Impact of HIV/AIDS-related Adult Mortality on Rural Households' Welfare in Zambia

This study estimates the impacts of prime-age (PA) adult morbidity and mortality on crop production and cropping patterns, household size, livestock and non-farm income in Zambia using nationally representative rural farm household longitudinal survey data. The findings provide important information to assist policy makers, donors, and development planners in designing interventions to mitigate the impacts of the AIDS on vulnerable households.food security, food policy, Zambia, HIV/AIDS mortality, Health Economics and Policy, Q18,

Emerging Structural Maize Deficits in Eastern and Southern Africa: Implications for National Agricultural Strategies

This note summarizes analysis of trends in net maize exports over the 1960-2005 period and examines whether these trends are being reflected in changing maize price levels in the region. The implications are highlighted of the findings for countries’ agricultural development strategies.food security, food policy, Zambia maize, Crop Production/Industries, Q18,

Direct and Indirect Effects of Subjective Financial Knowledge with Financial Satisfaction

In this study, we differentiate subjective financial knowledge from objective financial knowledge and propose that subjective financial knowledge relates to financial satisfaction both directly as well as indirectly through financial behavior. This study used data obtained from a multi-stage random sample of household financial officers in Kerala, India (n=450). Results showed that subjective financial knowledge significantly relates to household financial officers’ financial satisfaction after controlling for objective financial knowledge and other socioeconomic factors. The relationship between subjective financial knowledge and financial satisfaction could be both direct and indirect through financial behavior. The findings suggest that financial education programs should focus on enhancing not only objective financial knowledge but also subjective financial knowledge for engaging in responsible financial behavior, which in turn relates to financial satisfaction

An audit of the moderate to severe acute head injury patients in Chris Hani Baragwanath Academic Hospital

Objectives: Head injury is a devastating condition in developing countries like South Africa, contributing significantly to mortality and morbidity. The various factors affecting outcome like age, gender, mechanism of injury, clinical, radiological findings and treatment is reported. Their relation to outcome (Glasgow Outcome Score) of treatment in Chris Hani Baragwanath Academic hospital is analyzed. Methods: This is a retrospective, descriptive and demographic profile study. The sample group consists of moderate to severe head injury patients admitted in the neurosurgical unit of Chris Hani Baragwanath Academic hospital from January 2011 to June 2012. The data includes age, gender, nature of head injury (scalp, skull, intracranial), mode of injury (fall from height, road traffic accident, fire arm injury, assault, blast injury), condition at presentation [Glasgow Coma Scale (GCS)], pupillary reaction, Computed Tomography (CT) scan findings, treatment received and outcome [Glasgow Outcome Score (GOS)] of treatment. Results: A total of 292 patients was enrolled in the study, 258 males (88.3%) and 34 females (11.6%). In the age distribution 50 patients were below 19 years, 161 patients were between 20 to 39 years, 60 patients 40 to 59 years and 21 patients above 60 years. The various mechanisms of injury noted were assault in 127 patients, pedestrian vehicular accident in 50 patients, motor vehicular accident in 33 patients, motor bike accidents in 4 patients, train accidents in 2 patients, gunshot injury in 6 patients, fall from height in 35 patients and struck by heavy object in 5 patients.123 patients had a GCS between 3-5, 72 patients GCS between 6-8 and 97 patients GCS 8-12. 192 patients had equal and reacting pupils after the head injury, 52 patients unilateral fixed pupils and 10 patients bilateral fixed pupils. The Computed tomography (CT) of the brain showed 287 patients with focal intracranial findings, 107 with diffuse brain injury and 168 patients with features of raised intracranial pressure. 129 patients (44.1%) were surgically treated and 163 patients (55.8%) treated conservatively with medical treatment. The variables age, mechanism of injury, GCS, pupillary reaction, raised intracranial pressure and type of management was compared to GOS and found to be statistically significant. Conclusions: The outcome of patients with moderate to severe head injury has no effect on gender but has a significant relationship between age and mortality. The mechanism of head injury has a direct effect on the prognosis with gunshot head having the worst outcome. The important prognostic factors affecting the outcome include: age of patients, severity of head injury (GCS), pupillary reactivity to light and the pathology of the brain CT scan. The unfavorable prognostic factors are: old age, non-reacting pupils to light, severe head injury (low GCS) and raised ICP after head injury. Medical or surgical management have similar mortality rate.Submitted in fulfillment for the requirements of the degree of Master of Medicine in Neurosurgery Faculty of Health Science University of Witwatersran

Large Scale Constrained Trajectory Optimization Using Indirect Methods

State-of-the-art direct and indirect methods face significant challenges when solving large scale constrained trajectory optimization problems. Two main challenges when using indirect methods to solve such problems are difficulties in handling path inequality constraints, and the exponential increase in computation time as the number of states and constraints in problem increases. The latter challenge affects both direct and indirect methods. A methodology called the Integrated Control Regularization Method (ICRM) is developed for incorporating path constraints into optimal control problems when using indirect methods. ICRM removes the need for multiple constrained and unconstrained arcs and converts constrained optimal control problems into two-point boundary value problems. Furthermore, it also addresses the issue of transcendental control law equations by re-formulating the problem so that it can be solved by existing numerical solvers for two-point boundary value problems (TPBVP). The capabilities of ICRM are demonstrated by using it to solve some representative constrained trajectory optimization problems as well as a five vehicle problem with path constraints. Regularizing path constraints using ICRM represents a first step towards obtaining high quality solutions for highly constrained trajectory optimization problems which would generally be considered practically impossible to solve using indirect or direct methods. The Quasilinear Chebyshev Picard Iteration (QCPI) method builds on prior work and uses Chebyshev Polynomial series and the Picard Iteration combined with the Modified Quasi-linearization Algorithm. The method is developed specifically to utilize parallel computational resources for solving large TPBVPs. The capabilities of the numerical method are validated by solving some representative nonlinear optimal control problems. The performance of QCPI is benchmarked against single shooting and parallel shooting methods using a multi-vehicle optimal control problem. The results demonstrate that QCPI is capable of leveraging parallel computing architectures and can greatly benefit from implementation on highly parallel architectures such as GPUs. The capabilities of ICRM and QCPI are explored further using a five-vehicle constrained optimal control problem. The scenario models a co-operative, simultaneous engagement of two targets by five vehicles. The problem involves 3DOF dynamic models, control constraints for each vehicle and a no-fly zone path constraint. Trade studies are conducted by varying different parameters in the problem to demonstrate smooth transition between constrained and unconstrained arcs. Such transitions would be highly impractical to study using existing indirect methods. The study serves as a demonstration of the capabilities of ICRM and QCPI for solving large-scale trajectory optimization methods. An open source, indirect trajectory optimization framework is developed with the goal of being a viable contender to state-of-the-art direct solvers such as GPOPS and DIDO. The framework, named beluga, leverages ICRM and QCPI along with traditional indirect optimal control theory. In its current form, as illustrated by the various examples in this dissertation, it has made significant advances in automating the use of indirect methods for trajectory optimization. Following on the path of popular and widely used scientific software projects such as SciPy [1] and Numpy [2], beluga is released under the permissive MIT license [3]. Being an open source project allows the community to contribute freely to the framework, further expanding its capabilities and allow faster integration of new advances to the state-of-the-art

The Quality of Life of the Patients Under Palliative Care: The Features of Appropriate Assessment Tools and the Impact of Early Integration of Palliative Care

Based on the WHO definition, the primary objective of palliative care (PC) is to improve the quality of life (QoL) of the patients facing life threatening illness by means of a multidisciplinary approach. The assessment of QoL in patients under PC is an important process for the identification of patient’s overall conditions including psycho-social, spiritual issues as well as the evaluation of the services provided to the patient. The ideal assessment tool the measurement of QoL in patients under PC should be patient centered and contain both subjective and objective domains and be able to correlate with the definition of QoL. The factors which positively influence the extend of the QoL include, good doctor-patient communication, economic status, education, socio-economic support and spirituality. The negative factors are social isolation, lack of employment, poverty, rejection and stigmatization and experience of symptoms, such as uncontrolled pain. Early Integration of PC leads to higher psycho-social support and acceptance of diagnosis, and severity of illness, which in turn helps for the better symptom management and reduces the disease related stress, which clearly associated with improved QoL. It provides more time for the end of life decision making, promotes self-efficacy and sense of control in decision with respect to individual values

ANALYSIS OF DIFFERENTIAL GENE EXPRESSION AND ALTERNATIVE SPLICING IN THE LIVER AND GASTROINTESTINAL TRACT IN THE LACTATING RAT

Rat exon microarrays were utilized to detect changes in mRNA expression and alternative splicing in the liver, duodenum, jejunum, and ileum of the lactating rat when compared to age-matched virgin controls. Analysis of data at the level of gene expression revealed differential expression of genes involved in cholesterol biosynthesis in each tissue examined, suggesting increased Sterol Response Element Binding Protein activity. We also detected decreased mRNA from components of the T-cell signaling pathway in the jejunum and ileum. We characterized expression of solute carrier and adenosine triphosphate binding cassette proteins. In addition to characterizing genes by pathway, we have also grouped genes based on their pattern of expression to identify important genes. Amongst genes upregulated in all tissues was Slc39a4, which is a critical transporter in the absorption of zinc in enterocytes. Alternative splicing analysis detected a substantial amount of alternative splicing in the ileum compared to other tissues. In addition, in the liver Abcg8, a protein that functions as a heterodimer to export cholesterol in the bile, shows differential splicing in the liver, but not in other tissues. We also detected differential expression of Ugt1a6 in the liver based on usage of an alternative first exon, which is consistent with altered protein levels observed previously. Differential splicing also appears to occur in Ace2 in the ileum, which could have consequences on the renin-angiotensin pathway