The Pendulum Has Swung: How Do We Ensure a Life Course Approach to Immunisation in Australia?

Rather than concentrating primarily on children and adolescents, there has been a shift in the discourse around immunisation to encompass a whole-of-life approach. Despite this acknowledgement and ongoing high burdens of vaccine preventable diseases in adults, coverage for some adult risk groups remains sub-optimal. This study aimed to explore key informant's and stakeholder's perceptions of factors impacting provision of immunisation programs for Australian adults and to identify strategies to promote acceptance and uptake. Semi-structured telephone interviews were undertaken with people involved in adult immunisation program delivery, advocacy, policy or research between September 2020 and June 2021. Transcripts were inductively analysed, with the resulting themes categorised into the five influences on vaccination gaps that have informed program planning in other countries: Access, Affordability, Awareness, Acceptance and Activation. Participants spoke of improvements in the provision of vaccines to adults, however, ongoing challenges persisted. Participants agreed that the focus or emphasis of policies and the promotion/communication strategies has been on childhood vaccination in Australia, however there is a sense that the “pendulum has swung.” These included understanding of eligibility amongst the Australian population and the reluctance of some health providers to dedicate time to exploring immunisation needs with adult patients. In comparison to the childhood vaccination program, there has been a lack of data available on coverage for adult vaccines on the national immunisation program. This has contributed to the ongoing challenges of identifying and promoting certain vaccines. At a government level, questions were raised about why the Australian government has never set an aspirational target for adult vaccination (i.e., influenza or pneumococcal) coverage. While significant improvements have been made in adult immunisation uptake, there are still gaps across the program. While the system remains under stress because of the COVID-19 pandemic, it is not appropriate to implement any additional programs. There needs to be strong commitment to establish the value of adult vaccination in the eyes of community members, policy makers and healthcare professionals. Having a national adult immunisation strategic plan would help advance action

The association between acute flaccid myelitis (AFM) and enterovirus D68 (EV-D68) – what is the evidence for causation?

© 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved. Background: Enterovirus D68 (EV-D68) has historically been a sporadic disease, causing occasional small outbreaks of generally mild infection. In recent years, there has been evidence of an increase in EV-D68 infections globally. Large outbreaks of EV-D68, with thousands of cases, occurred in the United States, Canada and Europe in 2014. The outbreaks were associated temporally and geographically with an increase in clusters of acute flaccid myelitis (AFM). Aims: We aimed to evaluate a causal association between EV-D68 and AFM. ?Methods: Using data from the published and grey literature, we applied the Bradford Hill criteria, a set of nine principles applied to examine causality, to evaluate the relationship between EV-D68 and AFM. Based on available evidence, we defined the Bradford Hill Criteria as being not met, or met minimally, partially or fully. Results: Available evidence applied to EV-D68 and AFM showed that six of the Bradford Hill criteria were fully met and two were partially met. The criterion of biological gradient was minimally met. The incidence of EV-D68 infections is increasing worldwide. Phylogenetic epidemiology showed diversification from the original Fermon and Rhyne strains since the year 2000, with evolution of a genetically distinct outbreak strain, clade B1. Clade B1, but not older strains, is associated with AFM and is neuropathic in animal models. Conclusion: While more research is needed on dose–response relationship, application of the Bradford Hill criteria supported a causal relationship between EV-D68 and AFM

Biogeochemical and Optical Analysis of Coastal DOM for Satellite Retrieval of Terrigenous DOM in the U.S. Middle Atlantic Bight

Estuaries and coastal ocean waters experience a high degree of variability in the composition and concentration of particulate and dissolved organic matter (DOM) as a consequence of riverine/estuarine fluxes of terrigenous DOM, sediments, detritus and nutrients into coastal waters and associated phytoplankton blooms. Our approach integrates biogeochemical measurements (elemental content, molecular analyses), optical properties (absorption) and remote sensing to examine terrestrial DOM contributions into the U.S. Middle Atlantic Bight (MAB). We measured lignin phenol composition, DOC and CDOM absorption within the Chesapeake and Delaware Bay mouths, plumes and adjacent coastal ocean waters to derive empirical relationships between CDOM and biogeochemical measurements for satellite remote sensing application. Lignin ranged from 0.03 to 6.6 ug/L between estuarine and outer shelf waters. Our results demonstrate that satellite-derived CDOM is useful as a tracer of terrigenous DOM in the coastal ocea

Influenza and pneumococcal vaccination in Australian adults: A systematic review of coverage and factors associated with uptake

© 2016 The Author(s). Background: In the absence of an adult vaccination register, coverage estimates for influenza and pneumococcal vaccination come from surveys and other data sources. Methods: Systematic review and meta-analysis of studies examining vaccination coverage in Australian adults from 1990 to 2015, focusing on groups funded under the National Immunisation Program, and intervals prior to and following the introduction of universal funding. Results: Twenty-two studies met the inclusion criteria; 18 used self-report to determine vaccination status. There were 130 unique estimates of coverage extracted. Among adults aged ≥65y, during the period of universal funding (1999-onwards), the summary estimate of annual influenza vaccination coverage from 27 point estimates was 74.8 % (95 % CI 73.4-76.2 %; range 63.9-82.4 %); prior to this period (1992-1998) from 10 point estimates it was 61.3 % (95 % CI 58.0-64.6 %; range 44.3-71.3 %). For the period of universal funding for pneumococcal vaccination (2005-onwards) the summary estimate for coverage was 56.0 % (95 % CI 53.2-58.8 %; range 51.2-72.8 %, 10 point estimates); prior to 2005 it was 35.4 % (95 % CI 18.8-52.0 %; range 15.4-45.2 %). Coverage for both vaccines was significantly higher following the introduction of universal funding. Influenza vaccination coverage in those aged 18-65 years with a medical indication was lower but data were not combined. Seven studies reported on Aboriginal Australians with three studies reporting five coverage estimates for influenza vaccination in adults ≥65 years (range 71 % - 89 %). Conclusions: Adult influenza and pneumococcal vaccination coverage has increased since the introduction of universal funding, but remains sub-optimal, with pneumococcal coverage lower than influenza. Implications: This review highlights the need for more coverage data overall and in high risk groups, to support public health programs to improve coverage

An Improved Model for Dynamin Assembly Revealed by Cryo-EM

Continua com: Avaluació de la qualitat de l'aire a la ciutat de Barcelon

Water molecules in the antibody朼ntigen interface of the structure of the Fab HyHEL-5杔ysozyme complex at 1.7 A? resolution: comparison with results from isothermal titration calorimetry

The structure of the complex between hen egg-white lysozyme and the Fab HyHEL-5 at 2.7 A? resolution has previously been reported [Cohen et al. (1996), Acta Cryst. D52, 315�6]. With the availability of recombinant Fab, the X-ray structure of the complex has been re-evaluated at 1.7 A? resolution. The refined structure has yielded a detailed picture of the Fab� lysozyme interface, showing the high complementarity of the protein surfaces as well as several water molecules within the interface that complete the good fit. The model of the full complex has improved significantly, yielding an Rwork of 19.5%. With this model, the structural results can be compared with the results of isothermal titration calorimetry. An attempt has been made to estimate the changes in bound waters that accompany complex formation and the difficulties inherent in using the crystal structures to provide the information necessary to make this calculation are discussed

Gravitational Wave Bursts from Cosmic Superstring Reconnections

We compute the gravitational waveform produced by cosmic superstring reconnections. This is done by first constructing the superstring reconnection trajectory, which closely resembles that of classical, instantaneous reconnection but with the singularities smoothed out due to the string path integral. We then evaluate the graviton vertex operator in this background to obtain the burst amplitude. The result is compared to the detection threshold for current and future gravitational wave detectors, finding that neither bursts nor the stochastic background would be detectable by Advanced LIGO. This disappointing but anticipated conclusion holds even for the most optimistic values of the reconnection probability and loop sizes.Comment: 26 pages, 6 figures; v2: references added and typos correcte

Фітоценологічна типологія букових лісів Карпатського біосферного заповідника

Carpathian Biosphere Reserve is located in the Transcarpathian region on the south-western macro-slope of the Ukrainian Carpathians. Beech forests on the territory of Carpathian Biosphere Reserve are represented by 16 subformations and 124 associations. The construction of a generalized typological scheme of beech forests of Carpathian Biosphere Reserve on the basis of a dominance classification was carried out by means of graphical visualization of the results of indirect ordination in relation to the distribution of 33 species-dominants of herbal coverage in the context of 16 subformations. The evaluation of complex environmental gradients that determine the structure and direction of variation of forest vegetation was performed on the basis of Detrended Correspondence Analysis (DCA). To interpret the axes of ordination, the correlation of species coordinates with their environmental parameters on Ellenberg's ecological scales was determined. Organizing phytocoenological data on the basis of Detrended Correspondence Analysis allows executing a geometric interpretation of phytocoenological data and presents a dominance classification in the form of a typological scheme. The phytocoenological typological scheme of beech forests of Carpathian Biosphere Reserve can be represented as a hexagon, in the centre of which there is the subformation of Fageta (sylvaticae), and in the corners are as follows: 1) Carpineto (betuli)-Fageta (sylvaticae), Fraxineto (excelsioris)-Fageta (sylvaticae) 2) Abieto (albae)-Piceeto (abietis)-Fageta (sylvaticae), Piceeto (abietis)-Abieto (albae)-Fageta (sylvaticae) 3) Piceeto (abietis)-Fageta (sylvaticae) 4) Sorbeto (aucupariae)-Fageta (sylvaticae) 5) Querceto (petraeae)-Fageta (sylvaticae) 6) Fraxineto (excelsioris)-Ulmeto (glabrae)-Fageta (sylvaticae), Querceto (roboris)-Fageta (sylvaticae). In a three-dimensional space, the typological scheme has the form of a hexagonal pyramid, on the top of which there are the subformations Acereto (pseudoplatani)-Fraxineto (excelsioris)-Fageta (sylvaticae) and Ulmeto (glabrae)-Fageta (sylvaticae).Конструювання фітоценологічної типологічної схеми букових лісів Карпатського біосферного заповідника на основі домінантної класифікації здійснено способом графічної візуалізації результатів непрямої ординації щодо розподілу 33 видів-домінантів трав'яного покриву в розрізі 16 субформацій. Оцінку комплексних градієнтів середовища, які визначають структуру і напрямок варіювання лісової рослинності, виконано на основі аналізу відповідностей із видаленим трендом (DCA, Detrended Correspondence Analysis). Для інтерпретації осей ординації визначено кореляцію координат видів з їх екологічними параметрами за екологічними шкалами Г. Елленберга. Фітоценологічну типологічну схему букових лісів Карпатського біосферного заповідника можна представити у вигляді шестикутника, у центрі якого розташована субформація Fageta (sylvaticae), а в кутах: 1) Carpineto (betuli)-Fageta (sylvaticae), Fraxineto (excelsioris)-Fageta (sylvaticae); 2) Abieto (albae)-Piceeto (abietis)-Fageta (sylvaticae), Piceeto (abietis)-Abieto (albae)-Fageta (sylvaticae); 3) Piceeto (abietis)-Fageta (sylvaticae); 4) Sorbeto (aucupariae)-Fageta (sylvaticae); 5) Querceto (petraeae)-Fageta (sylvaticae); 6) Fraxineto (excelsioris)-Ulmeto (glabrae)-Fageta (sylvaticae), Querceto (roboris)-Fageta (sylvaticae). У тривимірному просторі типологічна схема має вигляд шестикутної піраміди, на вершині якої розташовані субформації Acereto (pseudoplatani)-Fraxineto (excelsioris)-Fageta (sylvaticae) і Ulmeto (glabrae)-Fageta (sylvaticae)