The design and development of “e-Vaccination” applications are not extensively researched within developing economies, in part because of the difficulty in gaining access to government officials and medical experts. Vaccination cards have been used to keep track of minors’ immunisation records in South Africa for over 30 years. The South African government is moving towards the use of electronic systems for the storage of such information. South Africa has a clearly defined electronic health strategy, which is to utilise information and communications technologies in healthcare to inter alia, engage in medical research, promote health education, monitoring of diseases and tracking public health. Supporting this strategy means digitising current paper-based systems. The result would be information that can be stored safely, backed up and analysed more easily than paper-based journals, documents and vaccination cards. The purpose of this research is to develop a better understanding of key stakeholders’ perceptions to the replacement of paper-based vaccination cards with an electronic system. This is important because digital records can be considered as a more effective method of storing vaccination data. This study is quantitative in nature and primary data in the form of Likert scale questionnaires were collected from 118 key stakeholders being nurses, doctors, parents and school administration staff. The Likert scale questionnaire data was analysed using the following statistical techniques: Cronbach Alpha Test, Chi-Square Test, Analysis of Variance Test and Principle Component Analysis. The analysis provided a deeper understanding of the key stakeholder’s perceptions to the use of e-Vaccination applications. e-Vaccination applications are affected by user friendliness of the application, the graphical design of the application, practicality of the application, user experience of the application as well as the usability of the application. The practical implications of this research on e-Vaccination applications is that designers, developers, policymakers and government have a deeper understanding of nurses, doctors, parents and school administration staff perceptions to the use of e-Vaccination. / School of Computing

Vaccinations are among the greatest accomplishments of public health. However, many parents are choosing not to vaccinate. The purpose of this study was to explore the association between social media influence and parents' decisions to vaccinate their children. The health belief model indicates that individuals' likelihood of engaging in a health-related behavior is determined by their perceptions of susceptibility, severity, benefits, and barriers. The research questions addressed whether there is an association between parents' perception of their children's disease susceptibility and their decisions about vaccination, and whether there is an association between exposure to messaging from social media and parents' decision to vaccinate. A quantitative, cross-sectional research design was used. The primary dependent variable was vaccination choices, and the primary independent variable was exposure to information about vaccination through social media. Data were gathered through a questionnaire administered to 269 White parents residing in Illinois with their own children between the ages of 0 and 18 years living with them. Binomial logistic regression showed that there was not a statistically significant relationship between parents' perception of disease susceptibility and vaccination choice or between parents' vaccination choice and exposure to online antivaccine advertisements. These study findings help in defining an overall picture of vaccine hesitancy in the United States. By focusing on the predictors of this behavior, it may be possible to implement interventions to combat the antivaccine movement with the goal of increasing vaccine compliance among parents.

In 1911, the Uruguayan Parliament approved a law of mandatory smallpox vaccination. It was a controversial measure that generated a strong anti-vaccination campaign, led by the naturist movement. Embracing a transcendental understanding of nature, they saw vaccines and surgeries as a threat to the natural balance between body and soul. In this dissertation, I study how Uruguayan naturists positioned themselves as a secular alternative to science that combined reason and spirituality, and I show how they had a documented impact on the local political and scientific culture. By focusing on a country with a distinct anti-clerical tradition, I bring to the fore how apparently contradictory phenomena like secularity and spirituality overlap. The spirituality imbricated in their idea of nature, I conclude, resulted in conservative political gestures, even within progressive movements. Among many other things, they embraced a language of purity and sacredness around the body, both human and animal, that led them to the opposition to vaccinations, surgeries and meat consumption, which they regarded as violent moral transgressions. The influence of naturism in the country has not yet been sufficiently considered, and my research presents a first approach to a central aspect of the intellectual life of the period. Besides being a popular movement, it influenced key political, scientific and cultural figures, who, in turn, shaped laws, scientific policies and the elite’s understanding of science and its possibilities. To demonstrate this, through a cultural studies perspective, and in dialogue with science and technology studies and medical humanities, I do close-readings of an unexplored archive of naturist and theosophist periodicals, pamphlets and books published in the first two decades of the 20th century. I also study more well-known anarchist publications and philosophical works by prestigious medical doctors, such as Mateo Legnani (1884-1964), and Carlos Santín Rossi (1884-1936), both close to naturism, focusing on how they also represent an alternative body of knowledge where scientific thought and spirituality coalesce. I conclude by studying essays by the Spanish-Paraguayan writer Rafael Barrett (1876-1910), who debated with the Uruguayan naturists and wrote illuminating pieces on the issue. To this end, I structure the dissertation in three chapters. In the first one, I discuss the political impact of naturism and argue that the movement’s opposition to the 1911 law of compulsory smallpox vaccination highlighted the Government's tendency to subordinate individual freedoms, a fundamental principle of the newly formed liberal state, to what they saw as the common good, which contradicted the Government’s modernizing discourse and agenda. Moreover, naturists formulated some well-founded systematic critiques of the political values imbricated in academic medicine. By pointing this out, I challenge the opposition between them and university trained physicians, the latter historically represented as defenders of science and reason, and the former as religious fanatics. Indeed, the public health paradigm adopted by medical authorities appealed to nature in a very similar way than naturists did. Several renowned medical doctors, some of them parliamentary representatives, without openly identifying themselves as such made direct references to naturists’ precepts in their books and in public documents, including law bills. The second chapter revolves around the vision of science developed by naturism and its political and epistemological implications; there, I argue that while naturists amplified the metaphysical elements present in the history of medicine, from vitalism to Neo-Hippocratism and romanticism, such spiritual views remained compatible with the anticlericalism that characterized the Uruguayan society. I study two iterations of the movement that represent different understandings of science and that reveal specific political and philosophical tensions present in Uruguayan society. One of them, led by Antonio Valeta (1882-1945), proposed an accessible version of science, highlighting the autonomy of the individual. He appealed to values of freedom and personal effort that were part of the liberal imaginary and came into tension with the centrality of the state and its reformist agenda. The second one was developed by Fernando Carbonell (1880-1947), a member of the Theosophical Society and other esoteric groups. His vision was informed by a sophisticated system of beliefs, composed of mystical and conceptually dense metaphysical, ethical and aesthetic teachings that led to valid epistemological criticisms to the model of laboratory science that was being embraced by the authorities. In the third and final chapter, elaborating on the fact that naturists and other groups across the political spectrum mobilized a secular spirituality inherent to the idea of nature, I posit that this led to conservative political positions, even within progressive movements and individuals that were attracted to naturist precepts. Indeed, naturism explicitly opposed actions that could be considered revolutionary in favor of a gradual evolutionism, appealing to the same principle of non-violence embraced in their vegetarianism. In turn, they elevated the philosophical and metaphysical purity of the defense of the life of all beings above the actual living conditions of people and human suffering, romanticizing poverty and illiteracy as states closer to nature. To conclude, my dissertation brings attention to the diversity of belief systems and values still at stake in the present-day scientific landscape. Current iterations of naturism, as illustrated by the anti-vaccination movement both in Uruguay and internationally, resort to claims and arguments eerily similar to those developed more than 100 years ago in Montevideo and other parts of the world. Now, as they did in the past, activists advocate for individual freedom and against the intervention of foreign substances that alter the natural balance of their bodies. Moreover, within the context of the coronavirus pandemic, scientific discussions are taking over the public sphere in an unprecedented way, echoing past dynamics where public figures denounced scientists as biased and despotic elitists who wanted to subject the people to their arbitrary regulations.

Problématique : Une évaluation économique, commandée par le ministère de la Santé et des Services sociaux du Québec, vise à évaluer le rendement de deux programmes d'immunisation, soient la vaccination primaire et la vaccination antigrippale. Un des volets de cette étude économique nécessitera l'utilisation d'un questionnaire auto-administré auprès de personnes vaccinées contre l'influenza plusieurs semaines après leur vaccination. Objectif : Vérifier la fiabilité et la validité d'un questionnaire auto-administré sur l'efficacité populationnelle et les coûts assumés lors de la vaccination par les adultes vaccinés contre l'influenza. Cet outil sera utilisé pour une évaluation économique selon une perspective sociétale du programme d'immunisation contre l'influenza chez les adultes. Méthode : Un test-retest a été réalisé en soumettant le questionnaire à un échantillon de convenance de 499 personnes âgées de [supérieur ou égal à]50 ans de la Montérégie. Un premier questionnaire a été administré dans les CLSC en novembre 2004 (test) durant le temps d'attente après l'injection du vaccin. Le deuxième questionnaire a été envoyé 10 semaines plus tard par la poste aux participants en janvier 2005 (retest). Les variables testées sont de nature qualitative (variables sociodémographiques, statut vaccinal, lieu de vaccination, moyen de transport, absence du travail) ou quantitative (date et durée de la vaccination, distance parcourue, revenu annuel, coût du transport, autres coûts). La fiabilité a été évaluée par la comparaison des réponses déclarées entre les deux questionnaires alors que la validité de certaines variables a été évaluée par la comparaison entre les réponses fournies par les participants et des sources de référence. Les principaux tests statistiques utilisés sont: l'accord observé (P[indice inférieur omicron]), le kappa de Cohen ([kappa]) et le coefficient de corrélation intra-classe (CCI). Résultats : Le taux de participation a été de 95%. Les variables sociodémographiques obtiennent un P[indice inférieur omicron] entre les deux questionnaires variant de 82% à 98% et un [kappa] de 0,556 à 0,936. Les autres variables qualitatives affichent un P[indice inférieur omicron] de 89% à 100% mais un [kappa] variant de -0,007 à 0,862. Quant aux variables quantitatives transformées en catégorie, P[indice inférieur omicron] varie de 45% à 100% et [kappa] de 0,031 à 1,000. La divergence entre les indices de concordance [Kappa] et P[indice inférieur omicron] est attribuable aux paradoxes de kappa. Les variables de temps, soient la date de vaccination et la durée de vaccination, présentent une faible fiabilité avec respectivement un P[indice inférieur omicron] de 57% et 49% et un CCI de 0,305 et 0,690. Un grand nombre de réponses manquantes (38%) est constaté pour la variable date de vaccination. La validité des variables sélectionnées (statut vaccinal, lieu et date de vaccination, taille de la ville et moyen de transport) est jugée relativement bonne avec un P[indice inférieur omicron] variant de 58% à presque 100%. Conclusion : À l'exception des variables de temps, le questionnaire est assez fiable. La validité des variables évaluées est bonne. Le taux de participation et l'effectif élevés assurent une puissance statistique adéquate pour les analyses. La participation volontaire des sujets peut être une source de biais de sélection. La fiabilité et la validité étant étroitement liées, elles sont défavorablement influencées par le biais de mémoire. Celui-ci peut être engendré par le délai de réponses entre les deux questionnaires. Malgré tout, ce questionnaire pourra être utilisé dans l'étude économique après quelques modifications.

Bakgrund: Barnets upplevelse av den första vårdkontakten är av stor betydelse, eftersom smärtsamma ingrepp på barn kan medföra problem vid framtida sjukvårdsbesök och kan orsaka långvarig sjukvårdsrädsla. På BVC kan procedurrelaterad smärta förorsakas vid venprovtagning eller vaccination. Exempel på smärtlindringsmetoder vid procedurrelaterad smärta är amning, EMLA och distraktion. Syfte: Studiens syfte var att beskriva BVC-personalens upplevelser av små barns behov av smärtlindring vid vaccination och/eller venprovtagning samt de metoder som användes för smärtlindring. Metod: För att besvara vårt syfte gjorde vi bandinspelade, semistrukturerade intervjuer med 8 personer som arbetar inom BVC med små barn i åldern 3 månader, 1-2 år och 5-6 år. Analys: Intervjutexten analyserades med kvalitativ innehållsanalys (Graneheim & Lundman, 2004). Resultat: Vid analysen framkom följande fyra domäner: Upplevda behov av att smärtlindra barn vid vaccination och Metoder för smärtlindring av barn vid vaccination, Upplevda behov av att smärtlindra barn vid venprovtagning och Metoder för smärtlindring av barn vid venprovtagning. Det framkom vid analysen att det var få som upplevde behov av att smärtlindra små barn vid vaccination, däremot vid venprovtagning var upplevda behov att smärtlindra små barn större. Med barnets stigande ålder använder sig intervjupersonerna av flera olika metoder samtidigt, så som att distrahera eller att använda sig av leksaker. Diskussion: Resultatet jämförs med metoder för smärtlindring som har stöd i forskning. Redan använda metoders verkan bekräftas men förslag på ytterligare smärtlindringsmetoder ges. Med ökad spridning av redan befintlig kunskap, kan BVC- personal med sin lyhördhet bemöta och guida barnet på ett sätt som kan motverka och lindra procedurrelateradsmärta.

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Since the introduction of vaccines, many deaths due to various diseases including measles, have been drastically reduced. In Canada, there is a recommended vaccine schedule for all residents of the country; however, vaccine practises and immunisation schedules can vary from location to location as well as vary from country to country, leading to discrepancies in vaccine coverage and herd immunities. In addition, some anti-vaccination movements have been noted to persuade individuals into refusing vaccines, even in historically well immunised locations. In order to investigate the effect of varying vaccine coverage, a two patch metapopulation model for measles incorporating a single dose vaccine is formulated and studied. / October 2016