Introduction: Stavudine is a commonly used drug in paediatric antiretroviral treatment (ART) regimens. Due to toxicity concerns, however, the drug abacavir has replaced stavudine in first-line paediatric regimens inmany countries.Wedescribe the frequency of stavudine toxicity in children receiving ART at a treatment clinic in Soweto, South Africa. Methods: Data on patient characteristics and outcomes of ART were collected from a cohort of 2222 HIV-infected children initiating ART between 2004 and 2008 when stavudine-containing regimenswere routinely recommended. At several time-points after treatment initiation, we estimate the proportion of children where an attending clinician discontinued stavudine due to lipodystrophy, pancreatitis, lactic acidosis or peripheral neuropathy. Factors associated with stavudine-related toxicities were identified. Results: At ART initiation, most children had advanced disease. The majority initiated an efavirenz/lamivudine/stavudine regimen (n¼1422), and 76% of children remained on their initial ART regimen after a median 19.9 months of ART. Replacement of stavudine due to drug toxicity occurred at a rate of 28.8 per 1000 child years on treatment (95% confidence interval¼23.6–35.2). Rates of toxicity increased with treatment duration (in their first year of ART stavudine was replaced in 0.5% of children, but after 3 years stavudine had been changed to abacavir in 12.6% of children). Toxicity was more common in older children and in girls. Lipodystrophy accounted for 87 of 96 toxic events. Conclusion: Stavudine-associated toxicity resulting in single-drug substitution was uncommon in this cohort, though its frequency increased steadily with ART duration, especially with lipodystrophy. Where drug options are limited, stavudine remains a relatively well tolerated and effective option for children.

Högkänslighet är än så länge ett relativt okänt karaktärsdrag i personligheten. Trots att 15-20 procent av befolkningen tros ha en högkänslighet, enligt tidigare studier, så är forskningen begränsad om fenomenet och dess konsekvenser på individnivå. Syftet med denna undersökning var att ta reda på upplevelsen av att leva med högkänslighet med hjälp av en kvalitativ metod. Intervjuer med nio stycken intervjupersoner med en högkänslig personlighet utfördes, spelades in, transkriberades och analyserades. Resultatet visade att överväldigande, strategier, uppvaknande och visioner var gemensamma teman för samtliga respondenter. Konsekvenserna var både negativa och positiva, såsom uttröttning, depression, lyckorus och en god empatisk förmåga. Det som kunde hjälpa en högkänslig individ var strategier för återhämtning och en förståelse från omgivningen. Undersökningen visade både gemensamma faktorer och skillnader i upplevelsen av högkänslighet. Om högkänslighet kan ses som en resurs istället för en nackdel, skulle kombinationen av högkänsliga och icke högkänsliga vara bra och till nytta för samhället.

A baixa eficiência da adubação fosfatada em solos altamente intemperizados é devido, entre outros fatores, à adsorção do fósforo (P) à superfície das argilas silicatadas do tipo 1:1 e, principalmente, dos (hidr)óxidos de Fe e de Al. Manejos do solo que induzem a solubilização de formas de P indisponíveis para as plantas têm sido intensamente estudados nos últimos anos. Uma tentativa de aumentar a concentração de P disponível na solução do solo para sua absorção pelas plantas é a mobilização de P por ânions de ácidos orgânicos de baixa massa molar (AOBMM). Ânions derivados de AOBMM exsudados pelas raízes de plantas ou excretados por microrganismos são associados com algumas condições de rizosfera como deficiência de P e fitotoxidez de Al e interagem com o solo de forma a aumentar a biodisponibilidade de P. Dependendo dos atributos do solo, do grau de dissociação, das propriedades e do número de grupos carboxílicos dos ânions orgânicos, o P pode ser mobilizado do solo principalmente devido à dissolução complexométrica de minerais e à adsorção competitiva dos grupos funcionais carboxílicos e fosfato nos sítios de superfície coloidais. A capacidade dos ânions citrato, malato e oxalato em mobilizar P de amostras de um Neossolo Quartzarênico típico (RQ) e de um Latossolo Vermelho ácrico (LVwf) foi avaliada por meio de um estudo de lixiviação de ânions em colunas. Devido a não detecção de P nos efluentes das colunas com LVwf, foi realizado outro estudo em colunas, no qual somente citrato foi lixiviado, mas num volume maior, e as alterações das formas de P nas amostras desse solo induzidas pela lixiviação de citrato foram identificadas por espectroscopia de absorção de raios-X na borda K do fósforo (X-ray absorption near edge structure -XANES - spectroscopy). A capacidade dos ânions de AOBMM em solubilizar P foi mais dependente do teor de P disponível e de outros atributos do solo que do número de grupos funcionais carboxílicos dos ânions orgânicos. Somente o oxalato mobilizou P do RQ, enquanto todos os ânions de AOBMM foram capazes de mobilizar P do LVwf. Quando baixos volumes de solução contendo ânions de AOBMM foram lixiviados no solo, além do aumento do pH, a mobilização de P foi acompanhada pela mobilização de Al no RQ (pH água = 5), e pela mobilização de Ca no LVwf (pH água = 5.6), o que indica solubilização de P pela complexação de Al, Ca, ou Fe, de fosfatos insolúveis, ou pela inibição da precipitação de P com esses metais. Ao lixiviar um volume maior de citrato no LVwf, o P também não foi detectado nos efluentes das colunas, mas houve lixiviação intensa de Al e Fe, bem como mudanças nas proporções de formas de P no solo caracterizadas pelos espectros XANES. Embora tenhamos encontrado indícios da ação dos principais mecanismos de solubilização de P (dissolução complexométrica de minerais e troca de ligantes entre grupos funcionais carboxílicos e P adsorvido ao solo), os ânions de AOBMM mostraram pouco potencial de efetivamente aumentar a biodisponibilidade de P. / Phosphate fertilization of acidic, highly weathered soils is inefficient because of the adsorption of phosphorus (P) to 1:1 silicate clays and, especially, to Fe and Al oxides. Different soil management practices to induce solubilization of unavailable forms of P to plants nutrition have been intensively studied in recent years. The mobilization of P with anions of low molecular weight organic acids (LMWOA) increases the concentration of available P in the soil solution for plant uptake. Anions derived from LMWOA exudates from plants root or excreted by microbes are associated with some rhizosphere conditions, as deficiency of P and Al phytotoxicity, and they interact with the soil in order to increase P availability. Depending on the soil attributes, and degree of dissociation, properties, and number of carboxyl groups from organic anions, P can be mobilized from soil mainly because of complexometric dissolution of soil minerals and ligand exchange of functional carboxyl groups and P adsorbed in soil surface sites. The capacity of citrate, malate and oxalate anions to mobilize P from a Typic Quartzipsamment (RQ) and an Anionic Acrudox (LVwf) was evaluated in a column leaching study. Because no P was detectable in columns effluents from LVwf, another column leaching study was performed, but only citrate was leached with a greater volume of solution, and citrate-induced changes at P forms in the soil were identified by P K-edge X-ray absorption near edge structure - XANES - spectroscopy. The capacity of LMWOA anions to solubilize P was more dependent of P status and other soil attributes, than number of carboxyl groups of organic anions. Only oxalate mobilized P from RQ, and all LMWOA anions were able to mobilize P from LVwf. Increasing of P mobilization and soil pH were followed by increases of Al mobilization from RQ (pH water = 5), and Ca mobilization from LVwf (pH water = 5.6) at lower volumes of LMWOA anions leaching. Phosphorus was solubilized by complexation of Al, Ca or Fe from insoluble phosphate minerals, or by inhibition of Al, Ca or Fe phosphate precipitation. After leaching a greater volume of citrate through LVwf, P was still undetectable in effluents from columns, but there was an intensively leaching of Al and Fe, as well as changes in proportions of adsorbed P characterized in soil XANES spectra. Although we have found evidences about the action of main mechanisms of P solubilization (complexometric dissolution, and ligand exchange of carboxylic functional groups for adsorbed P on soil minerals) by LMWOA anions, they had a little potential to really increase P availability.

Orientador: Ricardo Augusto Monteiro de Barros Almeida / Resumo: Introdução: Até há cerca de uma década, a infecção pelo HIV era considerada contraindicação absoluta para transplantes de órgãos. Estudos recentes sugerem que o transplante renal (TxR) é viável para pessoas vivendo com HIV/aids (PVHA) adequadamente selecionadas. Apesar de bastante efetivos, os TxRs em PVHA apresentam dificuldades importantes. A maioria dos estudos relatam incidências mais elevadas de rejeição aguda, chegando a mais de 50%. Fatores imunológicos e farmacológicos teriam grande influência. A literatura atual mostra que o melhor esquema antirretroviral (ARV) para os TxRs em PVHA ainda não foi identificado. Objetivo: Devido à relevância do tema e à ausência de ensaios clínicos randomizados (ECRs), o objetivo do estudo foi identificar, através de metanálise proporcional de série de casos, os esquemas de ARVs mais efetivos e seguros para PVHA submetidas ao TxR. Métodos: Foram incluídos estudos de relato e série de casos que tivessem avaliado qualquer esquema ARV utilizado em PVHA submetidas ao TxR e que fornecessem dados relacionados aos desfechos de interesse, que foram mortalidade, sobrevida do enxerto, episódios de rejeição aguda, função renal e curso clínico e laboratorial da infecção pelo HIV. A pesquisa em bases de dados foi realizada através das fontes: MEDLINE, EMBASE, Scopus e LILACS (até dezembro de 2014). Dois revisores independentemente selecionaram os estudos identificados pelas bases de dados. Foram realizadas metanálises proporcionais de série de casos comparando a ocorrência dos desfechos em diferentes esquemas ARVs por meio do software StatsDirect. A heterogeneidade estatística foi avaliada utilizando o teste estatístico I2 . Resultados e discussão: Dos 2841 estudos inicialmente identificados pela pesquisa bibliográfica, 24 respeitaram os critérios de inclusão e exclusão, totalizando 57 pacientes. Não houve diferença... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Until about a decade ago, HIV infection was considered absolute contraindication for organ transplants. Recent studies suggest that kidney transplantation (KTx) is feasible for people living with HIV/AIDS (PLWHA) in select cases. Although highly effective, the KTx in PLWHA presents major difficulties. Most studies report higher incidences of acute rejection, reaching more than 50%. Immunological and pharmacological factors have great influence. Current literature shows that the best antiretroviral (ARV) regimen for KTx in PLWHA has not been identified. Objectives: Due to the relevance of the subject and the absence of randomized controlled trials (RCTs), the objective of the study was to identify, the most effective and safest ARV regimens for PLWHA submitted to KTx. Methods: Case series studies that have evaluated any ARV regimen used in PLWHA submitted to KTx and that provided data related to the outcomes of interest - mortality, graft survival, acute rejection, renal function and clinical and laboratory course of HIV infection - were included. Research in databases was performed using the sources: MEDLINE, EMBASE, Scopus, and LILACS (until December 2014). Two reviewers independently selected studies through the databases. Meta-analyses of case series were conducted comparing the occurrence of different outcomes in ARV schemes through software StatsDirect. Statistical heterogeneity was assessed using the I2 statistic. Results and Discussion: From 2,841 studies initially identified by the literature search, 24 studies complied with the inclusion and exclusion criteria, totaling 57 patients. There was no statistically significant difference between groups of patients who used ARV regimens based on two nucleoside/nucleotide reverse transcriptase inhibitors plus one non-nucleoside/nucleotide reverse transcriptase inhibitors (2NRTI+NNRTI), a combination of abacavir, lamivudine... (Complete abstract click electronic access below) / Mestre

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-11-09T18:53:26Z No. of bitstreams: 1 RenatoFerneda_dissert.pdf: 585980 bytes, checksum: 7c6b97dc0f3805fe789d0fdbee741928 (MD5) / Made available in DSpace on 2018-11-09T18:53:26Z (GMT). No. of bitstreams: 1 RenatoFerneda_dissert.pdf: 585980 bytes, checksum: 7c6b97dc0f3805fe789d0fdbee741928 (MD5) Previous issue date: 2018-04-27 / Although the antirretroviral therapy, in spite of having reduced the mortality for AIDS and increased the lifespan of the HIV bearers, it can contribute to the arrise of adverse long time effects, besides renal ones. The tenofovir (TDF), a first line antirretroviral (ARV) for treatment, has low general toxicity. TDF can take to moderate reduction in glomerular filtration rate (GFR) and a larger prevalence of renal tubular dysfunction (RTD) when compared to those patients who are not on therapy of this medication. The decline of the renal function found in the patients can vary from mild to chronic injuries or a simple reduction in GFR. The mechanism of RTD is not completely understood, and it has been attributed to the mitocondrial lesion in the proximal tubule cells caused by the increasing of the intracelular TDF concentration. Aditionaly, host´s genetic polymorphisms have been considered one of the TDF concentration increasing causes. RTD can be characterized concisely by the deficiency in the solutes reabsorption as bicarbonate, uric acid, phosphate, glucose and low weight molecular proteins. Objectives: verify the prevalence of RTD in the HIV bearers on TDF treatment, identify the risk factors associated and compare the 24-hours urine methods with the serum creatinine and its clearance for the RTD identification. Methods: longitudinal prospective study, performed in the Complexo de Doenças Transmissíveis em São José do Rio Preto/SP, between january 2011 to december 2015. Results: 163 patients were included in the study, in which 106 (68,4%) didn't use TDF and 57 (31,6%) used TDF. RTD occured in 8 patients that used TDF, a prevalence of 14%. The patients age was identified as significant risk factor for the development of RTD. The proteinuria (average 109,2mg/24h) and the phosphaturia (average 791,9mg/24h) were significant for the diagnosis of RTD. Conclusions: the prevalence of RTD was 14%. The age was determined as risk factor for RTD, mainly in patients over 60 years-old. Phosphaturia and the proteinuria showed the greatest diagnosis sensibility for RTD, respectively. The serum creatinine and phosphorus concentration, the creatinine clearance and the stand alone hyperproteinuria should not be used as diagnosis predictors for RTD. / A TARV, apesar de ter reduzido a mortalidade por AIDS e aumentado a expectativa de vida dos portadores de HIV, pode contribuir para o aparecimento de efeitos adversos de longo prazo, inclusive renal. O tenofovir (TDF), antirretroviral (ARV) de primeira linha para o tratamento, tem baixo perfil geral de toxicidade. No entanto, pode levar a uma moderada redução na taxa de filtração glomerular (TFG) e uma maior prevalência de disfunção tubular renal (DTR) quando comparado àqueles pacientes que não o utilizam. O declínio da função renal encontrado nos pacientes podem ser injúrias agudas, crônicas ou uma simples redução na TFG. O mecanismo da DTR não é totalmente conhecido; atribui-se à lesão mitocondrial nas células dos túbulos proximais pelo aumento da concentração do TDF intracelular, além da suspeita da influência de polimorfismos genéticos dos hospedeiros. Pode ser resumidamente caracterizada pela deficiência na reabsorção de solutos como bicarbonato, ácido úrico, fosfato, glicose e proteínas de baixo peso molecular. Objetivos: Verificar a prevalência da DTR nos portadores de HIV em uso de TDF; identificar os fatores de risco associados e comparar os métodos de Urina de 24 horas com a creatinina sérica e o clearance para a sua identificação. Casuística e método: estudo longitudinal prospectivo, com 163 pacientes, realizado no Complexo de Doenças Transmissíveis em São José do Rio Preto/SP, no período de janeiro de 2011 a dezembro de 2015. Resultados: Foram incluídos 163 pacientes no estudo, dos quais 106 (68,4%) não utilizaram TDF e 57 (31,6%) utilizaram TDF. A DTR ocorreu em 8 pacientes que utilizaram TDF; uma prevalência de 14%. A idade dos pacientes (média de 43,9 anos) foi identificada como fator de risco significante para o desenvolvimento da DTR. A proteinúria (média 109,2mg/24h) e a fosfatúria (média 791,9mg/24h) foram significantes para o diagnóstico da DTR. Conclusões: A prevalência da DTR foi de 14%. A idade foi determinada como fator de risco para a DTR, principalmente, na faixa acima dos 60 anos. Os exames laboratoriais que mostraram a maior sensibilidade diagnóstica para a DTR foram a fosfatúria e a proteinúria, respectivamente. A creatinina sérica, o fósforo sérico, o clearance de creatinina e a hiperproteinúria isolada não mostraram sensibilidade como preditores diagnósticos para a DTR.

A baixa eficiência da adubação fosfatada em solos altamente intemperizados é devido, entre outros fatores, à adsorção do fósforo (P) à superfície das argilas silicatadas do tipo 1:1 e, principalmente, dos (hidr)óxidos de Fe e de Al. Manejos do solo que induzem a solubilização de formas de P indisponíveis para as plantas têm sido intensamente estudados nos últimos anos. Uma tentativa de aumentar a concentração de P disponível na solução do solo para sua absorção pelas plantas é a mobilização de P por ânions de ácidos orgânicos de baixa massa molar (AOBMM). Ânions derivados de AOBMM exsudados pelas raízes de plantas ou excretados por microrganismos são associados com algumas condições de rizosfera como deficiência de P e fitotoxidez de Al e interagem com o solo de forma a aumentar a biodisponibilidade de P. Dependendo dos atributos do solo, do grau de dissociação, das propriedades e do número de grupos carboxílicos dos ânions orgânicos, o P pode ser mobilizado do solo principalmente devido à dissolução complexométrica de minerais e à adsorção competitiva dos grupos funcionais carboxílicos e fosfato nos sítios de superfície coloidais. A capacidade dos ânions citrato, malato e oxalato em mobilizar P de amostras de um Neossolo Quartzarênico típico (RQ) e de um Latossolo Vermelho ácrico (LVwf) foi avaliada por meio de um estudo de lixiviação de ânions em colunas. Devido a não detecção de P nos efluentes das colunas com LVwf, foi realizado outro estudo em colunas, no qual somente citrato foi lixiviado, mas num volume maior, e as alterações das formas de P nas amostras desse solo induzidas pela lixiviação de citrato foram identificadas por espectroscopia de absorção de raios-X na borda K do fósforo (X-ray absorption near edge structure -XANES - spectroscopy). A capacidade dos ânions de AOBMM em solubilizar P foi mais dependente do teor de P disponível e de outros atributos do solo que do número de grupos funcionais carboxílicos dos ânions orgânicos. Somente o oxalato mobilizou P do RQ, enquanto todos os ânions de AOBMM foram capazes de mobilizar P do LVwf. Quando baixos volumes de solução contendo ânions de AOBMM foram lixiviados no solo, além do aumento do pH, a mobilização de P foi acompanhada pela mobilização de Al no RQ (pH água = 5), e pela mobilização de Ca no LVwf (pH água = 5.6), o que indica solubilização de P pela complexação de Al, Ca, ou Fe, de fosfatos insolúveis, ou pela inibição da precipitação de P com esses metais. Ao lixiviar um volume maior de citrato no LVwf, o P também não foi detectado nos efluentes das colunas, mas houve lixiviação intensa de Al e Fe, bem como mudanças nas proporções de formas de P no solo caracterizadas pelos espectros XANES. Embora tenhamos encontrado indícios da ação dos principais mecanismos de solubilização de P (dissolução complexométrica de minerais e troca de ligantes entre grupos funcionais carboxílicos e P adsorvido ao solo), os ânions de AOBMM mostraram pouco potencial de efetivamente aumentar a biodisponibilidade de P. / Phosphate fertilization of acidic, highly weathered soils is inefficient because of the adsorption of phosphorus (P) to 1:1 silicate clays and, especially, to Fe and Al oxides. Different soil management practices to induce solubilization of unavailable forms of P to plants nutrition have been intensively studied in recent years. The mobilization of P with anions of low molecular weight organic acids (LMWOA) increases the concentration of available P in the soil solution for plant uptake. Anions derived from LMWOA exudates from plants root or excreted by microbes are associated with some rhizosphere conditions, as deficiency of P and Al phytotoxicity, and they interact with the soil in order to increase P availability. Depending on the soil attributes, and degree of dissociation, properties, and number of carboxyl groups from organic anions, P can be mobilized from soil mainly because of complexometric dissolution of soil minerals and ligand exchange of functional carboxyl groups and P adsorbed in soil surface sites. The capacity of citrate, malate and oxalate anions to mobilize P from a Typic Quartzipsamment (RQ) and an Anionic Acrudox (LVwf) was evaluated in a column leaching study. Because no P was detectable in columns effluents from LVwf, another column leaching study was performed, but only citrate was leached with a greater volume of solution, and citrate-induced changes at P forms in the soil were identified by P K-edge X-ray absorption near edge structure - XANES - spectroscopy. The capacity of LMWOA anions to solubilize P was more dependent of P status and other soil attributes, than number of carboxyl groups of organic anions. Only oxalate mobilized P from RQ, and all LMWOA anions were able to mobilize P from LVwf. Increasing of P mobilization and soil pH were followed by increases of Al mobilization from RQ (pH water = 5), and Ca mobilization from LVwf (pH water = 5.6) at lower volumes of LMWOA anions leaching. Phosphorus was solubilized by complexation of Al, Ca or Fe from insoluble phosphate minerals, or by inhibition of Al, Ca or Fe phosphate precipitation. After leaching a greater volume of citrate through LVwf, P was still undetectable in effluents from columns, but there was an intensively leaching of Al and Fe, as well as changes in proportions of adsorbed P characterized in soil XANES spectra. Although we have found evidences about the action of main mechanisms of P solubilization (complexometric dissolution, and ligand exchange of carboxylic functional groups for adsorbed P on soil minerals) by LMWOA anions, they had a little potential to really increase P availability.

Made available in DSpace on 2016-04-28T20:19:07Z (GMT). No. of bitstreams: 1 2006-Joao Luiz de Macedo.pdf: 447755 bytes, checksum: 609ba2d76dfbdccc13f27b181ecc6606 (MD5) Previous issue date: 2006-01-24 / The present work approaches the most important topic discussed by people who deal daily with human resources: the leadership. Leadership is necessary in all kinds of human organization, either in companies or in each of their departments. It is essential in all administration functions: the manager needs to know the human nature as well how to deal with people, that is, to lead. The purpose is to investigate how leadership is carried out in the organizations, identify the leadership styles used, verify if these styles are adequate for the organizations and analyse employee s reaction according to the leadership styles of their superiors. The methodology follow Yin s(2004) proposal as case study, and Fleury (1996) for investigation and comparison of organizational cultures:, analysing the history of organizations, the socialization of new members, the communication process the work process. The variables proposed for the social research try to find out about the human relationship politics, the reward politics, the recognition for good services, the chief s power of decision, the satisfaction of the subordinate in the accomplishment of tasks, the motivation subordinate, the level of mutual confidence and the orientation the subordinates. For this purpose, a qualitative research was realized in a military organization of the Army Force and in a private company. It was detected that each organization has a leadership style, in the exercise of leadership the personal ability is more important than the technical ones and that the successful managers build confidence relations with their subordinates. / O presente trabalho aborda o assunto mais discutido por pessoas que lidam diariamente com recursos humanos; a lideran?a. A lideran?a ? necess?ria em todos os tipos de organiza??o humana, seja nas empresas, seja em cada um de seus departamentos. Ela ? essencial em todas as fun??es da administra??o: o administrador precisa conhecer a natureza humana e saber conduzir as pessoas, isto ?, liderar. O objetivo que se prop?e ? investigar como ? exercida a lideran?a nas organiza??es, identificar os estilos de lideran?a empregados, verificar se os estilos de lideran?a s?o adequados ?s organiza??es e analisar as rea??es dos funcion?rios diante os estilos de lideran?a de seus superiores. A metodologia utilizada segue o proposto por Yin (2004), como estudo de caso e Fleury (1996), como investiga??o e compara??o das culturas organizacionais, analisando-se a hist?ria das organiza??es, a socializa??o de novos membros, o processo de comunica??es, e o processo de trabalho. As vari?veis propostas para a pesquisa social realizada, procuram averiguar sobre a pol?tica de relacionamento humano das institui??es, a pol?tica de recompensas, o reconhecimento pelos bons servi?os prestados, o poder de decis?o dos chefes, a satisfa??o do subordinado na condu??o das tarefas, a motiva??o dos subordinados, o grau de confian?a m?tua e as orienta??es aos subordinados. Para tal, realizou-se uma pesquisa qualitativa em uma organiza??o militar das For?as Armadas e em uma empresa da iniciativa privada. Constatou-se que cada organiza??o possui um estilo de lideran?a, no exerc?cio da lideran?a as habilidades pessoais s?o mais importantes que as habilidades t?cnicas e que os administradores de sucesso constroem rela??es de confian?a com seus subordinados.

To meet increasing competition, get products to market in the shortest possible time, and satisfy heightened customer expectations, products must be made more robust and fewer failures must be observed in a short development period. In this circumstance, assessing product reliability based on degradation data at high stress levels becomes necessary. This assessment is accomplished through accelerated degradation tests (ADT). These tests involve over stress testing in which instead of life product performance is measured as it degrades over time. Due to the role these tests play in determining proper reliability estimates for the product, it is necessary to scientifically design these test plans so as to save time and expense and provide more accurate estimates of reliability for a given number of test units and test time. In ADTs, several decision variables such as inspection frequency,the sample size, and the termination time at each stress level are important. In this research, an optimal plan is developed for the design of accelerated degradation test with a reciprocal Weibull degradation data using the mean time to failure (MTTF) as the minimizing criteria. A non linear integer programming problem is developed under the constraint that the total experimental cost does not exceed a pre-determined budget. The optimal combination of sample size, inspection frequency and the termination time at each stress level is found. A case example based on Light Emitting Diode (LED) example is used to illustrate the proposed method. Sensitivity analyses on the cost parameters and the parameters of the underlying probability distribution are performed to assess the robustness of the proposed method.

In mid-1987, the existing workers’ compensation system in New South Wales was replaced by a new Scheme, called ‘WorkCover’. While WorkCover solved a number of the financial problems that had plagued its predecessor, its enactment created other issues. Furthermore, WorkCover has failed to deal with a number of gaps in providing compensation for occupational injuries, most notably those suffered by independent contractors. By combining a study of aspects of industrial law and industrial relations, this thesis will examine some of those problems and gaps, in particular: (a) Should WorkCover be amended to enable independent contractors to come within its ambit? (b) Should there be additional insurance cover available (known as ‘top-up’ insurance) to insure those parts of workers’ wages presently left unprotected by WorkCover? (c) Should workers be permitted to take out another form of ‘top-up’ insurance to increase the quantum of death cover presently provided by the Scheme? (d) Should independent contractors who arc permitted to enter WorkCover also be permitted to obtain the extended cover set out in (b) and (c) above? Where appropriate, the thesis compares WorkCover to the workers’ compensation schemes in other Australian jurisdictions. It develops each of the matters referred to above by referring to the results of the writer’s survey of members of the Institution of Engineers (NSW Branch) which was conducted in May and June 1991.

Highly-active antiretroviral therapy (HAART) has improved the prognosis of HIV-infected individuals. Unfortunately it has also been associated with impaired functional capacity and development of metabolic perturbations which increases health risk. This study tested the hypothesis that a combined cardiorespiratory and resistance exercise training (CARET) intervention may result in significant health benefits in HIV-infected individuals receiving HAART. Thirty-seven HIV-infected men and women, predominantly of lower socioeconomic status (SES), were recruited and randomly assigned to: 1) a group of moderate-intensity CARET for three months or 2) a control group receiving no exercise intervention for three months. At baseline and following the intervention, physical characteristics (body weight, body mass index, waist circumference, and blood pressure), physical fitness variables (estimated VO2max and one repetition maximum for upper and lower body), metabolic variables (fasting glucose and serum lipids), immune functioning (CD4+ T Cell count, CD4/CD8 ratio, and HIV RNA viral load), and quality of life (SF-36 Health Survey) were measured. Exercise participants evidenced increases in estimated VO2max (21%, p < 0.01), upper body strength (15%, p < 0.05), and lower body strength (22%, p < 0.05), while showing reductions in waist circumference (-2%, p < 0.05), and fasting glucose (-16%, p < 0.05). While the control group showed a significant decrease in CD4+ T cell count (-16%, p < 0.05) from baseline, the exercise group maintained a more stable count following training (-3%, p = 0.39). Finally, the exercise participants showed self-reported improvements in physical (11%, p < 0.03) and mental (10%, p < 0.02) quality of life. In conclusion, our study demonstrated that a three-month supervised and moderate intensity CARET program performed three times a week, can result in significant improvements in physical characteristics, physical fitness, metabolic variables, and physical and mental quality of life. Furthermore, the same intervention resulted in more favorable immunological responses following training in HIV-infected individuals of lower SES. Key words: Highly active antiretroviral therapy, HIV, combined aerobic and resistance exercise training, cardiorespiratory fitness, muscular strength, and immune functioning.