Published works cite that 70-80% of the total cost of a product is established during conceptual design, and that improvements in time-to-market, quality, affordability, and global competitiveness require the development of better approaches to assist decision-making during the early stages of product design, as well as facilitate enterprise knowledge management and reuse. For many years, concurrent engineering and teaming have been viewed as “the answer” to product development woes, but studies reveal teaming is not sufficient to handle the task complexities of product development and the long-term goal of enterprise learning. The work of Roberto Verganti provides new insights with regard to reciprocal interdependencies (RIs), feedforward planning, selective anticipation in the context of improving teaming and concurrent engineering, as well as enterprise learning, knowledge management, reuse. In this research, reciprocal interdependencies management (RIM) is offered as a means of addressing product development and concurrent engineering issues occurring in the early stages of design. RIM is combination of Verganti’s concepts, a conceptual RIs structure, new RIM-application strategies, RIM-diagramming, and a conceptual RIM-based decisions support system, which come together to form a vision of a RIM-based enterprise knowledge management system. The conceptual RIM-based DSS is presented using the specific case of supporting a working-level integrated product team (IPT) engaged in the design of an aircraft bulkhead. A qualitative assessment tool is used to compare RIM to other approaches in the literature, and initial results are very favorable.

Background: IPT is an effective, safe and feasible disease prevention scheme that should be administered for all PLHIV living in areas with high latent TB prevalence. Objective: To assess the impact of isoniazid in the incidence of tuberculosis among HIV infected individuals in Addis Ababa. Methods: A case control study design was undertaken among 489 HIV and TB infected patients in Addis Ababa from January 2008 to December 2010. Results: Tuberculosis incidence rate among those who developed TB after completing 6-9 month isoniazid preventative therapy was17.14 PYO compared to 10.28 PYO among those who were not. Isonizide reduced the chance of developing tuberculosis among HIV infected patients (OR= 0.072; 95% CI 0.044, 0.12). Age (AOR= 0.14; 95% CI 0.03, 0.97) and sex (AOR= 1.86; 95% CI 1.02, 2.23) of the patient, CD4 count at HIV diagnosis (AOR= 0.21; 95% CI 0.13, 0.31), clinical stage of HIV illness (AOR= 1.22; 95% CI 1.09, 1.84) and past tuberculosis history (AOR = 1.97; 95% CI 1.24, 3.67) were major factors associated with tuberculosis incidence. Conclusions: INH prophylaxis was associated with lower incidence of tuberculosis among PLHIV. / Health Studies / M. Public Health

Les résistances aux traitements actuels contre le cancer imposent de trouver de nouvelles cibles thérapeutiques. Une de ces cibles est le réseau vasculaire assurant un apport suffisant en nutriments et en oxygène à la tumeur, et permettant l’apparition de métastases. Détruire la vascularisation de la tumeur par l’utilisation d’agents antivasculaires (VDA)revient à l’asphyxier et à l’affamer, inhibant ainsi la prolifération des cellules tumorales et empêchant le processus métastatique. L’objectif de ce travail de thèse a été d’étudier des analogues contraints de l’isocombrétastatine A-4 (isoCA-4), une molécule phare du laboratoire, ayant un excellent pouvoir d’inhibition de la polymérisation de la tubuline et présentant une activité antivasculaire. Ces structures dont la double liaison est incluse dans différents types de cycles C,ont été étudiées également afin d’évaluer l’influence de l’angle dièdre formé par les noyaux A et B sur les activités biologiques des divers types de structures. Préalablement sélectionnés par modélisation moléculaire, ces analogues contraints sont de type 1-arylnaphtalène, 5-arylbenzoxépine ou 4-arylchromène et ont été préparés par des voies d’ accès originales développées dans le cadre de cette thèse. Parmi les composés synthétisés, l’analogue de type benzoxépine 3-53est aussi cytotoxique que l’isoCA-4 et possède un pouvoir d’inhibition de la polymérisation de la tubuline équivalent. Une évaluation plus poussée de son profil biologique, ainsi que celle des meilleurs représentants de chaque série chimique est actuellement en cours. / Most tumor cells rely on an efficient vascular supply for their survival, making the tumor vasculature an attractive target for anti-cancer therapy. This thesis aimed at the design and synthesis of constrained analogues of isocombretastatin A-4(isoCA-4), an antivascular agent developed in the laboratory, which exerts excellent cytotoxicities against a large panel ofcancer cell lines, and strongly inhibits tubulin polymerization. Conformationally restricted analogues of isoCA-4,featuring 1-arylnaphthalene, 5-arylbenzoxepine or 4-arylchromene skeletons were designed by computational studies andprepared by novel synthetic strategies. Of all synthesized compounds, benzoxepine analogue 3-53 strongly inhibits tubulinpolymerization and shows excellent cytotoxicities against several human cancer cell lines.

Background: IPT is an effective, safe and feasible disease prevention scheme that should be administered for all PLHIV living in areas with high latent TB prevalence. Objective: To assess the impact of isoniazid in the incidence of tuberculosis among HIV infected individuals in Addis Ababa. Methods: A case control study design was undertaken among 489 HIV and TB infected patients in Addis Ababa from January 2008 to December 2010. Results: Tuberculosis incidence rate among those who developed TB after completing 6-9 month isoniazid preventative therapy was17.14 PYO compared to 10.28 PYO among those who were not. Isonizide reduced the chance of developing tuberculosis among HIV infected patients (OR= 0.072; 95% CI 0.044, 0.12). Age (AOR= 0.14; 95% CI 0.03, 0.97) and sex (AOR= 1.86; 95% CI 1.02, 2.23) of the patient, CD4 count at HIV diagnosis (AOR= 0.21; 95% CI 0.13, 0.31), clinical stage of HIV illness (AOR= 1.22; 95% CI 1.09, 1.84) and past tuberculosis history (AOR = 1.97; 95% CI 1.24, 3.67) were major factors associated with tuberculosis incidence. Conclusions: INH prophylaxis was associated with lower incidence of tuberculosis among PLHIV. / Health Studies / M. Public Health

La investigación realizada a los sistemas de seguridad electrónica de edificios, plantea como objetivo principal el reconocimiento de tres gestos de un lenguaje corporal del personal de vigilancia, y la consecuente activación de alarma en forma automática. Inicialmente se realizó una encuesta dirigida a las administraciones y personal de edificios, para saber cuales eran las ocurrencias que vulneraban la seguridad de un edificio multifamiliar, luego se observaron y analizaron las imágenes capturadas por una cámara de vigilancia ubicada en la recepción, identificando las ocurrencias más vulnerables y gestos asociados a dichos eventos; se seleccionaron tres gestos que en forma inconsciente realizaba el personal de vigilancia ante dichas situaciones. A determinados cuadros que comprenden estas imágenes se le aplicaron técnicas de procesamiento espacial, con ayuda de una iluminación artificial que era más intensa en la parte posterior del sujeto de análisis, consiguiéndose la definición de una silueta binarizada en el entorno Matlab, técnicas como selección del plano rojo, plano de bits más significativo, invertir imagen y transformaciones morfológicas tipo cerradura, definieron una silueta que ayudó a desarrollar un algoritmo matemático para generar una señal eléctrica en el puerto serial USB del ordenador, donde se conectó físicamente una plataforma de hardware Arduino que activa la alarma. La elección de esta plataforma se debió a que Matlab cuenta con un grupo de instrucciones para Arduino, con el objetivo de lograr una comunicación sincronizada entre ordenador e interface. Las técnicas utilizadas reconocieron 62,5% de los eventos descritos en las encuestas realizadas y que no son mencionadas en temas de investigación similar. Para lograr el objetivo fue necesario analizar un cuadro por segundo. The research poses as their main objective the three gestures recognition of a body language of surveillance personnel and the consequent activation of alarm automatically. It was initially carried out a survey of the administration and the offices of the buildings to know which were the occurrences that violate the security of a multi-family building, then were observed and analyzed images captured by a surveillance camera located in the reception, identifying the most vulnerable occurrences and gestures associated with these events; were selected three gestures that unconsciously performs surveillance personnel before such situations; to certain pictures that comprise these images were applied spatial processing techniques, with the help of an artificial lighting that was more intense in the back of the subject of analysis, getting the definition of a silhouette binarized in the Matlab environment, techniques such as plane selection red, more significant bit plane, to invest an image and convolution close type, defined a silhouette that allowed to develop a mathematical algorithm that generated an electrical signal in USB serial port of the computer, where it is physically connected a hardware platform Arduino that active the alarm.This platform choice is due to the fact that Matlab has a group of instructions for Arduino, achieving an orderly communication between computer and interface. The techniques used recognized 62.5 % of the events described in the surveys carried out and which aren’t mentioned in similar research topics. To achieve the objective was necessary to analyze a picture per second.

The purpose of the study was to describe factors contributing to mortality among HIVinfected people on Isoniazid Preventive Therapy (IPT) in Botswana. A quantitative, explorative, descriptive study was used and 80 records of deceased IPT respondents were reviewed through the use of a checklist. The demographic factors, baseline physical examination, hospitalisation and drug history were taken into consideration. Out of the deceased patients, 75% were female. The major findings showed that 100% (N=80), the most highly indicated causes of death were gastroenteritis (18.75%), cryptococcal meningitis (17.5%) andpneumonia (16.25%). Of the patients (28.75%) who died before completing the six months of IPT. The causes of death were gastroenteritis (21.7%), symptoms and signs of bacterial pneumonia (17.4%), cryptococcal meningitis (13%), Pulmonary Tuberculosis (PTB) (13%), septicaemia (13%), and murder (13%). It has been recommended that there should be reorganisation of services of care for HIV-infected persons, such as provision of Cotrimoxazole Prophylaxis Therapy (CPT) and Antiretroviral Therapy (ART) to ensure holistic approach care. The future study should include HIV-infected children on IPT using the same or modified objectives. The conclusion drawn was that disintegrated interventions of IPT, CPT and ART and lack of holistic care for PLHIV lead to opportunistic infections that caused mortality on patients on IPT. / Department of Health Studies / M.A. (Public Health)

The purpose of the study was to describe factors contributing to mortality among HIVinfected people on Isoniazid Preventive Therapy (IPT) in Botswana. A quantitative, explorative, descriptive study was used and 80 records of deceased IPT respondents were reviewed through the use of a checklist. The demographic factors, baseline physical examination, hospitalisation and drug history were taken into consideration. Out of the deceased patients, 75% were female. The major findings showed that 100% (N=80), the most highly indicated causes of death were gastroenteritis (18.75%), cryptococcal meningitis (17.5%) andpneumonia (16.25%). Of the patients (28.75%) who died before completing the six months of IPT. The causes of death were gastroenteritis (21.7%), symptoms and signs of bacterial pneumonia (17.4%), cryptococcal meningitis (13%), Pulmonary Tuberculosis (PTB) (13%), septicaemia (13%), and murder (13%). It has been recommended that there should be reorganisation of services of care for HIV-infected persons, such as provision of Cotrimoxazole Prophylaxis Therapy (CPT) and Antiretroviral Therapy (ART) to ensure holistic approach care. The future study should include HIV-infected children on IPT using the same or modified objectives. The conclusion drawn was that disintegrated interventions of IPT, CPT and ART and lack of holistic care for PLHIV lead to opportunistic infections that caused mortality on patients on IPT. / Department of Health Studies / M.A. (Public Health)

Text in English / Malaria is endemic throughout Uganda and the leading cause of morbidity and mortality. Malaria causes complications in 80.0% of all pregnancies in Uganda. This study attempted to identify factors that influence pregnant women’s utilisation of anti-malaria services in the Buikwe district of Uganda. These factors were contextualised within the Social Learning Theory’s major concepts. The target populations comprised pregnant women attending antenatal clinics (phase 1) and midwives providing antenatal services (phase 2) at 16 clinics in the Buikwe district of Uganda during the data collection phase of the study. Structured interviews were conducted with a sample of 400 randomly selected pregnant women and with the accessible population of 40 midwives. Pregnant women, who had progressed beyond primary school level education, were more likely to take intermittent preventive treatment (IPT) drugs and to use long lasting insecticide treated nets (LLINs) to prevent malaria. Pregnant women were more likely to implement malaria-preventive actions if they lived within five kilometres of clinics, were satisfied with available health services, were knowledgeable about the malaria preventive measures and had used IPT during previous pregnancies. Pregnant women who implemented one malaria-preventive action were likely to implement other actions as well (Pearson’s correlation coefficient was 0.65; p<0.05). Midwives’ provision of malaria-preventive services to pregnant women were influenced by the availability of IPT drugs, accessibility of safe drinking water, frequency of giving health education to pregnant women, cooperation with village health teams, malaria-related in-service training, midwives’ education level and experience. Although 97.9% of the pregnant women had taken IPT and 84.2% of those who had received LLINs, utilised these nets, malaria prevention during pregnancy could be improved. All pregnant women should attend antenatal clinics at least four times during each pregnancy, commencing during the first trimester of pregnancy to receive adequate health education and prenatal services, including IPT and LLINs. All midwives should receive malaria-related in-service training. Regular audits of midwives’ records should identify and address strengths and weaknesses related to the prevention and management of malaria during pregnancy. Such actions could enhance the prevention and management of malaria, estimated to affect 80% of pregnant women in Uganda. / Health Studies / D. Litt. et Phil. (Health Studies)

Background Plasmodium falciparum malaria during pregnancy poses a substantial risk to mother and foetus. In recent years, convincing evidence has shown that preventive methods such as the use of insecticide treated bed nets (ITNs) and intermittent preventive treatment (IPT) in pregnancy with sulphadoxine-pyrimethamine (IPTp-sp) can greatly reduce the adverse effects of malaria during pregnancy. Purpose The main purpose of the study was to assess the knowledge and use of Intermittent Preventive Treatment of Malaria among pregnant women receiving Antenatal Care at the primary health centers of the Federal Capital Territory, Abuja Nigeria. Methods A quantitative, descriptive, cross-sectional study was conducted Structured questionnaires were administered to 300 pregnant women aged between 18 and 49 years. Data was analysed using Statistical Package for Social Sciences (SPSS) 22. Results The results revealed that most of the respondents had knowledge about IPT, majority of the respondents had received IPT drugs, in the clinic, but unfortunately none of them were supervised by a health worker during taking of the drug. Few of the respondents did not take the drugs at all for fear of complication, some of them did not know exactly how many tablets were given to them and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Conclusion Knowledge of malaria and IPT was good and many pregnant women received the drugs and used it, but some of them had challenges and did not use the drugs. / Health Studies / M.P.H.

The research objectives were to describe the age and gender of adult HIV positive clients on ART who received IPT; the incidence of tuberculosis among clients that received IPT and the defaulter rate among those that were commenced on IPT. Quantitative non-experimental descriptive retrospective cohort study was undertaken to ascertain the incidence of tuberculosis among adult HIV positive clients who received IPT. 104 clinic records of HIV positive adult clients accessing care at Isithebe Clinic, iLembe-South Africa who were commenced on IPT between 01 July 2010 and 30 November 2011 were analysed. The study found that 66 of 104 (63.5%) study respondents completed the course of IPT and the majority of those that defaulted were due to poor quality of care. Gender was statistically found to have played a role on whether a patient completes IPT. None of the study respondents that completed IPT was diagnosed with TB disease. / Health Studies / M.A. (Public Health)