Machakos County Research Articles

Overweight and Obesity and Associated Factors among Adolescent Students in Public Day Secondary Schools in Machakos County, Kenya

Background: Overweight and obesity have increased significantly worldwide, placing major economic problems on health systems. This study aims to determine socio-economic characteristics, dietary practices, physical activity levels, nutrition status, predictors of overweight and obesity, and their relationships among adolescents. Methods: The study adopted a cross-sectional analytical study design. 401 adolescents were randomly selected from five secondary day schools using a proportionate-to-size sampling method. Results: Based on the findings, one third (36.3%) of the adolescents were between ages 17-18, with more girls (55.9%) than boys. The number of meals consumed per day among adolescents was 3.34±1.24. Individual dietary diversity score among adolescents was 4.21±1.61. Based on Body Mass Index (BMI), the prevalence of overweight and obesity among boys was 5.2% and 1.8%, respectively, and for girls, it was 7.3% and 3.6%, respectively. Using bioelectrical impedance analysis, the prevalence rates for males were 8.8% and 4.1%, respectively, while for females the rates were 10.1% and 5.1%. Regression analysis revealed that the most significant predictors were energy intake and physical activity, with P˂0.05 based on BMI and bioelectrical impedance analysis. Conclusion: There is a significant relationship between nutritional status and energy intake, the number of meals, dietary diversity score, and physical activity. Physical activity and dietary practices were the most important predictors of overweight and obesity among adolescents. The study recommends nutrition education and public health interventions in schools’ curricula.

Strategic Procurement Practices and Performance of Export Processing Zone Firms in Machakos County, Kenya.

Export Processing Zones (EPZs) were established in Kenya to boost industrialization, attract foreign investment, and drive economic growth. However, despite significant government efforts, the performance of EPZ firms has been below expectations. This study investigates whether strategic procurement practices could improve the performance of EPZ firms in Machakos County, Kenya. Strategic procurement, which aligns procurement with organizational goals and emphasizes long-term value creation, was the focus. The study specifically explored the impact of strategic sourcing, strategic partnerships, strategic inventory management, and strategic contract management on the performance of EPZ firms in Machakos County. Using a descriptive research design, all 99 EPZ firms in Machakos County were surveyed through a census approach. Data was collected via structured questionnaires, with a pilot study conducted to ensure content validity and clarity. Both qualitative and quantitative data were analyzed, with results presented in tables and charts. The findings showed that the four strategic procurement practices adopted improved the performance of export processing zone (EPZ) firms in Machakos County. Strategic sourcing for instance significantly improved the operational efficiency and cost-effectiveness of EPZ firms. Firms that developed strategic partnerships with suppliers experienced enhanced product quality and supply chain reliability. Effective inventory management practices led to reduced waste and better resource allocation, positively impacting overall performance. Proper contract management was associated with improved compliance and reduced legal disputes, contributing to better performance metrics. The study concluded that adopting strategic procurement practices substantially enhances the performance of EPZ firms in Machakos County. By aligning procurement strategies with organizational goals and focusing on long-term value, firms can achieve greater efficiency, reliability, and cost savings. Policymakers should promote the adoption of strategic procurement practices within EPZs to boost economic performance.

Dissemination Approaches that Enhance Adoption of Climate Resilient TIMPS for Pigeon Pea, Sorghum and Green Grams Value Chains in Machakos County, Kenya

Dissemination approaches play a key role in facilitating the adoption of climate smart technologies, innovations and management practices among farmers. Various approaches used in Kenya include the top down approaches and bottom up approaches. This study was conducted to determine and validate dissemination approaches that enhance sustainable adoption of climate resilient TIMPs for Sorghum, Green grams and pigeon peas value chains among farmers in Machakos county. The objectives included: to Identify dissemination approaches for TIMPS in sorghum, green grams and pigeon peas in Machakos county, to assess the frequency of use of dissemination approaches for TIMPS by stakeholders and to determine the stakeholders’ perception on the effectiveness of the dissemination approaches for TIMPS. The study used a survey research design where 27 key informants comprising champion farmers and extension service providers were purposively selected for data collection. The descriptive analysis was conducted using the SPSS version 16. A weighted index was computed to aid comparison for various values chains and categories. The results showed that farmer-to-farmer (96%) and T&V (88.9%) dissemination approaches were the frequently used dissemination approaches whereas education institution (14.81%) was the least used dissemination approach in the three value chains in the county. Farmer to farmer effectiveness was ranked highest in Sorghum and Green grams while the T&V was highest for Pigeon peas Enhanced utilization of farmer-to-farmer, T&V and demand driven dissemination approaches for enhance adoption of green grams, pigeon peas and sorghum for improved productivity and household income.

Influence of Principals’ Provision of Motivational Strategies on Teacher Productivity in Public Secondary Schools in Machakos County, Kenya

Influence of Principals’ Provision of Motivational Strategies on Teacher Productivity in Public Secondary Schools in Machakos County, Kenya

Teachers’ Stress Level as a Correlate of Deviant Behaviours among Form Two Students in Machakos County, Kenya

Deviant behaviors among secondary school learners have continued to be a global issue and Machakos County is not exceptional. There are limited Studies showing the relationship between teacher level of stress and students’ deviant behaviors. This study was designed with the aim of exploring whether students’ tendency to engage in deviant behaviors is related to teacher levels of stress. The Cultural Deviance theory by Shaw and Mckay which views deviant behavior as a result of escape from freedom was used. The researcher used a correlational research design. The target population was 53 public secondary schools with 280 teachers. The study’s locale as well as the targeted schools were purposively selected. The sample from which data was gathered comprised of 160 teachers. The number of participants in each school was sampled proportionately. Stratified sampling technique helped in grouping the schools into distinct categories from which sample size was drawn from. The questionnaire which the researcher adapted from an existing instrument was filled to yield the data for the research. Piloting was done before the main data collection exercise to ascertain the validity of the adapted tool and enable testing the appropriateness of the data analysis technique. Quantitative data was analyzed through Statistical Package for Social Sciences (SPSS) (Version26). Pearson product moment correlation was applied to test the null hypothesis. The study found out that the higher the levels of teacher’s stress the higher the student’s deviant behavior and the lower the levels of the teacher stress the lower the student’s deviant behavior (152) =.49, p=00. The study concluded that teachers’ gender and working experiences were not significant predictors of students’ deviant behavior. The R Square value indicated that the predictor variable (teacher level of stress) accounted for about 53% of the total variance in students’ deviant behavior. The study recommended that there was need to effectively implement teacher performance, appraisal, and development fully and facilitate capacity building to ensure that the teachers’ efficacy skills were improved to reduce students’ deviant behavior in secondary schools.

Paideia Patristic Education

The acquisition of soft skills is increasingly recognized as a crucial component of higher education, essential for preparing students to meet the challenges of the modern workforce. This study investigates the process of acquiring soft skills through Paideia Patristic Education (PPE) in universities in Machakos County, Kenya. This quantitative study aims to evaluate the effectiveness of the PPE framework in promoting key soft skills such as communication, teamwork, critical thinking, and flexibility. Purposive sampling technique was used to target specific faculty members and students. Data was collected using structured and semi-structured questionnaires. The study's results show that PPE has a positive effect on students' soft skills, particularly in enhancing their ability to work effectively in teams and collaborate. Universities in Machakos County and beyond should strongly consider incorporating Paideia Patristic Education principles into their curricula. This would help cultivate crucial soft skills in students, better equipping them for the challenges of the contemporary job market.

Relationship Between Types Of Parental Attachment, Levels Of Self-Esteem, And Perceived Academic Performance Among Students In Mixed-Day Secondary Schools In Masinga Sub-County In Machakos County, Kenya

This study investigated the relationship between types of parental attachment, levels of self-esteem and academic performance among students in Mixed-day secondary schools in Masinga Sub- County, Machakos County, Kenya. The objectives included assessing types of parental attachment, examining self-esteem levels, assessing levels of academic performance, and establishing the relationship between these variables. Materials and Methods: The study was informed by Maslow’s theory of need and Bowlby’s attachment theory and adopted correlational research design. The target population comprised 4,796 students, with a sample size of 356 participants selected through simple random sampling. Parental Attachment Questionnaire, the Rosenberg Self-esteem Scale, and Demographic Questionnaires were used to collect data. Statistical Packages for the Social Sciences (SPSS version 25) software, descriptive statistics (frequencies and percentages) and inferential statistics (Pearson’s product-moment correlation analysis) were used to analyze data. Results: The study found that most (53.3%, n = 213) of the participants scored anxious parental attachment, 25.4% (n = 121) were at avoidance parental attachment, and 21.3% (n = 105) had secure parental attachment. It was also found that 70.5% (n = 281) of the participants scored low self-esteem, 6.7% (n = 27) were at high self-esteem and 43.6% (n = 174) were average in academic performance, 42.9% (n = 171) had low academic performance, while 13.5% (n = 54) had a high academic performance. Conclusion: The study established a negative but significant relationship (r = -.852, p =.000) between avoidance parental attachment and self-esteem. There was a moderate significant relationship (r = -.313, p =.000 ≤ 0.05) between anxious parental attachment and self-esteem. There was a high positive significant relationship (r = .766, p =.000 ≤ 0.05) between secure parental attachment and self-esteem. There was a strong positive significant relationship (r = .630, p = .003, ≤ 0.05) between secure attachment style and perceived academic performance. The study recommended that parents should listen to their children and be fully present in their lives. The parents should be made aware of the crucial stage of development of their adolescents and fully collaborate with teachers in school activities whenever they are called upon

Implication of Urban Domestic Water Distribution on Human Health in Machakos Central Ward, Machakos County

The world's water resources are running out, and this situation is made worse by how quickly people are populating new areas, particularly in developing nations. This has highlighted the critical requirement for prepared action to manage water resources for sustainable development efficiently. Increasing water demands due to climate change, global pressures from urbanization, the already-existing unsustainable variables, and challenges of water supply systems in urban centres pose a challenge in managing water resource effectively. The purpose of the study was to investigate the implication of urban domestic water supply on human health in Machakos Central Ward, Machakos County. Using a Survey Research Design (SRD) both primary and secondary data was collected by use of questionnaires, face-to-face interviews, photography, use of GIS, authors’ observation, and the review of relevant literature in order to (1) document household water supply, (2) determine water quality for the identified categories of households and domestic water supply systems, and (3) Determine how the distribution and coverage of domestic water in a household or home affects the prevalence of water-borne illnesses. The target population was 8,331 households, from which a sample size of 381 respondents was selected. These included households, water vendors and key informants from the Machakos Water and Sewerage Company. Questionnaires (for households and vendors), interview schedules (for water officers and chiefs) and observation schedules were used as instruments for data collection. Data was analysed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) software. The results revealed that the major factors attributed to lower accessibility are shortage of water, high cost of piped water connection, poor coordination, and participation of stakeholders, repairing of old and broken pipes. As a result, nearly half of the dwellers prefer to use alternative sources, exposing them to the risks of water-born diseases

Resource Allocation and Performance of Microfinance Institutions in Machakos County, Kenya

This research study sought to determine the impact of resource allocation on the performance of MFIs in Machakos County. The study adopted a descriptive research design. The target population for the study included 63 staff members from the 21 registered MFIs in the county. The study utilized a purposive sampling technique in an effort to identify the most suited respondents for the study. A structured questionnaire was utilized as the data collection tool. The questionnaire was divided into two parts containing the demographic data relating to the respondent's background as part one and the second part covering resource allocation. The questionnaire was structured with a 5-point Likert scale. Descriptive and Inferential statistics were used in the analysis of the data. The linear regression analysis method was used to assess the associations between resource allocation and performance. The study established that resource allocation positively influenced the performance of MFIs in Machakos County. The study concluded that the manner in which resources are allocated significantly affects the performance of microfinance institutions in Machakos County. The study recommends that policymakers and microfinance institution (MFI) leaders should prioritize developing clear guidelines and frameworks for efficient resource allocation

Appraising the Influence of Teacher Legitimate Authority on Teacher Role Performance: Evidence from Machakos County, Kenya

Teacher authority is an integral component of the learning process as it assists in upholding peaceful and orderly classrooms, facilitating the fulfilment of the teacher’s roles. Previously, conventional legitimate authority, which involved consistent application of classroom rules regulations, and values, was the norm. However, with a paradigm shift in culture, an emphasis on critical thinking, and creative problem-solving, and the pervasive influence of technology in teaching, studies have shown that a form of teacher authority that promotes absolute obedience, like legitimate authority, is no longer considered suitable or beneficial. This article aimed to determine the degree to which teachers employed legitimate authority and its impact on their role performance within classrooms in Machakos County. A descriptive survey research design was utilized for this study. The target population comprised 369 principals, 4,365 teachers, and 63,973 Form Two and Form Three students in 369 public secondary schools within the County. A sample population of 619 respondents was selected using a combination of systematic, stratified, and simple random, and proportional sampling techniques. Data was collected from the principals using an interview guide, while questionnaires were used to gather data from students and teachers. Analysis of the data from the questionnaires for students and teachers showed that they strongly agreed that teachers applied legitimate authority. Inferential statistics also showed that legitimate authority had a significant influence on the teachers’ role performance. Hence, the conclusion that use of legitimate authority practices enhanced the teachers’ role performance. Similar views were held by principals that the use of legitimate authority by teachers increased their role performance. The research concluded that while teachers predominantly employed legitimate authority practices, their effectiveness in roles required referent authority practices appeared to improve, indicating an inconsistency. The study recommends that the Teachers Service Commission (TSC) and Boards of Management (BOM) should provide induction for teachers on legitimate authority practices that align with children's rights. Additionally, there is a need to enhance the training curriculum to equip teachers with practices and approaches that foster referent authority.

Effects of Covid-19 Pandemic on Performance of Micro and Small Enterprises (MSEs): A Case of Agri-Businesses in Machakos County, Kenya

Effects of Covid-19 Pandemic on Performance of Micro and Small Enterprises (MSEs): A Case of Agri-Businesses in Machakos County, Kenya

COMMUNITY EMPOWERMENT AND IT’S INFLUENCE ON IMPLEMENTATION OF WATER PROJECTS IN MACHAKOS COUNTY OF KENYA

Objective: This study focused on the extent to which Community empowerment influence Implementation of water projects in Machakos County of Kenya. Accessibility to safe water has been a great challenge not only in Machakos County but to the developing world. The purpose of this study was to establish Community empowerment influence on Implementation of water projects in Machakos County of Kenya. Theoretical Framework: The study was anchored on Pragmatic paradigm and used descriptive survey research design. The target population for this study was Machakos County water representatives both staff and Community. Research sample comprised of, Water Resources Users Association officials, Water Resource Management Authority employees, County Ministry of Water and Irrigation staff, Water Services Trust Fund staff and Tana Athi Water Services Agency Staff, giving a total target population of 572 individuals. Method: The sample size of the study was derived from the various strata’s by using Krejcie and Morgan Table for sample size determination which gave a sample size of 226 participants. The research instruments used included: questionnaires; Key informant Interviews, Focus Group discussions, observation, documents review and Interview guides. Data was analysed using descriptive statistics and inferential statistics. Quantitative data was analysed using frequencies, percentages, mean, standard deviation, composite mean and standard deviation. Qualitative data was analysed by content analysis. Research Implications: This Study is significant to policy makers, students, water agency managers and primary stakeholders in the research region. It was concluded that Community empowerment significantly influence implementation of water projects in Machakos County in Kenya.

Factors Influencing the Use of Property Titles as Security for Lending in Rural Kenya: A Case Study of Kivani Location, Machakos County

The development of the world's economies, especially in emerging countries, depends significantly on land. Despite being a crucial tool for obtaining loans, the use of land as collateral is relatively low in rural Kenya. This has largely been attributed to lack of formal ownership documents attributable to poor titling, which has subsequently hindered investments and development in these areas. The research gap, therefore, lies in the need to understand and address the reasons behind the low uptake of land as collateral in rural Kenya, despite its potential as a valuable asset and its significant role in rural livelihoods and development. This study set out to establish factors influencing the use of property titles as loan security in a rural setting using Machakos County as a case study. Employing a descriptive research design, the study targeted 724 households in Kivani and 30 financial institution officers. Data was collected using questionnaires and topical discussions, achieving response rates of 96% and 100%, respectively. Findings reveal that 67 percent of respondents have never used land titles as collateral. Several factors were identified: social relations, lending conditions, and loan pricing. Social relations factors included communal land ownership, land succession problems, cultural norms, and sentimental attachment to land. Lending conditions encompassed land valuation processes, borrower creditworthiness requirements, collateral quality, and the need for family consent. Loan pricing factors involve the costs and fees associated with credit financing. The study recommends increasing awareness of individual land ownership, exploring alternative collateral options, establishing insurance markets for collateral assets, and improving loan evaluation processes to better support rural residents. These measures aim to enhance access to financing, thereby promoting rural development

Revitalizing Performance of Three Star Hotels in Machakos County, Kenya Through the Application of Turnaround Strategies

This study sought to assess the effect of turnaround strategies on performance of selected three-star hotels in Machakos County, Kenya. The specific objectives were to determine the impact of downsizing, divestiture, price bundling, and repositioning on the performance of three-star hotels in Machakos County, Kenya. The research was grounded on the balance scorecard theory, contingency theory, institutional theory, and resource-based view theory. The study adopted a descriptive research design. A total of 454 (Finance staff, HR staff, and Marketing staff, Guests) involved in operation of three-star hotels were targeted. A stratified random sampling technique was used to select a sample size of 135 respondents. Semi-structured questionnaires were utilized to gather primary data. A pilot study was done using 10 participants who were not involved in the final data gathering to check validity and reliability of study instrument. To explore the impact of the link between the independent and dependent variables, multiple regression analysis was performed. The study findings show that coefficient of correlation was 0.789, an indication that the study variables significantly influenced performance of three-star hotels. Coefficient of adjusted determination was 0.615 which translates to 61.5%. This indicates that variations in dependent variable was explained by the independent variables (downsizing strategy, divestiture strategy, price bundling and repositioning strategy). The findings also established that P-value was 0.001 which is less than 0.05 an indication that the study variables significantly influenced performance of three-star hotels. The study concludes that turnaround strategies significantly affect the performance of selected three-star hotels in Machakos County, Kenya. The hotel administrators should come up with reliable communication channels about the reasons behind the downsizing staff and offer support services for affected employees. The three-star hotels should conduct thorough due diligence before divesting any assets. This includes a comprehensive analysis of the financial implications, potential impact on market share, and considerations of the long-term strategic goals of the organization.

Influence of public participation in the planning phase on the outcome of water projects in Matungulu Sub-County, Machakos County

This study aimed to find out the influence of public participation in the planning phase on the phase-specific outcome and overall outcome of water projects in the Matungulu sub-county, Machakos County, Kenya. Employing a sequential mixed-method approach, data was gathered from 220 household heads, one water project manager, and eight water user committee representatives. Quantitative data analysis was done using linear regression, and the hypothesis was tested at a significance level of 0.05. A thematic approach was employed for the qualitative data analysis. Results indicated that public participation in the planning phase significantly influenced both the planning phase-specific outcome and the overall water project outcome. However, the level of public participation in the planning phase was found to be low. The study recommends that the Machakos County government officials and elected representatives prioritise public consultation and involvement in the planning phase since it ensures that water projects implemented are relevant to the needs of the local residents and enhances project ownership at an early stage. This ultimately guarantees project success and sustainability. This study provides insights to both the national and county governments on how the involvement of the local community in the planning phase fosters project ownership and leads to more sustainable water projects.

PERCEPTIONS OF CLIMATE CHANGE AND THEIR DETERMINANTS AMONG THE SMALLHOLDER FARMERS IN MACHAKOS COUNTY

Climate change is expected to affect the livelihoods of smallholder farmers in Machakos County due to their overdependence on rain-fed agriculture. Farmers perception of climate change and variability influences their understanding and management of climate change-induced risks and uncertainties, especially in rain-fed agriculture. The study was carried out to evaluate smallholder farmers awareness and perception of climate change and the factors influencing the perception of climate change in Machakos County. Data was collected from 400 farmers from six locations sampled through a multistage and simple random sampling procedure. The Heckman probit model was fitted to the data to avoid sample selection bias since not every farmer who may perceive climate change responds by adapting. The analysis revealed that 96% of smallholder farmers in Machakos County were aware of climate change, 87.3% perceived that temperature was rising, and 96.8% perceived that rainfall was decreasing. In this regard, the age of the household head, Gender, education, household size, group membership, distance to the nearest input sellers, distance to the closest market access to insurance, land size, off-farm income, access to information on climate change, access to extension services, access to credit, changes in temperature and rainfall were found to have a significant influence on the probability of farmers to perceive and/or adapt to climate change.

AGRICULTURAL SECTORS VULNERABILITY TO CLIMATE CHANGE AND VARIABILITY IN MACHAKOS COUNTY: A SYSTEMATIC REVIEW OF LITERATURE

Identifying the extent of exposure, agricultural systems sensitivity, and adaptive capacity is essential in addressing agricultural vulnerability in an area and can lead to timely, appropriate, and effective adaptation strategies.Using the systematic literature review approach, this paper documented the vulnerability to climate change and variability of the agriculture sector in Machakos County, Kenya. The results revealed high exposure to climate change and variability, high sensitivity, and low adaptive capacity. With regard to exposure, a warming trend was observed in the County, while climate model outputs predicted enhanced warming and drying towards the end of the 21st century. Farming systemswerefound to be highly sensitive to impacts of climate change and variability, characterized by high incidences of drought, high rural population density, high percentage of smallholder farmers, and extremelyhigh susceptibility to land degradation. Adaptive capacity is generally low but depicted by substantial social capital and highly diversified agricultural production.

Assessing the Impact of Administrative and Technological Enhancements on the Kenya Police Service: A Case Study of Machakos County

Assessing the Impact of Administrative and Technological Enhancements on the Kenya Police Service: A Case Study of Machakos County

Assessing Approaches to Strengthen Monitoring and Evaluation in Development Projects: Evidence from Donor-Funded Projects in Machakos County, Kenya

Monitoring and Evaluation improves the quality of programme or project management since it provides information on how results namely outcomes, outputs and impact are achieved and assesses the effectiveness, relevance, coherence, efficiency, impact and sustainability of specific development interventions. The objectives of the study were to examine the influence of participatory monitoring and evaluation among development project teams in Machakos County and to assess the influence of M & E as a learning tool on implementation of development projects in Machakos County, Kenya. The study was guided by the Theory of Change which describes how particular interventions or sets of interventions lead to specific changes. The target population of this study was 102 programme staff implementing donor-funded projects. A census was done and therefore the target group formed the sample for the study. Primary data sources used were key informant interviews and a survey questionnaire. Quantitative data was analyzed in SPSS Version 28 and qualitative data was thematically analyzed. According to the survey results, 58.2% agreed that the involvement of all relevant project stakeholders during the preliminary stages of project design strengthens M&E. The survey results showed that 49.45% of the respondents agreed that project planning reflected the various community needs and supported decision-making processes during project implementation. A majority (58.23%) agreed that feedback from various stakeholders was often incorporated and used to strengthen the delivery of various project activities informant interviews. Majority of the survey respondents (72%) indicated that learning is integral to ensuring M&E is effective and project teams can learn immensely from M & E. A majority (71%) agreed that project teams feared participating in M&E activities due to fear that it could be used against them. The findings show that the involvement of stakeholders in project design and implementation directly influenced successful project M & E. The study recommended involving relevant parties and stakeholders in a project since this influences its implementation and M & E among donor-funded development projects. Project managers need to put in place incentives for project teams to learn not just for reporting to funding agencies but for the benefit of internal learning among project teams.

The Perceptions of Complementary and Alternative Medicine among People with Chronic Diseases in Mwala Sub-County, Machakos County, Kenya

Purpose: This paper sought to determine the perceptions of the nurses on complementary and alternative medicine in Machakos County, Kenya. Methodology: This was a descriptive study, it had 3 objectives: to determine the perspectives of the nurses about CAM; establish the drivers of CAM in Machakos; and to investigate the available models of CAM in Machakos. A standardized questionnaire was used to collect quantitative data from the patients with chronic diseases. Findings: the nurses who knew about CAM were 60%; those who had negative perspective about CAM were 68%, those who had used some CAM treatment were 50%; the patients with chronic diseases hesitance to use CAM was based on issues of safety, unknown effects of the treatment, lack of clear dosage, ethical, and quality. However, a few had used CAM for external only. Unique Contribution to Theory Policy and Practice: The study concluded that for the people with chronic diseases perspectives towards CAM and consequently the usage of CAM needs more research to establish the validity and reliability of such perspectives. The consumers of CAM should be assisted to access more accurate information as front-line consumers of CAM that will dispel concerns correct dosages, safety of the CAMs, their effectiveness, any risks and possible therapeutic values from CAMs in general. The study recommends more random and controlled pragmatic clinical trials and sharing of information and experiences by paramedics.