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Spatial facility location problems (SFLPs) involve the placement of facilities in continuous demand regions. One approach to solving SFLPs is to aggregate demand into discrete points, and then solve the point-based model as a conventional facility location problem (FLP) according to a surrogate model. Solution performance is measured in terms of the percentage of continuous space actually covered in the original SFLP. In this dissertation I explore this approach and examine factors contributing to solution quality. Three error sources are discussed: point representation spacing, multiple possible solutions to the surrogate point-based model, and round-off errors induced by the computer representation of numbers. Some factors—including boundary region surrogate points and surrogate point location—were also found to make significant contributions to coverage errors. A surrogate error measure using a point-based surrogate model was derived to characterize relationships among spacing, facility coverage area, and spatial coverage error. Locating continuous space facilities with full coverage is important but challenging. Demand surrogate points were initially used as a continuous space for constructing the MIP model, and a point-based surrogate FLP was enhanced for extracting multiple solutions with additional constraints that were found to reduce coverage error. Next, a best initial solution was applied to a proposed heuristic algorithm to serve as an improvement procedure. Algorithm performance was evaluated and applied to a problem involving the location of emergency warning sirens in the city of Dublin, Ohio. The effectiveness of the proposed method for solving this and other facility location/network design problems was demonstrated by comparing the results with those reported in recently published papers.

Magister Curationis - MCur / Worldwide concerns have been raised about the presence and association of depressive symptoms, cognitive impairment, and dementia in older adults (60 years and older), which are often unrecognised and untreated in long-term care facilities (LTCF’s). The progression of cognitive impairment to dementia reduces quality of life with negative consequences of physical, mental, and psychosocial health. In many LTCF’s internationally, the standardised interRAI system is used to capture depressive symptoms and cognitive impairment. However, there is a fragmentation of systems for making evidence-based decisions to plan and manage care for residents with depressive symptoms, cognitive impairment, and dementia. This study, being the first of its kind in South Africa, addressed this gap, by describing a profile of depressive symptoms and cognitive impairment in residents, and analysing their coexistence, using the interRAI-LTCF in a LTCF in the Cape Metropole in South Africa. A quantitative, descriptive, and analytical cross-sectional secondary data analysis was conducted using the records of all 173 resident’s medical records of residents with a last interRAI-LTCF assessment from 2014 and 2016. The objectives were to determine the levels of depressive symptoms and cognitive impairment, and to assess variously associated demographics and clinical variables between depressive symptoms and cognitive impairment of the interRAI-LTCF in residents in a LTCF. Secondary data were analysed, using the IBM Statistical Package for Social Sciences (SPSS) software, version 25, to test any statistically significant relationship between the extracted variables (Significance was set as p˂0.05). The prevalence of possible depression, using the Depression Rating Scale (DRS) of the interRAI-LTCF in the residents in this study was 36.4%, of whom 54.3% had a documented clinical diagnosis of depression. The prevalence of cognitive impairment was 39.3%, using the Cognitive Performance Scale (CPS), of whom 34.1% had a documented clinical diagnosis of cognitive impairment/dementia. There were more females than males with the possibility for depression and cognitive impairment, especially in those who were older than 80 years of age, those without partners, and who had ≤12 years of education. The DRS and the CPS were able to predict the possibility for depression and CI. There is a 55.9% risk of possible depression with CI present as compared to a 23.8% risk of possible depression when CI is not present. That means that people meeting criteria for CI on the CPS are 2.3 times more likely to meet the criteria for possible depression on the DRS. Similarly, there is a 60.3% risk of CI with possible depression present as compared to a 27.3% risk of CI when possible depression is not present. That means that people meeting criteria for possible depression on the DRS are 2.2 times more likely to meet the criteria for CI on the CPS. The logistic regression confirmed the coexistence between depressive symptoms and cognitive impairment.

Masters Research - Fuculty of Health Sciences / Tuberculosis (TB) is one of the leading causes of mortality in the developing world. Mycobacterium tuberculosis, the causative organism, infects approximately a third of the world’s population. With high rates of HIV infection, particularly in sub-Saharan Africa, TB rates are inevitably soaring. Treatment regimens are based on multi-drug therapy taken over a prolo nged period, leading to poor patient compliance, in turn resulting in the development of multi-drug resistant TB (MDR-TB) which is difficult to treat. The need for new anti-TB drugs that can decrease the period of treatment or the number of doses and that will be effective against latent and MDR-TB is desperate. An added advantage would be the ability of a new class of anti-TB drugs to have a novel target to avoid potential crossresistance to existing drugs. Various approaches have been taken to antituberculosis drug development, including the high-throughput screening of plants, which represent an enormous, largely untapped resource of novel compounds. A further parameter to increase the chances of finding promising lead compounds is to focus research on plants that have traditionally been used to treat symptoms associated with TB. Traditional herbalists prescribing plant-based treatments have long played an important role in the provision of primary healthcare, especially in rural areas where most of the population is poor and unable to afford modern drugs. The aim of this study is to research literature resources pertaining to medicinal plants in southern Africa used to treat symptoms associated with TB, collect these plants, prepare methanol and acetone extracts for the antimicrobial and antimycobacterial testing, identify a plant with promising activity, and to isolate the active principle/s. These compounds in turn would be identified structurally and tested for activity against a range of micro-organisms, including mycobacteria, as well as for cytotoxicity. Twenty-three plant parts from nineteen different species were collected and 46 extracts prepared. These extracts were tested against a range of Gram-positive and –negative bacteria and fungi using the disc diffusion and broth micro-dilution methods. The effects of these extracts were also tested against non-pathogenic mycobacteria using the broth microdilution method, and against M. tuberculosis using the radiometric BACTEC 460 ABSTRACT V method. Te n of the nineteen species exhibited activity against two or more of the eleven organisms tested, namely Xerophyta retinervis bark, Helichrysum odoratissimum leaves, Ozoroa paniculosa bark, Eriocephalus africanus leaves, Siphonochilus aethiopicus roots, Conyza scabrida leaves, Syzigium cordatum bark, Tetradenia riparia leaves, Datura stramonium leaves and Dioscorea sylvatica tubers. The acetone extract of O. paniculosa was further pursued for the isolation of its active principles as it exhibited potent activity against Enterococcus faecalis, Pseudomonas aeruginosa, M. tuberculosis and Mycobacterium aurum with MIC’s of less than 1mg/ml. Previous work on related species has indicated anti-cancer, anti-helminthic, anti- malarial and anti-schistosomiasis activities, but no antimicrobial or antimycobacterial properties have been researched. Moronic, anacardic, and ginkgolic acids have previously been isolated from related species. Bio-assay guided fractionation led to the isolation of a known C15:1 anacardic acid (compound 1) and two HPLC fractions (HPLC2 and HPLC3) of which the predominant components of HPLC3 is the saturated analogue of anacardic acid. NMR data of HPLC2 suggest it is also a C15:1 anacardic acid, although the location of its double bond is as yet unkown. These compounds were cytotoxic to CHO cells at 44.9 – 64μg/ml. Compound 1 and HPLC2 were moderately active against M. tuberculosis with MIC’s of 125μg/ml, while HPLC3 had increased activity with an MIC of 31.3μg/ml, work not previously reported. Similarly, HPLC3 had the greatest activity a gainst M. smegmatis with an IC50 value of 22.1μg/ml. M. aurum had higher IC 50 values ranging from 98.4 to 112.5μg/ml for all three compounds. Compound 1 had potent activity against a range of Grampositive bacteria with IC50 values of 1.3, 2.1 and 6.5μg/ml against Bacillus cereus, E. faecalis and Staphylococcus aureus respectively. Furthermore, this compound had good activity against one of two drug-resistant strains of S. aureus tested with IC50’s of 6.9 and 43.2μg/ml. The saturated anacardic acid (HPLC3) in general had poorer activity against Gram-positives than its unsaturated analogues, consistent with reported literature. The anacardic acids had decreased activity against yeast and Gram-negative organisms tested, with IC50 values of around 80μg/ml against Candida albicans, 19 ->250μg/ml for Serratia odorifera, 26 - >250μg/ml for Klebsiella pneumoniae and 17 – 68μg/ml for ABSTRACT VI Pseudomonas aeruginosa, results comparable to those previously reported. The saturated anacardic acid appeared to have better activity than its unsaturated analogues against Gram- negatives and yeast. The current literature suggests that lipophilic compounds have greater activity against M. tuberculosis. Results obtained in this project are in support of these findings, as the saturated anacardic acid, believed to be the major constituent of HPLC3 based on NMR data available, had increased activity against this organism compared to the unsaturated and less hydrophobic compound 1 and HPLC2. It is possible that these findings implicate anacardic acid in the disruption of the mycobacterial cell wall.

The traditional two-dimensional (2D) delivery system in construction industry creates communication gaps among owners, architects, and contractors. These gaps exist in all phases of project, but are more evident in operation and maintenance. Owners, especially colleges, are now starting to explore and implement new methods to receive more valuable as-built information. Building Information Modeling (BIM) is an emerging information technology that promotes a collaborative process for the Architectural, Engineering, Construction and Facilities Management (AECFM) industry; it can facilitate the exchange and interoperability of information management, and therefore could provide enhanced benefits to colleges and universities¡¯ physical plant. The objective of this thesis is to determine the feasibility of using BIM concepts, principles and tools to support and enhance the informational needs for planning, design, procurement, construction, operation and maintenance of the physical plant of WPI. The methodologies used in this research include literature review of previous research conducted by WPI students; case study analysis; interview with managers at Department of Facilities, review other universities and owners¡¯ experience with BIM, and the review of material documented on the subject. The thesis provides a conceptual guideline for implementation of BIM for WPI that can be extended to other college campuses. The proposed guideline identifies the scope of information that needs to be included in the model, establishes a process for identify specific ways in which the information can be managed to meet the needs of the facility management at WPI.

Magister Public Health - MPH / Being healthy (‘feeling fine’) and health deterioration (‘getting sick’) were key health concerns among PLHIV prior to ART initiation. PLHIV often referred living with HIV as ‘being sick’ and experiencing poor health when already infected with HIV as ‘very sick’ and this perception about sickness and wellness partly determined the need and value placed on accessing HIV services. Motivations for starting treatment included needing to maintain or regain health, encouragement from HCWs, relatives and friends and believing in the effectiveness of ART to improve health. Prevention of HIV transmission to others was not cited to influence uptake. The majority of PLHIV reported stringent adherence to ART; even a half-hour delay in taking treatment was sometimes defined by participants as ‘non-adherence’. Initial reminders for taking ART (setting alarm, placing pills where visible) fell away as daily medication became routine. However, daily uptake of treatment had its own psychosocial and economic consequences which PLHIV had to navigate. With few exceptions, when taking the first line regimen, most PLHIV experienced both temporal (hallucinations, vomiting) and long-term (dizziness and irregular heartbeat) side-effects attributed to ART, which although not considered life threatening, could undermine ART adherence. HIV status disclosure was both limited and selective (mainly to spouses, close relatives, friends and co-workers) and deemed as promoting adherence to treatment and access to HIV services. HIV/AIDS stigma persisted even among relatively healthy PLHIV due to links with ‘promiscuity’, hampering disclosure and access to HIV services. Competing demands on participants’ time, especially livelihood activities, also disrupted accessing services. Good relationships between HCWs and PLHIV promoted access to services.

Facilities management is emerging rapidly as a distinct and critical field of study and professional practice for all sectors of the economy. In the past it has tended to be regarded as a service function and subsumed within other areas such as engineering, the built environment and business management. The health sector is an important part of the overall FM industry because it represents a driver of capital works that is both extensive and expensive. The health sector building requirements are growing, demand regular maintenance and upgrading, and are critical to core business. An extensive literature review revealed that there has been minimal published research into the development and implementation of a central feature of effective FM, namely, performance management. Performance management provides the primary evaluation and planning tool for FM, in that it identifies the performance indicators that are meaningful to FM and core business, provides measures for those indicators and enables projective planning and benchmarking to be undertaken. This research study assesses the possibility of developing a comprehensive performance measurement system for FM in the healthcare sector. The research has two main aims: - To identify the knowledge gaps in current FM performance measurement systems in general, and for the healthcare sector in particular. - To investigate the possibility of benchmarking FM performance across the healthcare sector using a weighted assessment across all categories of performance. In order to meet the research purpose and data collection requirements from the relatively limited number of FM experts who specialise in the health sector, the research methodology employs a combination of a case study approach as an exploratory tool, and a phenomenological approach as the main qualitative design. In achieving the aims and objectives, this research helps in improving FM practice in the healthcare sector through: - Providing facility managers with a comprehensive study which highlights the achievements and knowledge gaps in FM and its performance measurement - Providing top management with a study for the effectiveness of developing decision support strategy to make effective and efficient changes to their facility management practices - Facilitate the implementation of benchmarking techniques in the health sector, in order to improve the performance of the healthcare sector FM over time. The study concludes that developing aggregate/collective KPIs for each performance measurement category of possible measure (social/quality, financial, environmental, functional, and technical) is feasible. However, before being able to develop and implement that approach an improvement to the current FM practices is required. The improvement can be achieved via either a voluntarily or compulsory commitment from top management towards FM in the organizations. This commitment should be implemented with an appropriate hierarchy from the bottom to the top. The key components include: establishing the contribution of FM to the success of the overall business in financial terms; setting agreed FM objectives; deriving meaningful general KPIs; defining the data required for each KPI; establishing the system for collecting, analyzing and interpreting the data; and conducting the benchmarking process for continual improvement.

Zugl.: Speyer, Dt. Hochsch. für Verwaltungswiss., Diss., 2007.

We consider how the optimal decision can be made if the optimality criterion of maximizing profit changes to that of maximizing return on investment for the general uncapacitated facility location problem. We show that the inherent structure of the proposed model can be exploited to make a significant computational reduction.

Building Information Modeling (BIM) has changed the ways buildings are designed and constructed. Along with design and construction, operation and maintenance of the built facility is also gaining importance in the Architecture-Engineering-Construction industry. Facility management (FM) is widely adopted by industrial, healthcare and other types of commercial facilities for better maintenance and management of assets. BIM is being adopted in the field of Facility management and has become one of the most important tools for better application of operation and maintenance. Facility management is performed by professionals with training and experience in the related fields of building operation, maintenance, upgrade and repair. BIM is a professional tool which requires intense training and knowledge. This tool cannot be used and is hard to understand for non-professionals and people who do not have training to use it. Management of residences is as important as management of commercial, industrial and healthcare facilities for the life and smooth running of such facilities. Residential facilities are properties with one or more residential units or buildings. These buildings could be low rise, high rise or individual units. This thesis will help in analyzing the scope of using BIM and Application Programming Interface (API) for management of maintenance in residences by the owner who are not professionally trained. The research analyzes a single, basic function of a BIM tool to determine the potential for such a tool to help non-expert, first time user to be able to understand their residential facilities maintenance requirements. It is an attempt to propose a system which provides alerts to the owners regarding required maintenance and which shows the location of the work in a 3D model. The system was designed and tested in Microsoft Windows 7 operating system by using Autodesk® Revit building information software to make the 3D model, a Revit API plug-in to craft the alerts and show the location of work and Open Database Connectivity (ODBC) to export the model to a web browser. The system worked through Revit program, but the concept of applying the system to work through web browser failed.