El Hospital de Caridad de Cartagena fue fundado en 1693. Objetivo: determinar su área de influencia, los problemas sanitarios, enfermedades y lesiones más frecuentes y otros aspectos. La fuente principal ha sido el archivo del Hospital. Entre 1900 y 1936 el Hospital experimenta un gran auge. El 58% de enfermos proceden de la Ciudad, siguiéndole la zona minera (19%). Existe una correlación negativa entre los ingresos y la estancia media. Enfermedades más frecuentes: aparato digestivo (21%), respiratorias (15%), circulatorias (10%) y genitourinarias (9%). Enfermedades infecto-contagiosas más frecuentes: tuberculosis (20%), difteria (19%), paludismo (17%), sífilis (16%), fiebres tifoideas (4%) y viruela (3%). La tasa más elevada de hospitalización por paludismo corresponde a la zona húmeda de “El Hondón”. Existe una correlación negativa entre consumo de pan y de carne por estancia y número de estancias. Entre las urgencias predominan las heridas (59%), traumatismos osteoarticulares (24,3%), quemaduras (3,3%) y cuerpos extraños (2,6%). / The “Hospital de Caridad” in Cartagena was founded in 1693. Objective: to determine its area of influence, health problems, most common diseases and injuries and other aspects. The archive of the Hospital has been the main information source. Between 1900 and 1936 the Hospital experiences a great development. 58% of patients are from the City followed by those from the mining zone (19%). A negative correlation was observed between admissions and average length of inpatient hospital stay. Most frequent diseases: digestive system (21%), respiratory system (15%), cardiovascular system (10%) and genitourinary system (9%). Most frequent infect-contagious diseases: tuberculosis (20%), diphtheria (19%), malaria (17%), syphilis (16%), typhoid fever (4%) and smallpox (3%). The main zone affected by malaria is the wetland area called “El Hondón”. A negative correlation was observed between bread and meat consumption per hospital stay and average length of stay. Most common emergencies are wounds (59%), osteoarticular traumatisms (24.3%), burns (3.3) and foreign bodies (2.6%).

Syftet med den här studien är att undersöka vad som skiljer i personlighet mellan studenter som vaccinerade sig mot svininfluensan och studenter som inte vaccinerade sig. Studien genomfördes genom en kvantitativ enkätundersökning på 194 studenter från ett universitet i Svealand. Deltagarna fick besvara psykometriska personlighetstester som mätte känslighet, ångest, depression, sympati och pålitlighet. Därefter utfördes statistiska test i SPSS för att i huvudsak beräkna medelvärdesskillnader. Resultaten visar att vaccinerade studenter är signifikant känsligare än ovaccinerade studenter. Vaccinerade studenter är också mer ångestfyllda men skillnaderna är inte signifikanta. Det finns inga nämnvärda skillnader i depression, sympati eller pålitlighet. Typ av utbildning och kön predicerar heller inte vaccinering. Sammanfattningsvis ska känslighet därmed ses som den viktigaste prediktorn för vilka personer som vaccinerar sig vid pandemier. Resultatet kan generaliseras till den svenska befolkningen eftersom studiens andel vaccinerade motsvarar befolkningens andel vaccinerade. Studiens urval motsvarar däremot inte den svenska populationens genomsnittliga utbildningsnivå. Å andra sidan har utbildningsnivå inte visat sig vara en betydande faktor för hälsoskyddande beteenden i tidigare forskning, varför mitt resultat bör betraktas som betydelsefullt. / The purpose of this study is to examine which personality aspects that are differing from students who got vaccinated against the swine flu, to students who did not get vaccinated. This study carried out a quantitative survey on 194 students from a mid-region university in Sweden. The participants were to answer psychometric personality tests on sensitivity, anxiety, depression, sympathy and dependability. Thereafter, statistical tests were conducted through SPSS, mainly to calculate mean differences. The results conclude that vaccinated students are significantly more sensitive than un-vaccinated students. Vaccinated students are also more anxious but these differences are not significant. There are no notable differences in depression, sympathy or dependability. Type of education and sex do not either predict vaccination. Finally, sensitivity shall be viewed as the most important predictor in a person’s likeliness to get vaccinated at pandemics. The findings can be generalized to the Swedish population because the proportion of vaccinated students in this study corresponds to the proportion of vaccinated people of the Swedish population. However, the sample of this study does not correspond to the educational level of the Swedish population. On the other hand, educational level has not been shown as an important determinant in health protective behaviors in former research literature, why my result should be considered as meaningful.

This thesis investigates several uses of simulation methods to understand and control pandemic influenza in urban settings. An agent-based simulation, which models pandemic spread in a large metropolitan area, is used for two main purposes: to identify the shape of the distribution of pandemic outcomes, and to test for the presence of complex relationships between public health policy responses and underlying pandemic characteristics. The usefulness of pandemic simulation as a tool for assessing the cost-effectiveness of vaccination programs is critically evaluated through a rigorous comparison of three recent H1N1 vaccine cost-effectiveness studies. The potential for simulation methods to improve vaccine deployment is then demonstrated through a discrete-event simulation study of a mass immunization clinic.

This thesis investigates several uses of simulation methods to understand and control pandemic influenza in urban settings. An agent-based simulation, which models pandemic spread in a large metropolitan area, is used for two main purposes: to identify the shape of the distribution of pandemic outcomes, and to test for the presence of complex relationships between public health policy responses and underlying pandemic characteristics. The usefulness of pandemic simulation as a tool for assessing the cost-effectiveness of vaccination programs is critically evaluated through a rigorous comparison of three recent H1N1 vaccine cost-effectiveness studies. The potential for simulation methods to improve vaccine deployment is then demonstrated through a discrete-event simulation study of a mass immunization clinic.

In 1997, the first human case of avian influenza infection was reported in Hong Kong. Since then, avian influenza has become more and more hazardous for both animal and human health. Scientists believed that it would not take long until the virus mutates to become contagious from human to human. In this thesis, we construct avian influenza with possible mutation situations in bird-human systems. Also, possible control measures for humans are introduced in the systems. We compare the analytical and numerical results and try to find the most efficient control measures to prevent the disease.

In the thesis there are chronologically processed data about incidence of influenza Pandemic (H1N1) 2009 from its first incidence in spring 2009 in Mexico until the official end of the 6th phase of pandemic announced by the WHO in august 2010. These data were collected by means of secondary analysis. The thesis is focused on the Region of South Bohemia from the first proved incidence of Pandemic influenza (H1N1) 2009 here. The data necessary to meet the objectives of the work and to answer the research questions were collected in cooperation with the Regional Hygienic Station of the South Bohemia in České Budějovice. 3 deaths were analysed in the context of incidence of Pandemic influenza (H1N1) 2009 in the Region of South Bohemia and anti-epidemic measures were assessed. Differences in 121 people with Pandemic influenza (H1N1) 2009 in the Region of South Bohemia from the point of view of age and sex were described. In 52 people with the flu from the Region of South Bohemia ?traveller? history was recorded (these people were infected during their stays abroad) and most of them had stayed in Germany. Indicators of morbidity (ARI) in the Region of South Bohemia and in the whole Czech Republic were also processed and then graphically compared.

A compreensão dos caminhos de desativação não radiativa em polímeros conjugados é fundamental para o uso desses materiais em dispositivos luminescentes, células fotovoltaicas e sensores. Nesta tese, os processos não radiativos em filmes automontados de polímero luminescente foram investigados via análise da supressão de intensidade de fotoluminescência, utilizando a técnica de fluorescência estacionária, e através da medida do tempo de vida do estado excitado com fluorescência resolvida no tempo em arranjo de contagem de fótons. A camada emissiva constituída por poli(p-fenileno vinileno) (PPV) obtido da conversão térmica do precursor poli(cloreto de xilideno tetraidrotiofeno) (PTHT) apresentou tempos de vida entre 150 e 250 ps, e fraca dependência com o comprimento de onda de detecção da emissão. Na presença de uma monocamada contendo azocorante Vermelho do Congo (CR) ou ftalocianina tetrassulfonada de níquel (NiTsPc) atuando como receptor de energia foi observada supressão da fluorescência e encurtamento do tempo de vida (50-100ps). À medida que se aumenta a distância entre as camadas de doador e receptor via interposição de bicamadas de espaçador, a dinâmica do sistema tende à dinâmica de decaimento do estado excitado do PPV na ausência de receptor. A dependência da eficiência com a distância 1/r2 ou 1/r3 apontam para transferência de energia ressonante (RET) típica da interação plano-plano ou plano-camada. Os processos não radiativos foram também estudados em função da diluição de segmentos PPV dispersos em matriz de polieletrólito poli(cloreto de dodecildimetilamônio) PDAC. A diluição dos segmentos conjugados aumenta a eficiência quântica de emissão, torna o mecanismo de desativação mais lento (500 ps) e diminui a dependência do tempo de vida com o comprimento de onda de detecção, devido à menor eficiência dos mecanismos de desativação não radiativa. Na presença de uma camada receptora, a eficiência de transferência de energia é maior para amostras com segmentos mais diluídos indicando que esse mecanismo compete com os processos internos à própria camada emissiva. O tempo de vida aumenta em filmes com mais baixo grau de conjugação e a dependência com o comprimento de onda de emissão é mais forte. Em resumo, a técnica de automontagem se mostrou adequada para obter filmes com propriedades fotofísicas controláveis no nível molecular, que puderam ser estudadas com espectroscopias de fluorescência. / Understanding the pathway of excitation in conjugated polymers is important for using these materials as active layer in devices, photovoltaic cells and sensors. In this thesis, non-radiative processes in layer-by-layer (LbL) films were investigated with measurements of fluorescence quenching in steady-state fluorescence spectroscopy and of the singlet excited state lifetime using time-resolved fluorescence spectroscopy in a single photon counting (SPC) apparatus. The emissive layer of poly(p-phenylene vinylene) (PPV) obtained via thermal conversion of the soluble precursor poly(xylylidene tetrahydrothiophenium) chloride (PTHT) showed lifetime 150-250 ps and weak dependence on the emission wavelength. In the presence of an acceptor layer of either Congo Red (CR) or nickel tetrasulfonated phthalocyanine (NiTsPc) the PL intensity was quenched and the lifetime was shorter (50 -100 ps). Upon increasing the distance between the energy donor (PPV) and acceptor layers by interposing bilayers of inert polyelectrolytes the dynamics tended to the PPV dynamics. The distance-dependence of the energy transfer efficiency (1/r2 or 1/r3) points to a resonant process (RET) with a plane-to-plane or plane-to-slab interaction. The non-radiative processes were also studied for varying dilutions of the PPV segments in a matrix of the polyelectrolyte poly(dodecyl methylamonium chloride) (PDAC). This dilution increased the quantum efficiency and led to longer lifetimes (500 ps) owing to a less effective non-radiative energy transfer. When an energy acceptor layer is present, energy transfer is more efficient for the most diluted systems, indicating that such transfer competes with internal processes in the emissive layer. The lifetime increased in films with low degree of conjugation, for which there was a stronger dependence on the emission wavelength. It is concluded that the LbL methodology was suitable to obtain photophysical film properties that could be controlled at the molecular level, and investigated with varied fluorescence spectroscopies.

La grippe porcine est une infection enzootique touchant 50% du cheptel français. Elle passe parfois inaperçue, mais peut également induire une forte morbidité au sein des lots d’animaux touchés, entraînant une baisse des performances zootechniques et des pertes économiques importantes. La sévérité de l’infection à virus influenza A chez le porc peut dépendre de divers facteurs, comme les virus eux-mêmes, les pratiques d’élevage, le statut immunitaire des animaux, les infections concomitantes par d’autres pathogènes respiratoires, etc. De la même manière, diverses formes épidémiologiques de la grippe existent en élevage. Ainsi, des infections peuvent se répéter à un âge déterminé, sur toutes les bandes successives d’un élevage, notamment chez des jeunes présentant une immunité passive. Afin de mieux comprendre cette diversité clinique et épidémiologique de la grippe porcine, et aider à l’élaboration de stratégies d’intervention adéquates pour le contrôle de la maladie, nous avons cherché à apporter de nouvelles connaissances quant à certains facteurs pouvant favoriser l’exacerbation du syndrome grippal et/ou son caractère récurrent, et plus généralement aux mécanismes sous-jacents à la pathogenèse des virus influenza A chez le porc, en relation avec les réponses de l’hôte infecté. Nous avons d’abord comparé, suite à inoculations expérimentales de porcs exempts d’organismes pathogènes spécifiés, la pathogénicité des deux virus influenza porcins les plus fréquemment rencontrés chez le porc en France, l’un du lignage européen « avian-like swine H1N1 » (H1avN1), l’autre du lignage européen « human-like reassortant swine H1N2 » (H1huN2), seuls ou en association avec Mycoplasma hyopneumoniae (Mhp), autre pathogène respiratoire répandu en élevage. Nous avons montré que l’infection H1huN2 induit une pathologie plus marquée que l’infection H1avN1, et que la pré-infection des porcs par Mhp induit une exacerbation de l’infection H1avN1, mais pas H1huN2. Nous avons utilisé le modèle de co-infection Mhp/H1avN1 pour évaluer deux approches alternatives qui permettraient de diminuer l’impact des infections grippales et de leurs complications : l’apport de composés aux propriétés antioxydantes via l’alimentation ; et la restriction alimentaire de courte durée. Dans ces deux cas nous avons montré des effets bénéfiques sur les paramètres zootechniques pendant les jours suivant l’infection grippale. Ce travail a également apporté de nouvelles connaissances quant aux modifications des marqueurs plasmatiques de stress oxydant, ainsi que sur les modifications métaboliques faisant suite à la co-infection Mhp/H1avN1. La sévérité des manifestations cliniques de la grippe étant liée à la qualité de la réponse immunitaire mise en place chez l’hôte infecté, nous avons entrepris d‘étudier les réponses immunitaires du porc touché par la grippe et d’évaluer l’impact de facteurs tels que la présence de Mhp ou d’anticorps d’origine maternelle sur ces réponses. Nous avons ainsi montré que l’infection virale induit une inflammation et une réponse interféron. La pré-infection par Mhp exercerait un effet additif sur cette inflammation et pourrait favoriser la persistance du virus dans le poumon. Nous avons également montré que la présence d’immunité passive protège cliniquement le porcelet mais n’empêche pas l’excrétion du virus, retarde la réponse lymphocytaire T et inhibe la réponse humorale post-infectieuse. Malgré la réponse immunitaire humorale défaillante, les animaux étaient totalement protégés d’une seconde infection homologue lorsque les anticorps maternels avaient disparus. Ces travaux ont permis d’apporter de nouvelles connaissances sur les facteurs influençant l’infection grippale en élevage porcin ainsi que sur les mécanismes sous-jacents, ce qui est une prérequis pour l’amélioration des mesures de lutte et de maitrise de la maladie. Ils permettent, d’envisager d’améliorer la santé des animaux en agissant sur leur régime alimentaire. / Swine influenza is an enzootic infection affecting 50% of the French livestock. The infection can be unnoticed but can also induce high morbidity among batches of affected animals, resulting in lower production performance and significant economic losses. The severity of influenza A virus in pig is influenced by many factors such as the virus strain, husbandry practices, the immune status of animals, concomitant infections with other respiratory pathogens, etc. In the same way, various epidemiological forms of influenza exist in farms. Thus, infections can be repeated in all successive batches within a farm, especially among young animals with passive immunity. In order to better understand the clinical and epidemiological diversity of the swine flu, and help develop appropriate strategies to control the disease, we tried to bring new knowledge about factors that promote the exacerbation of the flu syndrome and/or its recurrence, and more generally to give new information about the mechanisms underlying the pathogenesis of influenza viruses in pigs, in relation to the response of the infected host. Firstly, we compared, through experimental infections of specific pathogen free pigs, the pathogenicity of the two swine influenza viruses mostly detected in pigs in France, i.e. one from the European “avian-like swine H1N1” lineage (H1avN1) and the other one from the European “human-like reassortant swine H1N2” lineage (H1huN2), each one alone or in co-infection with Mycoplasma hyopneumoniae (Mhp), another respiratory pathogen widespread in French farms. We showed that the H1huN2 infection induced a more marked pathology than the H1avN1 infection, and that Mhp pre-infection induced the exacerbation of the H1avN1, but not the H1huN2, infection. Then, we used the Mhp/H1avN1 co-infection model to evaluate alternative approaches that could reduce the impact of influenza infections and their complications: firstly, a supply of compounds with antioxidant properties in food; and secondly, a feed restriction of short duration. In both cases, we showed beneficial effects on zootechnical parameters the days following influenza infection. This work has also brought new knowledge on modulation of oxidative stress markers in plasma, as well as metabolic changes following the co-infection with Mhp and H1avN1 in pigs. The severity of flu clinical manifestations being related, among other, to the quality of the immune responses developed by the infected host, we studied these responses in pigs experimentally infected by H1avN1 and assessed the impact of factors such as the presence of Mhp or maternal derived antibodies on these responses. We showed that the viral infection induced inflammation and interferon response. The Mhp pre-infection exerted an additive effect on inflammation of lung tissue and may promote the virus persistence in the lung. Finally, we have shown that the presence of maternally-derived immunity protected the piglets clinically but did not prevent viral shedding, delayed the T cell response and strongly inhibited the post-infectious humoral response. However, despite the failed humoral immune response, animals were completely protected from a second infection occurring when maternal antibodies had disappeared. Therefore, this work have brought new knowledge on factors influencing influenza infection in pig as well as the underlying mechanisms, which is a prerequisite for improving disease control. They allow, between-other, to consider improving the health and welfare of animals by acting on their diet.

In 1918, the Spanish flu pandemic killed an estimate number of between 50 and 100 million people worldwide. 40 years later a new influenza pandemic, the Asian flu spread throughout the world. The Asian flu hit a large proportion of the world’s population but the case-fatality rate was lower and an estimated number of 2 to 4 million people died in the pandemic. In order for today’s governments to formulate good preparedness plan for future influenza pandemics, studying previous pandemics can give better understanding of how the community might be affected. The aim of this study was to investigate the effects of the Asian flu pandemic on the Swedish military forces. By seeing if the regiment was affected by the Asian flu one can then assume that the whole society was affected. Data from Swedish regiments has been collected from the Defence Medical Administration Service at the National Archives and processed trough SPSS. The findings show that there where an increase of the amount of sick as well as the number of sick leaves during 1957 compared to previous and later years. Because of the increase in sick leaves one can draw the conclusion that the society has a great risk of being influenced. Hence, a preparedness plan will be even more important. Conclusion: The community is affected by influenza pandemic in both an economical and a societal level. The effects are short in time since infected recover quite quick. However, there are effects which could be better handled if the government is prepared and has conducted a plan for when the next pandemic influenza strikes.

Evaluation of marketing communication selected from the group of pharmaceutical products, OTC drugs intended for treatment of flu and colds by a questionnaire survey focused on specific factors influencing consumer behavior of the target group of customers