http://ir.mu.ac.ke:8080/jspui/handle/123456789/45 2026-08-05T10:31:42Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10415 Title: Determinants of ultrasonography training outcomes among radiography diploma students in selected Kenya Medical Training Colleges, in Kenya public hospitals Authors: Chebet, Nancy Chepkwony Abstract: Background: Ultrasound technology has become an effective clinical diagnostic tool in low and middle income countries (LMICs) to meet the objectives of improved primary health care (PHC). However, availability of ultrasound machines and skill training needed continue to limit expanded use of ultrasound in LMICs. In Kenya, concerns have been raised over the quality of work output of sonographers and clinicians practicing ultrasound (Kagima et al., 2021). All these increase the risks of poor diagnosis and patient management and could result in increased morbidity and preventable deaths. This can be attributed to the quality of training and student related factors. Objectives: To determine how students ‘perception of curriculum space limitations affect ultrasonography training outcomes, to analyze how availability of ultrasound machines for training affects ultrasonography training outcomes and to examine how students attitudes on training moderates the relationship between institutional factors and ultrasonography training outcomes. Methods: Study was carried out using a mixed research approach employing both qualitative and quantitative methods. It targeted five Kenya Medical Training College (KMTC) campuses offering the radiography course that are based in four county (Level 6) and one level 5 teaching hospitals in the country, that is, Nakuru, Uasin Gishu, Nairobi Kisumu and Kericho respectively. The target population were final year KMTC students undertaking their radiography and imaging course, the faculty members and the hospital-based instructors. Systematic random sampling was used to select 98 students, of who 45 are females and 53 males, while the census method was used to select 26 faculty members and 10 hospital-based instructors. Questionnaires for students, interview schedules for lecturers, hospital-based instructors and Focus Group discussions for students were used for data collection. Quantitative data from the questionnaire were analyzed using both descriptive and inferential data analysis. Results: Students’ perception of curriculum space limitations did not significantly affect ultrasonography training outcomes. Availability of ultrasound machines for training significantly affects ultrasonography training outcomes and Students attitudes had a significant moderating effect on the relationship between institutional factors and ultrasonography training outcomes among diploma Radiography students. Conclusions: Students’ perception of curriculum space limitations did not have a statistically significant effect on ultrasonography training outcomes. Availability of ultrasound machines for training had a statistically significant effect on ultrasonography training outcomes. Recommendations: College management should establish clear guidelines and prerequisites for ultrasound training, ensuring that only students from relevant medical imaging or ultrasonography programs are prioritized. To address students’ lack of confidence in using the simulators for training, a blended training approach is recommended, where simulators are used to build foundational skills before transitioning to human models. Further, greater emphasis should be placed on mentorship, career guidance, and the long-term relevance of radiography and sonography careers to boost student motivation. 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10395 Title: Prevalence of occupational stress and associated factors among teachers in selected secondary schools in Uasin Gishu County, Kenya Authors: Jesang, Angela Abstract: Background: Teachers often encounter a variety of challenges in their profession, such as excessive workloads, demanding administrative responsibilities, disruptive student behavior, insufficient teaching materials, and limited access to support systems. These challenges can result in high levels of work-related stress, which, if left unmanaged, may adversely affect teachers’ psychological health, job satisfaction, and general well-being. The issue of occupational stress is particularly significant among secondary school teachers in Uasin Gishu County, Kenya. The primary sources of this stress include overwhelming responsibilities, bureaucratic pressures, difficulties with student discipline, lack of adequate teaching resources, and insufficient institutional support. Objectives: To determine the prevalence of occupational stress, assess factors associated with occupational stress among teachers, and explore mitigation strategies for stress. Methodology: This research utilized a mixed-methods cross-sectional design. The target population consisted of 537 secondary school teachers, from which a sample of 253 participants was drawn. A multistage sampling approach was implemented, beginning with the purposive selection of six sub-counties within Uasin Gishu County. From each sub-county, two schools were selected. Participants were then proportionally allocated across the 12 selected schools, followed by the use of consequtive sampling to identify the 253 teachers who took part in the study. Data collection involved the use of structured questionnaires for the teachers and interview guides for the school principals. Both quantitative and qualitative techniques were applied in the analysis of the collected data. Quantitative data were analyzed using descriptive statistics such as means, standard deviations, frequencies, and percentages. Chi-square tests were conducted to explore associations between variables, and findings were presented through tables and figures. For the qualitative data, thematic analysis was employed, with emerging themes identified and organized into categories aligned with the study’s research questions. Results: Summary statistics from a sample of 224 respondents revealed a balanced gender representation (48.2% male, 51.8% female) and a predominantly young workforce, with 62.5% of participants aged 35 years or younger. Most respondents held undergraduate degrees (58.0%) and possessed 6–10 years of professional experience (40.2%). The findings revealed a high prevalence of occupational stress, with 71.4% of teachers reporting moderate (38.8%) to high (32.6%) stress levels. Key stressors identified included heavy workloads (Mean= 4.22), emotional demands (mean= 4.18), and work-life imbalance (mean= 4.17). Disaggregated data analysis indicated a statistically significant association between gender and stress (p = 0.003), with female teachers reporting higher levels of moderate stress compared to males. Work experience also showed a significant correlation (p = 0.020), with mid-career teachers (6–10 years) being the most affected. Conversely, age, education level, school type, and residence did not show significant associations (p > 0.05). Qualitative themes highlighted a lack of clear implementation roadmaps and inadequate training as primary CBE-related stressors. Conclusions: Educators experience significant stress stemming from numerous job-related issues such as excessive workloads, difficulties in managing students, and pressure from administrative responsibilities. The findings indicate that both personal characteristics and professional conditions contribute to occupational stress among teachers. Additionally, the study found that teachers employ a range of individual and organizational approaches to cope with and reduce work-related stress. Recommendations: To address the high prevalence of occupational stress among teachers, it is recommended that schools and educational institutions implement comprehensive mental health programs such as Mental Health Awareness and Education Programs, and Stress Management and Resilience Training, to support teachers. 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10262 Title: Confronting the TB-HIV syndemic in adolescents and young adults: a call to action in a time of Ccrisis Authors: A. Enane, Leslie; Leonard, Adam; Diero, Lameck; Marcy, Olivier; Marcel Yotebieng, Marcel 2026-03-17T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10243 Title: Adequacy of analgesic practices among adult patients undergoing Laparotomy at Moi Teaching and Referral Hospital, Eldoret, Kenya. Authors: Njue, Gladys Kezziah M Abstract: Background: The prevalence of moderate to severe postoperative pain is estimated to be up to 100% in sub-Saharan Africa. Undertreatment is associated with physiological and psychological complications which can prolong recovery, lengthen hospitalization and add economic strain to patients and health care system. Adequate analgesia following surgery is generally considered when the visual analogue pain score (VAS) is ≤ 3. Faced with rising laparotomy rate at MTRH, lack of published data and absence of a procedure specific pain management guideline, the magnitude of acute postoperative pain and adequacy of analgesia practices remained unknown. Objective: To determine the adequacy of analgesia practices used in management of acute postoperative pain among adult patients who undergo laparotomy at MTRH, Eldoret, Kenya by establishing acute pain severity, identifying and evaluating the adequacy of pain-relieving modalities. Methods: The descriptive study was conducted among 241 participants who underwent laparotomy during the study period. The sample size was 241 people enrolled systematically. Participants were followed at different intervals including, at the postanesthetic care unit (PACU), at 24- and 48-hours. Data was collected through patients’ interviews, review of anesthetic charts and treatment sheets, to complete a structured questionnaire. The independent variables were demographic and clinical data (Elective/Emergency), types of analgesics and techniques of administration. The dependent variable of interest was pain severity. STATA version 16 software was used for analysis. Categorical data was summarized and findings presented in figures, corresponding percentages and tables. The study was conducted at 0.05 α level of significance. Pertinent ethical approvals were obtained. Results: The mean age of participants was 45.4 years with a female predominance. Majority of laparotomies were performed emergently (97.1%), with most common abdominal procedure being, exploratory laparotomy (41.9%). The proportion of patients with moderate or severe pain at PACU, 24 hours and 48 hours intervals, was 56%, 17% and 6.2%, respectively. The Conchran – Armitage test showed a statistically significant (P< 0.001) linear trend in pain score across the assessment periods. Paracetamol and tramadol were the most used combination at both 24 (31.1%) and 48 (28.9%) hours intervals. Conclusion: Postoperative pain management at MTRH is inadequate, as evidenced by many patients experiencing acute moderate to severe pain. A narrow range of opioid based systemic analgesics are used. Recommendation: Incorporation of additional interventions (such as adjuvant analgesics) and techniques (such as nerve blocks, epidural analgesia, cognitive behavioral therapy) with the goal of achieving VAS ≤ 3 post-operatively. Further research is needed to explore factors influencing post-operative pain management (comorbidities, anesthesia used, health care provider or system related factors). 2026-01-01T00:00:00Z