertilizer, respectively. All units were planted on the same day and harvested at 6, 8, 10, 12 and 14 weeks, in a sequential manner, starting with unit 1-5. All the blocks in each unit were harvested on the same day and the entire freshly harvested materials (per plot) were weighed. Representative grab samples were collected, chopped to pieces of 2 cm length, mixed and 2 composite samples (500 g each) were then taken for dry matter determination and chemical analysis following standard procedures. Yield of nutrients was also determined. Collected data was stored in MS-Excel and analyzed using SAS. From the results it was observed that, NDF in T1, T2 and T3 increased by 19.7, 14.1 and 19.2% between 6 and 14 weeks, respectively. ANOVA showed that treatment had effect on DMY (r2 = 0.7341; p< 0.01) at 14 weeks but not on CPY (r2 = 0.3705; p>0.05). Mean ME concentration in the forage was not influenced by either manure or fertilizer application. Strong correlation between nutrients and V. villosa age at harvest was observed. It was therefore concluded that, though fertilization had no effect on nutrient content, it improved their overall yield.
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