Bedsharing between infants and parents interacts with many factors to increase the risk of SIDS, eg maternal smoking, alcohol or drug consumption, overtiredness, excessive bedding and younger infant. However, bedsharing also encourages breastfeeding, settles babies, reduces parental tiredness and increases mother-baby interactions. We studied infants in the natural setting of their own home, in their usual situation (bedsharing or cot-sleeping) to identify risks and benefits, and to understand how bedsharing could be made safer for all infants. Methods: Overnight home video and physiological recordings of 40 bedshare infants (5-27 weeks), were compared with 40 cot infants matched for age and study season. Video data provided a log of infant/parent sleep positions, movements and interactions. The physiological recordings measured respiratory pattern, respiratory airflow, inspired CO2, oxygen saturation (SaO2), heart rate and core, peripheral and environmental temperatures. Results: All infants maintained normal core temperatures overnight although bedshare infants had a higher shin temperature [35.43 vs 34.60°C at 2hrs after sleep onset (difference 0.83, 95% CI: 0.18 to 1.49)]. Bedshare infants had thicker bedding (RR:2.35 (95% CI:1.76 to 3.14) and more face covered time [0.9h/night vs 0.2 (RR:5.62, 95% CI: 3.08 to 10.25)]. Awakenings in the bedshare group were more common, of shorter duration, and caused less change in infant temperatures. Exposure to >3% CO2 occurred in 18 bedshare infants and 1 swaddled, cot-sleep infant. The maximum exposure time was the same for both groups (60mins). These levels of CO2 significantly (p<0.05) elevated breathing rate and maintained normal SaO2. Central apnoeas of 5-10 seconds resulted in drops in SaO2 <90% (BS mean 6.8/night vs cot: 3.1, p<0.001). SaO2 rarely fell below 85% and heart rate did not ever fall below 90bpm. Bedshare infants commonly slept on their side, while cot infants slept supine. Prone sleeping was rare (BS:5 infants, 1.6-3.5h/night vs cot:2, 8.9-10.2) and for bedshare infants involved sleeping on mother�s chest. Bedshare infants woke and fed more frequently (mean wake times/night: 4.6 vs 2.5), but total sleep time was not different. Maternal checks were more frequent in the bedshare group (median:10, IQ range:7-23, max:55) than cot ( 4, 3-6, 16) and bedshare mothers frequently responded to infant initiated movements. During bedsharing baby and mother usually slept facing each other, touching, with infants at mothers� breast level. Father (or sibling) contact was rare. Conclusions: Bedshare infants sleep in a warmer environment and experience more potentially dangerous events such as head-covering and rebreathing. However, all infants in this study maintained normal rectal temperature and SaO2 suggesting they were protected by homeostatic responses. Infant safety is also facilitated by frequent maternal checking and maternal responses to infant movements. The mother-infant proximity during bedsharing allows prompt responses, reduces time infants are upset, and minimises disruption from frequent breast feeding - aspects valued by many. It is not known if infants of smoking mothers or parents with impaired responses eg due to alcohol, respond adequately to the potentially dangerous situations identified. Outcome: The results of this study will be used to formulate recommendations to parents for improving the safety of bedsharing.

Thesis--Yale University, 1971. / "72-17,134." "A note on sources": leaves [399]-415.

Thesis (M.A.)--York University, 2004. Graduate Programme in Interdisciplinary Studies. / Typescript. Includes bibliographical references (leaves 117-123). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ99392

The haptoglobin-haemoglobin receptor (HpHbR) is expressed by the African try- panosome, T. brucei, whilst in the bloodstream of the mammalian host. This allows ac- quisition of haem, but also results in uptake of trypanolytic factor 1, a mediator of in- nate immunity against non-human African trypanosomes. Here, the structure of HpHbR in complex with its ligand, haptoglobin-haemoglobin (HpHb), is presented, revealing an elongated binding site along the membrane-distal half of the receptor. A ~50&deg; kink allows the simultaneous binding of two receptors to one dimeric HpHb, increasing the efficiency of ligand uptake whilst also increasing binding site exposure within the densely packed cell surface. The possibility of targeting this receptor with antibody-drug conjugates is ex- plored. The characterisation of the unexpected interaction between T. congolense HpHbR and its previously unknown ligand, haemoglobin, is also presented. This receptor is iden- tified as an epimastigote-specific protein expressed whilst the trypanosome occupies the mouthparts of the tsetse fly vector. An evolutionary pathway of the receptor is proposed, describing how the receptor has changed to adapt to a role as a bloodstream form-specific protein in T. brucei. Apolipoprotein L1 (ApoL1) is the pore-forming component of the trypanolytic factors. An expression and purification protocol for ApoL1 is presented here, and the functionality of the protein established. Initial attempts to characterise the pores and structure of ApoL1 are described.

A privação do sono pode comprometer a saúde, uma vez que é durante o ciclo sono/vigília que são produzidos alguns hormônios que desempenham papéis vitais no funcionamento de nosso organismo. Distúrbios do sono em diabéticos do tipo 2, constituem fatores de risco para o agravamento do diabetes, pois podem interferir no controle metabólico através da síndrome da resistência à insulina. A apnéia do sono, insônia, movimentos periódicos das pernas, a higiene do sono e consumo de substâncias psicoativas são citados em estudos, porém pouco explorados. Ferramentas vêm sendo utilizadas na investigação acerca do ciclo sono/vigília, dentre eles o diário de sono, a polissonografia e o Índice de Qualidade do Sono de Pittsburgh (PSQI). Este é composto por sete componentes, onde é avaliada a qualidade subjetiva do sono, latência do sono, duração, eficiência habitual, distúrbios do sono, uso de medicação para dormir e sonolência diurna. O presente estudo foi do tipo observacional-transversal. A qualidade do sono foi investigada em 50 diabéticos pertencentes a um Centro Educativo de Enfermagem para Adultos e Idosos. Para tal, os pacientes diabéticos do tipo 2, após assinatura do termo de consentimento, foram submetidos a uma avaliação cognitiva inicial, através do exame do estado mental, para descartar demência. Foi aplicado um instrumento que avalia a qualidade do sono, denominado Índice de Qualidade do Sono de Pittsburgh (PSQI) e um instrumento para levantar variáveis demográficas e clínicas. A maioria dos participantes era do sexo feminino, casados, com 4 anos de estudo em média, não trabalha e possui renda mensal de 2 salários mínimos. Em relação às variáveis clínicas, 38% apresentam tempo de diagnóstico de diabetes superior a dez anos, 70% são hipertensos, 36% apresentaram valores de Hemoglobina A1c>7%, 72% com nictúria, 85% IMC equivalente à obesidade e 22% usam medicação para dormir. Os componentes do PSQI foram detalhados separadamente e obtido o escore global, sendo que (26) 52% apresentaram escores que indicam qualidade do sono ruim. A relação dos escores obtidos no PSQI com algumas variáveis foi realizada, e identificamos que aqueles com tempo de diagnóstico superior a 10 anos e aqueles com hipertensão, possuíam pior qualidade do sono. A nictúria parece não ter corroborado para uma qualidade do sono ruim. Para aqueles com valores de Hemoglobina A1c >7%, a qualidade do sono foi pior. Entre os que usam medicação para dormir e os que apresentaram IMC normal, a qualidade do sono mostrou-se pior. Os achados desta investigação reforçam a relevância da temática, pois não existem instrumentos específicos para a avaliação do sono do diabético do tipo 2, informações precisas acerca das conseqüências da privação do sono em indivíduos diabéticos do tipo 2, dificultando afirmações acerca da qualidade do sono do diabético. / Lack of sleeping can jeopardize health, because it is during the sleeping/vigil cycle that some hormones, which perform vital roles in the functioning of our organism, are produced. Sleeping malfunctions in type 2 diabetics constitute risk factors to the aggravating of diabetes since they can interfere in the metabolic control through the insulin resistance syndrome. Sleeping apnea, insomnia, occasional leg movements, sleeping hygiene and psychoactive substances consuming are quoted in studies, but scarcely explored. Tools have been used in the sleeping/vigil cycle investigation, and among them there are the sleeping diary, polissonography and Pittsburgh Sleeping Quality Index (PSQI) This one is composed by seven components, where the subjective sleeping quality, sleeping, duration and habitual efficiency latency, sleeping malfunctions, use of sleeping pills and morning sleepiness are evaluated. The present study was observation-transversal type. Sleeping quality was carried in 50 diabetics belonging to an Educational Nursing Center for adults and the elderly. For such investigation the type 2 diabetic patients, after signing the agreement term documents, were submitted to an initial cognitive evaluation, through mental estate exam, so that dementia could be discarded. A tool to evaluate the sleeping quality called Pittsburgh Sleeping Quality Index (PSQI) and another one to bring out demographic and clinic variants were applied. The majority of the participants was feminine, married, an average of 4-year-school, non-working and with an average of 2 minimal wages. Relating to clinic variants, 38% presented diabetes diagnosis time of over 10 years, 70% are hypertensive, 36% presented Hemoglobin A1c >7% values, 72% with nycturia, 85% IMC equivalent to obesity and 22% use sleeping pills. The PSQI components were separately detailed and the global score was obtained showing that (26)52% presented scores which indicate bad sleeping quality. The scores relation obtained in the PSQI along with some variants was carried and it showed that patients with a diagnosis time over 10 years and those with hipertension have the worst sleeping quality. Nycturia doesn´t seem to be a reason for a bad sleeping quality. For those with Hemoglobin A1c values >7% presented a worse sleeping quality. Among the ones who use sleeping medicine and those who presented normal IMC, the sleeping quality was even worse. The findings of this investigation strengthen the thematic relevance because there are no specifics tools for the evaluation of the type 2 diabetics´ sleeping; precise information about the consequences of lack of sleeping in type 2 diabetic individuals, making it difficult to get an affirmation about the sleeping quality of the diabetic.

Acute and chronic sleeping sickness are fatal neglected tropical diseases caused by Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense respectively (members of the sub-genus Trypanozoon). Accurate diagnostics are needed to guide treatment since the symptoms of disease are non-specific and the drugs that are used for treatment are too toxic to be administered to unconfirmed cases. Tests need to be simple enough to confirm clinical diagnosis of sleeping sickness in poorly-resourced, peripheral health centres and for use as epidemiological tools to detect T. b. rhodesiense in the zoonotic reservoirs of infection. This study focuses upon LAMP (loop-mediated isothermal amplification) as a novel diagnostic for sleeping sickness that may serve to bridge the gap between the need for sensitive, specific molecular diagnostics on the one hand and ‘field-friendly’ diagnostics on the other. Here, two previously published LAMP assays for Trypanozoons were compared to classic PCR based methods for the diagnosis of Trypanozoon infection status in 428 cattle blood samples. The results did not support the use of LAMP as an improved system for surveillance of T. b. rhodesiense in the zoonotic cattle reservoir. T. b. rhodesiense and T. b. gambiense subspecies specific LAMP assays were evaluated against traditional reference subspecies specific PCR tests, using DNA purified from 86 cryopreserved trypanosome isolates. Novel LAMP assays for these subspecies were also designed and evaluated. Both the published and novel assays for T. b. rhodesiense (targeting different regions of the SRA gene) were sensitive, specific and reliable when applied to purified DNAs, but were less consistent on field samples. The novel T. b. gambiense LAMP (targeting TgsGP) was sensitive and specific but this was not the case for the published LAMP assay (targeting the 5.8S rRNA gene). However reliability may be less than optimal for LAMP TgsGP. Finally, simple endpoint readout methods for LAMP were evaluated. The colour change reagent hydroxynaphthol blue was identified as the best currently available method taking cost, ease of use and reliability into consideration. In 2009 the number of reported sleeping sickness cases fell below 10,000 for the first time in 50 years. Improved LAMP diagnostics could facilitate the diagnosis of sleeping sickness and support the continued fight against this neglected, but deadly disease.

During the bloodstream stage of the Trypanosoma brucei lifecycle, the parasite exists in two different states: the proliferative slender form and the non-proliferative, transmissible, stumpy form. The transition from the slender to stumpy form is stimulated by a density-dependent mechanism and is important in infection dynamics, ordered antigenic variation and disease transmissibility. The slender to stumpy transition and the contribution of stumpy formation to within-host dynamics have been difficult to analyse, however, because cell-type specific markers have been restricted to imprecise morphological criteria. PAD1 is a recently identified stumpy-specific protein which acts as a molecular marker for stumpy formation and a functional marker for transmission. Here, the control of stumpy-specific gene expression via the 3’UTR has been analysed, identifying that there are repressive elements in the 3’UTR preventing inappropriate expression during the slender life stage. Further, both pleomorphic and monomorphic transgenic reporter cell lines utilising the PAD1 3’UTR have been created that report on stumpy formation in vitro and these have been used for the analysis of stumpyinducing chemical compounds. Finally, a sensitive and accurate qRT-PCR assay has been developed and optimised that faithfully reports both parasitaemia and stumpy formation throughout host infection. Using a chronic infection rodent model, stumpy levels have been monitored on the basis of conventional morphological and cell cycle assays, as well as by qRT-PCR for PAD1 expression. The results define the temporal order of events that result in the generation of stumpy forms early in a parasite infection and thereafter describe the dynamics of slender and stumpy forms in chronic infections extending over several weeks. This quantitative data has allowed the mathematical modelling of transmission competence in trypanosome infections, suggesting dominance of transmission stages throughout infection.

This thesis deconstructs the social, ecological, and colonial elements of the 1900-1910 Human African Trypanosomiasis (African Sleeping Sickness) epidemic which affected British Uganda and Belgian Congo. This paper investigates the epidemic’s medical history, and the subsequent social control policies which sought to govern the actions of the indigenous population. In addition, this paper argues that the failure to understand and respect the region’s ecological conditions and local knowledge led to disease outbreaks in epidemic proportions. Retroactive policies sought to inflict western medical practices on a non-western population, which resulted in conflict and unrest in the region. In the Belgian Congo, colonial authorities created a police state in which violence and stringent control measures were used to manage the local population. In Uganda, forced depopulation in infected regions destabilized local economies. This thesis compares and contrasts the methods used in these regions, and investigates the effects of Germ Theory on Sleeping Sickness policy and social perceptions during the colonial period in Africa.

Title: Comparison of thermal comfort of sleeping bag according to EN 13537 Objectives: Objectives of the proposed work was to measure the temperature inside the sleeping bag during sleeping. Then to compare it with the information given on the labels of sleeping bags. Methods: This work has a experimental character. In our work we have used methods of experiment and field study. These methods were used to sample 7 sleeping bags from various manufacturers. Results: The information reported by manufacturers always do not correspond to real use of sleeping bags. EN 13537 has primarily orientation character. For the choice of sleeping bags we do not recommend to follow according only to the EN 13537. It is necessary to follow other parameters of sleeping bags (type and weight of insulation material and construction of chambers). Keywords: sleeping bag, EN 13537, thermal comfort

The global One Health movement has become firmly entrenched in both political and scientific discourse pertaining to emerging infectious diseases in the past decade. Since the discovery of the H5N1 strain of Highly Pathogenic Avian Influenza in Hong Kong in 1997, the promotion of more holistic programmes for the control of emerging infectious disease has garnered “unprecedented support” in terms of donor funding and political mobilisation (Scoones 2010). Advocates of One Health argue that intersectoral approaches promoting better communication between the veterinary, medical and environmental disciplines at all levels of governance make not only sound economic sense, they are fundamental to the “new approach” required to address the growing disease threats of the 21st century. However, despite international endorsement of the One Health rhetoric, there is growing pressure to now “turn the rhetoric into reality” (Okello et al 2011). Using a multiple, embedded case study methodology, this thesis seeks to examine questions surrounding the practical implementation of One Health interventions, particularly in developing countries which experience limited resources and competing health priorities. Through examining the livestock and public health policy processes at both local and national levels in Uganda and Nigeria, I attempt to identify whether policy spaces exist for the formal inclusion of One Health approaches in future policy decisions. Furthermore, by scrutinising the current internationally dominant One Health narratives in light of global health governance perspectives and the emerging One Health Global Network, I question whether One Health can be better “packaged” to include endemic diseases and a more focussed sustainable livelihoods approach; arguably inciting greater motivation for developing countries to truly participate. Data from my three empirical chapters are presented in the context of three overriding “One Health propositions” for consideration; by questioning “whose world, whose health”, I aim to delve further into the issues of not whether, but how this “new health paradigm” can be operationalised, and how to address the potential gaps which may ultimately prevent One Health from becoming a truly global phenomenon.