O objetivo da tese é descrever uma coorte de nascidos vivos e os óbitos neonatais dela derivados e estimar as probabilidades de morte segundo características do recém-nascido, da gestação, do parto e da mãe, bem como das causas de morte. Utilizou-se como fonte de obtenção de dados as Declarações de Nascido Vivo (DN) e de Óbito (DO),documentos básicos dos Sistemas Oficiais de Informação do país. A coorte foi formada por 3225 nascimentos vivos de mães residentes e ocorridos no Munícipio de Santo André, no 1º semestre de 1992. Para a identificação dos óbitos neonatais foi empregada a técnica de \"linkage\", pareando-se as DO com as respectivas DN, obtendo-se 55 óbitos neonatais. A proporção de nascidos vivos de baixo peso ao nascer foi de 6,8 por cento . Obteve-se associação estatisticamente significativa para os nascidos vivos de baixo peso e a presença de gestações de pré-termo, parto normal e cujo nascimento havia ocorrido no hospital público do SUS. Este hospital é referência para as gestações de risco do municipio. Essa associação estava presente também nos recém-nascidos de mães adolescentes e idosas e nos de mães prímiparas ou grandes multíparas. Não se encontrou associação entre o baixo peso ao nascer e sexo, bem como com a variável anotação do nome do pai na DN. Os óbitos concentraram-se no 10 dia de vida (54,5 por cento ).Verificou-se que 94,6 por cento das crianças morreram sem que estas tivessem deixado o hospital após o nascimento. Com relação às causas básicas de morte, as mais frequentes foram as afecções perinatais. A análise das causas múltiplas permitiu uma melhor avaliação da participação da imaturidade/prematuridade e das infecções perinatais no processo que levou a morte. Estas causas estiveram presentes como causa básica ou associada em 63,6 por cento e 25,5 por cento dos óbitos, respectivamente. Os fatores de risco para os óbitos neonatais foram baixo peso ao nascer, gestações de pré-termo e a ausência do registro do nome do pai. Os partos cesareanos foram considerados como fator de confusão para o risco de morte neonatal, o efeito protetor destes partos desapareceu ao se controlar o peso ao nascer. O maior risco de morte encontrado nos nascimentos no hospital público do SUS também deixou de existir ao se controlar a variável peso. Observou-se um risco de morte significativamente maior para os nascidos vivos de baixo peso do sexo masculino que nos do sexo feminino. A categoria de recém-nascidos de baixo peso e de pré-termo apresentou risco de morte 82 vezes maior que os de termo com peso igual ou superior a 2500 gramas. Não se encontrou um risco de morte significativo para os nascidos vivos de mães primíparas ou grandes multíparas e de mães adolescentes ou idosas em relação aos recém-nascidos de mães multíparas e com idade entre 20 e 34 anos. Foram considerados como nascidos vivos de risco os nascimentos de baixo peso. Observou-se um risco de morte significativamente maior por anomalias congênitas e afecções perinatais nos nascimentos de baixo peso que entre aqueles que tinham peso igual ou acima de 2500 gramas. O risco de morte por infecções perinatais foi 94,0 vezes maior nesse grupo de recém-nascidos. Os nascidos vivos de baixo peso do sexo masculino apresentaram uma chance 3,6 vezes mais elevada de morrer por afecções respiratórias que os do sexo feminino deste grupo. Os dados obtidos sugerem que muitos destes óbitos poderiam ter sido evitados se houvesse uma melhor identificação das gestações de risco no pré-natal e fosse assegurada uma adequada atenção ao parto e aos recém-nascidos, bem como indicam que nem todos recém-nascidos de risco receberam os cuidados nescessários após o parto. / A cohort of live births was analysed and the risk of death according to some variables was estimated. The data was obtained from the birth and death certificates. The records were linked, and each death was matched with the birth certificate, in order to identify the neonatal deaths and the survivals of the cohort. It was studied 3,225 live borns of resident mothers of the Santo André Municipality. The births occurred in this area from 01/101/1992 to 06/30/1992. The incidence of low birthweight was 6.8 per cent and the proportion of preterm infants was 5.3 per cent . The low birthweight was associated to the preterm gestation, vaginal deliveries, and to the births which occurred on the SUS public hospital. There was also an association between the low birthweight and the live borns from adolescent and older mothers. The low and high parity were risk factors to the low birthweight. The abscence of notation of the father\'s name on the birth certificate was not associated to the low birthweight. The deaths occurred mainly in the first day of the life (54.5 per cent ) . The data showed that 94.6 per cent of the infant deaths occurred before hospital discharge . The perinatal afections were the leading cause of death. The prematurity/imaturity was assigned as underlying or associated cause in 63.6 per cent of the deaths and the perinatal infections in 25.5 per cent of these deaths. It was found a higher risk of death in low birthweight and preterm newborns and in infants with abscence of the father\'s name on the birth certificate. The cesarean section deliveries showed to be a confounding factor to the neonatal deaths, as well as, the type of the hospital in which the infants were deliveried. The male low birthweight infants presented higher risk of death than the female infants. The low birthweight and preterm babies showed a 82 times higher risk of dying than the normal weight and term infants. The low birthweight newborn showed a higher risk of death from congenital anommalies and perinatal afections. This group of live births, also presented a risk of death from perinatal infections 94.0 times higher than the normal weight babies. The male low birthweigth infants presented 3.6 times higher chance of dying from perinatal respiratory afections than the female newborns of this group. These results suggest that some deaths could be avoided by adequate prenatal, delivery and neonatal care in the maternity wards. The high risk death found in the preterm and very low birth weight infants also suggest that some of these high risk newborns did not had access to neonatal intensive care.

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Published Article / In response to the Human Immunodeficiency Virus (HIV) epidemic in the country, the South African Government started with the provisioning of Antiretroviral Therapy (ART) in the public health sector. Monitoring and evaluating the effectiveness of the ART programme is of the utmost importance. The current patient information system could not supply the required information to manage the rollout of the ART programme. A data warehouse, consisting of several data marts, was developed that integrated several disparate systems related to HIV/AIDS/ART into one system. It was, however, not possible to trace a patient across all the data marts in the data warehouse. No unique identifiers existed for the patient records in the different data marts and they also had different structures. Record linkage in conjunction with a mapping process was used to link all the data marts and in so doing identify the same patient in all the data marts. This resulted in a longitudinal patient record of an ART patient that displayed all the treatments received by the patient in all public health care facilities in the province.

Mortality statistics are much used although their accuracy is often questioned. Producers of mortality statistics check for errors in death certification but current methods only capture obvious mistakes. This thesis investigates whether non-obvious errors can be found by linking death certificates to hospital discharge data. Data: 69,818 deaths in Sweden 1995. Paper I: Analysing differences between the underlying cause of death from the death certificate (UC) and the main discharge condition from the patient’s last hospitalization (MDC). Paper II: Testing whether differences can be explained by ICD definitions of UC and MDC. Paper III: Surveying methods in 44 current studies on the accuracy of death certificates. Paper IV: Checking death certificates against case summaries for: i) 573 deaths where UC and MDC were the same or the difference could be explained; ii) 562 deaths where the difference could not be explained. Results: In 54% of deaths the MDC differed from the UC. Almost two-thirds of the differences were medically compatible since the MDC might have developed as a complication of the UC. Of 44 recent evaluation studies, only 8 describe the methods in such detail that the study could be replicated. Incompatibility between MDC and UC indicates a four-fold risk that the death certificate is inaccurate. For some diagnostic groups, however, death certificates are often inaccurate even when the UC and MDC are compatible. Conclusion: Producers of official mortality statistics could reduce the number of non-obvious errors in the statistics by collecting additional information on incompatible deaths and on deaths in high-risk diagnostic groups. ICD conventions contribute to the quality problem since they presuppose that all deaths are due to a single underlying cause. However, in an ageing population an increasing number of deaths are due to an accumulation of etiologically unrelated conditions.

published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

Managers and researchers have become increasingly interested in linking marketing activities to firm financial performance. That is, they desire to make marketing more financially accountable. One approach to achieving this goal has been to “valuate” customers to determine their degrees of profitability over the lifetime of their relationships with firms. However, traditional customer valuation techniques are largely based on quantitative factors and do not account for softer measures such as a customer’s behavior and performance both during and after service encounters. Additionally, while customer profitability is commonly valuated, employees are not generally assessed in this manner in profit linkage frameworks. This indicates that employee factors have not been deemed to have an equivalent, direct impact on the bottom line. Instead, if included at all, employee factors have mainly been positioned as antecedents to customer factors in past linkage models. Because both customers and employees play essential roles in determining the success of service encounters, both customer and employee factors should be fully considered before profitability is determined. In this dissertation, an innovative theoretical model is presented in which past profit linkage research is extended to include nonfinancial considerations. This research merges traditional financial valuation methods with nonfinancial metrics to assess organizational performance. Furthermore, a conceptually parallel framework is developed in which both employee and customer factors are hypothesized as links through which service encounter dynamics can be connected to firm financial performance. This research examines the linkages between service interactions, customer and employee outcomes, and overall financial performance. Within the contexts of two studies, the overall structural model is dissected into comparable performance models and examined within the retail banking and computer services industries. The overall empirical findings provide some evidence of a positive flow of interconnected relationships between service encounter dynamics and firm financial performance. Accordingly, this research presents some indication of the importance of service encounters as antecedents to outcome behaviors that have critical financial consequences.

Identification of allelic variation through quantitative trait loci (QTL) mapping offers possibilities for the improvement of quantitatively inherited traits. This requires a genetic map along with the phenotypic characterization of a mapping population. A doubled haploid (DH) Polo X Topas population consisting of 194 lines and a recombinant inbred line population of 92 lines was developed. Individual genetic maps derived from each population were integrated into a consensus map. The DH-based genetic map was used for QTL mapping. The DH-based map was comprised of 620 loci that were assembled into 19 linkage groups that were anchored to the B. napus chromosomes. The DH-based map covered 2244.1 cM genomic distance with an average marker interval of 3.7 cM. The DH population was phenotyped in four environments with each line replicated twice in a randomized complete block design. Days to flowering was recorded and oil content and fatty acid composition were determined using Near Infrared spectroscopy (NIR) and Gas Chromatography, respectively. Fourteen QTL were identified for oil content, 33 QTL for palmitic acid content, 18 QTL for stearic acid content, 21 QTL for oleic acid content, 20 QTL for linoleic acid content, 23 QTL for linolenic acid content, 16 QTL for arachidic acid content and 14 QTL for flowering time. Oil content QTL were identified on five linkage groups, A3, A10, C1, C5, and C6. An oil content QTL, qOIL-A10c appeared in all four environments, whereas qOIL-A10a appeared in only one environment but explained 26.99% variation. The oil content in the population ranged from 35% to 55.5% with the parents having values of 42% to 46%. Two genomic regions on C3, with map positions at 147.83 cM and 154.55 cM harbored QTL (rQTL) for all the fatty acids studied. The additive effects of the rQTL reveal a correlation pattern which is supported by the phenotypic correlation observed between the fatty acids. This suggests rQTL have role in the fatty acid composition and possibly determine total seed oil content. The rQTL and flanking markers of the identified QTL offer utility in further development of B. napus. / October 2015

<p>This thesis presents the study and the design analysis of apermanent magnet synchronous motor (PMSM) for the tractionapplication of an electric vehicle. An existing inductiontraction motor for an electric forklift benchmarks the expectedperformances of the proposed PMSM design. Further, thepossibility of using the identical stator as the one used inthe induction motor is explored for the fast prototyping. Theprototype motor is expected to be field-weakened and to have aconstant power speed range (CPSR) of 2.5 to 3.</p><p>A design approach based on the CPSR contour plot in aninterior permanent magnet (IPM) parameter plane is derived toobtain the possible designs that meet all the designspecifications and the targeted CPSR. This study provides thepossible alternative designs for the subsequent futureprototype motors.</p><p>An analytical approach to estimate the iron loss in PMsynchronous machines is developed and included in the designprocedure. The proposed technique is based on predicting theflux density waveforms in the various regions of the machine.The model can be applied at any specified load condition,including the field-weakening operation region. This model canbe ultimately embedded in the design process for a routine usein loss estimations.</p><p>The first prototype motor with an inset permanent magnetrotor has been built and the available measurements are used tovalidate the design performance. In particular, the thermalanalyses based both on the lumped-circuit approach and thenumerical method are compared with the measured results. Asecond and possibly a third prototype motor targeting a widerand higher performance will be carried out in the continuingphase of the project.</p><p><b>Keywords:</b>Constant Power Speed Range, Electric Vehicles,Field-weakening, Reference Flux Linkage, Iron Loss, PermanentMagnet Synchronous Motor, Thermal Analysis</p>

Long term longitudinal surveys have the advantage to enable several sampling of the studied phenomena and then, with the repeated measures obtained, find a confirmed tendency. However, these long term surveys generate large epidemiological datasets including more sources of noise than normal datasets (e.g. one single measure per observation unit) and potential correlation in the measured values. Here, we studied data from a long-term epidemiological and genetic survey of malaria disease in two family-based cohorts in Senegal, followed for 19 years (1990-2008) in Dielmo and for 16 years (1993-2008) in Ndiop. The main objectives of this work were to take into account familial relationships, repeated measures as well as effect of covariates to measure both environmental and host genetic (heritability) impacts on the outcome of infection with the malaria parasite Plasmodium falciparum, and then use findings from such analyses for linkage and association studies. The outcome of interest was the occurrence of a P. falciparum malaria attack during each trimester (PFA). The two villages were studied independently; epidemiological analyses, estimation of heritability and individual effects were then performed in each village separately. Linkage and association analyses used family-based methods (based on the original Transmission Disequilibrium Test) known to be immune from population stratification problems. Then to increase sample size for linkage and association analyses, data from the two villages were used together.