African horse sickness virus (AHSV), a member of the Orbivirus genus within the Reoviridae family, causes an acute disease in horses with a high mortality rate. AHSV encodes four nonstructural proteins (NS1, NS2, NS3/NS3A), whose functions in the viral life cycle are not fully understood. The NS1 protein is the most abundantly expressed viral protein during AHSV infection and forms tubular structures within the cell cytoplasm. No function has been ascribed to these tubules to date, although it has been suggested that they may play a role in cellular pathogenesis. Studies aimed at understanding the function of NS1 have been hampered by the lack of a suitable reverse genetics system for AHSV. However, the phenomenon of RNA interference (RNAi) has emerged as a powerful tool whereby the function of individual genes can be studied. In mammalian cells, RNAi can be triggered by exposing cells to double-stranded RNA either via exogenous delivery of chemically synthesized small interfering RNAs (siRNAs) or endogenous expression of short hairpin RNAs (shRNAs). Consequently, the aim of this investigation was to develop a plasmid DNA vector-based RNAi assay whereby expression of the AHSV-6 NS1 gene could be suppressed in BHK-21 cell culture with shRNAs directed to the NS1 gene. To investigate, complementary oligonucleotides corresponding to selected AHSV-6 NS1 gene sequences were chemically synthesized, annealed and cloned into the pSUPER shRNA delivery vector under control of the RNA polymerase III H1 promoter. The plasmid DNA vector-expressed shRNAs targeted sequences within the NS1 gene corresponding to nucleotides 710 to 728 (shNS1-710) and 1464 to 1482 (shNS1-1464), respectively. A NS1- eGFP chimeric gene was constructed and used towards establishing a simple assay whereby the gene silencing efficiency of different RNAi effector molecules could be evaluated by analysis of the protein level visually and quantitatively by fluorometry. The effect of the NS1- directed shRNAs on AHSV-6 NS1 protein expression was subsequently evaluated by cotransfection of BHK-21 cells with the respective recombinant pSUPER shRNA delivery vectors and the NS1 reporter plasmid pCMV-NS1-eGFP. The results indicated that shNS1- 710 and shNS1-1464 suppressed NS1-eGFP expression by 19% and 9%, respectively. The potential of the NS1-directed shRNAs to suppress NS1 mRNA expression was investigated by transfection of BHK-21 cells with the respective recombinant pSUPER shRNA delivery vectors, followed by transfection with the recombinant mammalian expression vector pCMVNS1 or infection with AHSV-6. Results obtained by semi-quantitative real-time PCR assays indicated that both NS1-directed shRNAs interfered with NS1 mRNA expression, albeit to different extents in the respective assays. Taken together, these results demonstrated that AHSV-6 NS1 gene expression can be suppressed in BHK-21 cells by plasmid DNA vectorderived shRNAs and suggests that this approach may, with further optimization, be useful in determining the function of the NS1 protein in virus-infected cells. / Dissertation (MSc)--University of Pretoria, 2011. / Microbiology and Plant Pathology / unrestricted

Model development for incorporating “indigenous” postnatal care into a midwifery healthcare system is of utmost importance in ensuring the provision of culturally congruent care. There has been only limited evidence of the availability of a model which addresses “indigenous” postnatal care practices in midwifery health care systems. As a result, the nurses operate from a modern healthcare point of view only, rather than combining the two worldviews. The main aim of the study was to develop a model for incorporating “indigenous” postnatal care practices into the midwifery health care system in Mopani District, Limpopo Province of South Africa. The study was conducted in three phases. During the first phase the meaning of the concept “incorporation” was analysed. The results guided the researcher during data collection in the second phase, consisting of in-depth individual and focus group interviews to explore the experiences and perceptions of postnatal patients, family members, traditional birth attendants, registered midwives, Midwifery lecturers and the maternal and child healthcare coordinators. The findings confirmed that currently the “indigenous” postnatal care practices are not incorporated in the Midwifery curriculum, books or guidelines for maternity care. As a result there is lack of knowledge amongst midwives regarding the “indigenous” postnatal care practices and it is difficult for them to provide culturally congruent care. Due to inadequate knowledge midwives are displaying negative attitudes towards the family members, traditional birth attendants and patients from diverse cultures. The participants confirmed that there is no teamwork between the registered midwives and the traditional birth attendants (family members). The study findings also confirmed that currently there are no follow-up visits by the midwives for patients during the postnatal period. The midwives are imposing their health beliefs an practices onto the patients on discharge after delivery, without the involvement of the family members or the traditional birth attendants, resulting in sub-standard postnatal care, leading to postnatal complications and an increasing maternal mortality rate. Based on the findings of phases one and two, a model for incorporating “indigenous” postnatal care practices into a midwifery healthcare system was developed and described. The implications for further studies suggested the evaluation and implementation of the model in the healthcare institutions, nursing colleges, clinics and hospitals as an initial step to assist the Department of Health in Limpopo Province in incorporating “indigenous” practices into healthcare systems. / Thesis (PhD)--University of Pretoria, 2012. / Nursing Science / unrestricted

Indicators of child mortality in the lowest age reflect the status of health care and maturity of the country. The most frequent indicator in this area is the infant mortality rate. This thesis is focused on evaluation of development of infant, neonatal and early neonatal rate in the European union between 1960 and 2010 from the perspective of time series, aplication of Box-Jenkins methodology and assessment of the relation between infant mortality rate and life expectancy at birth.

INTRODUÇÃO: A busca do entendimento das causas da mortalidade humana está relacionada diretamente ao conhecimento das condições de vida de uma população. Reduzir a mortalidade de crianças é uma das principais metas das políticas de saúde para a infância em todos os países. No Brasil, apesar da redução da mortalidade infantil (MI) observada nos últimos anos, existem, porém, grandes diferenciais do CMI entre algumas populações. OBJETIVO: Estudar a evolução da mortalidade infantil no Estado de Santa Catarina e a tendência de queda dos óbitos infantis evitáveis nas nove Macrorregiões Estaduais de Saúde do Estado, no período de 1997- 2008. METODOLOGIA: Estudo ecológico de séries temporais com cálculo e análise do CMI, segundo componentes e critérios de evitabilidade para óbitos ocorridos nas nove Macrorregiões catarinenses, no período entre 1997-2008. Foram analisadas, por regressão linear simples, as médias trianuais dos óbitos evitáveis, segundo Macrorregiões, no mesmo período. RESULTADOS: analisados 15.146 óbitos ocorridos no primeiro ano de vida, observou-se que 51por cento , aconteceu entre 0 e 6 dias,13,8por cento entre 7 e 27 dias e 35,8por cento , de 28 a 364 dias de vida. O Estado de Santa Catarina registra um dos menores CMIs do país e apresentou queda de 27,2por cento , principalmente às custas do componente pós-neonatal, mostrando, no entanto, preocupantes taxas de mortalidade infantil por óbitos evitáveis (58,6por cento ) e importantes diferenças no CMI entre as Macrorregiões catarinenses. O CMI por óbitos evitáveis do Planalto Serrano (11,90/00NV) foi o dobro da Macrorregião Nordeste (5,70/00NV). CONCLUSÕES: apesar do declínio do CMI, o Estado de Santa Catarina apresentou estabilização das taxas da MI para o componente neonatal e elevado índice de óbitos evitáveis, com diferenças substanciais das suas taxas entre as Macrorregiões, no período estudado. Essa realidade aponta para a necessidade urgente de estudos sequenciais que elucidem esses fatos, a fim de que intervenções ajustadas ás populações estudadas possam vir a acontecer, diminuindo as mortes infantis no território catarinense / INTRODUCTION: The pursuit for understanding the causes of human mortality is related straight to the knowledge of a living society conditions. The reduction of child mortality is the major goal of children health policies in all countries. In Brazil, despite of the infant mortality reduction observed in recent years, there are, however, huge differences of Infant mortality rate between populations. OBJECTIVE:In order to study the infant mortality evolution in the Santa Catarina State and the downward trend of avoidable child deaths in nine Health Macro-regions in the State, in each triennium from 1997 to 2008. METHODS: An ecological time series studies with calculation and analysis of Infant mortality rate second components of the infant mortality, in the nine Santa Catarina Macro-regions (Brazil) for avoidability deaths in a period between 1997 and 2008, the triennial averages of avoidable deaths, by regions in the same period, were analyzed by simple linear regression. RESULTS: Was analyzed 15,146 deaths in the first year of life between1997- 2008, the data showed that 51per cent of the total occurred from 0 to 6 of life days, 13.8per cent between 7 and 27 days and 35.8per cent of 28 to 364 days of life, the state of Santa Catarina showed a decline of CMI (27.2per cent), mainly due to a postneonatal fees period, showing, however alarming rates of infant mortality from preventable deaths (58.6per cent) and important differences among SC regions of the CMI. CONCLUSIONS: Despite the decline of CMI, the state of Santa Catarina showed stabilization of the neonatal ID and high rate of avoidable deaths, with significant differences in their rates among regions, in the study period. This reality leads to the urgent need for sequential studies that will elucidate these facts, so that interventions set to a studied of a specific populations may happen, reducing child deaths in the territory of Santa Catarina

Masters of Commerce / The provision of health care in South Africa is undergoing major restructuring. The aim is to achieve substantial, visible and sustainable improvements to the efficiency and accessibility of primary healthcare (PHC) services for all South Africans. One of the country's most critical problems is the weak and fragmented public sector PHC system. The most critical problems contributing to this are the maldistribution of resources (financial, physical and human) between hospitals and the primary care system, and between rural and urban areas. The health sector, therefore, faces the challenge of a complete restructuring and transformation of the national health care delivery system and related institutions. Choices need to be made about which services to cut, which to streamline and where savings can be made. Ways need to be found to use ALL of South Africa's resources optimally. This process of restructuring would be facilitated by the availability of accurate information on resource utilisation in the health sector. This study estimates the difference in the cost of primary diabetes treatment at dayhospitals and a provincial hospital in the Western Cape in 1992/93. Health economics is in its infancy in South Africa and serious data limitations exist. This study is therefore a pioneering effort in many ways. An appropriate methodological framework in which to conduct the costing had to be developed. The South African health sector, health spending arid the cost of primary diabetes treatment at day-hospitals and the provincial hospital are reviewed. Theoretical perspectives of the health care market and the methodologies of cost analysis are discussed. The cost analysis method of study is chosen, and arguments are advanced for its suitability in the South African context. A simple method of calculating the direct costs to obtain the average cost is proposed for the purpose of the study. Direct costs consist of staff costs and other related costs, such as medical supplies, non-medical supplies, building operations, equipment etc. These costs are then used to calculate the average costs per diabetic patient at the day-hospitals and the provincial hospital. The average cost per diabetic patient at day-hospitals amounted to R18.76, while at the provincial hospital the cost was R59.60. https://

京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第23822号 / 社医博第122号 / 新制||社医||12(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 木村 剛, 教授 西浦 博, 教授 長尾 美紀 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

Life insurance companies rely on mortality rate models to set appropriate premiums for their services. Over the past century, average life expectancy has increased and continues to do so, necessitating more accurate models. Two commonly used models are the Gompertz-Makeham law of mortality and the Lee-Carter model. The Gompertz-Makeham model depends solely on an age variable, while the Lee-Carter model incorporates a time-varying aspect which accounts for the increase in life expectancy over time. This paper constructs both models using training data acquired from Skandia Mutual Life Insurance Company and compares them to validation data from the same set. The study suggests that the Lee-Carter model may be able to offer some improvements compared to the Gompertz-Makeham law of mortality in terms of predicting future mortality rates. However, due to a lack of qualitative data, creating a competitive Lee-Carter model through Singular Value Decomposition, SVD, proved to be problematic. Switching from the current Gompertz-Makeham model to the Lee-Carter model should, therefore, be explored further when more high quality data becomes available.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-06-21T12:06:44Z No. of bitstreams: 1 lilianaguiarvieira.pdf: 829755 bytes, checksum: bafd8acee6f1b0f73d3e0f36cd430974 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-13T15:27:20Z (GMT) No. of bitstreams: 1 lilianaguiarvieira.pdf: 829755 bytes, checksum: bafd8acee6f1b0f73d3e0f36cd430974 (MD5) / Made available in DSpace on 2016-07-13T15:27:20Z (GMT). No. of bitstreams: 1 lilianaguiarvieira.pdf: 829755 bytes, checksum: bafd8acee6f1b0f73d3e0f36cd430974 (MD5) Previous issue date: 2012-03-28 / A relação existente entre capital social e a saúde tem sido objeto de estudo há longa data. A participação cívica encontra-se presente em legislações de saúde, nos movimentos pela prevenção e promoção da saúde e nas conferências e conselhos de saúde. Este estudo busca contribuir com a discussão da existência de associação entre saúde e capital social. Foram verificadas associações entre taxa de mortalidade por causas externas – agressão e lesões autoprovocada – e participação ativa na vida associativa dos indivíduos, manifestações de interesse na organização da sociedade civil e atividade dos conselhos gestores municipais, em municípios com mais de 100.000 habitantes. Aplicou-se o método de regressão múltipla assimétrica no modelo skew-normal. Utilizaram-se como variáveis de controle: Coeficiente de GINI, renda per capita dos municípios, IFDM e o PIB. Os resultados mostram existência de associação entre as taxas de mortalidade e variáveis que captam aspectos do capital social. Mortalidade por agressão e mortalidade por lesões autoprovocadas apresentaram perfis diferentes de associação com variáveis relacionadas ao capital social. / The relationship between social capital and health has been studied for a long time. Civic participation is present in the laws of health, health promotion movements and other councils and conferences about health. This study intends to contribute to the discussion of the existence of an association between health and social capital. Associations were found between mortality from external causes - aggression and self-harm injuries - and active participation in associational life of citizens, expressions of interest in civil society organization and activity of the municipal councils in cities with more than 100,000 habitants. Method was applied in multiple regression assymmetric skew-normal model. Thus, some control variables were used: Gini coefficient, per capita income of the cities, municipal development Firjan index (IFDM) and the Gross National Product (PIB). The results show an association between mortality rates and variables that capture aspects of social capital. Mortality from aggression and self-harm mortality showed different patterns of association with variables related to social capital.

Background Pregnancy and childbirth are normal physiological processes but the internal and external circumstances in which the child is conceived and born affect the life of the mother and child. Every pregnancy is associated with unpredictable risks and complications. Therefore, having a birth preparedness and complication prevention plan including safe motherhood are paramount to reduce maternal and infant mortality rates. Purpose of the study This study aimed to establish the pregnant women’s knowledge, perceptions and practices regarding birth preparedness planning, complication readiness and safe motherhood at Raleigh Fitkin Memorial Hospital to help reduce some of the avoidable causes of maternal and infant mortality rates. Research design and methods An exploratory, descriptive and qualitative research design was used for the study. Women who had delivered within a period of one week were purposively selected from the research site and interviewed using a structured interview guide until saturation of data. Ethical considerations were adhered to and measures of trustworthiness were applied. Giorgi’s analytic method was used for data analysis. Findings The findings revealed that most participants were not well informed about birth preparedness although some had managed to save for baby requirements and hospital fees. Transportation to the hospital for ANC and delivery was a problem to those who ended up delivering their babies at home or on the way to hospital. Knowledge about complications of birth was poor and only a few participants could name bleeding and prolonged labour. Most participants were not sure about safe motherhood, whilst some mentioned contraception and post-natal care. Conclusion Evidence from the study reveal that as much as pregnant women prepare baby’s clothes and money for labour and delivery, psychological preparation and transport preparation seemed poor. Complication readiness was not known by most participants. / Health Studies / M.A. (Health Sciences)

Introdução A mortalidade infantil (MI) no Município de São Paulo (MSP) apresenta queda, principalmente a partir da década de 80, entretanto é possível que existam diferenças regionais importantes entre Subprefeituras uma vez que estas apresentam características sócio-ambientais que podem influenciar neste indicador. Objetivo Descrever e analisar a evolução da MI no período de 2000 a 2007, segundo Subprefeituras do MSP. Métodos Estudo ecológico longitudinal, com 31 unidades de análise (Subprefeituras). Utilizou-se, para a análise estatística, o modelo de regressão linear multinível, considerando-se, como variável resposta, o CMI e oito anos de observação (2000 a 2007). O modelo incluiu variáveis relacionadas aos serviços de saúde. Resultados A queda da MI não ocorre de modo homogêneo entre as Subprefeituras evidenciadas pelas diferentes inclinações das retas e interceptos observados e estimados. Após a análise pelo modelo multinível observou-se redução da MI no período de 18,8% com declínio médio de 0,300/00nv ao ano Pelo modelo, 51% da variabilidade da MI se explica por características contextuais das Subprefeituras. No período de estudo, o CMI aumenta: 0,0560/00nv para cada 1% de aumento na proporção de mães com pré-natal inadequado, 0,2140/00nv para cada 1% de aumento na proporção da população exclusivamente usuária SUS, 0,0390/00nv para cada aumento na taxa de leitos obstétricos SUS. O CMI diminui: 0,1910/00nv para cada 1% de aumento na proporção de recuperação da vitalidade do nv. Conclusão A MI apresenta tendência de queda no período de 2000 a 2007 de modo não homogêneo segundo Subprefeitura. As variáveis que apresentaram associação com a MI são: o ano de observação, proporção de nascidos vivos de mães que realizaram até 6 consultas pré-natal (pré-natal inadequado); taxa de leitos obstétricos do Sistema Único de Saúde (SUS); proporção da população exclusivamente usuária do SUS e proporção de recuperação da vitalidade do nascido vivo. Na região periférica do MSP onde se encontram as maiores proporções da população exclusivamente usuária SUS, é também onde se apresentam os maiores CMI. / Introduction - Infant mortality (IM) in São Paulo (MSP) has declined, especially from the 80s. However, there may be important regional differences between Districts as their socio-environmental characteristics may influence this indicator. Objective - To describe and analyze IM trend in the period from 2000 to 2007, according to the Districts of MSP. Method - Ecological longitudinal study comprising 31 units of analysis (Districts). Linear multilevel regression model was used for statistical analysis. Infant Mortality Rate (IMR) and eight years of observation (2000-2007) were used as dependent variables. The model included variables related to health services. Results The decrease in IM does not occur homogeneously between Districts as evidenced by the different slopes and intercepts of the observed and estimated lines. A multilevel model showed an 18.8% reduction in IM in the period with an average decline of 0,300/00 living born (lb) per year. According to the model, 51% of the IM variability can be explained by contextual features of districts. During the study period, IMR increases: 0,0560/00lb for every 1% increase among mothers with inadequate prenatal care, 0,2140/00lb for every 1% increase among users of the Unified Health System (UHS), 0,0390/00lb for each increase in the UHS obstetric beds rate. IMR decreases 0,1910/00lb for every 1% increase in the vitality proportion of recovery of live births. Conclusion - IM shows a declining trend over the period from 2000 to 2007 in a non-homogeneous way according to District. The variables that were associated with IMR: year of observation, proportion of live births from mothers who had up to 6 prenatal visits (inadequate prenatal care), Unified Health System (UHS) obstetric beds rate, proportion of UHS users and vitality recovery of live birth proportion. The highest IMR is found in peripheral region of MSP where the largest proportion of UHS users is found.