Research report submitted in fulfilment of the degree of Master of Public Health (MPH) at the University of Witwatersrand July 2015 / Introduction: Swaziland is facing a very high HIV prevalence and critical human resources for health (HRH) crisis. The Nurse Initiated and Managed Anti-Retroviral Treatment (NIMART), a task shifting program to capacitate nurses to offer ART services, was introduced in 2009 by the government of Swaziland to address the human resources for health (HRH) challenges in the country. Although the country has attained 80% coverage in ART provision amongst adults, the ART coverage in children below 15 years of age is 9% which falls way below the WHO stipulated proportion of 15% in that age group. In addition, ever since the NIMART was introduced there have been limited studies done in Swaziland to explore the perceptions of health workers with regards to its implementation. This study explored providers’ perceptions on the facilitators and barriers to the NIMART implementation in Manzini Region. Materials and Methods: An exploratory qualitative study was used to explore providers’ perceptions of the facilitators and barriers to the implementation of NIMART services in Manzini Region, Swaziland. A semi-structured interview guide was used to interviews with nurses, clinic managers and medical doctors who were purposively selected from five urban and three rural clinics offering NIMART services in Manzini Region, Swaziland. Thematic content analysis was used to analyse data guided by the Donabedian conceptual framework. Results: The findings showed that two weeks training was offered to the professional nurses before they were certified as NIMART nurses. The first week of training was mainly theory classes while the second week was on-site practical training. The NIMART program was perceived as vital by the providers interviewed as it improved access to ART, reduced patient waiting times, empowered nurses and was a cost effective program to address the shortages of doctors in the country. Structural factors like availability of health facilities, professional nurses, antiretroviral drugs and antiretroviral treatment guidelines at the facilities visited were reported by most respondents as facilitators of the implementation of the program. Process factors like the training of NIMART nurses in some facilities, the partnership between the Ministry of Health and various nongovernmental organisations, the health workers commitment and team work greatly facilitated NIMART implementation. Structural barriers like limited paediatric antiretroviral regimen choices and limitations in paediatric ART policy and legislation were mentioned to negatively affect ART uptake in children. Other barriers like children’s dependency on adult caregivers for their health issues and poor socioeconomic circumstances in communities were mentioned to be hampering ART uptake in children. Process factors like inadequate training of the NIMART nurses in some clinics, parents’ and caregivers’ myths and misconceptions around HIV, AIDS and ART, high HIV and AIDS stigma and poor access to health services were also raised. Conclusion and Recommendations: Even though there were facilitating factors of the NIMART program like availability of ART drugs and ART treatment guidelines which have been seen to have played a major role in ART uptake in adults, there are still many barriers to the implementation of NIMART as evidenced by the poor ART uptake in children. The inadequate training of NIMART nurses on paediatric ART, children’s total dependency on adults for their health needs and parents’ and caregivers’ misconceptions around HIV and AIDS negatively impacted the paediatric ART program. Other barriers included poor socioeconomic status and paediatric ART policy and legislation limitations. As a result, the recommendations are that the NIMART training program for nurses be improved with particular emphasis on paediatric ART. There is need to incorporate NIMART training into the nursing curriculum to ensure that more nurses are trained in ART provision. Community awareness needs be raised to address the issues around stigma, myths and misconceptions of HIV and AIDS through educational programs. There is also a need to increase the recruitment of nurses and improve motivation of nurses through provision of incentives.

Blazars are a subclass of active galactic nuclei whose observable characteristics are generated by relativistic jets of high-energy plasma with trajectories closely aligned to the line of sight. This orientation results in extreme observed phenomena, such as ultraluminous emission, high amplitudes of variability, and high degrees of optical linear polarization. Furthermore, blazars are the most common extragalactic sources of γ-ray photons and have been proposed as sources of high-energy neutrinos. Long-timescale monitoring of blazars has revealed relatively quiescent states interspersed with active states featuring dramatic brightening events, with timescales ranging from months to years. New, high-time-resolution observations of blazars are revealing dramatic variability on timescales as short as several minutes, the physical drivers of which are not well understood. In this dissertation, I focus on observational signatures that can potentially identify these mechanisms. To characterize this variability, I combine observations of blazars from many telescopes, obtaining a comprehensive view of events occurring in the jets. Using the Very Long Baseline Array, I investigate moving and quasi-stationary features in the parsec-scale jets of 38 blazars. I find that the flow speeds, orientation, brightness temperatures, and opening angles of the jets in flat-spectrum radio quasars (FSRQs), BL Lacertae type objects (BL Lac objects), and radio galaxies (RGs) are statistically different, with FSRQs having the highest speeds and smallest viewing angles. Focusing on a typical source of each subclass, I characterize the optical variability observed at 2-min cadence (with the Transiting Exoplanet Survey Satellite), at gamma-ray energies (Fermi Large Area Telescope), X-ray energies (NICER, NuSTAR, and Swift satellites), and optical (ground-based instruments, especially, the Perkins telescope), including linear polarization measurements. I find that the minimum timescale of RG variability is longer than those of the FSRQ and BL Lac object, and is likely caused by changes in the accretion disk. In contrast, the variability in the FSRQ and BL Lac object can be associated with shocks, magnetic reconnections, and turbulence in the jet. The unprecedented availability of data, which promises to expand in the future, represents a new phase of observational astronomy that provides valuable information on changes in the jets of blazars.

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Yes / Objective: This article gives an in-depth insight into the ways in which communication between midwives and the birthing woman shape the birth experience. Background: Birth is a significant life event for many women that can have profound, long-lasting effects on how they see themselves as women and mothers. Within the literature the importance of control over the birth experience and the support that the birthing woman receives from midwives is stressed. Methods: Six women who had recently given birth participated in one-to-one semi-structured interviews designed to explore the kinds of support they received before, during and after their birth. An inductive thematic analysis was employed in order to identify and explore key issues which ran throughout the interviews. Results: Within the interviews the importance of being an active mother, someone who made decisions in relation to her labour, was stressed. The analysis explores the ways in which communication style and compassionate care either enabled or prevented women from adopting the position of ‘active’ mother. Conclusion: It is argued that a personal connection with midwives and clear and open communication which places the birthing woman in a position of control are key to positive birth experiences.

In this work, the potential of an active-skin is demonstrated for the reduction of broadband acoustic radiation from a vibrating structure. A simplified representation of the active-skin, employing acoustic monopoles as secondary sources, is explored as a precursor to the more complicated analyses of the device. Many design issues are addressed at this stage, taking advantage of the simplicity of this model. Numerical Methods, such as the Finite Element Method (FEM), are employed in the development of both structural and acoustic models for the active-skin. These modeling techniques are also employed for the primary structure, a simply-supported steel plate. The obtained models of the plate are validated using both theoretical and experimental comparisons. Experimental results are also used to verify the structural and acoustic models of the active-skin. Integration of these models into the control simulation provides a methodology for investigating the control characteristics of the active-skin. Two different skin configurations are investigated. The first employs the active-skin as a partial covering of a steel plate, while in the second configuration the active-skin completely covers a clamped aluminum plate. In each case, experimental results are presented, in which microphones are used as error sensors, for validation of the analytical active-skin model. The model is then used to investigate the effect of Structural Acoustic Sensing (SAS) on the control performance as an alternative to microphone error sensing. The adaptive feedforward Filtered-x Least-Mean-Square (LMS) algorithm is employed for both analytical and experimental control simulations showing the utility of such an active-skin in the control of structure-borne sound. A summary of the analytical and experimental findings is given and conclusions are drawn from these findings regarding the potential for the active-skin in the broadband attenuation of structurally radiated sound. / Master of Science

The characteristics of an automotive passenger seat in response to vibrational excitations are examined and an active vibration isolation system incorporating smart materials is designed, built, and tested. Human sensitivity to vibration is discussed. Characteristics of road roughness are discussed and used to implement a representative test input to a passenger seat system. extsc{Matlab} is used to model the car seat and vehicle system with four degrees of freedom to determine actuator requirements. Selection and implementation of a low--profile, prestressed piezoceramic device into an active seat suspension system is described, and experimental results of the actuator assembly performance are presented. Vibration isolation is realized in an experimental setup representing one quarter of a seat and passenger's total mass, using one actuator assembly (representing one corner of the seat suspension). For an input power spectrum representative of a passenger vehicle environment, the smart material actuator assembly, as applied to a quarter seat experimental setup, is proven to be capable of isolating vibration with an isolation frequency of 2Hz and no resonant peak, versus 6Hz and a resonant peak of 2g/g for an actual passenger seat tested. / Master of Science

Weight is a critical parameter in the design of any system launched into space. Current launch costs are on the order of 10,000 dollars per pound of payload capacity. Reducing weight and thus increasing payload capacity is always in the forefront of the design process. One method of increasing the payload capacity of launch vehicles is to reduce the acoustic environment in the interior of the fairing. A major problem is that passive methods currently used for noise suppression do not exhibit significant energy dissipation at low frequencies. This motivates the use of active noise control. Using active noise control for frequencies below 200 to 300 Hz in addition to the passive control means has potential to provide broadband noise suppression and thus a smoother, cheaper ride for any payload. The problem with this technique is that active noise control commonly uses electromagnetic speakers as the control element. The weight of the speaker adds more cost to the application due to the approximate cost per pound to send a launch vehicle and payload to space. At 10,000 dollars per pound of payload capacity, the added cost spent on protecting the payload can potentially reduce the amount of payload capacity a customer receives due to monies spent on non-payload mass. Therefore, necessity dictates a light weight noise control solution. This work investigates the feasibility of a transducer with less mass than that of a conventional loudspeaker which dissipates energy at the acoustic resonances of an enclosed cavity. The test setup involves using the transducer to lower the sound pressure levels of acoustic resonances which are excited by an external source, thus simulating the launch phase of a launch vehicle. The transducer is used as an actuator to add damping through feedback control. The transducer is comprised of three thin flexures that are actuated by piezoceramic material attached to both sides. The flexures actuate a speaker cone that is attached to the end of the flexures. The transducer can act as a sensor or an actuator due to the nature of the piezoceramics. The sound absorbing transducer is modeled to couple to the first acoustic resonance of a six foot cylindrical cavity. The cavity acts as a simplified model of a launch vehicle payload fairing. Equations of motion are derived to model actuator motion and the acoustic impedance of the cavity. A state-space model of the system was derived for two cases: a collocated sensor/actuator pair exciting the tube and an external source exciting the tube with the transducer acting as an absorber. The transducer is designed to affect the first mode, however damping is noticed in the next acoustic resonance. Analysis of the theoretical model indicated up to 70 percent reduction of the open-loop RMS values or a reduction of 10 dB. Experimental results with the optimized transducer produced a 35 percent reduction of the open-loop RMS value or 3.73 dB. The first acoustic resonance coupled well with the first structural mode of the transducer providing optimal noise suppression for the first mode. Damping was also noted in the second acoustic mode. Neglecting the inertia of the tip mass introduced errors in the predictions of the transducer resonances at higher frequencies. This problem limited the ability to control the higher modes of the cavity. / Master of Science

This study examined the effect of active learning seminars and a mentoring program on the use of active learning teaching techniques by college faculty. A quasi-experimental study was conducted using convenience samples of faculty from two private Christian supported institutions. Data for the study were collected from surveys and faculty course evaluations. The study lasted one semester. Faculty volunteers from one institution served as the experimental group and faculty volunteers from the second institution were the comparison group. The experimental group attended approximately eight hours of active learning seminars and also participated in a one-semester mentoring program designed to assist faculty in application of active learning techniques. Several individuals conducted the active learning seminars. Dr. Charles Bonwell, a noted authority on active learning, conducted the first three-hour seminar. Seven faculty who had successfully used active learning in their classrooms were selected to conduct the remaining seminars. The faculty-mentoring program was supervised by the researcher and conducted by department chairs. Data were collected from three surveys and faculty course evaluations. The three surveys were the Faculty Active Learning Survey created by the researcher, the Teaching Goals Inventory created by Angelo and Cross, and the college edition of Learner-Centered Practices by Barbara McCombs. The use of active learning techniques by the experimental group increased significantly more than the use by those in the convenience sample. No statistical difference was found in the change of professors' teaching beliefs or the course evaluation results.

This paper is the use of the active inductor instead of passive inductors to save area, enter the match aspects of the use of the feedback capacitor in parallel with the resistor to achieve matching with the control input voltage, in addition to adjusting the feedback resistor can control the noise. The LNA dissipates 13.2 mW power and achieves input return loss (S11) below -10dB, output return loss (S22) below -10 dB, forward gain (S21) of 11.3~14.5dB, reverse isolation (S12) below -40dB, and noise figure (NF) of 3~3.18 dB. 1-dB compression point (P1dB) of -24 dBm and input third-order inter-modulation point (IIP3) of -14 dBm .