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BACKGROUND: Cervical cancer is a global disease with a disproportionate burden among low- and middle-income countries. In Tanzania, cervical cancer is the most common female cancer and a prophylactic vaccine offering protection against four human papillomavirus (HPV) strains is a promising prevention method. The targeted age and sex, as well as the sexually transmitted nature and novelty of the vaccine, support the need for formative research on the knowledge, attitudes, and barriers toward vaccination. OBJECTIVES: The first objective of this thesis was to systematically review studies of HPV vaccine acceptability among African countries. The second and third objectives were to describe and determine the socio-demographic factors and HPV-related knowledge and attitudes associated with HPV vaccination and to identify the barriers to vaccination among a population-based sample of rural and urban women in the Kilimanjaro Region of Tanzania. METHODS: The literature was systematically reviewed by searching electronic databases, and a data abstraction form structured by the Health Belief Model was used to collect data and synthesize findings. For objectives 2 and 3, a cross-sectional study was conducted among rural (n=303) and urban (n=272) women aged 18-55. Differences in socio-demographic factors, knowledge, attitudes, and barriers were compared between groups, and multivariable models were used to identify associations among rural and urban women separately. RESULTS: Reviewed literature suggested that HPV vaccine-related knowledge was low, however predicted acceptance of the vaccine was high. Research on this topic was largely composed of cross-sectional studies in urban areas. Among rural women in the Kilimanjaro Region, independent associations with acceptance included variables related to cost, knowledge, access, and educational attainment. Among urban women, independent associations were related to social networks/norms and educational attainment. The most frequent perceived barriers to vaccination were cost, side effects, and safety. CONCLUSION: Educational programs on the HPV vaccine and cervical cancer are needed in Tanzania and in other areas of Africa. This research suggests that vaccine campaigns in the Kilimanjaro Region should focus on emphasizing financial and physical accessibility, peer acceptance, and safety, in addition to highlighting endorsement of the vaccine by healthcare providers and the government. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-10-15 21:01:17.426

Infectious disease is an important issue for animal breeders, farmers and governments. Solutions to control infectious disease are needed and research focused on the genetic loci determining variation in immune-related traits has the potential to deliver solutions. The primary aim of this thesis is to discover regions of the bovine genome which influence the immune response post immunisation. To accomplish this two types of immunising agents, a Foot-and-Mouth Disease Virus (FMDV) peptide (FMDV15) and a commercial vaccine for Bovine Respiratory Syncytial Virus (BRSV), were used to immunise the second generation (F2 and backcrosses) of the Roslin Bovine Genome (RoBoGen) herd, a Charolais Holstein cross population. The FMDV15 peptide consisted of two sections of the VP1 protein located on the FMDV capsid, together encompassing the major neutralising antibody sites that are known to be immunogenic. Protection against FMDV is generally believed to relate to the levels of neutralising antibody and has been correlated with IgG1 and IgG2 levels as well as interferon- . In addition it has been shown that T cell responses also play a role in protection against FMDV. Thus all of these were used as phenotypic measurements post immunisation to the FMDV15 peptide. The BRSV vaccine used was an attenuated live vaccine. Protective mechanisms against BRSV infection include IgA, IgG1, IgG2 and IgM BRSV-specific antibodies and antibody titres particularly those of the IgG isotypes are considered to be correlates of protection. Thus, IgG1 and IgG2 antibody levels were measured post vaccination with the BRSV vaccine. All phenotypes were measured across time, and allowed analysis of the primary and secondary adaptive immune responses. Both agents caused considerable variation in the phenotypes measured post immunisation, with significant responses detected two weeks post immunisation. REstricted Maximum Likelihood (REML) analysis attributed much of this variation to sire, highlighting the heritable component, and environmental effects. Significant positive correlations were detected across time within each trait for both the FMDV and BRSV responses. The FMDV and BRSV antibody levels also correlated with each other at later time points, suggesting that there may be animals which are genetically predisposed to be high or low responders in general. Initially a linkage mappingapproach was followed using 165 microsatellite markers, which detected 77 QTL in response to the FMDV peptide and 27 QTL in response to the BRSV vaccine. There were some overlapping QTL, for example QTL which spanned the Major Histocompatibility Complex. Further analysis was conducted by developing a Perl scripted program which genotyped the RoBoGen herd in two ways; 1) Single Nucleotide Polymorphism(s) (SNP) were genotyped within the confidence intervals of the previously discovered QTL and 2) SNP were genotyped via a candidate gene approach. Association study methodology, accounting for relationship stratification via principal components of the genetic relationship matrix, was used to detect significant SNP, in response to both the FMDV peptide and the BRSV vaccine. Twenty significant SNP associations were discovered across 19 traits, with some SNP located in genes with known biological relevance to an immune response, such as the Toll-Like Receptors (TLR), TLR4 and TLR8. This thesis has detected regions of the genome which are significantly associated with the immune responses elicited by two different agents, suggesting similar pathway(s)/gene(s) may be used in defence of multiple pathogens. Once regions of significance were detected, further analysis using SNP markers identified significant, non-synonymous SNP that were associated with the immunising agents. The novel markers discovered in this study may aid breeding for resistance to disease via marker assisted selection. In addition, they may also have highlighted new targets for vaccinologists to develop ‘next generation’ vaccines.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

OBJECTIVES: The anti-vaccination movement is prevalent in today's media with claims which continue to create feelings of fear and trepidation in the minds of many parents. The C.A.S.E. Approach (Corroboration, About Me, Science, Explain/Advise) is a method ofcommunication to be used in formulating meaningful, rapid responses to parents hesitant to vaccinating their children. This DNP project assessed the effects of a C.A.S.E. Approach learning module on family nurse practitioner (FNP) students' perceived levels of knowledge and self-efficacy regarding vaccination discussion with vaccine hesitant parents (VHPs). METHODS: This DNP project used a pretest-posttest design to measure the effects of the C.A.S.E. Approach training intervention on both knowledge and self-efficacy levels of FNP students. Fourteen students participated in this study. Each took the 20-question pretest C.A.S.E. Approach Questionnaire, then participated in the C.A.S.E. Approach learning module,and finished by repeating the questionnaire as a posttest following the intervention. The questionnaire was designed using four-item Likert questions scored 1 (strongly disagree) to 4(strongly agree), wherein higher scores reflected better understanding and self-efficacy in the C.A.S.E. Approach. Students were recruited via an online classroom format within a nursing course offered at the University of Arizona: Nursing 612, Introduction to Pediatrics. All testing and module information was accessed online and questionnaire responses were stored at Qualtrics.com, also online. RESULTS: Students' posttest scores following the intervention of the C.A.S.E. Approach learning module were significantly higher than pretest scores. Perceived knowledge (p< 0.001)of the C.A.S.E. Approach increased more significantly than did perceived self-efficacy (p =0.001) of the C.A.S.E. Approach following the module. Mean test scores increased on average 14.29 points in perceived knowledge of the C.A.S.E. Approach following the module, and 7.93 points for perceived self-efficacy following the module. CONCLUSION: Key findings included an observed increase in participating students' perceived knowledge regarding the C.A.S.E. Approach as well as an observed increase inparticipating students' perceived self-efficacy in using the C.A.S.E. Approach. There was strong statistical evidence (p≤0.05) to suggest the learning module increased student knowledge andself-efficacy regarding vaccine discussion.

Aging-related decline in immunity is believed to be the main driver behind decreased vaccine efficacy and reduced resistance to infections in older adults. Unrepaired DNA damage is known to precipitate cellular senescence, which was hypothesized to be the underlying cause of certain age-related phenotypes. Consistent with this, some hallmarks of immune aging were more prevalent in individuals exposed to whole-body irradiation (WBI), which leaves no anatomical repository of undamaged hematopoietic cells. To decisively test whether and to what extent WBI in youth will leave a mark on the immune system as it ages, we exposed young male C57BL/ 6 mice to sublethal WBI (0.5-4 Gy), mimicking human survivor exposure during nuclear catastrophe. We followed lymphocyte homeostasis thorough the lifespan, response to vaccination, and ability to resist lethal viral challenge in the old age. None of the irradiated groups showed significant differences compared with mock-irradiated (0 Gy) animals for the parameters measured. Even the mice that received the highest dose of sublethal WBI in youth (4 Gy) exhibited equilibrated lymphocyte homeostasis, robust T-and B-cell responses to live attenuated West Nile virus (WNV) vaccine and full survival following vaccination upon lethal WNV challenge. Therefore, a single dose of nonlethal WBI in youth, resulting in widespread DNA damage and repopulation stress in hematopoietic cells, leaves no significant trace of increased immune aging in a lethal vaccine challenge model.

Thesis (M.A.)--Boston University / Vaccines have been one of the greatest modern achievements within the fields of medicine and public health. Since their development they have prevented millions. from becoming infected and saved countless lives. Over the years though there have been various instances of anti-vaccinationist movements, which will raise concerns about vaccine safety but then eventually fade away once the virtues of the vaccine are proven greater than the possible opposed reaction or side effect. These movements have create significant drops in vaccination rates regionally and have put many at unnecessary risk of infection. However, over the last decade there has been a general increasing public distrust of vaccinations, which has continued to propagate even after the initial concerns were addressed. This paper aims to evaluate if there is significant justification for the current anti-vaccinationist movement within modernized societies by examining the proposed and eventually discredited link between autism and the measles-mumps-rubella vaccine that was initially suggested in the 1998 Wakefield et al. paper in The Lancet. This study will also evaluate opposing studies on the same to determine if any remaining concerns of a link between autism and the vaccine are justified while also evaluating the anti-vaccinationist rationale even though researchers have presented an overwhelming amount of scientific evidence showing the safety and efficiency of the vaccinations. Finally this study will look into how public health organizations can attempt to better efficiently deal with such movements in the future. The research for this paper is based on the analyzation of multiple recent research articles, as well as the evaluating trends obtained from public health records. [TRUNCATED]

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01