Egerton University Abstract: The introduction of government financial instructions and fees guidelines in public secondary schools is aimed at enabling schools attain better efficiency in the management of the available scarce financial resources. However, little information exists on the actual impact and adherence to these instructions, and the resultant coping mechanism adopted by public secondary schools in the country. This study sought to evaluate the impact of government instructions on financial management in public secondary schools. The study adopted an ex post facto research design. It targeted all the head teachers of the 18 public secondary schools within Nakuru municipality. Primary data was collected through administration of a structured questionnaire to the school head teachers. The collected data were processed and analyzed descriptively using percentage, frequencies and tables with the aid of Statistical Package for Social Sciences (SPSS) version 1 1.5 for windows. The study finds that government financial management instructions had limited the power of the schools to arbitrarily determine a.nd control the financing of physical facilities. The instructions regulated investment activities in the schools to avoid wastage of resources, and ensure high returns and accountability. The government instructions had well regulated staff training in the schools to match their needs and resources. The instructions had improved management, transparency and accountability in schools‘ recurrent expenditures. Lack of adequate resources and flexibility are the major challenges to the implementation of government financial management instructions and fees guidelines in the schools. Based on the above findings, the study recommends that there is a need to properly educate and train the head teachers (schools’ chief executives) on the importance and implementation of government financial management instructions and fees guidelines. All schools should engage in income generating activities to supplement their limited financial resources in order to effectively implement the government instructions. Finally, the government instructions are supposed to be flexible in order to take into account the differentiation amongst schools.

Building Information Modelling (BIM) is a technology and a process that has brought changes in the construction procurement system. Kenya lacks contractual guidelines on implementation of BIM, and this makes the adoption of BIM slow and difficult. Previous research on BIM has left a gap in contractual relationships, roles and resulting risks. The purpose of this study was to investigate how contractual roles and responsibilities are affected by BIM in relation to systems and structures. The objectives were to assess BIM adoption, determine underlying components in its adoption, investigate influence of BIM on Engineering Contract Management (ECM) in Nairobi, Kenya and to formulate a BIM adoption and implementation framework. The research was designed as a survey. It targeted an individual within eight strata that comprised of Civil Engineers, Construction Project Managers, Architects, Quantity Surveyors, Mechanical Engineers, Electrical Engineers, Contractors and Facility Managers. Data were collected through self-administered questionnaires with a sample size of 371 and in-depth interviews comprising of 10 knowledgeable persons. Descriptive analysis, correlation analysis, regression analysis and Exploratory Factor Analysis techniques were used to analyse quantitative data. Qualitative data were analyzed thematically. It emerged that BIM adoption level was at 56.6% and shallow understanding of BIM capabilities and the Traditional Procurement System (TPS) remain a barrier to its adoption and implementation. It was also established that BIM improves ECM; that is when time, cost, quality, collaboration and return on investment improve, ECM becomes effective and efficient. The underlying factors found in BIM and ECM relationship were legal implications, awareness and knowledge, efficiency, versatility, mandate and leadership, and competitiveness. Further, the study found out that BIM influence on ECM demands for establishment of standards, guidelines and legal framework which can be achieved by amending the Public Procurement Act. BIM needs a new system to perform in because it conflicts with the traditional system of procurement. The knowledge gained will be important to the construction industry professionals, clients, students, and the government towards the efforts of BIM adoption and implementation in Kenya. The study formulated a BIM adoption and implementation framework.

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Electronic health record system is computerized collection of patient’s information in a digital format. Most hospitals are using manual to enter patient’s information, so with this system of an electronic health record system is used to facilitate sharing patient’s information such medical records, charts, medication, billing and test results. These records can be shared across the different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. Electronic heal record system for several decades has been touted as key to increase of quality care. Electronic health record keeping systems are used for other reasons than charting for patients, providers are using data patients records to improve quality outcomes through their care management programs. Electronic combines all patients’ demographics into large pool, and uses the information to assist with the creation of “new treatments or innovation in health care delivery” which overall improves the goals in health care. Combining multiple types of clinical data from the system’s health records has helped clinicians identify and stratify chronically ill patients. Electronic health record keeping system can improve quality care by using the data and analytics to prevent hospitalizations among high-risk patients. Electronic health record keeping systems are designed to store data accurately and to capture the state of patient across time. It eliminates the need to truck down a patient’s previous paper medical records and assist in ensuring data is up-to-date, accurate and legible. It also allows open communication between the patient and the provider, while providing “privacy and security.” It can reduce risk of data replication as there is only one modifiable file, which means the file is more likely up to date and decreases risk of lost paperwork and is cost efficient. Due to the digital information being searchable and is a single file, Electronic medical record are more effective when extracting medical data for the examination of possible trends and long term changes in a patient. Population-based studies of medical records may also be facilitated by the widespread adoption of electronic health record keeping system.

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Hypertension is a public health problem and a term used to describe HBP. It is a condition that occurs as a result of repeatedly elevated blood pressure exceeding 140 over 90 mmHg whereby a systolic pressure above 140 with a diastolic pressure above 90. However, normal blood pressure is below 120/80; readings between 120/80 and 139/89 is called pre-hypertension. Flow of blood is based on the beat at which the heart pumps blood. The pressure of the heart does not stay at constant level at all times. It varies based on activities an individual do at a particular point in time. Hypertension occurs as a result to long duration of abnormal pressure of the main arteries (Cunha 2011.)Prevention of high blood pressure across all age groups is recognized as the controlling key to hypertension especially in developing countries. Identification of factors associated with hypertension is, an optimum steps to prevention. The purpose of the study was to determine factors associated with hypertension or high blood pressure at Africa Renewal University. Community based cross section survey was conducted so as to get baseline data on the factors associated with hypertension at Africa Renewal University. A total of fifty participants answered both closed and open ended questionnaires. The results of this study suggested that general knowledge of high blood pressure is inadequate at Africa Renewal University. Participants lacked of understanding in the etiology of high blood pressure. For instance: majority of the respondents’ lacked basic understanding of hypertension which was at a total frequency of 32, making 64% of the total respondents. Focus should be on public education in understanding high blood pressure by helping to control it. Findings from this study can assist in health planning programs on factors Associated with hypertension. Health workers need to educate the public on the effects of high blood pressure disease. Awareness must be created that early detection of hypertension is only by screening. The effects of salt reduction can be emphasized on preventing high blood pressure that may intend prevent other cardiovascular diseases. Health workers should increase the individuals control over own health through self-empowerment tool and educational approach.

On 30 January 2020, the World Health Organization (WHO) declared the coronavirus disease 19 (COVID-19) outbreak a public health emergency of international concern requiring global attention and action by heads of state. On the 30th, of March 2020, Uganda confirmed its first SARS-CoV-2 infection in a traveller from the United Arab Emirates. By April 15, 2020, 54 cases had been reported in the country, (Migisha, R., Kwesiga, B., Mirembe, B. B., & Amanya, G., et al…2020). In Uganda, a lockdown was announced by President Yoweri Museveni on 1st April, and it entered into force a few days later after the announcement the lockdown also involved the closure, among others, of universities, and recreational spaces (including sports clubs). To investigate the effects of COVID-19 lockdown effects on behavior change among students of Africa Renewal University. Data collection was collected using both qualitative and quantitative/ methods; quantitative approach was used in order to allow the researcher to gather more accurate and measurable information on the behavior of university students during C-19 lockdown. Qualitative method was used in order to allow respondents to express their thoughts on the effects of Covid-19 lockdown effects on the behavior change. Finding from this study indicate that, during Covid-19 lockdown, majority of students were badly affected by stress, suicidal thoughts and this was at the total frequency of 40, (64%) of the total respondents. Stress is a major risk factor for trauma and behavioral change, when one is stressed, they can do anything in search for happiness and peace of mind. This research reveals that, some students were engaged in uncontrolled sexual activities and this was at the total frequency of 11, (18%). More government intervention and NGOs should be of a crucial factor so as better mechanisms that can be put in place to up lift lockdown policies for example, movement restrictions should be up lifted with strict rules to the use of Masks and washing hands that can allow students to move and associate with families freely. This can reduce on the level of stress, trauma and performance of students.