La vaccination est un moyen de prévention très efficace contre les infections. La majorité des vaccins sont administrés par voie sous-cutanée ou intra-musculaire avec des adjuvants et stimulent ainsi des réponses immunitaires adaptatives systémiques. Les muqueuses représentent une porte d’entrée majeure pour de nombreux pathogènes ayant un impact en Santé Publique. Cependant, peu de vaccins sont délivrés par les muqueuses en raison du manque d’adjuvants adaptés à ces voies. Ainsi le développement d'adjuvants muqueux permettrait la stimulation de réponses immunitaires locales et une protection efficace avant la dissémination des pathogènes. Les agonistes des Toll-Like-Receptors (TLR) sont développés comme adjuvants vaccinaux car ils stimulent l’immunité innée et adaptative. Au laboratoire, la flagelline de Salmonella enterica qui est un puissant agoniste de TLR5 est utilisée comme modèle afin de disséquer les mécanismes d’action des adjuvants muqueux. En effet, l'administration intranasale de vaccins adjuvantés par la flagelline se caractérise par une réponse T CD4+ de type Th1/Th2, une réponse en anticorps sécrétoires dans le compartiment respiratoire et une réponse systémique contre les antigènes vaccinaux. Seule l’activation de TLR5 dans le compartiment épithélial est nécessaire à l’activité adjuvante.Dans un premier temps, l'analyse transcriptionnelle du tissu pulmonaire a permis d'identifier une signature épithéliale spécifique du recrutement de cellules immunitaires, en particulier de monocytes et de neutrophiles ainsi que de l'activation fonctionnelle des cellules dendritiques. L'analyse de la dynamique cellulaire au niveau du tractus respiratoire et des ganglions drainants a ensuite été réalisée en réponse à l’administration intranasale de vaccin adjuvanté. Bien que les monocytes inflammatoires et les neutrophiles infiltrent massivement les poumons et capturent les antigènes, ils ne jouent pas de rôle majeur dans l’activation de la réponse immunitaire. Au contraire les cellules dendritiques conventionnelles CD11b+ capturent, migrent et présentent efficacement l’antigène aux lymphocytes T CD4+. A l'instar de l’effet adjuvant, l’activation de ces cellules dendritiques par la flagelline n'est pas directe mais requiert une expression de TLR5 dans les cellules structurales incluant les cellules épithéliales de la muqueuse. De plus, nos travaux suggèrent que les interleukines de la famille IL-1 ne sont pas à l'origine de la transactivation des cellules dendritiques.En conclusion, ce travail de thèse ouvre des perspectives intéressantes quant au développement d’adjuvants muqueux. / Many pathogens of public health concern (including the influenza and respiratory syncytial viruses, and bacteria such as Streptococcus pneumoniae and Pseudomonas aeruginosa) enter the body via the respiratory tract in general and the lung mucosa in particular. Mucosal vaccines induce a local adaptive immune response (i.e. secretory antibodies and specific T cells) and constitute a unique means of directly preventing these infections. Most vaccines are delivered systemically and use systemic adjuvants. Although the few commercially available mucosal vaccines are generally effective, mucosal adjuvant candidates have not demonstrated sufficient levels of potency and safety. TLR signaling is instrumental for the induction of innate immunity and the concomitant ignition of adaptive immune responses. Thus TLR agonists are largely used as vaccine adjuvants. In the lab we use flagellin from Salmonella enterica (a potent TLR5 agonist) as a model to better understand the mode of action of mucosal adjuvants. The intranasal adjuvant effect of flagellin is characterized by an antigen-specific Th1/Th2 cell response, and a strong mucosal and systemic antibody response. However this adaptive immune response mainly depends on TLR5-mediated epithelial signaling.We used molecular profiling to show that cytokine/chemokine and dendritic cell maturation pathways are surrogate signatures for flagellin activation in the lung. Neutrophils and inflammatory monocytes were massively recruited to the lungs but were not essential for the adjuvant activity. In contrast, flagellin signaling did not induce a significant recruitment of conventional dendritic cells but enhanced their maturation and migration to the lymph nodes. In particular, CD11b+ migratory dendritic cells were essential for induction of a CD4+ T-cell response. Importantly, the functional activation of dendritic cells was independent of direct signaling via TLR5, suggesting the role of inflammatory cytokines produced by the activated epithelium. However or data suggest that IL-1 and IL-36 interleukins are not responsible for transactivation of dendritic cell. In conclusion, this thesis project opens up new perspectives for the development of mucosal adjuvants.

Research on health prevention behaviors of Mexican immigrant mothers regarding immunizations has been limited. As of 2014, Hispanics or Latinos comprised 9.6% of the population of the state of Oklahoma and were the largest minority group within Oklahoma. This minority population has continued to grow at a rapid rate in Oklahoma. The purpose of this study was to explore the perceptions of immunizations held by Mexican immigrants who are mothers residing in Oklahoma. The aim of this study was to identify their perceived risk of contracting a vaccine-preventable disease if not immunized and knowledge of immunizations as a health prevention behavior. The health belief model and the sociocultural theory provided the theoretical underpinnings for this qualitative study. Semistructured interviews were conducted with a purposeful sample of 12 immigrants living in a rural area of Oklahoma. Data were triangulated and analyzed to identify themes and patterns. Findings indicated participants perceived susceptibility of contracting a vaccine-preventable disease if not immunized, with the severity of the disease having the potential to cause death. Identified barriers in immunization uptake were language barrier, lack of immunization information in Spanish, and fear of deportation. Recommendations include public health outreach providing culturally, linguistic appropriate immunization information to immigrants within communities. Findings provide health psychologists and other health care professionals the ability to formulate interventions targeting immunizations in female Mexican immigrants. These interventions could promote positive social change by decreasing immigrants' and their children's risk of morbidity and mortality related to lack of immunization uptake.

Tanzania, one of many nations in Africa with high infant mortality to preventable diseases, continues to experience relatively low vaccination rates for childhood diseases. In this paper, we examine the maternal barriers to obtaining vaccines for their children in Tanzania. The risk and protective factors we analyzed include age of the mother and children, education level of the mother, number of children, maternal decision-making practices, power dynamics and others. Lack of control, limited decision practices, and decreased maternal empowerment were identified as key barriers to obtaining vaccines for children. Overall, this data is consistent with previous studies regarding barriers to vaccinations in Tanzania and other African nations.

There's a good adherence to the vaccination of children, about 98% of all two year olds are vaccinated. Despite this, there are cases of whooping cough and measles in Sweden. The purpose of the study was to describe what motivates parents to not vaccinate and reflections and attiudes about vaccinations. The study had a descriptive design with qualitative approach. Eight parents who had chosen not to follow the National Board of Health’s vaccination program or whom had decided to completely abandon, participated in the study. Data was collected with an interview guide with semi-structured questions. The results of the present study showed that it was not an easy decision to make whether to vaccinate or not, according to the parents. Parents also described that their perception was that the vaccine and its additives harms the body more than it will benefit. Parents also described that they see the body as a structure capable of handling childhood diseases without vaccination. The respons parents received in connection with the vaccination offer, influenced the decision if their children would get the vaccine or not. Parents also told us that they distrust the medical and pharmaceutical industries in which the information was understood as "one-sided" and directed. Conclusion; The parents said that they were inadequate and biased information in connection with the discussion of vaccination. It resulted in the parents took away from health care. Parents expected that healthcare professionals should be updated on what is written about the pros and cons of vaccines and adverse effects. This is important in order for healthcare professionals to provide the most adequate and honest information as possible and help the parents to decide on the issue. / Det finns en god följsamhet till vaccination av barn, ca 98 % av alla tvååringar är vaccinerade. Men trots detta så förekommer det fall med kikhosta och mässling i Sverige. Syftet med studien var att beskriva vad som motiverar föräldrar att inte vaccinera samt reflektioner och åsikter om vaccinationer. Studien hade en beskrivande design med kvalitativ ansats. Åtta föräldrar som inte har valt att följa socialstyrelsens framtagna vaccinationsprogram eller avstått helt deltog i studien. Med hjälp av en intervjuguide med semistrukturerade frågor samlades data in. Resultatet i föreliggande studie visade att det inte var ett lätt beslut att ta om att vaccinera eller inte enligt föräldrarna. Föräldrarna beskrev även att deras uppfattning var att vaccin och dess tillsatser skadar kroppen mer än det gör nytta. Föräldrarna beskrev också att de ser kroppen som en konstruktion som klarar av barnsjukdomar utan vaccin. Bemötandet föräldrarna fick i samband med vaccinationserbjudandet påverkade beslutet om deras barn skulle få vaccin eller inte. Föräldrarna beskrev även en misstro mot sjukvården och läkemedelsindustrin då informationen uppfattades som ”ensidig” och riktad. Slutsats; Föräldrarna beskrev att de fick otillräcklig och vinklad information i samband med diskussionen om vaccinering. Det resulterade i att föräldrarna tog avstånd från hälso- och sjukvården. Föräldrarna förväntade sig att hälso- och sjukvårdspersonal ska vara uppdaterad om vad som skrivs om för- och nackdelar av vaccin och biverkningar. Detta för att hälso- och sjukvårdspersonal ska kunna ge så adekvat och uppriktig information som möjligt och hjälpa föräldrarna att ta ställning i frågan.

Darbo tikslas: Išanalizuoti sergamumą oro-lašinėmis infekcijomis Kauno mieste 2002 – 2007 metais ir nustatyti sąsajas tarp sergamumo oro – lašinėmis infekcijomis ir imunoprofilaktikos. Darbo uždaviniai: 1. Įvertinti oro - lašinių infekcijų (tymai, epideminis parotitas, skarlatina, raudonukė, virusinis meningitas, infekcinsu meningokokas, vėjaraupiai) pasiskirstymą įvairiose amžiaus grupėse Kauno mieste 2002-2007 metais. 2. Palyginti sergamumo kai kuriomis oro- lašinėmis infekcijomis kitimą Kauno mieste 2002 – 2007 metais. 3. Nustatyti sąsajas tarp sergamumo oro – lašinėmis infekcijomis ir imunoprofilaktikos. Metodika: Informacija apie sergamumą oro-lašinėmis infekcijomis gauta iš Kauno visuomenės sveikatos centro. Duomenys apie sergamumą oro-lašinėmis infekcijomis paimti iš Kauno visuomenės sveikatos centro kompiuterinės duomenų bazės ULISAS (užkrečiamųjų ligų informacijos ir statistinės apskaitos sistema). Taip pat buvo naudojamasi 2002-2007 metų mėnesinėmis, pusmetinėmis ir metinėmis atskaitomis. Duomenys apdoroti ir išanalizuoti naudojantis statistine programa SPSS 16. Skaičiuotas vidurkis, SD, PI. Duomenys pateikiami absoliučiais skaičiais ir procentais. Buvo skaičiuojami sergamumo rodikliai 10 000 gyventojų. Rezultatai: Sergamumo pagal amžiaus grupes analizė parodė, kad rečiausiai sirgo 13 – 18 metų vaikai, o dažniausiai – 3-6 metų. Susirgimai vėjaraupiais sudaro didžiausią dalį visų oro – lašinių infekcijų - 80,1 proc. (be ūmių virusinių kvėpavimo takų infekcijų ir... [toliau žr. visą tekstą] / Aim of the study. To analyse morbidity of air-born infections in Kaunas city in 2002–2007 and to assess links between morbidity of air-born infections and immunoprophylaxis. Tasks of the study: 1. To assess prevalence of air-born infections (measles, mumps, scarlatina, rubella, viral meningitis, infectious meningococcus, varicella) in various groups of age in 2002–2007 in Kaunas city. 2. To compare trends of some air-born infections in Kaunas city in 2002–2007. 3. To assess links between air-born infections’ morbidity and immunoprophylaxis. Method: Information about morbidity of air-born infections is got from Kaunas Public Health Center. Data of air-born infections’ morbidity is taken from data basis ULISAS (a system of communicable diseases information and statistical accounting). Also, the monthly, half-yearly and annual records of the years 2002–2007 were used. Data was archived and analyzed by using the statistical programme SPSS 16. An average, SD, PI were counted. Results are submitted in total numbers and percents. Morbidity was calculated to 10000 population. Results: The analysis according to the age groups showed, that children of 13–18 years old were ill most rarely and most frequently – children of 13–16 years old. Ailment of chickenpox makes the biggest part of air-born infections – 81 % (without Acute upper airway infections and influenza), ailments of rubella were registered least – 0,2 %. Of 10698 ill cases, 67 diseases (0,63 %) were registered after... [to full text]

Vaccinations were noted as the top public health achievement in the 20th century (Centers for Disease Control and Prevention 1999). However, not everyone is getting vaccinated. Taking a sociological approach this study examined the extent to which African Americans, American Indian/Alaska Natives, and Latino populations received an influenza vaccination compared to whites at a micro and macro level from the 2009 Behavioral Risk Factor Surveillance System. Previous research on racial and ethnic health disparities, attitudinal difference, and other demographic characteristics are reviewed in the literature. The Behavioral Model of Health Services was employed as the theoretical framework for this study. The methods consisted of three levels of analysis beginning with multivariate logistic regression at the individual level, least squares dummy variable modeling (LSDV), and hierarchical logistic regression modeling to incorporate aggregate data from the 50 United States. The results from the logistic regression show African Americans and Latino respondents have lesser odds of receiving the flu vaccine compared to whites after controlling for medical costs, access to health care, and a variety of socio-demographic characteristics. Results also show American Indian/Alaska Natives had greater odds of receiving the flu vaccine compared to whites after introducing similar control variables. Least Squares Dummy Variable Modeling controlled for the effects states have on receiving a flu vaccine. The results presented were African Americans and Latinos have significant lesser odds of receiving the flu vaccine compared to whites. While American Indian/Alaska Natives had greater odds of receiving a flu vaccine compared to whites, statistical significance was lost once states were used as control variables. It was also found 13 states had greater odds and 13 states had lesser odds of receiving the flu vaccine compared to North Dakota. Hierarchical logistic regression models examined the influence of state level covariates on the odds of individuals receiving the flu vaccine, and the results indicated that African Americans and Latinos had lesser odds of receiving an influenza vaccine compared to whites, but American Indian/Alaska Natives were found to have greater odds compared to whites, with the results not being statistically significant. The implications of these results are discussed.

Personality rights are fundamental human rights which are the subject of much attention also during the provision of health care. A patient has right, above all, to data protection in his medical documentation, medical facilities have an obligation to maintain confidentiality on matters relating to the patient?s state of health. All therapeutic actions can be carried out only with the consent of a patient. However, the personality rights can be limited in order to protect public health. Legislation can impose a whole range of obligations and duties to patients and medical facilities in order to protect public health. The thesis summarizes fundamental legislation and regulations of the above mentioned issue. It describes a possibility to break the confidentiality in order to protect public health, a regulation of imposition of compulsory medical treatment and anti-epidemiological measures. The thesis briefly informs about company preventive care and related limited choice of a physician and a medical facility. The objective of the thesis was to find out the views of general public of limitations of personality rights in order to protect public health. For the practical part the method of quantitative research was chosen, the technique of a questionnaire. The research was conducted from January 2011 to March 2011 in the region of České Budějovice. The research group included 460 respondents, 405 respondents filled in the questionnaires properly and these were included in the research. To achieve the research objectives, three hypotheses were set. Hypotheses 1 and 3 were proven on the basis of obtained and statistically evaluated data. Hypothesis 2 was not proven. The research results demonstrated especially differences in respondents´ views of a possibility to refuse obligatory vaccinations.

Bakgrund:Vaccinationstätheten har minskat i samhället. Främst omtalat är kombinationsvaccinet mot mässling, påssjuka, röda hund (MPR). Att avböja vaccinationer leder till att mässling åter etableras i samhället. Mässling är en av de mest smittsamma infektionssjukdomar som existerar, där risken för följdsjukdomar är stor och drabbar 20 % av de smittade. Om vaccinationstätheten sjunker under 95 % finns risk att mässling åter får fäste i samhället. Metod:En integrativ litteraturstudie med artikelsökningar utförda i databaserna Academic Search Elite, Cinahl, PubMed och Social Service Abstract som resulterade i 13 relevanta artiklar. Resultat:Studien visar att de flesta föräldrar upplevde att de fick för lite information från hälso- och sjukvården avseende vaccinationer. De sökte sin information via webbsidor eller sökte råd hos andra föräldrar. Därför behöver trovärdig information ges när föräldrar besöker barnhälsovården och informationshäfte delas ut på olika språk för att nå de med olika kulturer. Konklusion och implikation:Studien visar vikten av trovärdig information om vaccinationer för att föräldrar ska kunna ta ställning. Kunskap gör det lättare för hälso- och sjukvårdspersonalen att lägga upp strategier för att undervisa och informera tveksamma föräldrar. Ökad kunskap fås vid fortsatt forskning i ämnet, vilket ökar möjligheterna att WHO når sitt mål om eliminering av mässling. / Background:Vaccination density has decreased in society. The primary concerns are the combination vaccine against measles, mumps and rubella (MMR). To decline vaccination leads to measles being re-established in the society. Measles is one of the most contagious infection diseases that exists, the risk of secondary diseases is substantial which affects 20% of the population. If the vaccination density goes below 95% measles is in the risk of being reaffirm in society. Method:A integrative literature study with article searches conducted in the database Academic Search Elite, Cinahl, PubMed and Social Service Abstract and resulted in 13 relevant articles.  Results:The study shows that most parents experienced that they did not get enough information from the health care sector. They searched for information on websites or through other parents. Therefore, credible information is necessary when visiting the children's health care and to distribute information sheets on different languages to reach those with different cultures. Conclusion and implication:The study shows how important it is with credible information about the vaccines for parents being able to take a stand. Knowledge makes it easier for healthcare personals to set up strategies to teach and inform doubtful parents. Increased knowledge gained from ongoing research in the subject, which increases the opportunities for WHO to reach the goal of eliminating measles.

The major goal of the thesis "Teaching prevention of infectious diseases in Czech school system" is to determine whether and to what extent is the curriculum of elementary schools incorporated lessons prevention of infectious diseases. Part of the curriculum in primary schools should be framework of basic education, prevention of infectious diseases, because it is the only way that the children instill awareness of the basic types of microorganisms, various ways of transmission, the difference between viral and bacterial diseases as well as the different treatment of these diseases. Only in such a way, the teaching of the issue touches the vast majority of primary schools (6-15years). The thesis consists of two parts, the theoretical part and the practical part.

No description available.