Using mathematical models to evaluate and inform immunisation strategies with MenAfriVac in the African meningitis belt

The countries of the African meningitis belt suffer from frequent epidemics due to meningococcal meningitis. The introduction of a tailor-made vaccine, known as MenAfriVac, in these countries through mass campaigns of 1-29 year olds has led to a remarkable decline in the burden of disease due to Neisseria meningitides serogroup A. The aim of this work is to identify immunisation strategies with MenAfriVac that best sustain population protection in the long-term and predict vaccine impact across all 26 meningitis belt countries. Firstly, I developed an age-structured transmission dynamic model to explore the impact of a range of different immunisation schedules. Numerical simulations of the model show a period of very low incidence following MenAfriVac introduction, while strong resurgence is predicted in the absence of any long-term immunisation strategy. Of the strategies considered, the introduction of the vaccine into the Expanded Programme on Immunisation at 9 months, 5 years after the initial campaign, together with a mini catch-up campaign resulted in the lowest average annual incidence. Next, my model is compared to an existing model, published two years earlier through a model comparison exercise. The comparison exercise identified a number of errors in the other study which explained the different predictions made by the two models and also led to a correction to the original study being published by the authors. As part of the Vaccine Impact Modelling Consortium, the model was adapted and used to provide estimates on the impact of MenAfriVac on disease incidence for the 26 countries of the meningitis belt under the current schedule of each country. The model consists of 100 age groups and keeps track of the number of cases, deaths and Disability Adjusted Life Years (DALYs) for each age group per year for the period 2010-2100. Assuming that the current schedule continues unchanged until 2100, the model predicts that more than 9 million cases will be prevented in total across all 26 countries. Further, the routine immunisation of school-age children is simulated as an alternative strategy to better understand the role of vaccine induced protection, as new data suggest that antibody response is short-lived when children under the age of two years are vaccinated. Assuming that vaccine protection lasts longer for individuals targeted after the age of five years, model simulations suggest that vaccination of older children would be more efficient in reducing the disease incidence and would also result in a smaller number of people needed to vaccinate to prevent one case. The main conclusion of this work is that sustained use of MenAfriVac is essential to maintain high levels of direct and indirect population protection. Results from this thesis have been used to inform the current immunisation strategy in the countries of the African meningitis belt. Assuming that vaccine duration is shorter for children less than 5 years old, it may be wiser to change the age of routine immunisation and target older children instead. This conclusion can be useful in the near future to inform strategies which will include the new pentavalent vaccine

Encouraging urban planning and development practice to contribute to sustainable development. A methodology and a use case

One of the most complex challenges the tourism industry faces is keeping up to date with information technology developments caused by the globalisation of information and advances in technology. The development of robust decision support systems for tourism land use planning is a way to address this challenge.This paper demonstrates how a spatial decision support system (SDSS), called the Land Use Decision sUpport System (LUDUS), can contribute in allocating complex forms of tourism. The system combines an artificial intelligence technique, called ontologies, with Geographic Information Systems and object-oriented programming to support decision-making in spatial planning. The system consists of two subsystems: the Insert Data Subsystem and the Graphic Imaging and Decision Support Subsystem. The core of the system is an ontology that is aligned to a standard of the Open Geospatial Consortium, called Geosparql.The case study of this paper is the Mastichochoria area of Chios Island, Greece. Therefore, the structure of the ontology was modelled according to the provisions of Greek legislation. The results produced confirmed the correct coding and application of the system’s criteria. The validity, accuracy and reliability of the results were also confirmed.The adopted approach facilitates the identification of alternative options for allocating, among other land use types, complex forms of tourism development in suburban areas, by examining the provisions of the legal framework as well as their geology and terrain

Bullying in ages 4-7; Teachers & school environment’s intervention in the Greek context

This piece of research is a case study that investigates the intervention of teachers and the school’s environment as far as bullying is concerned. The children that were observed attend a multicultural school in Athens. A review of the current literature in Greece and in the United Kingdom formed the basis for the offered description and analysis of the phenomenon. This paper examines the essential definitions of bullying, victim and bully. Moreover, in this research a range of forms of bullying, reasons for and potential intervention strategies are presented. Triangulation method was applied. Being more specific, a systematic observation of sixty three children from four to seven years old; an interview that contained twelve open-ended questions, divided in three categories, namely knowledge, intervention and teaching methods; and finally reasons that may justify any form of bullying. Six teachers who work in the same school that children attend were interviewed, in order to enlighten the findings of the observation. This research was brought to a conclusive end with a proposal for school bullying intervention strategies. Nevertheless, these results offer a wide range of intervention strategies in order to protect children from acting as bullies and become victims

Understanding the Role of Duration of Vaccine Protection with MenAfriVac: Simulating Alternative Vaccination Strategies.

We previously developed a transmission dynamic model of Neisseria meningitidis serogroup A (NmA) with the aim of forecasting the relative benefits of different immunisation strategies with MenAfriVac. Our findings suggested that the most effective strategy in maintaining disease control was the introduction of MenAfriVac into the Expanded Programme on Immunisation (EPI). This strategy is currently being followed by the countries of the meningitis belt. Since then, the persistence of vaccine-induced antibodies has been further studied and new data suggest that immune response is influenced by the age at vaccination. Here, we aim to investigate the influence of both the duration and age-specificity of vaccine-induced protection on our model predictions and explore how the optimal vaccination strategy may change in the long-term. We adapted our previous model and considered plausible alternative immunization strategies, including the addition of a booster dose to the current schedule, as well as the routine vaccination of school-aged children for a range of different assumptions regarding the duration of protection. To allow for a comparison between the different strategies, we use several metrics, including the median age of infection, the number of people needed to vaccinate (NNV) to prevent one case, the age distribution of cases for each strategy, as well as the time it takes for the number of cases to start increasing after the honeymoon period (resurgence). None of the strategies explored in this work is superior in all respects. This is especially true when vaccine-induced protection is the same regardless of the age at vaccination. Uncertainty in the duration of protection is important. For duration of protection lasting for an average of 18 years or longer, the model predicts elimination of NmA cases. Assuming that vaccine protection is more durable for individuals vaccinated after the age of 5 years, routine immunization of older children would be more efficient in reducing disease incidence and would also result in a fewer number of doses necessary to prevent one case. Assuming that elimination does not occur, adding a booster dose is likely to prevent most cases but the caveat will be a more costly intervention. These results can be used to understand important sources of uncertainty around MenAfriVac and support decisions by policymakers

Bio-based products and applications potential

As the current model of production and consumption which largely relies on fossil-based resources impacts irreversibly on the environment and the availability of natural resources is approaching a peak soon, significant steps are being taken around the world to move from today’s fossil based economy to a more sustainable economy based on biomass. A key factor in the realisation of a successful bio-based economy is the production of a range of bio-based products and bioenergy to substitute their fossil-derived equivalents by processing a wide variety of biological feedstock. The total European Bioeconomy amounts to a 2.1 trillion EUR turnover and provides 18.3 million jobs, which accounts for approximately 9% of the total EU workforce 1. The EU has declared the bio-based products sector to be a priority area with high potential for future growth, reindustrialisation, and addressing societal challenges. Ιn this report, a review of the application areas and market penetration of the following bio-based market segments is attempted, along with an assessment of possible barriers to uptake and growth and future trends that characterize each specific sector: Bio-based chemicals and building blocks; Bioenergy and biofuels; Bioplastics/ biomaterials; Bio-based food and feed ingredients; Biosurfactants; Biolubricants. This analysis was made following a review of relevant literature and based on several qualitative interviews with key stakeholders in the bio-based production domain. Additionally, information about the supply chains of bio-based products (relating to biomass feedstock used, processes and biorefineries) and about existing legislation and policy framework is presented

Αξιολόγηση του επιπέδου γνώσεων των σχολικών νοσηλευτών σχετικά με τις πρώτες βοήθειες και τη διαχείρισή τους στο οδοντικό τραύμα στην Ελλάδα

Εισαγωγή: O σχολικός νοσηλευτής είναι αυτός που θα πρέπει άμεσα και με ψυχραιμία να διαχειριστεί τον τραυματισμό ή το περιστατικό υγείας και να προβεί στις απαραίτητες ενέργειες για την προετοιμασία και την φροντίδα του ασθενούς μέχρι να τον παραδώσει στον θεράποντα ιατρό. Υλικό και μεθοδολογία: Στην παρούσα έρευνα διερευνάται το επίπεδο γνώσεων των σχολικών νοσηλευτών στην Ελλάδα σχετικά με τις πρώτες βοήθειες και τη διαχείρισή τους στις οδοντιατρικές τραυματικές βλάβες. Για την κάλυψη των ερευνητικών ερωτημάτων διεξήχθη ποσοτική έρευνα σε 158 σχολικούς νοσηλευτές ώστε να αξιολογηθεί το επίπεδο γνώσεων και ενημέρωσης σχετικά με το οδοντικό τραύμα. Αποτελέσματα: Από τους 158 συμμετέχοντες, 77 (48,7%) είχε ενημερωθεί στο παρελθόν σχετικά με το οδοντικό τραύμα και 82 (51,9%) είχε αντιμετωπίσει στο παρελθόν περιστατικό οδοντικού τραύματος σε παιδί στο σχολείο. H συνολική γνώση των συμμετεχόντων αξιολογήθηκε κατά μέσο όρο 59,56, τιμή που υποδηλώνει μέτρια προς υψηλά επίπεδα. Η μέση τιμή της συνολικής γνώσης των συμμετεχόντων που είχαν οποιαδήποτε ενημέρωση στο παρελθόν σχετικά με το οδοντικό τραύμα, η μέση τιμή της συνολικής γνώσης των συμμετεχόντων που είχαν αντιμετωπίσει στο παρελθόν περιστατικό οδοντικού τραύματος σε παιδί στο σχολείο και η μέση τιμή των ατόμων που πιστεύουν ότι μπορούν να βοηθήσουν ένα παιδί σε περίπτωση οδοντικού τραύματος ήταν στατιστικά μεγαλύτερες από τις αντίστοιχες όσων δεν είχαν (p <0,001). Συμπεράσματα: Η συνεχής εκπαίδευση και η εξειδικευμένη κατάρτιση των σχολικών νοσηλευτών κρίνονται απαραίτητα για να βελτιωθεί το επίπεδο γνώσεών τους, ώστε να αντιμετωπίζουν αποτελεσματικά περιστατικά οδοντικού τραύματος.Introduction: The school nurse is the one who should immediately and calmly manage the injury or health incident and take the necessary steps to prepare and care for the patient until he or she is delivered to the treating physician. Material and methodology: Current research investigates the level of knowledge of school nurses in Greece about first aid and their management in dental trauma injuries. To cover the research questions, a survey was conducted on 158 school nurses to assess the level of knowledge and information about dental trauma. Results: Of the 158 participants, 77 (48.7%) had previously been informed about dental trauma and 82 (51.9%) had previously experienced a case of dental trauma in a child at school. The total knowledge of the participants was evaluated on average 59.56, a value that indicates moderate to high levels. Average value of total knowledge of participants who had any previous information about dental trauma, mean value of total knowledge of participants who had a case of dental injury in a child at school, and average value of individuals who thought they could help a child in case of dental trauma were statistically greater than those who did not (p <0.001). Conclusions: Continuous education and specialized training of school nurses are considered necessary in order to improve their level of knowledge and deal effectively with dental trauma cases

Over The Top services in Long Term Evolution networks: The Quality of Experience perspective

Τη σημερινή εποχή, με τη συνεχή αύξηση του πλήθους των υπηρεσιών που βασίζονται στο Internet και τα πολυμέσα, δίνεται ολοένα και πιο μεγάλη έμφαση στo σχεδιασμό δικτύων τα οποία μπορούν να υποστηρίξουν αυτές τις υπηρεσίες με επαρκή ποιότητα υπηρεσίας. Στα δίκτυα κινητής τηλεφωνίας παρατηρείται μία ραγδαία μετάβαση από την ανάγκη για μέτρηση της ποιότητας υπηρεσίας QoS στην ανάγκη για εκτίμηση της ποιότητας εμπειρίας του χρήστη QoE. Προς αυτή την κατεύθυνση, η παρούσα διπλωματική επικεντρώνεται στη μελέτη της έννοιας QoE και στην εκτίμησή της, με τη βοήθεια προσομοιωτών του δικτύου και την ανάλυση αποτελεσμάτων σε ρεαλιστικά παραδείγματα προσομοίωσης. Αρχικά, παρουσιάζεται η αρχιτεκτονική του LTE-A συστήματος και οι βασικές έννοιες αυτού οι οποίες σχετίζονται με τη λειτουργία του δικτύου και είναι υπεύθυνες για την εξασφάλιση της αναμενόμενης ποιότητας εμπειρίας στον χρήστη. Έπειτα περιγράφεται η έννοια του QoS και πώς μπορεί μέσα από τις μονάδες του LTE-A δικτύου (bearers), να διαφοροποιηθεί ως προς επιλεγμένους παρόχους (OTT Over The Top Providers). Στη συνέχεια, περιγράφεται ο προσομοιωτής NS3 και η μελέτη της απόδοσης των σεναρίων προσομοίωσης για την LTE-A τεχνολογία δικτύωσης. Τέλος, παρουσιάζεται το εργαλείο QoE Monitor, το οποίο έχει δημιουργηθεί στα πλαίσια του NS3 προσομοιωτή για να προβλέψει την ποιότητα του βίντεο ή του ήχου έτσι όπως γίνεται αντιληπτός στον τελικό χρήστη μέσω αντικειμενικών μετρήσεων. Για την εξαγωγή αποτελεσμάτων QoE παρουσιάζονται δύο πραγματικά σενάρια προσομοίωσης με διαφορετικά είδη τοπολογίας δικτύου στα οποία διασταυρώνεται κίνηση.Nowadays, due to the continuous increase in Internet-based multimedia services, there is placed great emphasis in the design of networks that can support those services with adequate quality of service. In mobile networks, there has been observed a rapid transition from having the need to measure the Quality of Service to assess the user’s Quality of Experience. Due to this fact, this thesis focuses on the concept and the assessment of the QoE, with the aid of network simulators by demonstrating results of the analysis in realistic simulation examples. Initially, the architecture of the LTE-A system is presented and its’ basic concepts related to the networks’ operation, in order to guarantee the user’s expected quality of experience. Then, the QoS (Quality of Service) is described and how it can be differentiated for selected providers (OTT( Over The Top Providers)). Next, NS3 simulator is described as well as some scenarios that test the performance of the LTE-A networking technology. Finally, the QoE Monitor tool is shown, which has been created, within the NS3 simulator, to predict through objective measurements the quality of the video or audio as it is perceived by the end user. To export simulation results, user experience is examined on two real scenarios of cross traffic on different network topologies

Η επαγγελματική εξουθένωση στους εκπαιδευτικούς της πρωτοβάθμιας εκπαίδευσης

Το επάγγελμα του εκπαιδευτικού κατέχει μια από τις πιο υψηλές θέσεις ,ανάμεσα σε άλλα «στρεσογόνα» επαγγέλματα. Η επαγγελματική εξουθένωση(Burnout Syndrome) είναι ένα σύνδρομο σωματικής και ψυχικής εξάντλησης. Ο εκπαιδευτικός κυριεύεται από συναισθήματα άγχους, έλλειψη ενδιαφέροντος και θετικών αισθημάτων για τους μαθητές του, διαμορφώνει αρνητική εικόνα για τον εαυτό του και αδυνατεί να αντιμετωπίσει τα προβλήματα που ανακύπτουν κατά την εκπαιδευτική διαδικασία. Η επαγγελματική εξουθένωση στο επάγγελμα των εκπαιδευτικών πρέπει να προλαμβάνεται και να αντιμετωπίζεται άμεσα, αφού η παραγωγή έργου είναι ιδιαίτερα σημαντική, καθώς συνδέεται με την απόκτηση και βελτίωση των γνώσεων των μαθητών. Σκοπός της παρούσας εργασίας είναι η διερεύνηση του συνδρόμου της επαγγελματικής εξουθένωσης των εκπαιδευτικών που υπηρετούν σήμερα στην Πρωτοβάθμια Εκπαίδευση. Στην παρούσα έρευνα, πέρα από την απάντηση του κεντρικού ερωτήματος, εάν δηλαδή οι Έλληνες δάσκαλοι πάσχουν από τη «νόσο» της επαγγελματικής εξουθένωσης, ιδιαίτερο ενδιαφέρον παρουσιάζει και η σχέση της επαγγελματικής εξουθένωσης με τα δημογραφικά στοιχεία που μελετούνται.The vocation of teachers is considered as one of the most stressful professions. The Burnout Syndrome is a syndrome of physical and mental exhaustion. A teacher is seized by a sense of stress, lack of interest and positive feelings for his/her students, while he/she molds a negative impression about himself/herself and cannot face the issues derive during the teaching process. Considering the importance of the teaching process and its correlation with the acquisition and improvement of the students’ knowledge, the Burnout Syndrome in teachers, must be prevented and counteracted immediately. The objective of this thesis, is to investigate the Burnout Syndrome of elementary education teachers. In the present research, apart from the answer to the main question -if the Greek Teachers are suffering by the Burnout Syndrome- it is also investigated the correlation between the Burnout Syndrome and the demographics