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Larson H.J.,London School of Hygiene and Tropical Medicine | Jarrett C.,London School of Hygiene and Tropical Medicine | Schulz W.S.,London School of Hygiene and Tropical Medicine | Zhou Y.,Chinese Center for Disease Control | And 15 more authors.
Vaccine | Year: 2015

In March 2012, the SAGE Working Group on Vaccine Hesitancy was convened to define the term "vaccine hesitancy", as well as to map the determinants of vaccine hesitancy and develop tools to measure and address the nature and scale of hesitancy in settings where it is becoming more evident. The definition of vaccine hesitancy and a matrix of determinants guided the development of a survey tool to assess the nature and scale of hesitancy issues. Additionally, vaccine hesitancy questions were piloted in the annual WHO-UNICEF joint reporting form, completed by National Immunization Managers globally. The objective of characterizing the nature and scale of vaccine hesitancy issues is to better inform the development of appropriate strategies and policies to address the concerns expressed, and to sustain confidence in vaccination. The Working Group developed a matrix of the determinants of vaccine hesitancy informed by a systematic review of peer reviewed and grey literature, and by the expertise of the working group. The matrix mapped the key factors influencing the decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine-specific. These categories framed the menu of survey questions presented in this paper to help diagnose and address vaccine hesitancy. © 2015.

Eskola J.,Finnish National Institute for Health and Welfare | Duclos P.,World Health Organization | Schuster M.,World Health Organization | MacDonald N.E.,Dalhousie University | And 11 more authors.
Vaccine | Year: 2015

Based on the concerns about vaccine hesitancy and its impact on vaccine uptake rates and the performance of national immunization programmes, the Strategic Advisory Group of Experts (SAGE) on Immunization Working Group on Vaccine Hesitancy [1], carried out a review, and proposed a set of recommendations directed to the public health community, to WHO and its partners, and to the World Health Organization (WHO) member states. The final recommendations issued by SAGE in October 2014 fall into three categories: (1) those focused on the need to increase the understanding of vaccine hesitancy, its determinants and the rapidly changing challenges it entails; (2) those focused on dealing with the structures and organizational capacity to decrease hesitancy and increase acceptance of vaccines at the global, national and local levels; (3) and those focused on the sharing of lessons learnt and effective practices from various countries and settings as well as the development, validation and implementation of new tools to address hesitancy. © 2015.

Padma A.,VSB Engineering College | Giridharan N.,Dal Housie University
International Journal of Imaging Systems and Technology | Year: 2016

A computer software system is designed for the segmentation and classification of benign and malignant tumor slices in brain computed tomography images. In this paper, we present a texture analysis methods to find and select the texture features of the tumor region of each slice to be segmented by support vector machine (SVM). The images considered for this study belongs to 208 benign and malignant tumor slices. The features are extracted and selected using Student's t-test. The reduced optimal features are used to model and train the probabilistic neural network (PNN) classifier and the classification accuracy is evaluated using k fold cross validation method. The segmentation results are also compared with the experienced radiologist ground truth. Quantitative analysis between ground truth and segmented tumor is presented in terms of quantitative measure of segmentation accuracy and the overlap similarity measure of Jaccard index. The proposed system provides some newly found texture features have important contribution in segmenting and classifying benign and malignant tumor slices efficiently and accurately. The experimental results show that the proposed hybrid texture feature analysis method using Probabilistic Neural Network (PNN) based classifier is able to achieve high segmentation and classification accuracy effectiveness as measured by Jaccard index, sensitivity, and specificity. © 2016 Wiley Periodicals, Inc.

Dube E.,Institute National Of Sante Publique Du Quebec | Gagnon D.,Institute National Of Sante Publique Du Quebec | MacDonald N.E.,Dalhousie University | MacDonald N.E.,Dal Housie University | And 12 more authors.
Vaccine | Year: 2015

When faced with vaccine hesitancy, public health authorities are looking for effective strategies to address this issue. In this paper, the findings of 15 published literature reviews or meta-analysis that have examined the effectiveness of different interventions to reduce vaccine hesitancy and/or to enhance vaccine acceptance are presented and discussed. From the literature, there is no strong evidence to recommend any specific intervention to address vaccine hesitancy/refusal. The reviewed studies included interventions with diverse content and approaches that were implemented in different settings and targeted various populations. Few interventions were directly targeted to vaccine hesitant individuals. Given the paucity of information on effective strategies to address vaccine hesitancy, when interventions are implemented, planning a rigorous evaluation of their impact on vaccine hesitancy/vaccine acceptance will be essential. © 2015.

Goldstein S.,University of Witwatersrand | Goldstein S.,Soul City Institute for Health and Develop ment Communication | MacDonald N.E.,Dalhousie University | MacDonald N.E.,Dal Housie University | And 12 more authors.
Vaccine | Year: 2015

Health communication is an evolving field. There is evidence that communication can be an effective tool, if utilized in a carefully planned and integrated strategy, to influence the behaviours of populations on a number of health issues, including vaccine hesitancy. Experience has shown that key points to take into account in devising and implementing a communication plan include: (i) it is necessary to be proactive; (ii) communication is a two-way process; (iii) knowledge is important but not enough to change behaviour; and (iv) communication tools are available and can be selected and used creatively to promote vaccine uptake. A communication strategy, incorporating an appropriate selection of the available communication tools, should be an integral part of every immunization programme, addressing the specific factors that influence hesitancy in the target populations. © 2015.

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