Iowa Immunization Program Annual Report 2013, April 30, 2014

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

Public Risk Interpretation and Community Resilience Planning: A Case Study in Aberdeen, Washington

Thesis (Master's)--University of Washington, 2016-06

Coproducing flood risk management through citizen involvement: insights from cross-country comparison in Europe

Across Europe, citizens are increasingly expected to participate in the implementation of flood risk management (FRM), by engaging in voluntary-based activities to enhance preparedness, implementing property-level measures, and so forth. Although citizen participation in FRM decision making is widely addressed in academic literature, citizens’ involvement in the delivery of FRM measures is comparatively understudied. Drawing from public administration literature, we adopted the notion of “coproduction” as an analytical framework for studying the interaction between citizens and public authorities, from the decision-making process through to the implementation of FRM in practice. We considered to what extent coproduction is evident in selected European Union (EU) member states, drawing from research conducted within the EU project STAR-FLOOD (Strengthening and Redesigning European Flood Risk Practices towards Appropriate and Resilient Flood Risk Governance Arrangements). On the basis of a cross-country comparison between Flanders (Belgium), England (United Kingdom), France, the Netherlands, and Poland, we have highlighted the varied forms of coproduction and reflected on how these have been established within divergent settings. Coproduction is most prominent in discourse and practice in England and is emergent in France and Flanders. By contrast, FRM in the Netherlands and Poland remains almost exclusively reliant on governmental protection measures and thereby consultation-based forms of coproduction. Analysis revealed how these actions are motivated by different underlying rationales, which in turn shape the type of approaches and degree of institutionalization of coproduction. In the Netherlands, coproduction is primarily encouraged to increase societal resilience, whereas public authorities in the other countries also use it to improve cost-efficiency and redistribute responsibilities to its beneficiaries.

Review of the flood risk management system in Germany after the major flood in 2013

Widespread flooding in June 2013 caused damage costs of €6 to 8 billion in Germany, and awoke many memories of the floods in August 2002, which resulted in total damage of €11.6 billion and hence was the most expensive natural hazard event in Germany up to now. The event of 2002 does, however, also mark a reorientation toward an integrated flood risk management system in Germany. Therefore, the flood of 2013 offered the opportunity to review how the measures that politics, administration, and civil society have implemented since 2002 helped to cope with the flood and what still needs to be done to achieve effective and more integrated flood risk management. The review highlights considerable improvements on many levels, in particular (1) an increased consideration of flood hazards in spatial planning and urban development, (2) comprehensive property-level mitigation and preparedness measures, (3) more effective flood warnings and improved coordination of disaster response, and (4) a more targeted maintenance of flood defense systems. In 2013, this led to more effective flood management and to a reduction of damage. Nevertheless, important aspects remain unclear and need to be clarified. This particularly holds for balanced and coordinated strategies for reducing and overcoming the impacts of flooding in large catchments, cross-border and interdisciplinary cooperation, the role of the general public in the different phases of flood risk management, as well as a transparent risk transfer system. Recurring flood events reveal that flood risk management is a continuous task. Hence, risk drivers, such as climate change, land-use changes, economic developments, or demographic change and the resultant risks must be investigated at regular intervals, and risk reduction strategies and processes must be reassessed as well as adapted and implemented in a dialogue with all stakeholders.

Addressing surprise and uncertain futures in marine science, marine governance, and society

On an increasingly populated planet, with decreasing biodiversity and limited new opportunities to tap unexploited natural resources, there is a clear need to adjust aspects of marine management and governance. Although sectarian management has succeeded in addressing and managing some important threats to marine ecosystems, unintended consequences are often associated with overlooking nonlinear interactions and cumulative impacts that increase the risk of surprises in social-ecological systems. In this paper, we begin to untangle science-governance-society (SGS) interdependencies in marine systems by considering how to recognize the risk of surprise in social and ecological dynamics. Equally important is drawing attention to our state of preparedness, adaptation, and timeliness of response in ecosystem governance and society, which involve fostering transformations away from rigid and nonintegrated structures of governance. More inclusive decision-making processes, deeper understanding of complexity, and colearning across SGS can help to build constructive solutions that are likely to benefit multiple stakeholders and build capacity to understand and respond to change.

Exploring Relationships Between Vector-Borne Diseases and Landscape Architecture: Aedes aegypti, Aedes albopictus and Landscape Architecture

Thesis (Master's)--University of Washington, 2016-06

Debriefing in simulation conducted in small and large groups : nursing students’ experiences

The debriefing phase in human patient simulation is considered to be crucial for learning. To ensure good learning conditions, the use of small groups is recommended, which poses a major challenge when the student count is high. The use of large groups may provide an alternative for typical lecture-style education and contribute to a more frequently and repeated training which is considered to be important for achieving simulation competency. The purpose of the present study was to describe nursing students’ experiences obtained during the debriefing conducted in small and large groups with the use of a qualitative descriptive approach. The informants had participated in a human patient simulation situation either in large or small groups. Data was collected through the use of five focus-group interviews and analysed by content analysis. The findings showed that independent of group-size the informants experienced the learning strategies to be unfamiliar and intrusive, and in the large groups to such an extent that learning was hampered. Debriefing was perceived as offering excellent opportunities for transferable learning, and activity, predictability and preparedness were deemed essential. Small groups provided the best learning conditions in that safety and security were ensured, but were perceived as providing limited challenges to accommodate professional requirements as a nurse. Simulation competency as a prerequisite for learning was shown not to be developed isolated in conjunction with simulation, but depends on a systematic effort to build a learning community in the programme in general. The faculty needs to support the students to be conscious and accustomed to learning as a heightened experience of learning out of their comfort zone.

Augmentation de l'immunogénicité de la nucléoprotéine de l'influenza par multimérisation in vitro

Les travaux effectués au cours de ce mémoire ont permis de développer une alternative aux vaccins présentement utilisés contre le virus de l’influenza. Nous avons utilisé la nucléoprotéine (NP) de l’influenza comme base vaccinale puisque cette protéine est conservée chez les souches d’influenza A et qu’elle possède un potentiel de protection croisée. Nous avons montré que la multimérisation de la NP grâce à un gabarit d’ARN permet d’augmenter son immunogenicité. Cette multimérisation en pseudo-nucléoparticule virale (NLP) a augmenté la réponse humorale et cellulaire spécifique à NP et l’ajout d’un adjuvant (PAL) a permis d’amplifier davantage la réponse humorale contre NP. Une dose du vaccin candidat NLP-PAL n’a pas réussi à protéger des souris contre une infection létale avec une souche homotypique d’influenza. Cependant, des résultats avec un régime de deux immunisations montrent des résultats encourageants qui permettent d’espérer une protection envers une infection virale.

Développement et évaluation pré-clinique de nouveaux vaccins inactivés contre l’influenza et suivi de l’évolution des souches virales A/H3N2

Les virus influenza de type A sont des pathogènes respiratoires causant des épidémies saisonnières et des pandémies de manière plus occasionnelles. Au cours d’une saison, 10 à 20 % de la population mondiale est touchée, ce qui constitue un problème majeur de santé publique. Les virus de sous-type A/H3N2 sont associés à une plus forte morbidité et mortalité que les virus de sous-type A/H1N1. La vaccination reste le moyen le plus efficace de contrôler les infections, cependant l’efficacité de ces vaccins est de courte durée et compromise en cas de non-appariemment entre les souches circulantes et vaccinales. La première partie de cette thèse a été consacrée à l’optimisation des vaccins inactivés A/H3N2 en testant de nouveaux adjuvants et de nouvelles voies d’administration chez la souris et le furet. Nous avons démontré que l’adjuvant AS25 semble prometteur pour le développement de vaccins plus efficaces. La seconde partie de cette thèse a été consacrée à suivre l’évolution moléculaire et antigénique des souches A/H3N2 circulantes au Québec entre 2009 et 2011. Notre conclusion est qu’il n’y a pas que le nombre de mutations dans la HA qui est important, en ce sens que la nature et la localisation de ces dernières jouent un rôle clé lors d’une dérive antigénique. Après avoir suivi les souches A/H3N2 sous pression immunitaire, nous avons suivi dans la troisième partie de cette thèse une souche A/H3N2 sous pression d’un nouvel antiviral; le laninamivir. Les antiviraux sont la première ligne de défense en cas de pandémie ou lors d’une épidémie lorsqu’il y a un mésappariemment entre les souches circulante et vaccinale. Notre conclusion est que la réplication de notre mutant est conservé in vitro mais non in vivo. Les différentes expériences effectuées au cours de cette thèse ont permis de suivre l’évolution des souches A/H3N2 et de mettre en œuvre de nouveaux moyens de prévention et de traitement.

PERCEPTIONS OF THE PREPARATION OF EFFECTIVE MIDDLE SCHOOL PRINCIPALS

The primary purpose of this quantitative study was to examine middle school administrators’ perceptions of their preparation programs. The following research questions were addressed as a part of the study: 1. What skills, behaviors, and attitudes do middle school principals perceive to be important to be an effective middle school principal? 2. How do middle school principals perceive their level of preparedness in relation to the specific skills, behaviors, and attitudes? 3. To what degree do middle school principals believe that their level of preparation has influenced them to stay in their current role? 4. Which components of their preparation program do middle principals perceive to be the most valuable? 5. To what extent do middle school principals believe that the school district should design a program specifically to develop middle school principals? Middle school principals were selected to participate in this study. Quantitative data were gathered via online questionnaires. The research questions were addressed through analysis of the questionnaire data, using descriptive and inferential statistics. This study resulted in recommendations to provide a framework for the development of a principal preparation program designed to train effective middle school principals.

Operacionalização do processo de treino no futebol feminino:situações de bola parada no meio campo ofensivo

Relatório de Estágio apresentado para a obtenção do grau de Mestre em Desporto com especialização em Treino Desportivo – Futebol

Methods matter: computational modelling in public health policy and planning

This work is aimed at understanding and unifying information on epidemiological modelling methods and how those methods relate to public policy addressing human health, specifically in the context of infectious disease prevention, pandemic planning, and health behaviour change. This thesis employs multiple qualitative and quantitative methods, and presents as a manuscript of several individual, data-driven projects that are combined in a narrative arc. The first chapter introduces the scope and complexity of this interdisciplinary undertaking, describing several topical intersections of importance. The second chapter begins the presentation of original data, and describes in detail two exercises in computational epidemiological modelling pertinent to pandemic influenza planning and policy, and progresses in the next chapter to present additional original data on how the confidence of the public in modelling methodology may have an effect on their planned health behaviour change as recommended in public health policy. The thesis narrative continues in the final data-driven chapter to describe how health policymakers use modelling methods and scientific evidence to inform and construct health policies for the prevention of infectious diseases, and concludes with a narrative chapter that evaluates the breadth of this data and recommends strategies for the optimal use of modelling methodologies when informing public health policy in applied public health scenarios.

Human Rights Protection and Terrorism – Reflections in the Context of Strasburg Jurisprudence

The phenomenon of terrorism is one of the most asymmetrical, amorphous and hybrid threats to international security. At the beginning of the 21st century, terrorism grew to a pandemic. Ensuring freedom and security of individuals and nations has become one of the priority postulates. Terrorism steps out of all legal and analytic-descriptive standards. An immanent feature of terrorism, e.g. is constant conversion into malicious forms of violence. One of the most alarming changes is a tendency for debasement of essence of law, a state and human rights Assurance of safety in widely accessible public places and in private life forces creation of various institutions, methods and forms of people control. However, one cannot in an arbitrary way limit civil freedom. Presented article stresses the fact that rational and informed approach to human rights should serve as a reference point for legislative and executive bodies. Selected individual applications to the European Court of Human Rights are presented, focusing on those based on which standards regarding protection of human rights in the face of pathological social phenomena, terrorism in particular, could be reconstructed and refined. Strasbourg standards may prove helpful in selecting and constructing new legal and legislative solutions, unifying and correlating prophylactic and preventive actions.

Comunicação de risco em saúde : a importância do eWOM

Os surtos de doenças infeciosas estão atualmente no topo das preocupações relacionadas com riscos de saúde, devido à grande capacidade de disseminação e difusão que as caracteriza e, não menos importante, por causa da eventual possibilidade de evolução dos surtos para o nível de pandemia. A nível global, os Governos e as organizações oficiais de saúde estão empenhados em criar planos para lidar com os riscos de saúde, de forma a mitigar e controlar os efeitos nefastos provocados pelas doenças infeciosas na população. O mundo mudou, devido às novas tecnologias, tornou-se globalmente digital. As pessoas, hoje, têm um novo estatuto, são atores sociais, unidos por laços sociais no seio das redes digitais, dentro das quais, têm acesso a uma vasta panóplia de informação - acerca de assuntos de saúde por exemplo, que flui livremente através da rede e diminui os limites entre o cidadão comum e os profissionais e os peritos acerca dos mais diversos temas. O utilizador atual de internet, é um "prosumer". A tecnologia permite-lhe pesquisar a informação que procura e, adicionalmente, compartilhar e comentar o resultado das suas pesquisas e da sua própria experiência pessoal. No contexto dos riscos de saúde, a comunicação é um elemento preponderante em qualquer estratégia de planeamento de risco. Por sua vez, a internet, os novos media digitais e as redes sociais online, são ferramentas postas à disposição dos consumidores, que lhes possibilitam a procura a partilha e o armazenamento de informação. Em virtude da importância que assume a comunicação nos cenários de crise, no âmbito deste trabalho, centraremos o foco da nossa atenção, nos fenómenos de comunicação, conhecidos por “passa-palavra” e “passa-palavra eletrónico” (WOM e WOM), revelando a sua influência na participação dos consumidores na dinâmica comportamental de partilha de eWOM, dentro do grupo restrito de cada indivíduo (eWOM dentro do grupo). Para produzir o nosso modelo concetual, usaram-se medidas adaptadas de outros construtos retirados da literatura, nomeadamente, “Credibilidade da fonte”; “Credibilidade de informação” e “eWOM Dentro do Grupo”.

From the human rights-based approach to an ecological approach on how to achieve successful inclusion in international disability education

The barriers that people with disabilities face around the world are not only inherent to the limitations resulting from the disability itself, but, more importantly, these barriers rest with the societal technologies of exclusion. Using a mixed methodology approach, I conduct a quest to revealing several societal factors that limit full participation of people with disabilities in their communities, which will contribute to understanding and developing a more comprehensive framework for full inclusion of people with disabilities into the society. First, I conduct a multiple regression analysis to seek whether there is a statistical relationship between the national level of development, the level of democratization, and the level of education within a country’s population on one hand, and expressed concern for and preparedness to improve the quality of life for people of disabilities on another hand. The results from the quantitative methodology reveal that people without disabilities are more prepared to take care of people with disabilities when the level of development of the country is higher, when the people have more freedom of expression and hold the government accountable for its actions, and when the level of corruption is under control. However, a greater concern for the well-being of people with disabilities is correlated with a high level of country development, a decreased value of political stability and absence of violence, a decreased level of government effectiveness, and a greater level of law enforcement. None of the dependent variables are significantly correlated with the level of education from a given country. Then, I delve into an interpretive analysis to understand multiple factors that contribute to the construction of attitudes and practices towards people with disabilities. In doing this, I build upon the four main principles outlined by the United Nations as strongly recommended to be embedded in all international programmes: (1) identification of claims of human rights and the corresponding obligations of governments, hence, I assess and analyze disability rights in education, looking at United Nation, United States, and European Union Perspectives Educational Rights Provisions for People with Disabilities (Ch. 3); (2) estimated capacity of individuals to claim their rights and of governments to fulfill their obligations, hence, I look at the people with disabilities as rights-holders and duty-bearers and discuss the importance of investing in special capital in the context of global development (Ch. 4); (3) programmes monitor and evaluate the outcomes and the processes under the auspices of human rights standards, hence, I look at the importance of evaluating the UN World Programme of Action Concerning People with Disabilities from multiple perspectives, as an example of why and how to monitor and evaluate educational human rights outcomes and processes (Ch. 5); and (4) programming should reflect the recommendations of international human rights bodies and mechanisms, hence, I focus on programming that fosters development of the capacity of people with disabilities, that is, planning for an ecology of disabilities and ecoducation for people with disabilities (Ch. 6). Results from both methodologies converge to a certain point, and they further complement each other. One common result for the two methodologies employed is that disability is an evolving concept when viewed in a broader context, which integrates the four spaces that the ecological framework incorporates. Another common result is that factors such as economic, social, legal, political, and natural resources and contexts contribute to the health, education and employment opportunities, and to the overall well-being of people with disabilities. The ecological framework sees all these factors from a meta-systemic perspective, where bi-directional interactions are expected and desired, and also from a human rights point of view, where the inherent value of people is upheld at its highest standard.