Human papillomavirus (HPV) is a sexually transmitted infection that represents a serious health issue that can lead to significant morbidity and mortality. Although FDA-approved vaccines for the prevention against the majority of strains responsible for cervical cancer and genital warts have been available for many years, immunization rates remain low. This study will consider cervical cancer as the main consequence of HPV and thus will investigate parents of daughters. This is of particular relevance to Arizona, given the large Hispanic population and the racial and ethnic disparities that exist in the incidence, mortality and survival of cervical cancer when compared to the national average. Administration of the three-dose series is recommended for girls and boys beginning at 12 years of age. The target population of this study was parents as the HPV vaccine necessitates parental consent and immunization rates remain low. This study specifically aimed to explore the knowledge, attitudes and beliefs of Hispanic parents in Maricopa County toward the HPV vaccine in efforts to identify barriers to immunization and create future implications for practice. Findings were consistent with previous literature: Hispanic parents exhibited suboptimal knowledge regarding HPV and HPV vaccination. Specific opportunities for education include the etiology, transmission and health consequences of HPV. Despite many areas for education, the majority of Hispanic parents indicated they would follow their health providers' recommendation on vaccination.

published_or_final_version / abstract / Zoology / Master / Master of Philosophy

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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.