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Associations of peak shifts in age--prevalence for human malarias with bednet coverage.

Effects of bednet coverage (C) on prevalence of malaria were analysed using data from 1990-92 from 9 Papua New Guinean villages. Effects of coverage varied by age, resulting in a shift in age of peak prevalence from 4.7 (C = 0%) to 11.6 (C = 100%) years for Plasmodium falciparum, from 3.4 to 4.9 years for P. vivax and from 11.0 to 16.8 years for P. malariae. In small areas with no bednets the age distribution of P. falciparum parasitaemia was like that of a holoendemic area. Where coverage was complete the pattern corresponded to mesoendemicity. Thus, protracted use of bednets can result in profound changes in the endemicity of malaria even when coverage is incomplete and without insecticide treatment. Average entomological inoculation rates (EIRs) estimated from indoor landing rates on individuals without bednets were 35, 12 and 10 infectious bites per person per annum for P. falciparum, P. vivax and P. malariae, respectively. Logistic regression analyses indicated that the EIR estimate for P. falciparum was related to prevalence of this species independently of effects of bednet coverage. However, the recent EIR still accounted for much less variation than did the bednets. A similar pattern was seen for P. malariae, while there were no significant relationships between the recent EIR and the parasite positivity for P. vivax. It is concluded that short-term variations in inoculation rate are not important determinants of parasite prevalence in this population.

Adolescent↗
PubMed2006

Countdown to 2015: tracking intervention coverage for child survival.

BACKGROUND: The fourth Millennium Development Goal (MDG) calls for a two-thirds' reduction between 1990 and 2015 in deaths of children younger than five years; achieving this will require widespread use of effective interventions, especially in poor countries. We present the first report of the Child Survival Countdown, a worldwide effort to monitor coverage of key child-survival interventions in 60 countries with the world's highest numbers or rates of child mortality. METHODS: In 2005, we developed a profile for each of the 60 countries to summarise information on coverage with essential child survival interventions. The profiles also present information on demographics, nutritional status, major causes of death in children under 5 years of age, and the status of selected health policies. Progress toward the fourth MDG is summarised by comparing the average annual rate of reduction in under-5 mortality in each country with that needed to achieve the goal. The profiles also include a comparison of the proportions of children in the poorest and richest quintiles of the population who received six or more essential prevention interventions. Each country's progress (as measured by defined indicators of intervention coverage) was put into one of three groups created on the basis of international targets: "on track"; "watch and act"; and "high alert". For indicators without targets, arbitrary thresholds for high, middle, and low performance across the 60 countries were used as a basis for categorisation. FINDINGS: Only seven countries are on track to met MDG-4, 39 countries are making some progress, although they need to accelerate the speed, and 14 countries are cause for serious concern. Coverage of the key child survival interventions remains critically low, although some countries have made substantial improvements in increasing the proportion of mothers and children with access to life saving interventions by as much as ten percentage points in 2 years. Children from the poorest families were less likely than those from wealthier families to have received at least six essential prevention interventions. INTERPRETATION: Our results show that tremendous efforts are urgently needed to achieve the MDG for child survival. Profiles for each country show where efforts need to be intensified, and highlight the extent to which prevention interventions are being delivered equitably and reaching poor families. This first report also shows country-specific improvements in coverage and highlights missed opportunities. The "Countdown to 2015" will report on progress every 2 years as a strategy for increasing accountability worldwide for progress in child survival.

Child Mortality↗
PubMed2002

Influenza and pneumococcal vaccination in Scottish nursing homes: coverage, policies and reasons for receipt and non-receipt of vaccine.

A national survey was carried out to determine the coverage of influenza and pneumococcal vaccines, policies, reasons for receipt, non-receipt of vaccine and strategies to improve vaccine coverage in Scottish nursing homes. Of the 550 nursing homes, 72% (394) participated in the study. Overall coverage was 85% for influenza vaccine in 2001-2002 season and 11% for pneumococcal vaccine in the last 5-year period. Only 6% (23/394) of homes were reported to have a systematic immunization record. The most frequently stated reasons for improved coverage of both vaccines were clear immunization policies (76%), awareness and education for staff and residents (68%), and consent on behalf of the incompetent residents (66%). The presence of vaccination policies was higher for influenza vaccine than pneumococcal vaccine expressed as verbal agreement (27% versus 3%), written policies with set target (24% versus 5%) and written policies without set target (17% versus 2%). Advice from the members of the community health care team was the principal reason for the receipt of both vaccines. The predominant reasons for non-receipt of vaccine were refusal by residents and family members (both vaccines) and lack of advice from general practitioners (pneumococcal vaccine). The substantial disparity in coverage of influenza and pneumococcal vaccine reflects the lack of national recommendations and policies for reimbursements for pneumococcal vaccination. These data suggest that greater efforts are needed to improve prevention behaviors of health care professionals and the public, organized vaccine delivery strategies and systematic vaccination documents to increase influenza and pneumococcal vaccination rates in nursing homes and other long-term care facilities.

Bacterial Vaccines↗
PubMed2003

Houseofficers' reactions to media coverage about the sequencing of the human genome.

After the announcement that sequencing of the human genome was nearly complete, media coverage was extensive. In light of ample evidence that the media are a primary source of health and science information, even for health professionals, media portrayals are often inaccurate or misleading, and discoveries that emanate from sequencing the human genome are likely to influence future health care, it is important to assess physicians' interpretations of media coverage about the human genome announcement. This paper describes the reactions of a sample of new physicians in the United States to this announcement, as well as the content of the stories they read or heard. Semi-structured surveys were distributed to all incoming houseofficers during Orientation at one major academic medical center. Eighty-one percent of 190 houseofficers returned a survey; 123 completed surveys were analyzed. Fifty-four percent of respondents thought the media message was only positive and 21% thought it was negative or mixed. Participants who reported radio as their media source were less likely to recall positive messages (p<0.05). Sixty-five percent and 76%, respectively, had positive perceptions of the impact of the accomplishment on people and on the medical profession. Overall, 48% were enthusiastic and 52% were guarded about the accomplishment. Enthusiasm was related to being an adult primary care houseofficer (p=0.07) or to having heard about it on television or in the newspaper (p<0.05). Of the 36 stories analyzed, newspaper and television reports focused more on medical implications and radio reports focused more on ethical issues. The degree of enthusiasm about the accomplishment reflects the content of the media coverage, and, at least for adult primary care houseofficers, probably reflects the increasing relevance of genetic discoveries to medical practice. Since physicians obtain much of their health and science information from the media, they can play an instrumental role in helping their patients interpret media coverage of advances in genetics and their impact on health care. However, this will require that physicians develop an appreciation of the newsmaking process, and how subtle interactions between politics, the media and science influence the "framing" of media coverage.

Academic Medical Centers↗
PubMed2001

National, state and urban-area vaccination-coverage levels among children aged 19-35 months, United States, 1999.

BACKGROUND: Assessment of vaccination coverage is an important component of the U.S. vaccination program and is primarily measured by the National Immunization Survey (NIS). METHODS: The 1999 NIS is a nationally representative sample of children aged 19 to 35 months, verified by provider records, that is conducted to obtain estimates of vaccination coverage rates. Coverage estimates are calculated for the nation, states, and selected urban areas for recommended vaccines and selected vaccine series. RESULTS: Coverage estimates are presented by a variety of demographic and healthcare-related factors: overall, by poverty status, race/ethnicity, selected milestone ages, participation in WIC, level of urbanicity, provider participation in VFC, and by provider facility type. In 1999, national coverage estimates were high for most vaccines and among most demographic groups. State and urban-area level estimates varied.

Aid to Families with Dependent Children↗
PubMed2001

Vaccination status of children in the Women, Infants, and Children (WIC) Program: are we doing enough to improve coverage?

BACKGROUND: Vaccination-promoting strategies in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been shown to produce dramatic improvements in coverage and other health outcomes. OBJECTIVES: To determine national and state-specific population-based vaccine coverage rates among preschool children who participate in the WIC program, and to describe the strategies for promoting vaccination in WIC. DESIGN/METHODS: Demographic data, WIC participation, and vaccination histories for children aged 24 to 35 months in 1999 were collected from parents through the National Immunization Survey. The healthcare providers for the children in the survey were contacted to verify and complete vaccination information. We defined children as up-to-date (UTD) if they had received four doses of diphtheria and tetanus toxoids and pertussis vaccine (DPT), three doses of poliovirus vaccine, one dose of measles-mumps-rubella vaccine (MMR), and three doses of Haemophilus influenzae type b vaccine (Hib) by 24 months. Description of state-level vaccination-promoting activities in WIC was collected through an annual survey completed by the state WIC and immunization program directors. RESULTS: Complete data were collected on 15,766 children, of whom 7783 (49%) participated in WIC sometime in their lives. Nationally, children who had ever participated in WIC were less well-immunized at 24 months compared to children who had not: 72.9% UTD (95% CI, 71.3-74.5) versus 80.8% UTD (95% CI, 79.5-82.1), respectively. In 42 states, 24-month coverage among WIC participants was less than among non-WIC participants, including 13 states where the difference was > or = 10%. Vaccination activities linked with WIC were reported from 76% of 8287 WIC sites nationwide. States conducting more-frequent interventions and reaching a higher proportion of WIC participants had 40% higher vaccination coverage levels for the WIC participants in that state (p<0.05). CONCLUSIONS: Children served by WIC remain less well-immunized than the nation's more-affluent children who do not participate in WIC. Thus, WIC remains a good place to target these children. This study provides evidence that fully implemented WIC linkage works to improve vaccination rates. Strategies that have been shown to improve the vaccination coverage levels of WIC participants should be expanded and adequately funded to protect these children.

Aid to Families with Dependent Children↗
PubMed2002

Tuberculosis in patients with and without primary health coverage.

BACKGROUND: The aim of this study was to determine whether tuberculosis (TB) treatment and follow-up is a feasible option for patients without primary health coverage when free access to health care and drug delivery is provided on an outpatient basis. METHODS: We conducted a retrospective analysis of patient characteristics, treatment modalities, and evolution up to 9 months of follow-up at Saint-Louis Hospital, Paris, France. RESULTS: TB patients without (n=44) compared to those with (n=49) primary health coverage at diagnosis tended to be younger and more frequently homeless (P<0.05) or had illegal status (P<0.001). They had similar TB presentation when starting treatment, but required free drug delivery more often (74 vs. 21%, P<0.001). After the same duration of follow-up, patients considered as cured or as having completed treatment (52.3 vs. 51%), dead (2.3 vs. 8.2%), still under treatment (13.2 vs. 6.1%), or lost to follow-up (31.8 vs. 34.7%) were similar in both groups. At the end of the follow-up period, 43% of the patients without primary health coverage had managed to obtain 70% or 100% free medical aid or social security. CONCLUSIONS: Free access to health care and drug delivery is worthwhile in TB patients without primary health coverage since it permits the same clinical results as in TB patients with primary health coverage. However, efforts should be made to improve the management and follow-up of TB patients and to lower the number of patients lost to follow-up, whatever their social status.

Journal Article↗
PubMed2000

Validity and coverage of estimates of relative accuracy.

PURPOSE: Studies comparing test accuracy often restrict the confirmation procedure to subjects classified as positive by either test. Relative sensitivity (RSN) and relative false-positive rate (RFP) are two estimable comparative measures of accuracy. This article evaluates the influence of sample size, disease prevalence, and test accuracy on the validity of point estimates of RSN and RFP, and on the coverage of their confidence intervals (CI). METHODS: For each combination of sample size, disease prevalence, test accuracy, and interdependence between tests 1,000 samples were generated using computer simulations. The percent bias in the RSN and RFP estimates was measured by comparing the means of the 1,000 values computed in each simulation (log-transformed) with their theoretical values. Coverage of the estimated CI was measured by computing the proportion that actually included the theoretical values. Application of these methods was illustrated with data from a study comparing mammography and physical examination in screening for breast cancer. RESULTS: RSN estimates were valid if the true number of diseased cases exceeded 30, and RFP estimates were valid if the number of nondiseased subjects exceeded 200. When the numbers of diseased and nondiseased subjects exceeded 150 each, the 95% CI of RSN and RFP provided adequate coverage of the parameters (95 +/- 2%). CONCLUSION: Sample size is the most important variable for the validity and coverage of RSN and RFP estimates. For small samples, validity and coverage of RSN and RFP also depend on the accuracy of each test and on the degree of interdependence between the tests.

Adult↗
PubMed2006

Child immunization in Vietnam: situation and barriers to coverage.

This paper addresses the overall performance and inequalities in the immunization of children in Vietnam. Descriptive and logistic analysis of cross-national demographic and health data was used to examine inequality in immunization, identify the most vulnerable groups in immunization coverage, and identify the gap in coverage between hard-to-access people and the remainder of the population. The gap in the coverage was found to occur primarily in vulnerable groups such as the poor minority or poor rural children. No evidence was found of a difference in immunization coverage because of sex or birth order. However, the age of children showed a significant influence on the rate of immunization. Mother's education and regular watching of television had a significant influence on child immunization. In order to improve child immunization coverage in Vietnam, efforts should be concentrated on poor children from minority groups and those living in rural areas, especially remote ones. Community development, investment for immunization and re-organization of immunization services at the grassroots level are also key factors to remove the barriers to immunization for vulnerable populations in Vietnam.

Child↗
PubMed2003

High sequence coverage of proteins isolated from liquid separations of breast cancer cells using capillary electrophoresis-time-of-flight MS and MALDI-TOF MS mapping.

A method has been developed for high sequence coverage analysis of proteins isolated from breast cancer cell lines. Intact proteins are isolated using multidimensional liquid-phase separations that permit the collection of individual protein fractions. Protein digests are then analyzed by both matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) peptide mass fingerprinting and by capillary electrophoresis-electrospray ionization (CE-ESI)-TOF MS peptide mapping. These methods can be readily interfaced to the relatively clean proteins resulting from liquid-phase fractionation of cell lysates with little sample preparation. Using combined sequence information provided by both mapping methods, 100% sequence coverage is often obtained for smaller proteins, while for larger proteins up to 75 kDa, over 90% coverage can be obtained. Furthermore, an accurate intact protein MW value (within 150 ppm) can be obtained from ESI-TOF MS. The intact MW together with high coverage sequence information provides accurate identification. More notably the high sequence coverage of CE-ESI-TOF MS together with the MS/MS information provided by the ion trap/reTOF MS elucidates posttranslational modifications, sequence changes, truncations, and isoforms that may otherwise go undetected when standard MALDI-MS peptide fingerprinting is used. This capability is critical in the analysis of human cancer cells where large numbers of expressed proteins are modified, and these modifications may play an important role in the cancer process.

Amino Acid Sequence↗
PubMed2001

CO oxidation on Pd(100) and Pd(111): a comparative study of reaction pathways and reactivity at low and medium coverages.

We have performed density functional theory calculations with the generalized gradient approximation to investigate CO oxidation on a close-packed transition metal surface, Pd(111), and a more open surface, Pd(100), aiming to shed light on surface structure effects on reaction pathways and reactivity, an important issue in catalysis. Reaction pathways on both surfaces at two different coverages have been studied. It is found that the reaction pathways on both surfaces possess crucial common features despite the fact that they have different surface symmetries. Having determined reaction barriers in these systems, we find that the reaction on Pd(111) is strongly coverage dependent. Surface coverages, however, have little effect on the reaction on Pd(100). Calculations also reveal that the low coverage reactions are structure sensitive while the medium coverage reactions are not. Detailed discussions on these results are given.

Journal Article↗
PubMed2003

Coverage effects and the nature of the metal-sulfur bond in S/Au(111): high-resolution photoemission and density-functional studies.

The bonding of sulfur to surfaces of gold is an important subject in several areas of chemistry, physics, and materials science. Synchrotron-based high-resolution photoemission and first-principles density-functional (DF) slab calculations were used to study the interaction of sulfur with a well-defined Au(111) surface and polycrystalline gold. Our experimental and theoretical results show a complex behavior for the sulfur/Au(111) interface as a function of coverage and temperature. At small sulfur coverages, the adsorption of S on fcc hollow sites of the gold substrate is energetically more favorable than adsorption on bridge or a-top sites. Under these conditions, S behaves as a weak electron acceptor but substantially reduces the density-of-states that gold exhibits near the Fermi edge. As the sulfur coverage increases, there is a weakening of the Au-S bonds (with a simultaneous reduction in the Au --> S charge transfer and a modification in the S sp hybridization) that facilitates changes in adsorption site and eventually leads to S-S bonding. At sulfur coverages above 0.4 ML, S(2) and not atomic S is the more stable species on the gold surface. Formation of S(n)(n > 2) species occurs at sulfur coverages higher than a monolayer. Very similar trends were observed for the adsorption of sulfur on polycrystalline surfaces of gold. The S atoms bonded to Au(111) display a unique mobility/reactivity not seen on surfaces of early or late transition metals.

Journal Article↗
PubMed2005

Coverage-dependent adsorption of atomic sulfur on Fe(110): a DFT study.

Adsorption of atomic sulfur at different coverages on the Fe(110) surface is examined using density functional theory (DFT) in order to investigate the effect that adsorbate-adsorbate interactions may have on the surface properties. S is adsorbed in the high-symmetry adsorption sites: 4-fold hollow, bridge, and atop sites in the following surface arrangements: c(2 x 2) and p(1 x 1) which correspond to coverages of 1/2 and 1 monolayer, respectively. The binding energy, work function change, adsorption geometry, charge density distribution, magnetic properties, and density of states are examined and compared to our previous study of S adsorbed at 1/4 monolayer coverage and p(2 x 2) arrangement [Spencer et al. Surf. Sci. 2003, 540, 420]. It was found that S forms polar covalent bonds to the surface. The bonding goes from being S-Fe dominated at the low coverages to being S-S dominated at the higher coverages where the S atoms are located closer together on the surface and interact with each other.

Journal Article↗
PubMed1997

Health insurance coverage of the children of immigrants in the United States.

OBJECTIVES: This study assesses the health insurance coverage of children of immigrants in the United States and variations among immigrant groups. METHOD: The study uses data from the March supplements of the 1994 and 1996 Current Population Survey to compare health insurance coverage of children who report foreign parentage. Separate logistic regressions are conducted to estimate the likelihood of being covered by any insurance, public insurance, and private insurance. RESULTS: 27.3% of all children of immigrants are without health insurance, 34.1% are on public insurance, and 44.3% have private insurance. Foreign-born children who have not yet become U.S. citizens are the most likely to be without health insurance (38.0%). Many of these children are not covered because their parents are unable to find jobs that provide coverage and Medicaid fails to enroll as many of them as possible. Overall, the children's chances of being covered by any health insurance vary little according to when their parents came to this country. However, children of recent immigrants are more likely to rely on public health insurance (40.1% vs. 24.8%) and less likely to be covered through private sources (36.8% vs. 60.6%) than those of established immigrants. Among immigrant groups, children of Haitian (48.4%) and Korean (45.3%) immigrants are at the highest risks of being uninsured. Both children of the Dominican Republic (65.9%) and Laos (83.3%) report high rates of public insurance coverage. CONCLUSIONS: Greater disparity in health insurance coverage among children of immigrants is expected once the new welfare reform bills take effect. In particular, noncitizen children, children of recent immigrants, illegal immigrants, and Dominican Republican immigrants will be affected most. Efforts aimed at reducing the harm should target these vulnerable groups.

Animals↗
PubMed2001

Restorations with extensive dentin/enamel-bonded ceramic coverage. A 5-year follow-up.

The durability of restorations with extensive dentin/enamel-bonded posterior partial and complete ceramic coverages were investigated. The effect of luting with a dual-cured and a self-cured luting agent was also studied. In 110 patients, 182 ceramic coverages (IPS Empress) were placed. In 58 restorations, Syntac was used in combination with the dual-cured resin composite Variolink. In the other restorations luted with the chemically cured resin composite Bisfil 2B, 25 were bonded with Gluma, 57 with Allbond 2, and 42 with Syntac. Of the 182 ceramics, 13 (7.1%) were assessed as non-acceptable after a mean observation period of 4.9 yr (range 4.3 7.5 yr). The reasons for failure were fracture (5), lost restorations (4), secondary caries (3) and endodontic treatment (1). No significant differences in failure rate were seen between the two luting agents or between the three dentin-bonding agents. Ceramic coverages placed on non-vital teeth failed in 9.7% of cases (3/31) and on vital teeth in 6.6% (10/151). The success rate of the dentin-enamel-bonded ceramic coverages reduces the need for a traditional full-coverage therapy and/or post or pin(s) and core placement. The technique investigated showed many clinical advantages such as less destruction of healthy tissue, and avoidance of endodontic treatment and/or deep cervical placement of restoration margins.

Adult↗
PubMed2006

Polyvalent vaccines for optimal coverage of potential T-cell epitopes in global HIV-1 variants.

HIV-1/AIDS vaccines must address the extreme diversity of HIV-1. We have designed new polyvalent vaccine antigens comprised of sets of 'mosaic' proteins, assembled from fragments of natural sequences via a computational optimization method. Mosaic proteins resemble natural proteins, and a mosaic set maximizes the coverage of potential T-cell epitopes (peptides of nine amino acids) for a viral population. We found that coverage of viral diversity using mosaics was greatly increased compared to coverage by natural-sequence vaccine candidates, for both variable and conserved proteins; for conserved HIV-1 proteins, global coverage may be feasible. For example, four mosaic proteins perfectly matched 74% of 9-amino-acid potential epitopes in global Gag sequences; 87% of potential epitopes matched at least 8 of 9 positions. In contrast, a single natural Gag protein covered only 37% (9 of 9) and 67% (8 of 9). Mosaics provide diversity coverage comparable to that afforded by thousands of separate peptides, but, because the fragments of natural proteins are compressed into a small number of native-like proteins, they are tractable for vaccines.

AIDS Vaccines↗
PubMed2001

[Defect coverage of the hand and forearm with a free scapula-parascapula flap].

BACKGROUND: Complex defects of the forearm and hand are associated with the loss of important structures. Single-stage reconstruction of these defects requires composite tissue transplantations. The subscapular region offers various components for the coverage of complex defects. The scapular and the parascapular flaps can be used each as cutaneous, fasciocutaneous and osteocutaneous or as a combined flap as well. The purpose of this study was to present our experience with the combined scapular-parascapular free flap for defect coverage of the forearm and hand in 13 patients. PATIENTS AND METHOD: Evaluation of 12 patients who underwent coverage of forearm and hand defects with the combined scapular-parascapular free flap during a five-year period. Other treatment options are discussed. RESULTS: Average age of the patients was 39 years, there were ten male and two female patients. Average follow-up was 20 months. Eleven patients suffered from massive trauma, one patient from severe infection of the forearm and hand. The defect size varied from 12 x 8 cm to 45 x 20 cm. In nine cases, a cutaneous and/or fasciocutaneous scapular-parascapular flap was used, two patients underwent defect coverage with an osteocutaneous scapular-parascapular flap, and in one patient, a "four-flap-mega-flap" was transplanted. One flap developed a partial necrosis. Eight patients developed a good or very good functional outcome with their hand and forearm, two patients have a moderate degree of disability. Two patients can use their hand as a supporting hand. CONCLUSION: This study demonstrates that the combined scapular-parascapular free flap is a reliable treatment choice for early coverage of defects of the forearm and hand. The advantages are the long, large and consistent vascular pedicle, the possibility of combination with other flaps and "custom-tailoring", including whatever component is necessary to close the particular defect.

Adult↗
PubMed2005

Newspaper coverage of women's sports during the 2000 Sydney Olympic Games: Belgium, Denmark, France, and Italy.

In general, women are well represented among sport participants and sport audiences but not in the media. Data show that women's sport is greatly underreported and trivialized in newspapers. Therefore, the purpose of this study was to measure press coverage during the 2000 Summer Olympic Games in the largest circulating Belgian, Danish, French, and Italian daily newspapers by: (a) number of articles, (b) size, (c) page placement, (d) accompanyingphotographs, and (e) photograph size. For each sport covered, the athletes' nationality and the gender were recorded. Compared to the 1996 Atlanta Games, there was an increase of 326 female athletes (+4 %), and women competed in 25 sports and 132 events (44 %) of the total 300 events. Although only 29.3 % of the articles and 38 % of photos were on women 's sports, the newspaper coverage was similar to the distribution of participating athletes and events. No significant gender differences were found with respect to article size, page placement, accompanying photographs, or photograph size. The most covered sport was track and field, independent of national achievement. Other sports received different coverage in relation to national expectations, achievement, and participation. In conclusion, there was a trend to overcome gender inequities in media coverage during the Olympic Games, which may be due to the International Olympic Committee's actions to promote increased participation of women in sport activities and to publicize their achievements. Moreover, during the Olympic Games, a nationalistic fervor might affect the equality of gender coverage.

Australia↗