Thesis (M.P.H.M.)--Mahidol University, 1999.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2003.

Thesis (M.A.(Population and Reproductive Health Research))--Mahidol University, 2005. / LICL has E-Thesis 0005 ; please contact computer services.

Thesis (Ph. D.)--University of California, San Diego, 1999. / Vita. Includes bibliographical references (leaves 118-126).

Thesis (M.A.)--York University, 2006. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 76-91). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR29568

Thesis (M.A.)--Northern Kentucky University, 2009. / Made available through ProQuest. Publication number: AAT 1467385. ProQuest document ID: 1848731771. Includes bibliographical references (p. 34-35)

The bursa of Fabricius is a central lymphoid organ essential for B cell development and generation of humoral immune responses in birds. The bursa is connected dorsally to the cloaca and continually “samples” the intestinal fluid phase for the presence of antigen. It is comprised of folds or plicae, which are seeded with individual follicles, where antigen processing and presentation occurs for B cell development as well as generation of antibody responses. The plicae are separated from the bursal lumen by interfollicular epithelium (IFE) and specific regions of follicle-associated epithelium (FAE). The FAE is comprised of M cell-like cells, which are specialized for transcytosis of antigen from the bursal lumen into underlying follicles. The uptake of particulate and soluble antigen in the bursa of Fabricius has been previously demonstrated, but how particle size affects their internalization within bursal FAE and the transport of particulate antigen into deeper follicles has not been explored. It has been shown that nanoparticles (NPs) ≤40 nm are most efficiently internalized by the epithelium of the murine intestine and vaginal tract. Therefore, we examined the uptake of 0.04 - 2 μm fluorescent polystyrene NPs in bursa at 1 hour or 6 hours after bursal administration to determine whether bursal epithelium is similarly constrained. Using immunofluorescence microscopy (IFM) and spectrofluorophotometry we found that NP uptake is inversely correlated with NP size. NPs ≤40 nm are most efficiently internalized by the bursal epithelium and bursal follicles, while NPs ≥500 nm are not effectively taken up by the bursal epithelium within 6 hours of administration. Moreover, once the size-limited capabilities of the bursal epithelium were established, we also found that bursal priming of chickens with 20 nm NPs conjugated to IMP-1, a protective antigen of an important avian pathogen Eimeria maxima, induces IMP-1-specific serum IgG following sub-cutandous boosting. We induced similar IMP-1-specific serum antibody responses in chickens primed bursally and sub-cutaneously boosted as those primed and boosted sub-cutaneously. Whether this route of immunization is able to elicit long-term protection must be investigated. A number of infectious diseases, including Infectious Bursal Disease Virus (IBDV), which directly targets the bursa of young birds and prevents the development of the immune system and causes mortality, are prevalent in the poultry industry. While vaccines exist for many of these diseases they confer only partial or incomplete protection; therefore, alternative vaccine strategies must be investigated. In addition, the bursa is an ideal in vivo model for the investigation of endocytic mechanisms for uptake of particulate antigen. Therefore, further characterizing the mechanisms of NP uptake at mucosal surfaces and their immunogenicity will be important for the development of NP-based mucosal vaccines for agriculturally relevant species such as poultry.

The purpose of this project is to develop a clinical practice guideline with recommendations for vaccination and vaccine hesitancy in the pediatric setting. Routine vaccinations are given to children at recommended ages to decrease the incidence of, and prevent infectious disease. These vaccinations prevent diseases such as rotavirus, diphtheria, pertussis, tetanus, hepatitis B, haemophilus influenza type B, pneumococcal disease, polio, influenza, measles, mumps, rubella, varicella and hepatitis A. There are currently no guidelines that combine evidence-based interventions to increase vaccination rates, the recommended vaccine schedule, specific information on each vaccination, its side effects, and ingredients of each vaccination. By developing this guideline, it is hoped that pediatric providers will be able to effectively approach the caregivers of vaccine-aged children with evidence based information about vaccination, and be able to address specific concerns regarding vaccines. The available literature was formally evaluated using GRADEpro software. These results were put into the BRIDGE-Wiz (Building Recommendations in a Developer ’s Guideline Editor) software to create clear, concise, key action statements for the guideline. There were five recommendations that were created based on the literature review which include assessing parental concerns regarding vaccination at each visit, educating parents on vaccination, each vaccine, at each visit and when concerns arise, recommending vaccinations during each visit and when the opportunity arises, recommending pre-scheduling vaccination appointments, and implementing a reminder/recall system when vaccinations are due or past due. There were also informational tables created for provider reference that include important information regarding vaccines. The first table includes each vaccination, the disease it prevents, and the risk of the disease vs the risk of the vaccination. The second table includes the vaccine ingredients that commonly cause concern, and information to address those concerns. The guideline can be used in pediatric primary care to guide interventions to increase the uptake of vaccinations, and as a tool for providers to use while educating parents on specific vaccinations. The guideline was formally evaluated using the AGREE II tool by three experts in the field of pediatric primary care. All three of the reviewers stated that they would recommend the guideline for use in the pediatric setting.

Class of 2017 Abstract / Objectives: To determine whether pharmacy students were more willing to receive, administer, recommend and counsel patients about vaccinations after completing an immunization training program Methods: Anonymous and voluntary questionnaires administered on paper during a regularly scheduled class collected ratings of confidence on the willingness of first year pharmacy students to receive, administer, recommend and counsel about vaccinations prior to and after the completion of an immunization training program. Data on gender, age range, status of completion and source of the immunization training program completed was also collected. This study was approved by the University of Arizona Institutional Review Board (IRB). Results: Questionnaires were completed by 110 students at the Tucson and Phoenix campus. Students were equally willing (p=0.235) to receive all vaccinations, even if they were not required to by the UA COP, before and after the immunization training program.There was a statistically significant difference in the willingness to administer (p<0.001), to recommend (p=0.024) and to counsel (p<0.001) about vaccinations after completion of an immunization training program. Conclusions: Completing an immunization training program did not have influence on the willingness of pharmacy students to receive vaccinations. However, the results suggest pharmacy students are more willing to administer, recommend and counsel about vaccinations after the completion of an immunization training program.

Class of 2015 Abstract / Objectives: To establish the impact pharmacists can have on adult immunization rates by having pharmacists available to provide, administer, and advocate for immunizations. Methods: The following databases were searched from inception to November 2014: NLM PubMed; Ovid/MEDLINE; and Google Scholar. Inclusion criteria were comparative studies reporting pharmacist intervention and their impact on immunization rates. Of 38 publications originally identified, 15 met inclusion criteria. Variables examined included study characteristics, pharmacist intervention, and immunization rates. Results: Of the 15 studies we identified, only ten studies could be analyzed in the meta-analysis. All studies showed increases in immunization rates with pharmacist involvement, but there was high variance. Pharmacist interventions at hospital sites had the greatest benefit for increasing immunization rates (average odds ratio [OR], 10.64, confidence interval [CI] 95%, 5.25-21.49). Pharmacist intervention at one or two community sites had the second highest impact (OR, 2.81; CI 95%, 2.31-3.41). Studies covering multiple sites (more than two) showed the lowest increase in immunization rates (OR 2.26; CI 95%, 1.81-2.81). Conclusions: Pharmacist’s involvement in advocating and administering immunizations directly increases immunization rates in some patient populations. The greatest increases in immunization rates can be seen when pharmacists advocate for immunizations in the hospital setting.