BackgroundAs countries scale up adult voluntary medical male circumcision (VMMC) for HIV prevention, they are looking ahead to long term sustainable strategies, including introduction of early infant male circumcision (EIMC). Although a number of devices for EIMC are prequalified by the World Health Organization, evaluation of additional devices can provide policy-makers and clinicians the information required to make informed decisions. We undertook a field evaluation of the safety and acceptability of the AccuCirc device in Kisumu County, Kenya.MethodsProcedures were performed by four trained clinicians in two public facilities. Participants were recruited from surrounding public health facilities through informational talks at antenatal clinics, maternity wards, and maternal neonatal child health clinics. Healthy infants ages 0–60 days, with no penile abnormality, without a family history of bleeding disorder, with current weight-for-age within –2 Z-scores of WHO growth standards, and whose mother was at least 16 years of age were eligible for EIMC. The procedure was performed after administration of a penile dorsal nerve block using 2% lidocaine and administration of Vitamin K. The mother was given post-operative instructions on wound care and asked to remain in the clinic with the baby for an observational period of one hour, during which a face-to-face questionnaire was administered.ResultsOf 1259 babies screened, 704 were enrolled and circumcised. Median age of the infants was 16 days (IQR: 7–32.5) and of the mothers was 26 years (IQR: 22–30). Median time for the procedure was 19 minutes (IQR: 15–23). There were no serious adverse events (AE), and 20 (2.8%) moderate AEs, all of which were due to bleeding that required application of one to three sutures. There were 22 (3.8%) procedures in which the device did not fully incise the entire circumference of the foreskin and had to be completed using sterile scissors. 89.9% of mothers had knowledge of EIMC, but few (8.1%) had any knowledge of devices used for EIMC. Protection against HIV/AIDS was the most cited reason to circumcise a baby (65.3%), while the baby being ill (38.1%) and pain (34.4%) were the most cited barriers to uptake. 99% of mothers were “very satisfied” or “completely satisfied” with the procedure.ConclusionsThis evaluation of the AccuCirc device is the largest to date and indicates that the device is safe and acceptable, achieving high levels of parental satisfaction. The AccuCirc device should be considered for WHO prequalification to increase options for safe and sustainable provision of EIMC.

Food waste within the hospitality’s restaurant operations contribute immensely to the global food wastes, and studies reveal that it contributes 45% of wastes through food preparation and production processes, 21% through food spoilage as a result of poor storage and 34% through food leavers as observed from customer plates. Further, research confirms that food wastage has directly resulted in the starvation of over 842 million people, with over 1.3 billion tons documented as food wastages, while substantial amounts of this food waste and losses taking place within the larger hospitality restaurant’s operations. The factors influencing these food waste generation included; the type of service, the type of food served, the expected and actual numbers of customers, the season and the food service organization, which are addressed by this study in an attempt to propose ways of reducing food waste and losses, and hence promoting food security. The study narrows down to the prevention solutions approach, which was employed on the basis of; menu design, portion choices and customized dishes, use of smaller plates during service, procuring optimized quantities, proper application of product specifications, and employment of waste tracking and analytics methodologies, which when appropriately applied in the restaurant food operations business will significantly reduce food waste and losses, and by extension global food insecurity.

Tipping is believed to have vast influence on restaurant food service tangibility, and thus, quality. This forms the basis of the assumption that foodservice clients are in a better position to reward and monitor the quality of restaurant food services. Nonetheless, the act of tipping has seriously been abused by food servers, hence compromising food service tangibles and thus quality. As a consequence, this is the origin of the observed service failures, not only within restaurant food service but also in the entire service industry. Therefore, the study sought to investigate the relationship between tipping and tangibility of restaurant foodservice. Cross tabulation, correlation as well as multiple regression was used in the analysis of data. The study found a weak significant association between tipping and food service tangibility (Pearson's R = 0.150, P-value > 0.05). However, multiple regression results indicate that restaurant tipping does not statistically significantly predicts the dependent variable – tangibility of food service (F = 45.619). Thus, at 95% confidence level, the study therefore concluded that there is no statistically significant relationship between restaurant tipping and tangibility of food service within the sampled hotels in Kisumu County, Kenya.

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