The 2009 H1N1 pandemic caused serious concerns worldwide due to the novel biological feature of the virus strain, and the high morbidity rate for youth. The urban scale is crucial for analyzing the pandemic in metropolitan areas such as the Greater Toronto Area (GTA) of Canada because of its large population. The challenge of exploring the spatial dynamics of H1N1 is exaggerated by data scarcity and the absence of an immediately applicable methodology at such a scale. In this study, a stepwise methodology is developed, and a retrospective spatial statistical analysis is conducted using the methodology to estimate the spatial dynamics of the 2009 H1N1 pandemic in the GTA when the data scarcity exists. The global and local spatial autocorrelation analyses are carried out through the use of multiple spatial analysis tools to confirm the existence and significance of spatial clustering effects. A Generalized Linear Mixed Model (GLMM) implemented in Statistical Analysis System (SAS) is used to estimate the area-specific spatial dynamics. The GLMM is configured to a spatial model that incorporates an Intrinsic Gaussian Conditionally Autoregressive (ICAR) model, and a non-spatial model respectively. Comparing the results of spatial and non-spatial configurations of the GLMM suggests that the spatial GLMM, which incorporates the ICAR model, proves a better predictability. This indicates that the methodology developed in this study can be applied to epidemiology studies to analyze the spatial dynamics in similar scenarios. / Thesis (Master, Geography) -- Queen's University, 2012-10-30 17:41:28.445

Teachers are often in contact with children whose family members are affected or infected by the HIV and AIDS pandemic, or children themselves who are affected or infected by the HIV and AIDS pandemic. Often, it is teachers themselves who are suffering due to the HIV and AIDS pandemic. School training and tertiary training are one of the most important components, which need a lot of attention in a developing country. Teachers play a very important role in developing the youth’s thoughts. School training is often negatively impacted due to absenteeism of teachers, negative attitudes of teachers and the time wasted to replace teachers who are negatively impacted by the HIV and AIDS pandemic or who take medical discharge. Teachers often don’t know how to handle the impact of the HIV and AIDS pandemic and they are also unaware of resources available in this regard. The REds-programme is a support programme designed for teachers who are affected by the HIV and AIDS pandemic. The aim of the REds-programme is to provide teachers with support so that they will be able to handle the impact of the HIV and AIDS pandemic. The focus is specifically on teachers, as they don’t live or work in isolation. Teachers form part of communities and school units whom are directly impacted by the HIV and AIDS pandemic. The REds-programme was vi implemented in 2004. This programme is thus running, tested and still in the process of testing, for the past six years. Article 1 consists of the following: The nature and content of the REds-programme. The group work process, as well as a discussion of each group work session. Article 2 consists of the following: An evaluation of the REds-programme by means of the qualitative and quantitative results obtained. From the results, it is clear that the REds-programme is a very effective programme from which life orientation teachers can benefit. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012

The objectives of this research were investigate the lived experiences of school-going learners who are HIV-positive; and develop ecosystemic management strategies to help learners who are HIV-positive. The literature research investigation revealed that HIV/AIDS is not just a health problem but also attacks the education system itself. Demand for education is dropping and changing, many educators are ill and dying, and the trauma of loss associated with HIV/AIDS is entrenched in South African classrooms. The HIV/AIDS pandemic has a traumatic impact on all educators and learners. The work of educators both those who are HIV positive and those who have developed full-blown AIDS will be compromised by periods of illness. The pandemic thrives on sexual violence, male domination and child abuse in South Africa. It is the ecosystemic paradigm that helps in seeing the connecting link between family-school-community-society-world or school and peers and this helps in providing a more useful synergistic focus than trying to work in isolation with discrete segments of a microsystem for example, with an individual in isolation. Management strategies for dealing with HIV/AIDS include the notion that achieving sustainability requires bringing together a variety of legitimate stakeholders, drawing on a variety of accepted bodies of knowledge, to negotiate a learning path based on a series of conflict resolutions within ecological constraints. Continual learning based on free flow of information and mutual respect, and investment in effective management of HIV/AIDS are keys to success. The empirical research investigation revealed that psychologically disturbed, emotional well-being, spiritual well-being, physical well-being, social life, their scholastic performance, daily routine, there is a change in their behaviour or health after the HIV- positive status has been revealed, they fear of death, their academic performance at school is affected by absenteeism and lack of concentration, there is absence of strategies to assist learners who are absent frequently because of illness, they loose valued level of functioning, lack assistance at school, fear being discriminated or ridiculed, there is absence v of measures to deal with discrimination at school, there is a lack of information on HIV/AIDS, learners fear disclosing to friends and teachers, there is a lack of communication between parents and infected learners about issues regarding HIV/AIDS. Educators are also affected emotionally, spiritually and physically. They become affected socially and they do not cope with the impact of HIV. The level of communicating the HIV/AIDS pandemic within the schools is low, the principals are not doing much as leaders to supplement this low level of communicating about HIV/AIDS, school policies on HIV/AIDS in these schools do not address issues of support for learners and educators who are incapacitated because of HIV/AIDS, there is no monitoring tool used in these schools to ensure HIV-policy adherence, principals in these schools do not ensure that educators teach learners about matters pertaining to HIV/AIDS, health programmes in these schools do not assist learners living with HIV/AIDS within the school and the level of accepting and accommodating infected learners and the personnel in these schools is low. The level of involvement of community members in matters pertaining to HIV/AIDS in these schools is low. An ecosysternic management system is proposed in this research vi / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2008.

No mês de março de 2013 foram reportados pela Organização Mundial da Saúde (OMS) os primeiros casos de infecções humana pelo vírus Influenza aviário A(H7N9). Em maio de 2017 já haviam sido registrados 1439 casos. As infecções em humanos causadas por este vírus são associadas a consideráveis níveis de mortalidade e morbidade. A vacinação é atualmente o meio mais efetivo para prevenir as infecções e as severas complicações na saúde humana causada pelo vírus da Gripe. Desenvolver e produzir vacinas contra a Gripe pandêmica é a estratégia principal para uma resposta contra a pandemia (WORLD HEALTH ORGANIZATION, 2005). Este projeto produziu os bancos de vírus H7N9, um lote piloto e três lotes industriais em condições (BPF) dos monovalentes utilizados para a produção da vacina contra a gripe pandêmica, A(H7N9). Estes lotes foram caracterizados, avaliados em relação aos padrões de qualidade e testados quanto a imunogenicidade em ensaios com camundongos. / In March 2013 it was reported by the World Health Organization (WHO) the first cases of human infections with avian influenza virus A (H7N9). In May 2017 they had been registered 1439 cases. The infections in humans caused by this virus are associated with considerable morbidity and mortality levels. Vaccination is currently the most effective way to prevent infections and severe complications on human health caused by the flu virus. Developing and producing vaccines against pandemic influenza is the main strategy for a response to the pandemic (WORLD HEALTH ORGANIZATION, 2005). This project produce the seeds virus A(H7N9), a pilot batch and three industrial lots (GMP) of the monovalents used to produce the pandemic influenza vaccine against A(H7N9). These batches were characterized, evaluated for quality standards and tested for immunogenicity in mouse assay.

With a case fatality rate higher than the 1918 Spanish Flu pandemic, H5N1 highly pathogenic avian influenza represents a threat to global public health. Efforts to identify locations with the greatest potential for pandemic emergence, as well as how the virus is spreading, may help minimize this threat. First detected in Egypt in 2006, H5N1 viruses have resulted in the deaths of millions of birds in both commercial and backyard poultry flocks, and more than 350 human infections, the most of any country, have been confirmed. Human outbreaks have been so far constrained by poor viral adaptation to non-avian hosts. There are two evolutionary mechanisms by which the H5N1 avian influenza virus could acquire pandemic potential: 1) via reassortment as a result of coinfection with another subtype (such as low pathogenic avian influenza H9N2); and/or 2) via antigenic drift and the accumulation of randomly occurring genetic changes found to improve viral fitness, herein called key substitutions (KS). Both mechanisms were investigated using geospatial methods including ecological niche modeling and hot spot analyses to predict locations with elevated potential for pandemic emergence. Using ecological niche modeling environmental, behavioral, and population characteristics of H5N1 and H9N2 niches within Egypt were identified, with niches differing markedly by subtype. Niche estimates were combined using raster overlay to estimate co-infection potential, with known occurrences used for validation. Co-infection was successfully predicted with high accuracy (area under the receiver operating characteristic (ROC) curve (AUC) 0.991). 41 distinct KS in H5N1 were detected in Egyptian isolates, including 17 not previously reported in Egypt. Phenotypic consequences of detected KS were varied, but the majority have been implicated in improving mammalian host adaptation and increasing virulence. Statistically significant spatial clustering of high KS rates was detected in the northwestern portion of the Nile River delta in the governorates of Alexandria and Beheira. To investigate how the virus spreads between poultry farms, landscape genetics techniques were employed. Viral genetic sequences were evaluated using phylogenetics to determine viral relatedness between samples, then distance models representing competing diffusion mechanisms were created using road networks and a least-cost path model designed to approximate wild waterbird travel using niche modeling and circuit theory. Spatial correlations were evaluated using Mantel tests, Mantel correlograms, and multiple regression of distance matrices within causal modeling and relative support frameworks. Samples from backyard farms were most strongly correlated with least cost path distances, implicating wild bird diffusion, while samples from commercial farms were most strongly correlated with road network distances, implicating human-mediated diffusion. Results were largely consistent across gene segments. Identifying areas at risk of co-infection can help target spaces for increased surveillance. Similarly, detecting spatial hot spots of KS highlight areas of concern for pandemic emergence from antigenic drift. Demonstration of different diffusion mechanisms by farm type should inform both surveillance and biosecurity practices. Knowledge of where to focus intervention efforts, both spatially and strategically, allows limited public health resources to be targeted most effectively. By detecting where in the country pandemic influenza is likely to emerge and identifying how the virus is spreading between farms, this work contributes to efforts to predict and prevent the next influenza pandemic.

During the 2009 H1N1 influenza pandemic, public health nurses (PHNs) were called upon to protect their communities against a deadly influenza virus. Currently, there appears to be no literature that describes the experience of Canadian PHNs responding to the first influenza pandemic of the 21st century. A qualitative research study was conducted and the data were analyzed by using content analysis. Thirteen nurses were interviewed from an Urban, Rural and Northern health region in Manitoba. Focus groups were conducted for the Urban and Rural nurses while Northern nurses were interviewed by telephone. Communication and dissemination of information, personal and professional challenges, personal face of the pandemic, regional support and lessons learned were themes generated from the data analysis. Communication and information flow was a major theme that impacted the overall PHNs’ response experience. Practice, administration, research and education implications and the limitations of the study are presented in the study.

On June 11, 2009, the World Health Organization declared a global influenza pandemic due to a novel influenza A virus subtype of H1N1. Public health emergencies, such as an influenza pandemic, can potentially impact disadvantaged populations disproportionately due to underlying social factors. Canada???s First Nation population was severely impacted by the 2009 H1N1 influenza pandemic. Most First Nation communities suffer from poor living conditions, impoverished lifestyles, lack of access to adequate health care, and uncoordinated health care delivery. Also, there are vulnerable populations who suffer from co-morbidities who are at a greater risk of falling ill. Moreover, First Nation communities that are geographically remote (nearest service center with year-round road access is located over 350 kilometers away) and isolated (only accessible by planes year-round) face additional challenges. For example, transportation of supplies and resources may be limited, especially during extreme weather conditions. Therefore, remote and isolated First Nation communities face unique challenges which must be addressed by policy planners in order to mitigate the injustice that may occur during a public health emergency. The Assembly of First Nations noted that there has been very little inclusion of First Nations??? input into current federal and provincial pandemic plans. Disadvantaged groups know best how they will be affected by a public health emergency and are able to identify barriers and solutions. Therefore, the objective of my research was to gain retrospective insight into the barriers faced by three remote and isolated First Nation communities of sub-arctic Ontario (i.e., Fort Albany, Attawapiskat, and Kashechewan) during their 2009 H1N1 pandemic response. Culturally-appropriate community-based suggestions for improvement of existing community-level pandemic plans were also elicited. Collected data informed modifications to community-level pandemic plans, thereby directly applying research findings. Being a qualitative community-based participatory study, First Nation community members were involved in many aspects of this research. Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the three main sectors responsible for health care services (i.e., federal health centers, provincial hospitals, and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis to reveal similarities and differences experienced within and between each community (and government body) regarding their respective pandemic response. Another round of semi-directed interviews (n=4) and community pandemic committee meetings were conducted to collect additional information to guide the modifications to the community-level pandemic plans. Reported barriers due to being geographically remote and isolated included the following: overcrowding in houses, insufficient human resources, and inadequate community awareness. Primary barriers faced by government bodies responsible for health care delivery were reported as follows: receiving contradicting governmental guidelines and direction from many sources, lack of health information sharing, and insufficient details in community-level pandemic plans. Suggested areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies, and community awareness. Additionally, participants recommended that complementary communication plans should be developed. As suggested by participants, community-specific information was added to update community-level pandemic plans. Remote and isolated First Nation communities faced some barriers during their 2009 H1N1 health sector pandemic response. Government bodies should focus efforts to provide more support in terms of human resources, monies, and education. In addition, various government organizations should collaborate to improve housing conditions, timely access to resources, and the level of coordination regarding health care delivery. Furthermore, as pandemic plans are dynamic, government bodies should continue to aide First Nation communities with updating their community-level pandemic plans to satisfy their evolving needs. These recommendations should be addressed so that remote and isolated western James Bay First Nation communities and other similar communities can be better prepared for the next public health emergency.

During the 2009 H1N1 influenza pandemic, public health nurses (PHNs) were called upon to protect their communities against a deadly influenza virus. Currently, there appears to be no literature that describes the experience of Canadian PHNs responding to the first influenza pandemic of the 21st century. A qualitative research study was conducted and the data were analyzed by using content analysis. Thirteen nurses were interviewed from an Urban, Rural and Northern health region in Manitoba. Focus groups were conducted for the Urban and Rural nurses while Northern nurses were interviewed by telephone. Communication and dissemination of information, personal and professional challenges, personal face of the pandemic, regional support and lessons learned were themes generated from the data analysis. Communication and information flow was a major theme that impacted the overall PHNs’ response experience. Practice, administration, research and education implications and the limitations of the study are presented in the study.

The objectives of this research were investigate the lived experiences of school-going learners who are HIV-positive; and develop ecosystemic management strategies to help learners who are HIV-positive. The literature research investigation revealed that HIV/AIDS is not just a health problem but also attacks the education system itself. Demand for education is dropping and changing, many educators are ill and dying, and the trauma of loss associated with HIV/AIDS is entrenched in South African classrooms. The HIV/AIDS pandemic has a traumatic impact on all educators and learners. The work of educators both those who are HIV positive and those who have developed full-blown AIDS will be compromised by periods of illness. The pandemic thrives on sexual violence, male domination and child abuse in South Africa. It is the ecosystemic paradigm that helps in seeing the connecting link between family-school-community-society-world or school and peers and this helps in providing a more useful synergistic focus than trying to work in isolation with discrete segments of a microsystem for example, with an individual in isolation. Management strategies for dealing with HIV/AIDS include the notion that achieving sustainability requires bringing together a variety of legitimate stakeholders, drawing on a variety of accepted bodies of knowledge, to negotiate a learning path based on a series of conflict resolutions within ecological constraints. Continual learning based on free flow of information and mutual respect, and investment in effective management of HIV/AIDS are keys to success. The empirical research investigation revealed that psychologically disturbed, emotional well-being, spiritual well-being, physical well-being, social life, their scholastic performance, daily routine, there is a change in their behaviour or health after the HIV- positive status has been revealed, they fear of death, their academic performance at school is affected by absenteeism and lack of concentration, there is absence of strategies to assist learners who are absent frequently because of illness, they loose valued level of functioning, lack assistance at school, fear being discriminated or ridiculed, there is absence v of measures to deal with discrimination at school, there is a lack of information on HIV/AIDS, learners fear disclosing to friends and teachers, there is a lack of communication between parents and infected learners about issues regarding HIV/AIDS. Educators are also affected emotionally, spiritually and physically. They become affected socially and they do not cope with the impact of HIV. The level of communicating the HIV/AIDS pandemic within the schools is low, the principals are not doing much as leaders to supplement this low level of communicating about HIV/AIDS, school policies on HIV/AIDS in these schools do not address issues of support for learners and educators who are incapacitated because of HIV/AIDS, there is no monitoring tool used in these schools to ensure HIV-policy adherence, principals in these schools do not ensure that educators teach learners about matters pertaining to HIV/AIDS, health programmes in these schools do not assist learners living with HIV/AIDS within the school and the level of accepting and accommodating infected learners and the personnel in these schools is low. The level of involvement of community members in matters pertaining to HIV/AIDS in these schools is low. An ecosysternic management system is proposed in this research vi / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2008.

Teachers are often in contact with children whose family members are affected or infected by the HIV and AIDS pandemic, or children themselves who are affected or infected by the HIV and AIDS pandemic. Often, it is teachers themselves who are suffering due to the HIV and AIDS pandemic. School training and tertiary training are one of the most important components, which need a lot of attention in a developing country. Teachers play a very important role in developing the youth’s thoughts. School training is often negatively impacted due to absenteeism of teachers, negative attitudes of teachers and the time wasted to replace teachers who are negatively impacted by the HIV and AIDS pandemic or who take medical discharge. Teachers often don’t know how to handle the impact of the HIV and AIDS pandemic and they are also unaware of resources available in this regard. The REds-programme is a support programme designed for teachers who are affected by the HIV and AIDS pandemic. The aim of the REds-programme is to provide teachers with support so that they will be able to handle the impact of the HIV and AIDS pandemic. The focus is specifically on teachers, as they don’t live or work in isolation. Teachers form part of communities and school units whom are directly impacted by the HIV and AIDS pandemic. The REds-programme was vi implemented in 2004. This programme is thus running, tested and still in the process of testing, for the past six years. Article 1 consists of the following: The nature and content of the REds-programme. The group work process, as well as a discussion of each group work session. Article 2 consists of the following: An evaluation of the REds-programme by means of the qualitative and quantitative results obtained. From the results, it is clear that the REds-programme is a very effective programme from which life orientation teachers can benefit. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012