L’exemption de paiement des soins associée à la supervision et à la formation au Burkina Faso : les effets sur la prescription de médicaments

L’accès financier limité aux soins de santé a suscité l’instauration de politiques sanitaires de subvention des soins en Afrique. Au Burkina Faso, une ONG, en complémentarité avec la politique sanitaire nationale subventionne à 100% depuis septembre 2008 les soins et les médicaments pour les enfants de moins de cinq ans dans le district sanitaire de Dori. L’intervention regroupe formation du personnel soignant, supervisions et suppression de paiement des soins et des médicaments. L’objectif de l’étude est d’analyser l’effet de cette intervention sur l’adéquation des prescriptions médicales. Neuf centres de santé ont été pris en compte. Au total 14956 ordonnances d’enfants de moins de cinq ans ciblés par l’intervention ont été sélectionnées par échantillonnage systématique à partir des registres de consultation un an avant et un an après l’instauration de l’intervention. Quatorze prescripteurs ont été interviewés. Les prescriptions ont été analysées par comparaison au référentiel de l’OMS ainsi qu’au référentiel national. Le discours des prescripteurs a été analysé en vue de comprendre leur perception de leur changement de pratiques depuis de début de la subvention. L’intervention a eu pour effet de diminuer l’utilisation des injections (Rapport de cote (RC) =0,28; p<0,005) dans le cas des infections respiratoires aiguës (IRA). Elle a entraîné une diminution de l’utilisation inappropriée des antibiotiques dans les cas de paludisme seul (RC=0,48; p<0,0005). Le nombre moyen de médicaments par ordonnance a également diminué de 14% dans les cas d’IRA (p<0,0005). Les prescripteurs ont affirmé pour la plupart que leurs pratiques se sont soit maintenues soit améliorées. L’intervention a entrainé une amélioration de l’adéquation des prescriptions médicales dans certains cas.

Nutrition parentérale du nouveau-né : modulation du stress oxydant et conséquences hépatiques

Introduction : Les enfants prématurés ont la particularité de naître alors que leur développement est souvent incomplet et nécessite la mise en œuvre de soins intensifs visant à poursuivre leur croissance en dehors de l’environnement utérin. Souvent cependant, le stade développemental de l’enfant ne lui permet pas d’assimiler une alimentation entérale du fait de l’immaturité de son système digestif. Le recours à une voie centrale délivrant les nutriments assurant le développement devient alors une nécessité. Ce type de nutrition, appelée nutrition parentérale (NP, ou total parenteral nutrition TPN), permet l’administration de molécules simples, directement dans le sang du prématuré. Il n’est toutefois pas exempt de risques puisqu’exposée à la lumière, la NP peut s’oxyder et générer des molécules oxydantes telles que des hydroperoxydes lipidiques susceptibles de se fragmenter par la suite en hydroxy-alkénals. Ceci devient problématique au vu de l’immaturité des systèmes de défenses antioxydants du nouveau-né prématuré. L’utilisation prolongée de la NP est d’ailleurs à l’origine de maladie hépatiques dans lesquelles le stress oxydant et la nécro-inflammation sont des composantes majeures. Nous avons émis l’hypothèse que l’infusion chez les enfants prématurés, d’aldéhydes d’origine lipidique est en relation avec le développement du stress oxydant et de l’inflammation hépatique. Objectif : Notre étude a consisté à évaluer la relation entre les quantités d’hydroxy-alkénals dans la NP et les effets hépatiques engendrés sur les marqueurs de stress oxydant et les voies de signalisation responsables d’une induction de processus inflammatoire. Dans ce but, nous avons cherché à mesurer la peroxydation lipidique dans l’émulsion lipidique de la NP et la conséquence de l’infusion en continue d’hydroxy-alkénals sur les marqueurs de stress oxydant, sur la voie de signalisation médiée par le Nuclear Factor κB et sur le déclenchement du processus inflammatoire hépatique. A la suite de ce travail, nous avons également travaillé sur des alternatives à la photoprotection, qui est la seule méthode réellement optimale pour réduire la peroxydation des lipides de la NP, mais cliniquement difficilement praticable. Résultats : Nos résultats ont mis en évidence la génération de 4-hydroxynonenal in vitro dans la NP, ce phénomène est augmenté par une exposition lumineuse. Dans ce cadre, nous avons montré l’inefficacité de l’ajout de multivitamines dans l’émulsion lipidique comme alternative à la photoprotection. Dans la validation biologique qui a suivi sur un modèle animal, nos résultats ont permis de démontrer que l’augmentation des adduits glutathion-hydroxynonenal était imputable à l’augmentation de 4-hydroxynonenal (4-HNE) dans la NP, et non à une peroxydation endogène. Nos données indiquent que la probable augmentation hépatique des niveaux de 4-HNE a conduit à une activation du NFκB responsable de l’activation de la transcription des gènes pro-inflammatoires du Tumour Necrosis Factor-α (TNF-α) et de l’interleukine-1 (IL-1). Nous avons alors évalué la capacité d’une émulsion lipidique enrichie en acides gras polyinsaturés (AGPI) n-3 à baisser les concentrations de 4-HNE dans la NP, mais également à moduler le stress oxydant et les marqueurs pro-inflammatoires. Enfin, nous avons démontré, en collaboration avec l’équipe du Dr Friel, que certains peptides isolés du lait humain (par un processus mimant la digestion) permettent également une modulation du stress oxydant et du processus inflammatoire. Conclusion : Le stress oxydant exogène issu de la NP a conduit par activation de facteurs de transcription intra-hépatiques au déclenchement d’un processus inflammatoire potentiellement responsable du développement de maladies hépatiques reliées à la NP telle que la cholestase. Dans ce sens, les AGPI n-3 et les peptides antioxydants peuvent se poser en tant qu’alternatives crédibles à la photoprotection.

Found Footage, mouvement cinématographique contemporain

Ce travail a pour objet le found footage, analysé en tant que pratique de recyclage culturel et comme important mouvement cinématographique de notre époque. L’étude trace d’abord un parallèle entre la fabrication du film d’images trouvées et le processus de recyclage industriel. Ensuite, le travail aborde les influences artistiques de ce mouvement du cinéma expérimental initié dans les années 1960, qui s’intensifie de plus en plus depuis l’avènement des dernières technologies numériques. En dernier lieu, l’étude propose une mise au point sur le found footage à l’ère des technologies numériques, en analysant les causes et conséquences de la (re)montée du mouvement, et en tenant compte de sa présence qui se multiplie sur l’Internet, par le biais du mashup.

Génération automatique de configurations et de scénarios d'utilisation d'outils de visualisation à partir de spécifications de tâches d'analyse de logiciels

Nous proposons une approche qui génère des scénarios de visualisation à partir des descriptions de tâches d'analyse de code. La dérivation de scénario est considérée comme un processus d'optimisation. Dans ce contexte, nous évaluons différentes possibilités d'utilisation d'un outil de visualisation donnée pour effectuer la tâche d'analyse, et sélectionnons le scénario qui nécessite le moins d'effort d'analyste. Notre approche a été appliquée avec succès à diverses tâches d'analyse telles que la détection des défauts de conception.

Preparation and characterisation of certain II-VI, I-III-VI2 semiconductor thin films and transparent conducting oxides

There is an increasing demand for renewable energies due to the limited availability of fossil and nuclear fuels and due to growing environmental problems. Photovoltaic (PV) energy conversion has the potential to contribute significantly to the electrical energy generation in the future. Currently, the cost for photovoltaic systems is one of the main obstacles preventing production and application on a large scale. The photovoltaic research is now focused on the development of materials that will allow mass production without compromising on the conversion efficiencies. Among important selection criteria of PV material and in particular for thin films, are a suitable band gap, high absorption coefficient and reproducible deposition processes capable of large-volume and low cost production. The chalcopyrite semiconductor thin films such as Copper indium selenide and Copper indium sulphide are the materials that are being intensively investigated for lowering the cost of solar cells. Conversion efficiencies of 19 % have been reported for laboratory scale solar cell based on CuInSe2 and its alloys. The main objective of this thesis work is to optimise the growth conditions of materials suitable for the fabrication of solar cell, employing cost effective techniques. A typical heterojunction thin film solar cell consists of an absorber layer, buffer layer and transparent conducting contacts. The most appropriate techniques have been used for depositing these different layers, viz; chemical bath deposition for the window layer, flash evaporation and two-stage process for the absorber layer, and RF magnetron sputtering for the transparent conducting layer. Low cost experimental setups were fabricated for selenisation and sulphurisation experiments, and the magnetron gun for the RF sputtering was indigenously fabricated. The films thus grown were characterised using different tools. A powder X-ray diffractometer was used to analyse the crystalline nature of the films. The energy dispersive X-ray analysis (EDX) and scanning electron microscopy i (SEM) were used for evaluating the composition and morphology of the films. Optical properties were investigated using the UV-Vis-NIR spectrophotometer by recording the transmission/absorption spectra. The electrical properties were studied using the two probe and four probe electrical measurements. Nature of conductivity of the films was determined by thermoprobe and thermopower measurements. The deposition conditions and the process parameters were optimised based on these characterisations.

Spectral and nonlinear optical characterization of ZnO nanocomposites

The spectral and nonlinear optical characteristics of nano ZnO and its composites are investigated. The fluorescence behaviour of nano colloids of ZnO has been studied as a function of the excitation wavelength and there is a red shift in emission peak with excitation wavelength. Apart from the observation of the reported ultra violet and green emissions, our results reveal that additional blue emissions at 420 nm and 490 nm are developed with increasing particle size. Systematic studies on nano ZnO have indicated the presence of luminescence due to excitonic emissions when excited with 255 nm as well as significant contribution from surface defect states when excited with 325 nm. In the weak confinement regime, the third-order optical susceptibility χ(3) increases with increasing particle size (R) and annealing temperature (T) and a R2 and T2.5 dependence of χ(3) is obtained for nano ZnO. ZnO nanocolloids exhibit induced absorption whereas the self assembled films of ZnO exhibit saturable absorption due to saturation of linear absorption of ZnO defect states and electronic effects. ZnO nanocomposites exhibit negative nonlinear index of refraction which can be attributed to two photon absorption followed by weak free carrier absorption. The increase of the third-order nonlinearity in the composites can be attributed to the enhancement of exciton oscillator strength. The nonlinear response of ZnO nanocomposites is wavelength dependent and switching from induced absorption to saturable absorption has been observed at resonant wavelengths. Such a change-over is related to the interplay of plasmon/exciton band bleach and optical limiting mechanisms. This study is important in identifying the spectral range and the composition over which the nonlinear material acts as an optical limiter. ZnO based nanocomposites are potential materials for enhanced and tunable light emission and for the development of nonlinear optical devices with a relatively small optical limiting threshold.

Fabrication and Characterization of All-Fiber Components for Optical Access Networks

This Thesis deals with the fabrication and characterization of novel all-fiber components for access networks. All fiber components offer distinctive advantages due to low forward and backward losses, epoxy free optical path and high power handling. A novel fabrication method for monolithic 1x4 couplers, which are vital components in distributed passive optical networks, is realized. The fabrication method differs from conventional structures with a symmetric coupling profile and hence offers ultra wideband performance and easy process control. New structure for 1x4 couplers, by fusing five fibers is proposed to achieve high uniformity, which gives equivalent uniformity performance to 1x4 planar lightwave splitters, isolation in fused fiber WDM is improved with integration of long period gratings. Packaging techniques of fused couplers are analyzed for long term stability.

Influence of Processing Variables on Protein Quality and Frozen Storage Stability of Two Commercially Important Species of Squid (Loligo duvaucelii and Doryteuthis sibogae )

Cephalopods are utilized as an important food item in various countries because of its delicacy as raw consumed food. Mainly sepia and loligo are consumed raw by Japanese and Russians. The freshness of the products is very important when the product is consumed raw. The major species that dominate our squid catch are Loligo duvaucelii and Doryteuthis sibogae. There is a noticeable difference in the quality of both the species. The needle squid (Doryteuthis sibogae ) contributes about 35% of the total squid landing. Due to the fast deterioration , a major portion of the needle squid, which is caught during the first few hauls, is thrown back to sea. The catch in the last hauls only are taken to the landing centers. At present the needle squid is processed as blanched rings and the desired quality is not obtained if it is processed as whole, whole cleaned or as tubes. In this study an attempt is made to investigate the biochemical characteristics in both the species of squid in relation to their quality and, the process control measures to be adopted. The effect of various treatments on their quality and the changes in proteolytic and lysosomal enzymes under various processing conditions are also studied in detail.Thus this study can provide the seafood industry with relevant suggestions and solutions for effective utilization of both the species of squid with emphasis on needle squid.

Photoconductivity studies on some semiconducting thin films for photovoltaic applications

Photoconductivity (PC) processes may be the most suitable technique for obtaining information about the states in the gap. It finds applications in photovoItaics, photo detection and radiation measurements. The main task in the area of photovoltaics, is to increase the efficiency of the device and also to develop new materials with good optoelectronic properties useful for energy conversion, keeping the idea of cost effectiveness. Photoconduction includes generation and recombination of carriers and their transport to the electrodes. So thermal relaxation process, charge carrier statistics, effects of electrodes and several mechanisms of recombination are involved in photoconductivity.A major effect of trapping is to make the experimentally observed decay time of photocurrent, longer than carrier lifetime. If no trapping centers are present, then observed photocurrent will decay in the same way as the density of free carriers and the observed decay time will be equal to carrier lifetime. If the density of free carriers is much less than density of trapped carriers, the entire decay of photocurrent is effectively dominated by the rate of trap emptying rather than by the rate of recombination.In the present study, the decay time of carriers was measured using photoconductive decay (PCD) technique. For the measurements, the film was loaded in a liquid Helium cryostat and the temperature was controlled using Lakshore Auto tuning temperature controller (Model 321). White light was used to illuminate the required area of the sample. Heat radiation from the light source was avoided by passing the light beam through a water filter. The decay current. after switching off the illumination. was measured using a Kiethely 2000 multi meter. Sets of PCD measurements were taken varying sample temperature, sample preparation temperature, thickness of the film, partial pressure of Oxygen and concentration of a particular element in a compound. Decay times were calculated using the rate window technique, which is a decay sampling technique particularly suited to computerized analysis. For PCD curves with two well-defined regions, two windows were chosen, one at the fast decay region and the other at the slow decay region. The curves in a particular window were exponentially fitted using Microsoft Excel 2000 programme. These decay times were plotted against sample temperature and sample preparation temperature to study the effect of various defects in the film. These studies were done in order to optimize conditions of preparation technique so as to get good photosensitive samples. useful for photovoltaic applications.Materials selected for the study were CdS, In2Se3, CuIn2Se3 and CuInS2• Photoconductivity studies done on these samples are organised in six chapters including introduction and conclusion.

Development and Evaluation of Blind Identification Techniques for Nonlinear Systems

Identification and Control of Non‐linear dynamical systems are challenging problems to the control engineers.The topic is equally relevant in communication,weather prediction ,bio medical systems and even in social systems,where nonlinearity is an integral part of the system behavior.Most of the real world systems are nonlinear in nature and wide applications are there for nonlinear system identification/modeling.The basic approach in analyzing the nonlinear systems is to build a model from known behavior manifest in the form of system output.The problem of modeling boils down to computing a suitably parameterized model,representing the process.The parameters of the model are adjusted to optimize a performanace function,based on error between the given process output and identified process/model output.While the linear system identification is well established with many classical approaches,most of those methods cannot be directly applied for nonlinear system identification.The problem becomes more complex if the system is completely unknown but only the output time series is available.Blind recognition problem is the direct consequence of such a situation.The thesis concentrates on such problems.Capability of Artificial Neural Networks to approximate many nonlinear input-output maps makes it predominantly suitable for building a function for the identification of nonlinear systems,where only the time series is available.The literature is rich with a variety of algorithms to train the Neural Network model.A comprehensive study of the computation of the model parameters,using the different algorithms and the comparison among them to choose the best technique is still a demanding requirement from practical system designers,which is not available in a concise form in the literature.The thesis is thus an attempt to develop and evaluate some of the well known algorithms and propose some new techniques,in the context of Blind recognition of nonlinear systems.It also attempts to establish the relative merits and demerits of the different approaches.comprehensiveness is achieved in utilizing the benefits of well known evaluation techniques from statistics. The study concludes by providing the results of implementation of the currently available and modified versions and newly introduced techniques for nonlinear blind system modeling followed by a comparison of their performance.It is expected that,such comprehensive study and the comparison process can be of great relevance in many fields including chemical,electrical,biological,financial and weather data analysis.Further the results reported would be of immense help for practical system designers and analysts in selecting the most appropriate method based on the goodness of the model for the particular context.

Synthesis,characterization and application studies of some polymer supported metal complexes

Polymer supports are efficient reagents,substrates and catalysts and they are extensively used for carrying out reactions at controlled rates.Tailor-made polymer supports are highly versatile which have opened an excellent area of research.Now polymer supported chemistry is being exploited at an amazing rate and it seems to join the routine world of organic synthesis.Polymer supported ligands are found to be efficient complexing agents whose high selectivity enables the analysis and removal of heavy metal ions which are toxic to all the living organisms of land and sea.polymer supported membranes function as ion selective potentiometric sensors which allow the exchange of specific ions among other ions of the same charge.In this investigation three series of polymeric schiff bases and three series of metal complexes have been prepared.An attempt is done to develop optimum conditions for the removal of heavy metal ions using polymeric schiff bases.A novel copper sensor electrode have also been prepared from polymer supported metal complex.

Modification of Linear Low Density Polyethylene for Improved Photo and Biodegradation

LLDPE was blended with poly (vinyl alcohol) and mechanical, thermal, spectroscopic properties and biodegradability were investigated. The biodegradability of LLDPE/PVA blends has been studied in two environments, viz. (1) a culture medium containing Vibrio sp. and (2) a soil environment over a period of 15 weeks. Nanoanatase having photo catalytic activity was synthesized by hydrothermal method using titanium-iso-propoxide. The synthesized TiO2 was characterized by X-Ray diffraction (XRD), BET studies, FTIR studies and scanning electron microscopy (SEM). The crystallite size of titania was calculated to be ≈ 6nm from the XRD results and the surface area was found to be about 310m2/g by BET method. SEM shows that nanoanatase particles prepared by this method are spherical in shape. Linear low density polyethylene films containing polyvinyl alcohol and a pro-oxidant (TiO2 or cobalt stearate with or without vegetable oil) were prepared. The films were then subjected to natural weathering and UV exposure followed by biodegradation in culture medium as well as in soil environment. The degradation was monitored by mechanical property measurements, thermal studies, rate of weight loss, FTIR and SEM studies. Higher weight loss, texture change and greater increments in carbonyl index values were observed in samples containing cobalt stearate and vegetable oil. The present study demonstrates that the combination of LLDPE/PVA blends with (I) nanoanatase/vegetable oil and (ii) cobalt stearate/vegetable oil leads to extensive photodegradation. These samples show substantial degradation when subsequent exposure to Vibrio sp. is made. Thus a combined photodegradation and biodegradation process is a promising step towards obtaining a biodegradable grade of LLDPE.

Queueing Models with Vacations and Working Vacations

The thesis entitled “Queueing Models with Vacations and Working Vacations" consists of seven chapters including the introductory chapter. In chapters 2 to 7 we analyze different queueing models highlighting the role played by vacations and working vacations. The duration of vacation is exponentially distributed in all these models and multiple vacation policy is followed.In chapter 2 we discuss an M/M/2 queueing system with heterogeneous servers, one of which is always available while the other goes on vacation in the absence of customers waiting for service. Conditional stochastic decomposition of queue length is derived. An illustrative example is provided to study the effect of the input parameters on the system performance measures. Chapter 3 considers a similar setup as chapter 2. The model is analyzed in essentially the same way as in chapter 2 and a numerical example is provided to bring out the qualitative nature of the model. The MAP is a tractable class of point process which is in general nonrenewal. In spite of its versatility it is highly tractable as well. Phase type distributions are ideally suited for applying matrix analytic methods. In all the remaining chapters we assume the arrival process to be MAP and service process to be phase type. In chapter 4 we consider a MAP/PH/1 queue with working vacations. At a departure epoch, the server finding the system empty, takes a vacation. A customer arriving during a vacation will be served but at a lower rate.Chapter 5 discusses a MAP/PH/1 retrial queueing system with working vacations.In chapter 6 the setup of the model is similar to that of chapter 5. The signicant dierence in this model is that there is a nite buer for arrivals.Chapter 7 considers an MMAP(2)/PH/1 queueing model with a nite retrial group

Ground- and excited-state properties of M-center oxygen vacancy aggregates in the bulk and the surface of MgO

Aggregates of oxygen vacancies (F centers) represent a particular form of point defects in ionic crystals. In this study we have considered the combination of two oxygen vacancies, the M center, in the bulk and on the surface of MgO by means of cluster model calculations. Both neutral and charged forms of the defect M and M+ have been taken into account. The ground state of the M center is characterized by the presence of two doubly occupied impurity levels in the gap of the material; in M+ centers the highest level is singly occupied. For the ground-state properties we used a gradient corrected density functional theory approach. The dipole-allowed singlet-to-singlet and doublet-to-doublet electronic transitions have been determined by means of explicitly correlated multireference second-order perturbation theory calculations. These have been compared with optical transitions determined with the time-dependent density functional theory formalism. The results show that bulk M and M+ centers give rise to intense absorptions at about 4.4 and 4.0 eV, respectively. Another less intense transition at 1.3 eV has also been found for the M+ center. On the surface the transitions occur at 1.6 eV (M+) and 2 eV (M). The results are compared with recently reported electron energy loss spectroscopy spectra on MgO thin films.

Probability Theory. Stochastic Processes And Their Applications Probabilistic Analysis Of Some Queueing And Inventory Models

In this thesis we attempt to make a probabilistic analysis of some physically realizable, though complex, storage and queueing models. It is essentially a mathematical study of the stochastic processes underlying these models. Our aim is to have an improved understanding of the behaviour of such models, that may widen their applicability. Different inventory systems with randon1 lead times, vacation to the server, bulk demands, varying ordering levels, etc. are considered. Also we study some finite and infinite capacity queueing systems with bulk service and vacation to the server and obtain the transient solution in certain cases. Each chapter in the thesis is provided with self introduction and some important references