Suchergebnisse

This book examines the process of Spanish integration into the European Community, from 1962 when Spain under the Franco regime applied to the European Community to 1985, when democratic Spain became a member of the EEC. It aims to prove that, first the European Community was the crucial external factor determining political change in Spain, and secondly that Europeanism was a mechanism of political change, as it was the only aim which unified the whole political spectrum from the Francoist establishment to the democratic opposition.

Infectious diseases are caused by pathogenic micro-organisms which can be bacteria, viruses, parasites or fungi. The diseases can be spread through many different routes, either directly or indirectly. Military personnel are at high risk of contracting infections, in particular vector-borne and zoonotic infections, during overseas deployments, where they may be exposed to endemic or emerging infections to which they do not have immunity. Additionally, overcrowded settings with poor sanitation are high risks for disease. Genomics is having a transformational impact on medicine. It is enabling advances in accurate diagnosis of infectious disease, development of effective and targeted treatment strategies and opportunities to assess pathogenicity. Further, it supports the detection, surveillance of infectious diseases, the development and assessment of vaccines, as well as the assessment and prediction of anti-microbial resistance. These capabilities are all key military needs to protect personnel in this inter-connected world. The advances in sequencing technologies have resulted in an explosion of genomic data. However, making sense of genomic data requires advances in computational analysis technologies together with crossdisciplinary scientific approaches, skill sets and people. There are extensive reference databases of genomic data. One such open access database is PubMLST.org: it contains well curated genomes for more than 100 microbial species and genera integrated with provenance and phenotype information. All levels of sequence data, from single gene sequences up to and including complete, finished genomes can be accessed on this platform. This data is, however, both large and complex and intractable to analyse and understand using traditional analysis tools. This paper will discuss the challenges of analysing such genomic data for bacterial infections and consider the application of bioinformatics tools and techniques to analyse and communicate microbial genomic data in healthcare.

Introduction: Invasive meningococcal disease is uncommon but associated with a high-case fatality rate. Carriage prevalence of the causative bacteria, Neisseria meningitidis, is high in adolescents. A large (n=34 500) cluster randomised controlled trial (RCT) to assess the impact of a meningococcal B (MenB) vaccine on meningococcal carriage was implemented in the state of South Australia (SA) for year 10, 11 and 12 senior school students in 2017–2018. This study will assess the impact of MenB vaccine (4CMenB) on carriage prevalence in school leavers in SA, 1 and 2 years after implementation of the cluster RCT in adolescents. Measuring the impact of population programmes on carriage can assist in informing future meningococcal immunisation programmes such as targeted age groups and use of catch-up campaigns.Methods and analysis: This repeat cross-sectional study will assess carriage prevalence in 2018 and 2019. All school leavers who attended year 12 in any school in SA in 2018 or 2019 will be invited to participate in this study. An oropharyngeal swab will be taken from each participating student and a risk factor questionnaire completed by the student following informed consent. Students will attend clinics at SA universities, technical colleges, and metropolitan, rural and remote government council clinics. Confirmed vaccination history will allow a comparison in carriage prevalence between vaccinated and unvaccinated school leavers. A sample size of 4096 students per year will provide 80% power to detect a 20% difference in carriage prevalence of disease-causing meningococci (defined as genogroup A, B, C, W, X or Y) between years.Ethics and dissemination: The study was approved by the Women's and Children's Health Network Human Research Ethics Committee. Results will be published in international peer review journals and presented at national and international conferences.