Effective larviciding to manage mosquito aquatic habitats offers an additional strategy for malaria vector control by complementing benefits already achieved by long lasting insecticidetreated nets (LLINs) and indoor residual spraying (IRS). Sustainable implementation of larviciding requires comprehensive understanding of the ecology of disease vectors and robust monitoring of factors governing local disease transmission. Treatment of aquatic habitats with the juvenile hormone analogue Pyriproxyfen (PPF), inhibits adult mosquito emergence at extremely low concentrations that are potentially deliverable by PPF-contaminated gravid adult females, a phenomenon termed „autodissemination‟. The primary aim of this thesis was to investigate a range of adult mosquito behaviours that might be exploited to disseminate PPF. The effectiveness of PPF to sterilize adult mosquitoes for malaria vector control was also assessed in a controlled system. Vector dynamics, malaria transmission intensity and risk factors were evaluated at the field site where the PPF autodissemination strategy would be evaluated in field trials and potentially implemented. Field monitoring of indoor malaria transmission risk factors revealed that even in the communities with high coverage of bednets, LLINs did not reduce the indoor densities of An. gambiae s.l (RR= 0.74 (0.50 - 1.11, p > 0.05) but reduced An. funestus indoor densities by 56% (RR= 0.44 (0.23 - 0.87, p < 0.05)). Houses with eave gaps had 3.3 and 5.5 times more An. gambiae s.l. (RR= 3.3 (2.39 - 4.56, p < 0.05)) and An. funestus ((RR = 5.55 (3.25 - 9.46, p < 0.05)) respectively. Intact screening over windows reduced up to 66% (RR = 0.34 (0.17 - 0.69)) and 83% (RR = 0.17 (0.08 - 0.39)) indoor entry of An. gambiae s.l. and An. funestus respectively. Furthermore, surveillance of wild malaria vectors populations and susceptibility to insecticide resistance demonstrated significant increase in An. funestus densities in 2012 (RR=1.56 (1.33-1.69)) compared to An.gambiae s.l. (p <0.0001). In 2014, the proportion of An. gambiae s.l. catches (67%; 4373/6373) was higher than An. funestus (33%; 2100/6373). PCR results revealed change in relative proportion between the two sibling species of An.gambaie s.l. with a significant decrease in An. gambiae s.s. from approximately 14% (414/2,924) in 2008 to 0% (0/435) in 2014. Insecticide susceptibility tests indicated high resistance in An. funestus against deltamethrin (mortality rate in discriminating dose assay = 87%), lambda cyhalothrin (74%), permethrin (65%), bendiocarb (65%), and DDT (66%). Similarly, An. arabiensis showed insecticide resistance to permethrin (77%), deltamethrin (64%) and lambda cyhalothrin (42%) in 2014. In large screened cages it was demonstrated that adult An. arabiensis can disseminate PPF from clay pots treated with PPF to the aquatic habitats, resulting in 76.5% reduction in adult emergence, with higher mean proportion of adult emerging from untreated chamber, 0.95 (0.56 -1.34) compared to the treated chamber, 0.21 (0.09 - 0.51, p < 0.0001). Treatment of a single clay pot resulted in 58% reduction in adult emergence in six habitats, with mean proportion of 0.34 (0.21 – 0.45) compared to the controls, 0.98 (0.96 – 1.00, p < 0.0001), showing a high level of habitats coverage amplification of the autodissemination event. After treating the walls and ceilings of cattle shelters with PPF, mosquito sterilization resulted in > 95% (89.3 - 102.9%) reduction in adult An. arabiensis production. This research provides evidence on the need of better housing and larviciding to complement LLINs in controlling the remaining malaria transmission transmitted by An. funestus and An. arabiensis. It also demonstrated for the first time that the PPF autodissemination strategy and sterilization of adult females present a promising malaria vector control option for field trial. PPF-autodissemination can be integrated into a vector management toolbox to control outdoor malaria transmission and also target multiple disease-carrying mosquitoes that share aquatic habitats with malaria vectors. These findings highlight the potential of PPF for controlling outdoor and indoor malaria vectors and call for further testing in the field.

No description available.

It is the purpose of this thesis, by analysing the context of public health reform in the nineteenth century, to reconsider the methods, both verbal and visual, by which Punch proselytised reform. Drawing on a range of primary data, this thesis uses a thematic case study to undertake a systematic re-examination of Punch's distinctive stylistic form from 1841 to 1858. This will also assist in identifying how the `character' of the magazine evolved. Case study chapters will focus specifically on the campaigns surrounding the removal of Smithfield Market and the amelioration of the polluted River Thames, providing a point of comparison from which to study the growth of a range of shared motifs developed for discussing reform and social change. Taking a chronological approach, it will be argued that from the close of the 1840st here was a simultaneous shift in both the organisation of the Punch `brotherhood' and in scientific understandings of the cause of disease and pollution. From 1849 the problems of how to communicate the need for reform begin to be resolved due to the increased profile the topic of public health received in the public sphere, particularly through periodicals like Punch. This change is evident from an analysis of the references logged in the Punch Database on Public Health (Appendix Two).

Road safety is one of the priorities for every government in Europe and including in the UK. One of the major concerns for road safety is the consumption of alcohol by drivers which seriously increases the risk of an accident. According to the department of transport in 2007, there were over 17,000 drink-drive casualties including 530 fatalities in England alone. For this reason, the police force needs a fast and easy way to assess the alcohol level of drivers. We propose a new method of detection, using microwaves, which would detect the alcohol-blood ratio from the finger/wrist of the driver. We also study the possibility of blood sugar detection for diabetes using microwave resonators. The system is based on microwave resonators using very low power sources (lmW). This PhD project explores the limits and feasibility of a rectangular cavity resonator and a microstrip suspended ring resonator for use with water/ethanol samples and water/glucose samples. Samples of water/ethanol are tested in three parts for each sensor, 0% (water) to 100% (ethanol) in 5% increments, 1% to 5% in 1% increments and samples less than to 1% in 0.2% increments. Samples of water/glucose are tested from Omol of glucose to 1mol per litre of water in O.lmol/1 increments. Both systems are studied, designed, simulated and tested for the full ranges of both mixtures. The data acquisition software has been written in C# in order to allow ease of data extraction and manipulation during the tests. Using variables such as the Qfactor, the resonant frequency and the reflection coefficient, the resonators can detect permittivity changes in the samples. The rectangular cavity is able to detect a lower limit of 1% of ethanol, and a tenth of a mole for water/glucose mixtures. The suspended ring resonator can detect down to 1% of ethanol using the Q-factor, the resonant frequency and the magnitude and down to 0.2% using the transmission magnitude at a fixed frequency. This method can also detect a lower limit of O.lmol/l for glucose/water mixtures.

Background: There is an ever increasing population of obese people worldwide (Kelly et al., 2010), with associated increased costs in terms of morbidity and mortality (Berrington de Gonzelez et al., 2010), so there is a need for appropriate public health interventions. Subjective well-being (SWB) has been identified as facilitating health and longevity (Diener & Chan, 2011), so may be a useful mediator to counteract the negative effects of obesity. Aims: Two major aims of the study were; to identify the facets of SWB that protect against psychological ill-health in the obese and those that activate change. Method: A mixed-methods approach was taken that included both quantitative cross-sectional survey data based on validated constructs that combine to measure SWB and qualitative longitudinal data based on unstructured interviews. The ideographic approach brought a narrative to the nomothetic data and elevated the study from the ‘what’ to the ‘why’. Two key samples were selected; adolescents (N = 549) and obesity surgery candidates (N = 125) to represent the spectrum of obesity experience. Results: Findings support the study’s aims in highlighting the role of SWB correlates in mapping the pathway to progress in the regulation of obesity. The alignment of the constructs and the configuration of the models accounted for up to 51% of the variance in life-satisfaction, and up to 73% of the variance in self-esteem. Qualitative analysis suggested emerging themes either reflected in the constructs used in the study, or concepts raised in the literature review, such as cognitive dissonance, and illustrated adaptive and maladaptive behavioural processes to the challenges of obesity. Conclusion: Salient outcomes provide recognition of; the physical appearance anxiety measure (PASTAS), as an identification marker for maladaptive problems at a critical phase of adolescent development; the role of optimism for agentic shift towards a positive perspective; and the understanding that controlled anti-depressant drug use may facilitate freedom and empowerment for adaptive purposes in a severely obese population.

Evidence suggests continuous subcutaneous insulin infusion (CSII) is an effective method of achieving glycaemic control in those with Type 1 diabetes (T1D). Among the advantages of CSII is the opportunity for patients to potentially discard the dietary inflexibility imposed by other regimes such as multiple daily injections (MDI). There are also reported improvements in quality of life. Furthermore, patients with T1D who achieve good glycaemic control may present a normal quantitative lipid profile; however, various qualitative atherogenic lipid abnormalities may exist, potentially leading to increased cardiometabolic (CM) risks. Literature investigating this in those using CSII is sparse and frequently dated; as is evidence regarding their eating behaviours and quality of life and is therefore worthy of further research. To investigate these issues an initial audit of CSII patients’ medical records spanning 8 years was performed, with a focus on routinely measured clinical markers of risk (n = 260). Then a cross-sectional study was carried out to compare those using CSII (n = 40) vs. MDI (n = 40). This involved the use of a food diaries and food frequency questionnaires to determine eating behaviours; semi-structured interviews and questionnaires were used to ascertain quality of life and CM risks were assessed by further interrogating participants’ medical records and analysing a sample of plasma for lipoprotein quality. Finally, using similar methods, longitudinal case studies (n = 5) were performed to elucidate the transition from MDI onto CSII over one year. The results indicated that upon commencing CSII HbA1c was significantly reduced from 8.3 to 7.6% (p = < 0.001) and insulin dose significantly lowered from 54.5 to 46.4 IU (p = < 0.001) after using CSII for 12 months and these improvements were maintained over the following 3 years. There were few changes in both quantitative and qualitative lipids; however, systolic blood pressure decreased significantly and unexpectedly both over the 4 year audit period (128.2 to 122.1 mmHg; p = 0.003) and when comparing those using CSII against their MDI counterparts (123.5 mmHg vs. 135.3 mmHg; p = 0.023). Significant reductions were also shown in diastolic blood pressure (75.2 to 72.0 mmHg; p = 0.027). There was little variance in the diets of the two treatment groups; however, subtle differences existed and the intake of certain nutrients such as fibre and iron in females failed to meet the RNI. Many qualitative themes emerged from the interviews regarding participants’ quality of life and in particular highlighted how the device was largely held in positive regard for its ability to improve glycaemic control and offer unprecedented flexibility which allowed a largely unrestricted lifestyle. Despite limitations, this study offers useful information for those working in the field, allowing, for the first time, a deep insight into the eating behaviours, cardiometabolic risks and quality of life of a group of patients using contemporary CSII therapy. It is hoped these findings will assist with decision making processes in clinical practice, thus improving the lives of those with T1D.

Women in the UK have access to NHS maternity services and most will attend hospital to give birth in the NHS. Much effort has been undertaken over several decades to improve childbirth and to enhance the experiences of those using NHS maternity services. However, while most women report positive experiences of maternity care, existing evidence suggests that women from ethnic minority groups in the UK have poorer pregnancy outcomes, experience poorer maternity care, are at higher risk of adverse perinatal outcomes and have significantly higher severe maternal morbidity than the resident white women (Puthussery, 2016; Henderson et al, 2013; Puthussery et al., 2010; Straus et al., 2009). Muslim women of child-bearing age make up a significant part of UK society, yet their health needs and their experiences of health services have not been extensively researched. The term ‘Muslim’ is often combined with ethnic group identity, rather than used to refer to people distinguished by beliefs, practices or affiliations. Muslim women commonly observe certain religious and cultural practices during their maternity journey and the little research there is in this area suggests that more could be done from a service provision perspective to support Muslim women through this, spiritually and culturally significant life event (McFadden et al., 2013; Alshawish et al., 2013). This study explores Muslim women’s perceived needs and the factors that influence their health seeking decisions during their transition to motherhood. Using a generic qualitative approach, seven English-speaking first time pregnant Muslim women and a Muslim mother who is second time pregnant but experiencing motherhood as a Muslim for the first time, were interviewed at different stages of their maternity journey (antenatal, post-labour and postnatal); five focus groups were conducted with Muslim mothers; and 12 semi-structured interviews were conducted with healthcare professionals. Thematic analysis of the transcripts revealed that Muslim women: 1) had a unique perspective on motherhood based on Islamic teaching; 2) sourced information from a number of sources, additional to midwives; 3) experienced difficulty expressing their religious requirements when preparing a birth plan; 4) assumed that healthcare professionals would have a negative view of Islam and Islamic birthing practices. While one-to-one interviews revealed that healthcare professionals: 1) varied in their perceptions of Muslim women; 2) had a general awareness of Muslim women’s Islamic practices but not specific to motherhood; 3) sourced cultural and religious information to enhance their understanding of women’s needs and their specific practices; 4) had some challenges when addressing women’s specific religious practices such as fasting; 5) would benefit from cultural/religious competency training that incorporates lived experience and group discussion. The implications for institutions, midwifery practice and further research are outlined. The study concludes that transcultural knowledge and specifically Muslim women’s worldview incorporated into healthcare professional training would enhance the competency and quality of healthcare services.

Made available in DSpace on 2014-10-09T12:33:26Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:05:40Z (GMT). No. of bitstreams: 1 16670.pdf: 2089009 bytes, checksum: f896d72659a7989cae6cf6366e343b78 (MD5) / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP; Faculdade de Odontologia, Universidade de Sao Paulo, Sao Paulo

Made available in DSpace on 2014-10-09T12:28:23Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:56:27Z (GMT). No. of bitstreams: 0 / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP; Faculdade de Odontologia, Universidade de Sao Paulo, Sao Paulo

Made available in DSpace on 2014-10-09T12:33:26Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:05:40Z (GMT). No. of bitstreams: 1 16670.pdf: 2089009 bytes, checksum: f896d72659a7989cae6cf6366e343b78 (MD5) / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP; Faculdade de Odontologia, Universidade de Sao Paulo, Sao Paulo