Magister Scientiae (Physiotherapy) - MSc(Physio) / Stroke is a leading cause of death and disability worldwide. Individuals with stroke often face functional limitations. There are several factors that are associated with functional outcome post stroke. Treatment in a stroke unit with a multidisciplinary approach reduces the likelihood of dependency after stroke. The aim of the present study is to identify factors influencing functional outcome of stroke patients admitted to a South African tertiary hospital. A descriptive, observational, longitudinal quantitative study design was used to obtain the data. Convenience non-probability sampling method was used. The research instruments used to collect the data were National Institute of Health Stroke Scale (NIHSS), Hospital Anxiety and Depression Scale (HADS), Barthel Index and a socio-demographic and medical profile data form. All the instruments were used at admission and discharge while at two months only Barthel Index was used for data collection. The data analysis was done using SPSS v 18 and SAS v 9. Mean, standard deviation, range and percentages were used for descriptive purposes and Tobit analysis was used to determine the association between independent and dependent variables. The descriptive results showed that the mean age was 59.83 years with number of females slightly more than males and hypertension being the most common risk factor. The results of the quantitative analysis revealed four factors that influence functional outcome at either discharge or at two months: age, severity of stroke, functional level at admission. Age and severity of stroke influenced the functional outcome at both the stages. The necessary ethical clearance was obtained in prior to commencement of the study. The outcomes of the study could contribute to enhance rehabilitation of stroke patients at an inpatient settings and awareness among population.

Recent advances in graphics processing units (GPUs) have resulted in massively parallel hardware that is easily programmable and widely available in commodity desktop computer systems. GPUs typically use single-instruction, multiple-data (SIMD) pipelines to achieve high performance with minimal overhead for control hardware. Scalar threads running the same computing kernel are grouped together into SIMD batches, sometimes referred to as warps. While SIMD is ideally suited for simple programs, recent GPUs include control flow instructions in the GPU instruction set architecture and programs using these instructions may experience reduced performance due to the way branch execution is supported by hardware. One solution is to add a stack to allow different SIMD processing elements to execute distinct program paths after a branch instruction. The occurrence of diverging branch outcomes for different processing elements significantly degrades performance using this approach. In this thesis, we propose dynamic warp formation and scheduling, a mechanism for more efficient SIMD branch execution on GPUs. It dynamically regroups threads into new warps on the fly following the occurrence of diverging branch outcomes. We show that a realistic hardware implementation of this mechanism improves performance by an average of 47% for an estimated area increase of 8%. / Applied Science, Faculty of / Electrical and Computer Engineering, Department of / Graduate

La reducción de la desnutrición crónica infantil (DCI) en el Perú ha tenido resultados halagadores en los últimos diez años: el promedio nacional se ha reducido de 28% en el 2005 a 13,5% en el 2016. Asimismo, en el ámbito rural se ha experimentado una reducción de 47,1% en el 2005 a 27,2% en el 2016 (INEI 2016), convirtiendo al país en un ejemplo a seguir a nivel internacional. Sin embargo, detrás de las estadísticas se esconde una enorme inequidad al momento de evaluar los resultados en las zonas más pobres del territorio, donde la DCI puede superar al 80% de la población infantil de un distrito. Ese es el caso de Río Tambo, distrito ubicado en la selva central de la región Junín, habitado por una mayoría asháninka que representa más del 70% de la población total, donde los niveles de prevalencia de desnutrición son muy elevados a pesar de los esfuerzos que hacen los diferentes sectores para asignar recursos económicos y humanos para reducir los niveles de DCI que actualmente superan con creces el promedio nacional. De esa manera, los Programas Estratégicos, los Fondos de Estímulo y los Programas de Incentivos del Ministerio de Economía y Finanzas (MEF) no han logrado obtener los resultados esperados; al igual que los programas sociales Juntos y Qaliwarma del Ministerio de Desarrollo e Inclusión Social (MIDIS); así como los Planes Nacionales del Ministerio de Salud (MINSA). Por el contrario, los niveles de anemia, enfermedad asociada directamente con la DCI, experimentaron un alarmante incremento en los últimos dos años del anterior gobierno. En este contexto se desarrolla el presente trabajo de investigación, explorando los factores asociados a la implementación de la política pública contra la DCI en el distrito de Río Tambo, mediante una inmersión en el ambiente de investigación a través de entrevistas, opinión de expertos, observaciones en el campo y el análisis de estudios previos, así como de las experiencias exitosas registradas en localidades de similares características, con el objetivo de entender por qué los niveles de DCI permanecen tan elevados a pesar de toda la movilización de recursos por parte del estado, y proponer la creación e implementación de una unidad de cumplimiento a nivel distrital, empleando para ello la metodología del “delivery unit”. Esta metodología fue creada por Michael Barber para identificar los cuellos de botella que existen en la cadena de suministros del sector público que impiden la entrega eficiente de productos o servicios dirigidos a la ciudadanía, con el fin de articularlos con los procesos administrativos del Estado para corregir sus acciones en el camino y así conseguir mejores resultados (Bonifaz 2017). Normalmente su implementación se encuentra directamente ligada al concepto de Centro de Gobierno, sin embargo, como se verá en el desarrollo del trabajo de investigación, también viene siendo empleada en niveles sub nacionales. Resultado del esfuerzo señalado, el presente documento contiene una propuesta sobre la identificación de los factores más significativos que afectan la reducción de la desnutrición crónica en Río Tambo, así como una serie de actividades que podrían generar un cambio en su desempeño, y los actores que deberían participar en este proceso. Sin perjuicio de lo anterior, el valor adicional de este trabajo de investigación radica en la propuesta de crear e implementar una unidad de cumplimiento a nivel distrital que acompañe los esfuerzos de los sectores involucrados en la reducción de los altos índices de desnutrición crónica y anemia que afectan a la población del distrito de Río Tambo.

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The subject of this thesis was to propose an appropriate solution for creating more effective logistics processes which have been connected with the transportation of packages in the company Pivovary Lobkowicz, Inc. Practical experienc and theoretical knowledge obtained from literature was used in conclusions and calculations in the analysis. The flow analysis of packages and information had been created by using selected logistics methods and led to the development of proposal to reduce the number of transportations of empty packages.

Acute ischemic stroke (AIS) is a major cause of death and disability in the United States. With advancements in therapeutic reperfusion, it has become clear that improving time-to-treatment is among the most important factors in yielding better outcomes for patients. When AIS occurs in the community, away from readily available interventions, timely recognition and transport are paramount to decreasing the time-to-treatment and ultimately increasing rates of reperfusion and reducing morbidity and mortality. Over the past several years, investigations have launched studying the efficacy of mobile stroke units (MSU) in reducing the morbidity and mortality burden of AIS. MSUs are specially designed transport vehicles, run by trained expert stroke management personnel, and stocked with diagnostic imaging equipment in the form of computed tomography scanners and fibrinolytic therapy. In a number of prospective study designs comparing MSUs to standard management by emergency medical services, researchers have utilized several endpoints including time-to-treatment, rates of symptom resolution, and long-term recovery from AIS. These studies have generally demonstrated better outcomes with MSUs and provided evidence for the efficacy of the MSU model in treating AIS. However, most studies have been limited to metropolitan regions of the country, and no randomized-controlled trials have been completed, although one is currently underway. There is little evidence, however, evaluating the cost-effectiveness of MSUs in the management of AIS. The expense of constructing and operating these specialized vehicles over ten years has been estimated to be millions of dollars, while the cost of a single case of AIS can range anywhere from the cost of the emergency department visit to the inclusion of long-term care from resultant sequelae depending on the patient outcome. It remains unclear to what degree the upfront investment in quicker management for AIS is capable of producing downstream cost savings for the healthcare system in the setting of demonstrated improved outcomes. In this study, I propose a method of cost-effectiveness analysis to compare the MSU model to standard management of AIS occurring in metropolitan communities to determine whether MSUs are cost-effective, or possibly cost-saving.

Synthetic unit hydrographs, which assume uniform rainfall excess distribution and static watershed conditions, are frequently used to estimate hydrograph characteristics when observed data are unavailable. The objective of this research was to develop a spatially distributed unit hydrograph (SDUH) model that directly reflects spatial variation in the watershed in generating runoff hydrographs. The SDUH model is a time-area unit hydrograph technique that uses a geographic information system (GIS) to develop a cumulative travel time map of the watershed based on cell by cell estimates of overland and channel flow velocities. The model considers slope, land use, watershed position, channel characteristics, and rainfall excess intensity in determining flow velocities. The cumulative travel time map is divided into isochrones which are used to generate a time-area curve and the resulting unit hydrograph. Predictions of the SDUH model along with the Snyder, SCS, and Clark synthetic unit hydrographs were compared with forty observed storm events from an 1153-ha Virginia Piedmont watershed. The SDUH model predictions were comparable or slightly better than those from the other models, with the lowest relative error in the peak flow rate prediction for 12 of the 40 storms, and a model efficiency of at least 0.90 for 21 of the storms. Despite the good predictions of the hydrograph peak flow rate and shape, the time to peak was underpredicted for 34 of the 40 storms. Runoff from the 40 storms was also generated for two subwatersheds (C: 462 ha; D: 328 ha) in Owl Run to assess the effect of scale on the SDUH model. Peak flow rate predictions were more accurate for the entire watershed than for either subwatershed. The time to peak prediction and model efficiency statistics were comparable for the entire watershed and subwatershed D. Subwatershed C had poorer predictions, which were attributed to a large pond in the main channel, rather than to scale effects. The SDUH model provides a framework for predicting runoff hydrographs for ungauged watersheds that can reflect the spatially distributed nature of the rainfall-runoff process. Predictions were comparable to the other synthetic unit hydrograph techniques. Because the time to peak and model efficiency statistics were similar for the 1153-ha watershed and a 328-ha subwatershed, scale does not have a major impact on the accuracy of the SDUH model. / Master of Science

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M.Sc. (Nursing), Faculty of Health Sciences, University of the Witwatersrand, 2009