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1
Boros, Christina Ann. „Factors affecting the immunogenicity and protective efficacy of routine childhood immunisations“. Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phb736.pdf.
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Includes list of publications arising from the thesis. Bibliography: leaves 327-341. Examines the effect of adverse storage on the immunogenicity of pertussis, diphtheria and tetanus vaccines, the protective efficacy of pertussis vaccines and the effect of premature birth on antibody response to routine childhood immunisations.
2
Lu, Qiuying Sandy, und 呂秋瑩. „Health economic evaluation of universal infant hepatitis B vaccination programmes in China“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/207183.
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Introduction: China has about 120 million hepatitis B virus (HBV) carriers and a 7.2% hepatitis B surface antigen (HBsAg) prevalence in 2006.This creates a huge disease burden and also leads to significant economic losses. Since 2002, a free universal infant hepatitis B vaccination programme has provideda 3-dose primary vaccination for all infants. Although some economic evaluations of this programme have been conducted, a comprehensive cost-effectiveness analysis (CEA) to estimate long-term benefit using mathematical modeling would aid understanding of population strategies for hepatitis B control in large populations. Moreover, the most common mode of infection is perinataltransmission at birth. However the more effective immunization programme involving screening women during pregnancy for HBV-carrier status and providing passive-active vaccination for newborns has not been implemented in China.
Aims: To identify the most cost-effective universal infant hepatitis B vaccination strategy for China.
Method: A hospital-based survey was conducted during 2010-2011 in a general hospital in Shenzhen, China, in order to obtain costing data to estimate the economic burden of chronic hepatitis B patients. Annual direct and indirect costs from this study were used as cost parameters in the CEA models. Mathematical models were developed to simulate perinatal transmission, vaccination programmes and disease progression using Markov modeling and decision trees. Quality-adjusted life year (QALYs) as well as health and monetary outcomes were also assessed. Univariate sensitivity analysis and probabilistic sensitivity analysis using Monte Carlo simulation were performed to test parameter uncertainty. Two programmes of screening of pregnant women for both HBsAg and/or HBeAg and the infant passive-active vaccination were compared with the current vaccine-only programme in one CEA, while the other CEA estimated the effect of the current infant programme compared with no vaccination.
Findings: The estimated total economic burden including annual direct and indirect cost among hepatitis B patients of RMB 43104.5 (US$6340.8). The economic burdens of associated disease states of hepatitis B infection were highest for hepatocellular carcinoma (HCC) (RMB 77297.1), decompensated cirrhosis (RMB 50725.7), chronic active hepatitis B (CAH) (RMB 37449.5) and finally compensated cirrhosis (RMB 37276.9). The average total economic burden per hepatitis B patient amounted to 46% of Shenzhen GDP per capitain 2010, and 5.4% of the city’s annual per capita income. The current vaccine-only infant vaccination programme was justified by costsavings, from both a societal and health care payer’s perspective, reducing new HBV infections by about 76%. This has produced a gain of 743,000 life-years and 620,000 QALYs given current numbers and savings of US$2~3billion saved over the lifetime of a national cohortof 10,000,000 newborns. A universal control programme involving the screening of pregnant women for HBsAg and passive-active vaccination, would reduce new infections by 13%, saving 436,000 life years and gaining 121,000 QALYs for a saving of about US$546 million compared with current vaccine-only programme.
Implications: The universal infant hepatitis B vaccination programme is currently a cost-effective strategy for hepatitis B control in China.A beneficial amendment to the current strategy wouldinclude screening of all pregnant women for HBsAg and vaccinating newborns in a passive-active way.published_or_final_version
Public Health
Doctoral
Doctor of Philosophy
3
Brisson, Marc. „Economic evaluation of vaccination programmes : a special reference to varicella vaccination“. Thesis, City University London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.407544.
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4
Dinan, Leonie Rita. „Antibody responses after Hib immunisation in premature and term infants /“. Title page, table of contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmd583.pdf.
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5
Tchakoute, Christophe Toukam. „Effects of delayed BCG vaccination on cellular immune responses in HIV-exposed infants“. Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/6007.
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6
Vermeulen, Françoise. „Réponses immunitaires du grand prématuré à la vaccination contre la coqueluche“. Doctoral thesis, Universite Libre de Bruxelles, 2013. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209427.
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Les enfants nés prématurément, et plus particulièrement les grands prématurés nés avant31 semaines d’âge gestationnel, sont à haut risque de contracter des infections. La
vaccination peut prévenir certaines infections, dont la coqueluche qui est causée par la
bactérie Bordetella pertussis (Bp). Cependant, cette maladie infectieuse hautement
contagieuse est en recrudescence depuis plusieurs années malgré une bonne couverture
vaccinale. La morbidité et surtout la mortalité de la coqueluche affectent plus
particulièrement les jeunes enfants, incomplètement ou non encore vaccinés.
Il existe deux types de vaccins contre B. pertussis :les vaccins de première génération à
cellules entières et les vaccins acellulaires, plus récents. Suite à l’apparition d’effets
secondaires causés par le vaccin à cellules entières, les vaccins acellulaires, comprenant
seulement un certain nombre d’antigènes purifiés de B. pertussis, sont utilisés en Belgique
comme dans de nombreux autres pays industrialisés.
L’immunité protectrice contre B. pertussis fait appel tant à l’immunité cellulaire qu‘à
l’immunité humorale. De nombreuses études ont démontré une production d’anticorps
spécifiques aux antigènes de B. pertussis suite à l’administration des différents types de
vaccins. Par contre, peu d’entre elles ont analysé la réponse d’immunité cellulaire spécifique
caractérisée, entre autres, par une sécrétion d’Interféron-gamma (IFN-&
Doctorat en Sciences médicales
info:eu-repo/semantics/nonPublished
7
Njikan, Samuel Ayaba. „Correlates of risk of TB disease in infants with differential response to BCG vaccination“. Doctoral thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/12873.
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Includes bibliographical references.Studying prospective immune correlates of risk of TB disease following BCG vaccination is an important first step towards determining correlates of protection against TB, which can be identified only in a placebo-controlled randomized controlled trial (RCT) of an effective vaccine. To study correlates of risk of TB disease, we collected and stored blood from healthy 10-week old infants vaccinated with BCG at birth. During two years of follow up, infants who developed lung TB were defined as cases, while those who did not develop TB disease were defined as controls. We measured Th1/Th17 cytokine production by BCG-specific T cells, release of pro- and anti-inflammatory mediators, cytotoxic T cell potential and proliferation in response to BCG as potential correlates of risk of TB disease but none of these outcomes were different between cases and controls. However, transcriptional profiling of PBMC revealed two clusters of infants and interestingly, the gene expression profiles from cases and controls in the two clusters were in opposite directions. Based on this, we hypothesised that analysing the two clusters of infants separately will allow discovery of correlates of risk of TB, which were absent when clustering was not taken into account.
8
Alsalih, Dina A. „The Impact of Vaccination Schedules on Infants' and Children's Physio-Psychological Health: A Qualitative Investigation“. ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/112.
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Many people may have become increasingly concerned about the risks associated with vaccines. At the same time, there is a lack of qualitative research on the impact of various vaccinations schedules on individuals' physio-psychological health. In addition, "mandatory" versus "nonmandatory, but recommended" vaccines are still under debate in some Western countries. The purpose of this ethnographic study was to provide an in-depth understanding of the beliefs, experiences, and perceptions of adolescents, parents, and health care providers regarding different vaccination schedules. The health belief model was used as the theoretical framework. The sample consisted of adolescents and parents from different vaccination backgrounds, as well as of healthcare providers who were involved with vaccination schedules (N=72). Purposeful sampling strategy was applied and individual interviews were conducted. All interviews were recorded and transcribed verbatim, and the obtained data were analyzed thematically. According to the results of the study, participants' perceptions on vaccination were generally positive, and a mandatory vaccination schedule was mostly recommended. Adolescents who received mandatory vaccination reported that this scheme was appropriate against several diseases. Further, health care members indicated that vaccination side effects were mainly emotional, and they suggested that public health agencies should disseminate more scientifically-sound information on the benefits and risks of vaccination. The findings of this study may be used as the basis for the formulation of an effective public health policy to adopt a nationally-and internationally-accepted vaccination schedule.
9
DUTOT, PHILIPPE. „Evaluation des lactobacilles comme vecteurs vivants de vaccination“. Université Louis Pasteur (Strasbourg) (1971-2008), 1996. http://www.theses.fr/1996STR13232.
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Dans le cadre du developpement de nouveaux vecteurs vivants de vaccination administrables par voie mucosale, le potentiel de bacteries commensales du genre lactobacillus a ete etudie. Ceci impliquait d'aborder les domaines suivants: microbiologie (choix de la souche vaccinale), biologie moleculaire (production d'antigenes heterologues) et immunologie (nature et intensite des reponses immunes induites). La souche lactobacillus paracasei lbtgs1. 4, isolee du vagin de souris, a ete selectionnee comme souche modele. Elle a ete utilisee pour mener des etudes de colonisation chez la souris: cette souche s'est averee capable de persister pendant 48 heures dans la cavite nasale, sept jours dans l'intestin et entre 16 et 36 jours dans le vagin selon le traitement hormonal effectue. Plusieurs promoteurs et regions d'attachement aux ribosomes (rbs) ont ensuite ete examines pour leur efficacite chez la souche lbtgs1. 4. Les plus performants (promoteur p#2#5 de streptococcus thermophilus et sequence rbs du gene d-ldh de lactobacillus plantarum) ont ete selectionnes pour etre incorpores dans le vecteur d'expression de base ptg2247. Ce dernier a ete utilise pour produire chez la souche lbtgs1. 4 des antigenes modeles (sous-unite b de la toxine cholerique, -amylase de bacillus stearothermophilus, proteine m6 de streptococcus pyogenes) dans differentes localisations cellulaires: intracellulaire, extracellulaire, exposition a la surface. Enfin, l'immunogenicite des souches recombinantes correspondantes a ete testee en modele souris. Plusieurs voies d'immunisations systemiques ou locales ont ete investiguees. Des reponses seriques specifiquement dirigees contre l'antigene heterologue ont pu etre induites dans la plupart des cas. Une reponse mucosale de type iga etait, de plus, detectable apres certaines administrations locales. Ceci demontrait la faisabilite de l'approche proposee
10
Ortega, Omayra Y. „Evaluation of rotavirus models with coinfection and vaccination“. Diss., University of Iowa, 2008. http://ir.uiowa.edu/etd/34.
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11
Peterson, Tia. „Evaluation of Vaccination Policies Among Utah Pediatric Clinic Employees“. BYU ScholarsArchive, 2015. https://scholarsarchive.byu.edu/etd/5560.
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Introduction: Pediatric health care settings are high risk environments for spreading communicable and vaccine preventable diseases from health care workers to susceptible patients. Methods: All managers of pediatric clinics operating in the state of Utah were included. Participants were invited to complete a two-page questionnaire regarding their clinic vaccination policies. Results: Half (n = 23, 50%) of Utah pediatric outpatient clinics recommend employee vaccinations, although employee refusal is allowed without consequence. Of all adult vaccines, influenza was most often included as part of the employee vaccination policy. Some clinics required unvaccinated employees to wear masks in the event of illness, but many had no additional requirements for unvaccinated and ill employees. Discussion: Vaccination of health care workers is an effective approach to reduce disease transmission. Mandatory vaccination policies can significantly improve vaccination rates among health care workers.
12
Sullivan, Janet E. „Hearing Evaluation in Infants: An Update for Pediatricians“. Scholar Commons, 2003. https://scholarcommons.usf.edu/etd/1487.
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This paper provides an overview of developmental timetables relevant to hearing and of current pediatric audiological techniques and practices. The first sections summarize structural and functional development of the auditory pathway and the development of primary auditory processing. These developmental sequences appear to follow similar paths in humans and animals. Speech and music perception involve more complex processing and are strongly influenced by experience. Hearing disorders affect the perception of complex sounds in a variety of ways, depending on the site(s) of lesions. Early onset hearing impairment, including conductive loss from chronic otitis media, can seriously impede language development.
Language cannot develop normally without adequate speech stimulation. Sensitive and inexpensive techniques are available for performing neonatal hearing screening, and early intervention has a positive effect on development of language skills in hearing-impaired children. Thus, the National Institute of Health has recommended nationwide universal newborns hearing screening. The rationale and methodology of universal screening programs is summarized in the chapter.
Advances in the field of the genetics of hearing impairment are also reviewed
Recent advances in the field of auditory physiology - coupled with longstanding concerns about delayed identification of hearing impairment - have precipitated public health initiatives (National Institute of Health, 1993) and legislation for neonatal hearing screening programs (Blake & Hall, 1990). Pediatric audiology, once more “art” than science, is now largely based on physiologic methods rather than observed behavior. With current techniques, it is not only possible to detect hearing impairment at birth but also to determine the site of the lesion and to obtain close estimates of hearing threshold at specific frequencies (Werner, Folsom, & Mancl, 1993). Habilitative measures, including amplification, can begin within weeks of birth. Protocols for the management of hearing impairment are guided not only by the site of the lesion but by the developmental sequences and interactions among all of the child’s sensory modalities.
This chapter provides an overview of developmental timetables relevant to hearing and of current pediatric audiological techniques and practices.
13
PELLAT, COIGNET BRIGITTE. „La coqueluche dans les bouches-du-rhone : evaluation de la couverture vaccinale“. Aix-Marseille 2, 1993. http://www.theses.fr/1993AIX20191.
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14
Arenas, Gamboa Angela Maria. „Evaluation of microencapsulation as an improved vaccination strategy against brucellosis“. [College Station, Tex. : Texas A&M University, 2007. http://hdl.handle.net/1969.1/ETD-TAMU-1384.
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15
Knight-Jones, Theo. „Field evaluation of foot-and-mouth disease vaccination in Turkey“. Thesis, Royal Veterinary College (University of London), 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.618321.
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16
Le, Louarn Anne. „Evaluation du programme national de vaccination dans le département de la Gironde“. Bordeaux 2, 1994. http://www.theses.fr/1994BOR23075.
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17
Prentice, Philippa. „The evaluation of blood and breast milk biomarkers relating to patterns of infancy growth and nutrition“. Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709022.
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18
Dube, Frederick. „The effect of birth weight and gestational age on BCG-induced immune responses in infants following BCG vaccination“. Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/10377.
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Includes bibliographical references (leaves 102-114).Bacillus Calmette?Gu?rin (BCG), the only currently licensed tuberculosis (TB) vaccine, provides variable efficacy. Despite the use of BCG, TB remains a global health problem. BCG is administered at birth; however, more than 15% of infants are born preterm [PT (<37 weeks gestation)], or have low birth weights [LBW (<2,500g)], with >90% of these born in developing countries, where the majority of TB cases are found. It is not known how birth weight at the time of vaccination may affect the BCG-induced immune response and subsequent protection against TB. We hypothesised that BCG-vaccinated PT and LBW infants would have a qualitatively and quantitatevely less optimal immune response, compared to term or normal birth weight (NBW) infants.
19
Luchsinger, Rebecca. „Creation and evaluation of an informational website about the influenza vaccination“. The University of Arizona, 2011. http://hdl.handle.net/10150/623568.
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Class of 2011 AbstractOBJECTIVES: The purpose of this study was to create and evaluate the usability and credibility of an informational website about the influenza vaccination. METHODS: This was a descriptive study of user’s reactions to a website. Questionnaires administered during a regularly scheduled class collected ratings of the usability and credibility of an informational website about the influenza vaccination; data on vaccination status, year in pharmacy school and plans for future vaccination were also collected. RESULTS: Questionnaires were completed by 8 students. Eighty-eight percent of participants were in their 3rd year of pharmacy school and 62% received the influenza vaccination in the past season. Only one participant had used the internet to access information about vaccines in the past. The means scores for the 9 usability and credibility statements were between 2 to 2.9 indicating agreement with the statements. CONCLUSION: The influenza website is easy to navigate and provides a source of credible information about the influenza vaccination.
20
Kuruvilla, Denison John. „Evaluation of erythropoiesis in anemic low birth weight preterm infants“. Diss., University of Iowa, 2015. https://ir.uiowa.edu/etd/1981.
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Anemia of prematurity is characterized by a progressive decline in hemoglobin level during the first month of life. Unlike term newborns, preterm infants become anemic and often require red blood cell transfusions. Various factors contribute to the development of this anemia. These include short infant red blood cell (RBC) lifespan, decline in erythropoiesis rate after birth, and blood losses caused by repeated phlebotomies.
The objectives of this work were to develop novel models to evaluate fetal and neonatal erythropoiesis, and to study in vivo adult and neonatal RBC survival in low birth weight preterm anemic infants. The model developed to evaluate fetal erythropoiesis was based on the in utero growth of the fetus over time. Neonatal erythropoiesis rate was estimated using a hemoglobin (Hb) mass-balance based method that has the advantage of not relying on specific structural pharmacodynamic model assumptions to describe the Hb production, but instead utilizes simple mass balance principles and nonparametric regression analysis to quantify the amount of Hb produced and the Hb production rate during the first month of life. To study RBC survival, two separate models, one describing the elimination of neonatal RBCs produced under non-steady state conditions, and the second describing the elimination of adult RBCs produced under steady state conditions were developed and applied to the RBC survival data obtained from low birth weight anemic preterm infants. The proposed mathematical models and its implementation provides a flexible framework to study both in utero non-steady state (non-SS) fetal erythropoiesis and neonatal erythropoiesis in newborn infants.
21
Clark, Michael. „Benefits and risks of neonatal bacille Calmette-Guerin (BCG) vaccination among Aboriginal infants in Canada: Assessment by Markov model“. Thesis, University of Ottawa (Canada), 2003. http://hdl.handle.net/10393/26461.
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Bacille Calmette-Guerin (BCG) vaccine is given to Canadian Aboriginal neonates in communities at high risk for tuberculosis (TB). However, severe reactions and deaths associated with the vaccine have been reported among infants born with immunodeficiency syndromes. A Markov model was developed to estimate the burden of TB among Canadian Aboriginal children, evaluate the effectiveness of BCG vaccination, and estimate threshold values for severe combined immunodeficiency (SCID) incidence at which a BCG program will reduce quality-adjusted life expectancy. Estimated thresholds for SCID are lower than the rate reported in one North American Aboriginal population, regardless of the assumed risk of tuberculous infection. The possibility that Canadian Aboriginal children are at increased risk for SCID has serious implications for continued BCG use in this population. In this context, enhanced TB Control---including early detection and treatment of infection---may be a safer, more effective alternative.
22
Nundalall, Trishana. „CD4 and CD8 T-cell responses to acellular pertussis and rotavirus vaccination in breast-fed HIV exposed, uninfected infants“. Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25382.
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Introduction: Vaccination is one of the most efficient ways to prevent infectious diseases, however due to the naivety and regulation of immunity found in infants, induction of vaccine-mediated immunity is challenging. Respiratory and diarrheal diseases are major contributors to infant mortality. Additionally, Human Immunodeficiency Virus-1 (HIV) infections increase the risk of mortality. Current advances in Prevention of Mother-to-Child Transmission (PMTCT) have prevented HIV infections in almost 97% of infants being born to HIV-infected mothers. As a result there is an increasing number of HIV exposed, uninfected infants (HEU). HEU infants have a higher rate of infectious disease related mortality and morbidity compared to unexposed infants, the underling causes of these differences are still not understood. In this dissertation, responses to two childhood vaccines, live, attenuated rotaviral vaccine (Rotarix) and acellular Pertussis (aP), were analyzed in HEU infants, with specific focus on T-cell responses to Rotarix and aP, due to the current lack of published data on T-cell responses. Additionally, the influence of feeding mode, that is breast or formula feeding, was also assessed as it is well established that breast fed infants contract fewer infections compared to formula fed infants. Methods: This dissertation included infants from a larger cohort which includes three groups of infants; HIV unexposed breast fed (UBF), HIV exposed breast-fed (EBF) and HIV exposed formula fed (EFF) infants. Infants were recruited at birth and followed up until 36 weeks of age. As no Rotavirus vaccine T-cell assay was previously published, multiple techniques were utilized to attempt to optimize an assay capable of detecting Rotavirus (RV) vaccine-specific T-cell responses. To determine T-cell responses to Bordertella pertussis (BP), blood was collected from infants at each time-point and 200ul was stimulated with BP antigen in a 12-hour whole blood assay. Cells from all assays were fixed and stained for flow cytometric analysis of CD4 and CD8 T-cell responses. The markers used included live/ dead, CD3, CD4 and CD8 for identification of T-cell populations, IFNγ, IL-2 and TNFα cytokines, HLA-DR and Ki67 for activation and proliferation, and CD45RA and CD27 memory differentiation. Data analysis was then completed using Microsoft Excel, Flow.Jo V9, GraphPad prism V6, Pestle 1.7 and Spice V5.33 software packages. Results: Despite multiple attemps it was not possible to optimise an assay capable of consistently detecting Rotavirus vaccine specific responses. This was partly due to interferance from contaminating agents in the protein antigens used, and difficulty in culturing and purification of whole virus. Assessment of aP spcific CD4+ T-cell memory demonstrated an overall increase in terminally differentiated (TD) memory cells accross time. This mirrored the ontogeny of the total T cell pool which showed an overall decrease in naïve T-cell frequencies with a consequent increase in late and terminally differentiated CD4 and CD8 T-cell populations over time through the first months of life. Both total and aP specific CD4+ early differentiated (ED) memory T-cells remained unchanged over time. ED CD8+ memory T-cells peaked at week 15 in EBF infants. A similar observation was found in UBF infants but at a non-significant level. EFF infants had no significant changes in CD8+ naive, ED and late differentiated (LD) memory populations over time. Additionally all infants demonstrated high levels of Ki67 expression at D4-7, which is prior to vaccination and maintained this level of proliferation after vaccination. HEU infants had higher levels of activation compared to HU infants in the first week of life but this normalised to HU infant levels by week 7. Furthermore EFF infants had peak T-cell activation at week 7 as compared to week 15 in EBF infants. In addition HU infants had better cytokine responses than HEU infants at week 7 but similar responses at week 15 and 36. In Addition, EFF infants also had increased vaccine specific CD4+ responses at week 7 and week 36 compared to EBF infants. This was true for overall cytokine expressing CD4 T-cells and single TNFα expressing CD4+ T-cells. Disscussion: Given the important role T-cells play in the clearance of Rotavirus, it is important that an assay capable of detecting RV vaccine specific T-cell responses be developed. Furthermore, T cells play a role in providing help for antibody responses to BP and for killing of intracellular bacteria. Our findings regarding immunity to aP suggest that all infants, regardless of HIV exposure status and feeding mode, are able to mount a T cell response to aP vaccination. However the differing ontogeny of responses seen in all three groups of infants lends some insight on the complex determinants of vaccine T -cell immunogenicity. In this case, age since vaccination, HIV exposure, and feeding mode resulted in apparent changes in vaccine responses as well as T cell differetiation and activation.
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Keyser, Alana. „BCG-specific T cell proliferation and cytotoxic capacity in infants as risk of tuberculosis disease, following newborn BCG vaccination“. Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/14085.
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Includes bibliographical references.BCG is the only vaccine against tuberculosis and has been used for over 90 years. BCG efficacy is variable, especially in countries with high TB prevalence, where over a million deaths due to tuberculosis, are still reported annually. New TB vaccines are under development to either replace or boost the BCG vaccine. However, our understanding of the immune response required for protection against TB disease, remains inadequate. Identification of a protective immune response is only possible in a clinical trial of an efficacious vaccine, allowing comparison of vaccine-induced immune responses in protected and unprotected individuals. In the absence of such a vaccine, as is the case with TB, we can only explore biomarkers of risk of disease. The most commonly measured outcomes of anti-mycobacterial immunity in clinical trials, specific Th1 cells, are typically thought to be protective in TB. However, to date, human mycobacteria-specific Th1 responses have not correlated with risk of TB disease. New approaches are urgently required to identify other factors at play in conferring protection against TB. In this thesis, we explored BCG-specific cytotoxic T cells as candidate correlates of risk of TB disease in BCG-vaccinated infants. We hypothesized that reduced production of cytotoxic molecules by T cells in response to BCG are associated with risk of developing TB disease. We designed a case/control study nested within a large trial of newborn BCG-vaccination.Blood was collected at 10 weeks and infants, were followed up for two years.We compared outcomes in infants ultimately diagnosed with TB (at risk of TB disease) and two groups of healthy infants (not at risk of TB disease), the first group had household contact with TB cases, the second group were randomly selected from the community, which is endemic for TB. Amongst these groups, we designated a training and a test cohort to allow validation of candidate correlates of risk of TB.
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Chan, Susan Deborah. „Impact evaluation of a milk supplementation programme on weight of children 6-24 months of age in Guyana, South America“. Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0007/MQ44143.pdf.
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Jayaraj, Ramamoorthi, und Jayaraj@menzies edu au. „Expression of stage-specific Fasciola proteases and their evaluation in vaccination trials“. RMIT University. Applied Science, 2008. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20081029.100156.
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The liver flukes Fasciola hepatica and F. gigantica cause infectious disease in ruminants and humans. The geographical range of these two parasite species (temperate and tropical respectively) ensures that infection can occur worldwide. Although anthelmintic treatment is effective against disease, emerging drug resistant strains leads to the development of a vaccine. However, despite several decades of research, there is no commercial vaccine available. The main challenge at present is to produce recombinant proteins in an immunologically active form using recombinant DNA technology. This is an essential step in Fasciola vaccine production. Cysteine proteases are probably the most important facilitators of virulence in flukes and are produced by all stages of the fluke life-cycle. Two classes of cysteine protease are found in the excretory and secretory material of liver flukes- these are cathepsin L and cathepsin B. As such, the major aims of this thesis were to investigate the expression and purification of Fasciola recombinant cysteine proteins, and characterisation by SDS-PAGE and immunoblotting using monoclonal and polyclonal antibodies. These studies demonstrate the production of functionally active cathepsin proteins in S. cerevisiae BJ3505 cells which will lead to vaccine candidate analysis. The second aim of this thesis was to determine the protective efficacy of stage specific target antigens against experimental infection. In addressing this issue, the protective efficacy of single and multivalent recombinant protein vaccinations of adult stage F. hepatica cathepsin L5, immature F. gigantica cathepsin L1g and juvenile F. hepatica cathepsin B were analysed in Sprague Dawley rats against F. hepatica infection. This study demonstrates that juvenile fluke target antigen-cathepsin B induces better immune protection than adult fluke antigen-cathepsin L5. Cocktails of juvenile and adult stage fluke recombinant proteins (cathepsin B and L5) elicited the highest protective immunity against experimental infection and this combination showed not only reduction in fluke recovery and size of flukes, but also marked diminution in the intensity of liver lesions in vaccinated rats. In order to assess the immunogenic property of an early infective stage fluke secreting cysteine protease as a vaccine candidate, DNA vaccination vectors encoding cathepsin B were analysed in BALB/c mice. In this study, the ability of four DNA vaccination strategies such as secretory, chemokine-activating, lymph node targeting vectors encoding cathepsin B were assessed by antibody titre, antibody avidity, western blotting and ELIPSOT assay. The results have further validated the immunoprophylactic potential of a cathepsin B vaccine against F. hepatica. In this study, we have expressed and attained high yields of F. gigantica cathepsin L1g from E. coli BL21, and compared this to a yeast-expressed system. This protease was over-expressed and formed insoluble inclusion bodies that were subsequently solubilised with urea or guanidine hydrochloride. In order to purify the urea-solubilised protein, step-wise urea gradient chromatography was used. For refolding of solubilised protein, a dilution and dialysis procedure was utilised. Proteolytic activity was confirmed by gelatin SDS-PAGE analysis. In conclusion, the determination of the immune potential of recombinant stage specific antigens allows the development of effective vaccines against Fasciola infection.
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Selim, Mohamed E. „Tick-host interactions : evaluation of resistance, salivary gland antigens, and DNA vaccination /“. The Ohio State University, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=osu1488193272067399.
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Aquilano, Giulia <1979>. „Evaluation of immune function in preterm infants using Immuknow® assay“. Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7293/.
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Background. Neonatal immune system is not fully developed at birth; newborns have an adequate leukocytes and lymphocytes count at birth but these cells lack of function.
Objective. To assess the functional activity of T-cells at birth and at 30 days of life and the influence of the main perinatal factors in a population of preterm infants.
Design. A prospective longitudinal study was carried out in a population of 59 preterms. Fifteen healthy adults were included as a control group. Blood samples were collected at birth and at 30 days of life to evaluate CD4+ T cell activity using the Immuknow® assay.
Results. CD4+ T cell activity at birth and at 30 days of life were significantly lower compared with adult controls (p < .001). Twins showed lower activity compared to singletons (p= .005). Infants born to vaginal delivery had higher CD4+ T cell activity compared to those born to c-section (p=0.031); infants born after pPROM showed a higher activity at birth (p= .002). Low levels of CD4+ T cells activation at birth were associated with necrotizing enterocolitis development in the first week of life (p=.049).
Conclusions. Preterm infants show a lack in CD4+ T cells activation at birth. Perinatal factors such as intrauterine inflammation, mode of delivery, zygosity can influence the levels of adaptative immune activity at birth and can contribute to expose these infants to serious complications such as NEC.
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Gonin, Patrick. „Evaluation de vecteurs recombinants adénovirus comme vaccins contre les virus de l'immunodéficience féline (FIV) et de la peritonite infectieuse féline (PIF)“. Paris 11, 1995. http://www.theses.fr/1995PA114837.
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Song, Andrew M. Eng Massachusetts Institute of Technology. „Financial viability and technical evaluation of dendritic cell-carrying "vaccination nodes" for immunotherapy“. Thesis, Massachusetts Institute of Technology, 2008. http://hdl.handle.net/1721.1/45353.
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Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Materials Science and Engineering, 2008.Includes bibliographical references (leaves 66-69).
Cancer immunotherapy attempts to stimulate the immune system to reject and destroy tumor cells. Despite the amount of ongoing intensive research to prevent cancer, tumor cells continue to evade immune responses. Currently, dendritic cell vaccines are in development, in which autologous antigen-loaded dendritic cells are injected back into the patient in order to generate an appropriate immune response. Improving upon this idea, members of the Irvine laboratory are in development of an injectable dendritic cell based formulation that gels in situ around the tumor site. In this way, immune cells (most notably T cells) can be recruited and become activated against specific tumor antigens, and (hopefully) kill tumor cells. Recent studies have shown the potential benefit of incorporation of cytokine interleukin-15 complexed with its soluble receptor interleukin-5R[alpha], which is discussed. Economic considerations are also discussed, including topics such as intellectual property, barriers to entry, initial markets and market drivers, and entry into the current supply chain considerations. A business strategy is outlined and evaluated.
by Andrew Song.
M.Eng.
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Stocksdale, Sarah Louise. „Evaluation of Vaccination Policies Among Outpatient Oncology Clinics in Utah: A Pilot Study“. BYU ScholarsArchive, 2015. https://scholarsarchive.byu.edu/etd/5849.
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Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown. Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees. Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic's employee vaccination policy and the consequences for refusing the policy. Findings: Most vaccination policies applied to employees primarily assigned to work in the back office area. Most commonly, influenza and Hepatitis B vaccines were required as part of the vaccination policy. Most managers offered free vaccinations to employees, although most managers also allowed employees to refuse to follow the vaccination policy for medical, religious, or personal reasons.
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Banks, Kristina L. „Process Evaluation of Group Well Child Visits for One-Month-Old Infants“. Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1460750207.
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Bodamer, Cheryl N. „Evaluation of an Early Discharge Policy For Infants With Apnea of Prematurity“. VCU Scholars Compass, 2008. http://hdl.handle.net/10156/1698.
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Rajananthanan, Palasingam. „Evaluation of novel aggregate structure adjuvants to potentiate immune responses to soluble protein antigen“. Thesis, Queen Mary, University of London, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325240.
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Walters, Adam Alexander. „The development and evaluation of a nanoparticulate antigen delivery system for vaccination of cattle“. Thesis, University of Surrey, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.600038.
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Conventional subunit vaccine regimes can be modified in order to stimulate strong immune responses resulting in memory cell formation. An adjuvant system that has gained increased attention in recent years is the use of particulate antigen delivery. Particulate systems have a number of advantages over conventional approaches since they are believed to be taken up preferentially by dendritic cells (DC) where they prolong the release of antigen resulting in enhanced T cell stimulation. Furthermore, they offer a versatile system that allows for targeted delivery of antigen and adjuvant to the same DC. A wide range of particle types have been used to enhance vaccine potency. Poly (Iactic-co-glycolic) acid (PLGA), in particular, has been used successfully by many groups. However, there are a great variety of means to synthesise and characterise the desired particles. This study, firstly, set out to develop and optimise a protocol to generate nanoparticles with defined properties. A number of parameters were evaluated including, particle size, protein loading, protein coating and surface charge. In addition to conventional methods, such as electron microscopy and dynamic light scattering, particles were characterised by novel flow cytometric methods. While particles have been shown to adjuvant candidate vaccine proteins, this property should be enhanced when the particle is targeted to dendritic cells by increasing specific uptake. Specific targeting has previously been performed through either targeting with natural receptor ligands or monoclonal antibodies. However, there is currently conflicting data in other studies as to whether this can be achieved. It was thus the second objective of this study to devise methods to implement this technology and to determine whether targeting can be achieved through either approach. It was 1 Abstract found that there was potential in targeting DC populations with monoclonal antibodies, while targeting with natural ligands yielded more mixed results. As a final component, the adjuvant properties of the particles rationally loaded with antigens and molecular adjuvant was tested in vivo in cattle using a viral challenge model. The experiment had a promising outcome with the vaccine particles inducing both T cell and antibody responses resulting in a degree of protection against virus challenge. Furthermore, it highlighted areas where the system, both the particles and the model, may be improved, which could form the basis of future work.
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Bearchell, Melissa Clare. „Evaluation of tumour response to DNA vaccination using MRI : development of a model system“. Thesis, University of Cambridge, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.621265.
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Thambiran, Mona. „Economic evaluation of a school based human papillomavirus (HPV) vaccination program in South Africa“. Diss., University of Pretoria, 2014. http://hdl.handle.net/2263/46147.
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Introduction Oncogenic human papillomavirus (HPV) types 16 and 18 pose the greatest risk for cervical cancer. Infection with HPV types 16 and 18, which cause 70% of cervical cancer worldwide, could be prevented with commercially available HPV 16 and 18 vaccines. A previous study in South Africa demonstrated that vaccination of 12 year old girls with a HPV vaccine, prior to sexual debut, is cost effective, however this was carried out prior to the roll-out of the HPV vaccination program. The aim of this study is to provide an up-dated cost effectiveness analysis of HPV 16 and 18 vaccination of nine year old school girls in South Africa, from a public sector healthcare provider perspective. Methods Treeage Pro Suite® software was used to create a lifetime static Markov model, to determine the cost effectiveness of a school based vaccination program in the public sector compared to cervical cancer screening alone. The time horizon was based on average life expectancy of 61 years of females in South Africa. The costs and effects of vaccination, screening and treatment compared to screening and treatment of precancerous lesions and cervical cancer were modelled with data obtained from published literature. Expert opinion was sought, where no published data was available. Cost and effects were discounted by 5% and a one way sensitivity analysis was performed on a range of parameters. Results Results of this study showed that HPV vaccination was more cost effective than screening alone. The incremental cost-effectiveness ratio (ICER) of adding HPV vaccination to the existing screening program was R10 567.79, and dominant for the HPV vaccination compared to screening alone from a public sector payer perspective. The cost estimate of a two-dose schedule, school based HPV vaccination, is R636.75 per vaccinated girl. The vaccination cost to avert one case of cervical cancer stage 1 due to HPV 16 and/or 18 is R58 581.92 and over a lifetime, the number of new cervical cancer stage 1 cases averted due to HPV 16 and 18 vaccination of 507 073 nine year old girls is 5 538. The ICER for the exploratory model of HPV vaccination of HIV-infected nine year old girls also showed that HPV vaccine strategy with dominant with ICER of R2 375.62 per QALY. Conclusions A school based vaccination program of girls, prior to sexual debut, is a cost effective strategy to reduce the risk of cervical cancer when compared to screening alone in the public healthcare sector.Dissertation (MSc)--University of Pretoria, 2014.
tm2015
School of Health Systems and Public Health (SHSPH)
MSc
Unrestricted
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Chong, Siu-yung, und 莊少容. „Evaluation of Apgar score as an intermediate assessment of the risk ofearly mortality“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B30273195.
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Yuan, Siyang. „Socially excluded mothers and infants : an evaluation of community based health promotion programmes“. Thesis, Queen's University Belfast, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486264.
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The aim of this thesis was to evaluate two community based health promotion programmes for Irishborn (NI) and Chinese immigrant mothers and infants living in deprived areas. Study 1: A cross-sectional study to compare differences in NI and Chinese immigrant mothers' dental health and mother and infant's weight status. Mothers' oral health and health related knowledge, attitudes and behaviours regarding oral health, infant feeding, childhood obesity and mother-infant bonding were compared. The findings suggested that Chinese compared with NI mothers had poorer oral health and health related knowledge, attitudes and behaviours, poor mother-infant bonding as well as poorer dental health. Study 2: An evaluation of'Treasure Baby Teeth' focussed on preschool child dental registration in deprived areas. It was delivered by health visitors during home visits. Dental registration rates were assessed 6 months before, 24 months during and 5 months after the intervention. The results indicated the improved dental registration rates for 0-2-year-old children living in the intervention wards 24 months during and 5 months after the intervention. Study 3: An evaluation 'of the CHllvIE (Chinese Immigrant Mothers health Education) Programme. This was developed and targeted at Chinese immigrant mothers of infants living in deprived areas using a controlled trial. Intervention group mothers were visited by SY at 8 weeks and 6 months on a one-to-one basis. Health topics included oral hygiene, dental attendance, infant feeding in relation to childhood caries and obesity, and mother-infant bonding. Two telephone calls were made at 4 months and 9 months to reinforce the information and provide supports to intervention group mothers. Improvements were demonstrated in the intervention group mothers' knowledge, attitudes and behaviours regarding oral health, infant feeding and childhood obesity a~d.'mother-infant bonding.
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Tan, Enda. „Infants’ performance on sociomoral evaluation tasks predicts parent report of preschool social functioning“. Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/54293.
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The present study examined developmental continuity in social functioning from infancy to preschool. Specifically, we examined the relationships between infants’ performance on sociomoral evaluation studies and parent report of their preschool social functioning. Infants’ performance, emotional stability (fuss-out rate), and average habituation rate in moral evaluation tasks were collected. Preschool social functioning was measured through parent-report online scales. The results showed 1) that better performance on infant moral evaluation studies was associated with lower rates of parent report of preschool attention problems, social responsiveness problems, and callousness-unemotional traits, as well as higher rates of parent report of adaptive social skills, 2) that fuss-out rate across infant moral evaluation studies was positively associated with parent report of preschool anxiety, depression, and withdrawal, 3) that the relationships between the performance on infant moral evaluation studies and parent-report preschool functioning were stronger for males than for females, and that 4) these relationships were domain-specific. Together these findings provide preliminary evidence for longitudinal continuity in social functioning from infancy to preschool.Arts, Faculty of
Psychology, Department of
Graduate
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Jackson, Elizabeth Anne. „A critical evaluation of respiratory function testing in spontaneously breathing and ventilated infants“. Thesis, University College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299878.
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Nguyen, Amy, Sarah Deitering, Hanna Phan, Megan Brandon und Kathryn Matthias. „Evaluation of Treatment and Outcomes in Infants and Children with Urinary Tract Infection“. The University of Arizona, 2015. http://hdl.handle.net/10150/614007.
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Class of 2015 AbstractObjectives: In 2011, the American Academy of Pediatrics released an updated urinary tract infection guideline that addressed diagnosis, antibiotic treatment, and duration of therapy in children ages 2-24 months. The objectives of this study were to evaluate the appropriateness of antibiotic prescribing and compare outcomes between age groups. Methods: This retrospective chart review included patients aged 1 month through 12 years admitted to a regional academic medical center from January through July 2014 and diagnosed with UTI or pyelonephritis. Patients were identified using ICD-9 codes. Demographic information, antibiotic treatment, length of stay, and complications were collected and the chi square statistical test was used to compare results between age groups. Results: There were 104 patients included in this study. The most common bacteria cultured were Escherichia coli (85%). Ceftriaxone (71%) and cephalexin (30%) were the most commonly prescribed empiric and discharge antibiotic, respectively. Based on guideline recommendations and culture results, inappropriate antibiotic selection only occurred with 7% of the orders while inappropriate prescribing occurred 35% of the time. Readmission within 90 days occurred in 15% of patients aged 2-24 months (guideline age group) and in 14% of all other patients (P>0.05). Conclusions: There was no difference between age groups with respect to inappropriate antibiotic prescribing or complications for pediatric UTI treatment and inappropriate antibiotic dosing occurred more frequently than inappropriate selection. More research is necessary to assess the impact of the guidelines on prescribing practices and factors associated with inappropriate prescribing.
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Best, Emma Women's & Children's Health Faculty of Medicine UNSW. „Once daily gentamicin in infants and children: an evaluation of safety and the role of therapeutic drug monitoring in minimising toxicity“. Awarded by:University of New South Wales, 2007. http://handle.unsw.edu.au/1959.4/35192.
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AIMS: To assess (i) the safety of once daily dosing (ODD) of gentamicin by systematic evaluation of ototoxicity and nephrotoxicity; and (ii) the usefulness of therapeutic drug monitoring (TDM) in a paediatric cohort. METHOD: Infants and children with suspected or proven gram negative sepsis were enrolled prospectively to receive ODD gentamicin at 7 mg/kg/day. Neonates were excluded. Hearing and renal function were assessed at baseline, during and after therapy by otoacoustic emissions (OAE) and by either serum creatinine or glomerular filtration rate. Abnormal OAE were followed with audiometry. TDM was performed using an interval adjusted graphical method (Hartford nomogram) with levels taken between 6-14 hours after dose. Assessment of efficacy (clinical and microbiological) was a secondary outcome measure. RESULTS: There were 106 episodes of therapy in 79 children (median age 5.6 years; range 1 month - 16 years), 60% of which were for febrile neutropaenia. Evaluation was complete in 88% (93/106) for ototoxicity and 92% (98/106) for nephrotoxicity. Two children (1.88%, 95% CI 0.10 - 7.13) experienced permanent hearing loss. Three children did not complete full assessment after preliminary abnormalities on OAE. Incorporating these cases gives a ???worst case scenario??? incidence of 4.71% (95% CI 1.71 - 10.91) possible ototoxicity. One child (0.94%, 95% CI < 0.10 - 5.73) experienced transient nephrotoxicity. No ???toxic??? serum gentamicin levels were detected, including in those children who experienced clinical toxicity. All children with detectable toxicity were undergoing treatment for malignancies and had received nephro or ototoxic medications prior to the gentamicin course. Complete or partial efficacy was seen in 93% (non oncology) and 78% (oncology) treatment episodes, equivalent to prior literature reports. CONCLUSION: In this systematically evaluated paediatric cohort receiving ODD gentamicin, toxicity occurred infrequently and only in those with identifiable risk factors. TDM did not identify children who developed clinical toxicity. The development of toxicity appears to be associated with factors such as underlying medical condition, prior courses of gentamicin, exposure to other oto or nephrotoxic medications, all of which may be more predictive of toxicity than elevated serum gentamicin levels. TDM in healthy children on short course gentamicin appears unnecessary, but may be warranted in conjunction with renal and hearing assessments in those with risk factors.
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Biswal, Jitendra Kumar. „Evaluation of mucosal immunity in FMDV vaccinated and infected cattle“. Thesis, Royal Veterinary College (University of London), 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.572448.
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Byers, Stacey Renee. „Bovine viral diarrhea virus : evaluation of persistent infections, acute transmission, and vaccination protection in alpacas“. Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Thesis/Spring2009/s_byers_041509.pdf.
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Thesis (M.A. in veterinary science)--Washington State University, May 2009.Title from PDF title page (viewed on Apr. 23, 2010). "Department of Veterinary Clinical Sciences." Includes bibliographical references (p. 83-89).
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Harding, Scott V. „Evaluation of the iron, antioxidant and dietary status of iron supplemented breastfed healthy infants /“. Internet access available to MUN users only, 2003. http://collections.mun.ca/u?/theses,160317.
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Neelotpol, Sharmind. „Evaluation of lead in meconium : a study on UK infants of South Asian origin“. Thesis, University of Leeds, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.634214.
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Human exposure to lead, a persistent inorganic metal, can pose a significant risk to health and can arise from several sources e.g. lead-based paint, soil, dust, water pipes, and traditional cosmetics/remedies. A principal concern of lead exposure is for the foetus because without noticeable symptoms in the child lead can lower IQ, Standard Assessment Test (SATs) scores, and may increase the involvement in crime. The aim of this study was to evaluate lead exposure in South Asian infants. The hypothesis was that, living in the same environment, the South Asian 'mother-foetus unit' is more exposed to lead than white counterparts, because of their cultural orientation and lifestyle. To assess mothers' exposure to lead, a lifestyle questionnaire survey was compiled and completed by all participants (South Asians, n=98; white, n=38). Meconium (newborn's first stool) was chosen · as the biomatrix for measuring lead, because meconium accumulates throughout pregnancy and is likely to reflect the transfer of chemicals across the placenta. Matched samples of maternal antenatal blood and cord-blood were also collected with meconium to measure lead by Inductively Coupled Plasma-Mass Spectrometry. Measured lead concentrations in blood were below the current tolerable threshold of 5 I-Ig/dl. Significant differences were observed between participant groups in the lead levels in blood and meconium (p
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Skillern, Laurence Howard. „Evaluation of the fetal electrocardiogram in the detection of myocardial ischaemia in preterm infants“. Thesis, King's College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243594.
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Salem, Hanaa A. „Design and evaluation of a hepatitis B immunization program for pharmacy students“. Scholarly Commons, 1992. https://scholarlycommons.pacific.edu/uop_etds/2226.
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The objectives of this study are: (1) To compare the effectiveness of two dosing schedules of hepatitis B vaccine in achieving compliance within the vaccines; (2) To determine the immunization requirements in U.S. pharmacy schools both at admission and before the students begin clinical clerkships; and, (3) To design an immunization program for pharmacy students at the University of the Pacific in an attempt to enhance compliance.
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Rivera, Jocelyn Renee, und Jocelyn Renee Rivera. „Development and Evaluation of a Clinical Practice Guideline to Promote an Evidence-based Approach to Vaccine Hesitancy in Primary Care“. Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626638.
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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.
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Ashok, M. S. „Evaluation Of The Efficacy Of DNA Vaccines For Japanese Encephalitis In A Murine Intracerebral Japanese Encephalitis Virus Challenge Model“. Thesis, Indian Institute of Science, 2000. http://hdl.handle.net/2005/169.
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Japanese encephalitis virus (JEV), a member of the family flaviviridae, is one of the most important pathogens of the developing countries, causing high mortality and morbidity amongst children. The present study is aimed at the development of a DNA vaccine for Japanese Encephalitis (JE). As a first step towards developing a DNA vaccine for JE, an eukaryotic expression plasmid encoding the envelope (E) glycoprotein of Japanese Encephalitis Virus (pCMXENV) was constructed. This plasmid expresses the E protein intracellularly, when transfected into Vero cells in culture. Several independent immunization and intracerebral (i.e.) JEV challenge experiments were carried out and the results indicate that 51% and 59% of the mice are protected from lethal i.e. JEV challenge, when immunized with pCMXENV via intramuscular (i.m.) and intranasal (i.n.) routes respectively. JEV-specific antibodies were not detected in pCMXENV-immunized mice either before or after challenge. JEV-specific T cells were observed in mice immunized with pCMXENV, which increased significantly after JEV challenge indicating the presence of vaccination-induced memory T cells. Enhanced production of interferon-y (EFN-y) and complete absence of interleukin-4 (IL-4) in splenocytes of pCMXENV-immunized mice on restimulation with JEV antigens in vitro indicated that the protection is likely to be mediated by T helper (Th) lymphocytes of the Thl sub type. These results demonstrated that immunization with a plasmid DNA expressing intracellular form of JEV E protein confers significant protection against i.e. JEV challenge even in the absence of detectable antiviral antibodies. We then examined the potency of JEV DNA vaccines as well as that of the inactivated mouse brain derived BIKEN vaccine in the i.e. challenge model. The results indicate that all the mice immunized with BIKEN JE vaccine were protected against i.e. JEV challenge while 50% protection was observed in case of mice immunized with pJME or pJNSl and 38% protection was observed in pCMXENV-immunized mice. Immunization with both pJME and pJNSl resulted in 66% protection. These results indicate that the BIKEN JE vaccine confers better protection against i.e. JEV challenge than DNA vaccines. The fact that the BIKEN vaccine conferred better protection against i.e. JEV challenge than DNA vaccines indicated that the i.e. JEV challenge model can be exploited further to examine the potency of different DNA vaccine constructs. Towards this goal, we constructed plasmids that encode secretory or nonsecretory forms of JEV E protein and examined their potency in the i.e. JEV challenge model. Our results indicate that i.m. immunization of mice with plasmid encoding secretory form of JEV E protein confers higher level (75%-80%) protection than those encoding nonsecretory forms. Cytokine analysis of splenocytes isolated from DNA immunized mice after stimulation in vitro with JEV revealed that immunization with plasmid encoding secretory form of JEV E protein induces both Thl and Th2 responses while those encoding nonsecretory forms induce only Thl type of response. Thus, synthesis of secretory form of JEV E protein results in an altered immune response leading better protection against i.e. JEV challenge. Based on our studies, we propose that both cellular and humoral immune responses play a key role in protective immunity against i.e. JEV challenge and DNA vaccines that can induce higher levels of neutralizing antibodies will be as efficient as the BIKEN vaccine in conferring protection against i.e. JEV challenge.