A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Objective and Hypothesis Methicillin resistant Staphylococcus aureus (MRSA) is currently a major cause of skin and soft tissue infections (SSTI) in the United States. In order to characterize the spread of MRSA in the pediatric population we built a probabilistic, discrete-event, individual-based simulation. Specifically, our model looked at the spread of MRSA in households and at schools to determine if there was a difference in communicability between the two settings. Methods We developed a probabilistic, discrete-event, individual-based model. This model was validated using insurance billing data for skin and soft tissue infections. The first validation trained the model for two years of data, and validated it with the next two years of data. The second method trained the model in one region and validated it in another. Following the validation, the Poisson-bootstrap resampling method was used to find specific values for a contagiousness factor(CF) in households and schools. Results Both methods of validation supported the model with no statistically significant difference. The bootstrap resulted in a CFhousehold of 30.69 (95% CI [29.09, 32.29]) and a CFschool of 0.55 (95% CI [0.46 to 0.64]). Effective reproduction number for the school setting was found to be 0.0015 and 0.06 to 3.04 for households of different size. Conclusion In this study we characterize a marked difference in communicability in the household and at school, which has not previously been shown. The identification of colonization clusters in households can be used to design strategies reduce the disease burden. The model can be used to simulate and predict responses to different interventions.

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Drawing upon field work, mass media accounts, and Canadian government internal documents, this thesis considers how settler/Aboriginal power relations were reproduced when Taiwan Aboriginal artefacts held by the Royal Ontario Museum were used in a 2001 exhibition in Taipei to commemorate the centennial of the death of the Taiwanese nationalist hero, George Leslie Mackay (1 844-1 901). I argue that this exhibition and related Taiwan-Canada state Aboriginal exchanges have been hierarchically structured by organizational narratives in which coalitions of settler state institutions function as adept heroes who quest to help inept Aboriginal peoples deal with various reified difficulties such as "cultural loss" or "economic development." Aboriginal participants are portrayed as thankful for the heroes' sacrifices and thereby morally validate the heroes' quests and relations between settlers and Aborigines. Helping Aborigines thereby allows for moral claims by involved institutions that just@ the use of Aboriginal exchanges to advance multiple institutional agendas including Canadian government nation branding, Taiwanese government informal diplomacy, and corporate advertising.

Background The inexorable rise in antimicrobial resistance (AMR) interferes with the goals of health care services around the world, given how critical the antibacterials are in making infections treatable and surgical procedures doable. Nursing homes residents have been identified as a reservoir for AMR, possibly due to the combination of being physically and mentally frail, frequently treated with antibacterials, and frequently moved between nursing home and hospital. Microbiological surveillance is a key countermeasure against further AMR development. Yet, surveillance data is easily biased due to precision problems regarding how the data is collected and evaluated. Methods Beginning in 2008, we launched two programmes (“SHADES” and “MIDIO”) aimed to gathering AMR data in a systematic fashion from elderly nursing home residents and elderly people living in their own place of residence. In doing so, we focused on colonizing strains of the two most important nosocomial infectious agents, Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). The bacteria were collected from multiple body sites and analysed with respect to antimicrobial susceptibility and genetic diversity. Results Active surveillance of AMR showed that (i) a S. aureus isolate could be retrieved from 1 in every 2 individuals given a single round of sampling, but aggregating several rounds of sampling, this figure might reach 7 in every 10 individuals, (ii) an E. coli isolate could be retrieved from 4 in every 5 individuals, (iii) the overall prevalence of AMR was favourable when compared to the situation in many other countries, (iv) the genetic diversity of S. aureus was generally high and provided only limited evidence of clonal expansion or contraction, and (v) diabetes mellitus was one of very few patient-level factors to show an association with the degree of genetic diversity in S. aureus. Conclusions The prevalence of colonization with S. aureus and E. coli was somewhat higher than expected, but the degree of AMR was very low. The genetic diversity of S. aureus was generally high. Diabetes mellitus emerged as the only patient-level factor associated with a higher degree of genetic diversity in S. aureus.

Le mouvement de germanophones vers l’Atlantique Sud n’a pas commencé avec les Nazis cherchant refuge dans l’après-guerre, ni avec la mise en place d’un protectorat allemand au Sud-Ouest africain en 1884. Tout au long du XIXe siècle, la grande majorité des germanophones ayant quitté l’Europe a voyagé et migré en Amérique du Nord, mais un certain nombre de germanophones avaient choisi l’Argentine et la Namibie bien avant le tournant du XIXe siècle. Des marchands et missionnaires germanophones avaient commencé à voyager dans l’Atlantique Sud et à s’y installer dans les années 1820s. Ces germanophones de l’Atlantique Sud étaient influencés par les conditions changeantes en Europe : la mobilité accrue des personnes et des biens au travers de l’évolution technologique et de la dominance croissante d’Etats-nations sur la scène politique de l’Europe occidentale. Après sa fondation en 1871, l’Etat-nation allemand étendît son influence politique avec ses croissantes aspirations au pouvoir sur le marché global. Après 1900 en particulier, les Allemands politiquement actifs ont cherché à contrer la compétition croissante des Etats-Unis sur le plan économique ; en tentant de rediriger les migrants germanophones des Etats-Unis vers les territoires qu’ils considéraient plus aptes pour l’aide et le contrôle continu de la part de l’Etat-nation allemand. Dans ce contexte, la majorité des Allemands reconnaissaient le Sud-Ouest africain allemand en tant que seul territoire à la hauteur de la colonisation allemande à grande échelle. Au même moment, les germanophones en Argentine devenaient actifs en promouvant l’Argentine comme destination idéale pour la migration germanophone, et un grand nombre de publications le louaient en tant que « pays d’avenir ». Les publications sur les Allemands aux Etats-Unis et au Canada sont nombreuses, mais les germanophones ayant choisi l’Atlantique Sud ont reçu moins d’attention. Parmi cette littérature secondaire, les Allemands en Argentine étaient traités comme des migrants étrangers à la République, tandis que les Allemands en Namibie ont été tout d’abord étudiés par rapport au colonialisme allemand. J’argumente que c’est les historiens qui ont crée cette division qui accentue davantage les différences entre les trajectoires historiquement rendues, et qui cachent les connections et similarités qui étaient évidentes aux migrants germanophones du XIXe siècle. Je me propose d’étudier ces germanophones dans un seul champ analytique. J’argumente que malgré les différences des circonstances politiques respectives, les expériences du quotidien des germanophones de ces deux côtés de l’Atlantique Sud étaient plus similaires que différentes. J’analyse les publications et les pensées des contemporains du XIXe siècle afin de surmonter la dichotomie crée par les historiens en tant que genres de mouvement mondiaux distincts et mutuellement exclusifs. Ce qui s’est passé dans l’Atlantique Sud peut être appelé « colonisation transnationale » : des Etats-nations émergents étaient impliqués dans le processus de colonisation –l’Argentine en Amérique du Sud et l’Allemagne dans le Sud-Ouest africain – et des fonctionnaires aidaient à accroitre leur expansion. Cependant, au sein de ces Etats, les personnes qui maintenaient une variété d’identités et d’origines européennes, étaient des agents actifs dans le processus de colonisation. Mes sources primaires comprennent des textes produits par les migrants de courte et longue durée, comme les récits de voyage, ainsi que les archives des communautés et gouvernements actuellement situés en Allemagne, en Argentine et en Namibie... / The movement of German-speakers to the South Atlantic did not begin with Nazis seeking refuge in Argentina in the aftermath of World War II, nor did it start with the organization of the German protectorate of South-West Africa in 1884. Throughout the nineteenth century, the great majority of German-speakers leaving Europe travelled and migrated to North America, but some German-speakers had begun settling in both Argentina and Namibia well before the turn of the twentieth century. German-speaking merchants and missionaries started travelling to and settling in the South Atlantic in the 1820s. These South Atlantic German-speakers were influenced by the changing conditions in Europe: the increasing mobility of people and goods through the advancement of technology, and the increasing dominance of Nation-states on Western Europe’s political scene. After its founding in 1871, the German nation-state expanded its political reach with the German Empire’s increasing desire for power on the global market. After 1900 in particular, politically active Germans sought to compete against the increasing economic competition from the United States by attempting to redirect German-speaking migrants from their U.S. rival to areas they deemed more apt for continued German state aid and control. In this context, many Germans recognized German South-West Africa as the only territory suitable for large-scale German settlement. Meanwhile, German-speakers in Argentina became involved in marketing Argentina as the ideal destination for German-speaking migration and numerous publications praised it as the “land of the future.”German-speaking migration to the United States and Canada is well documented, whereas scholars have paid less attention to those migrants who went to Argentina and Namibia. Within the existing secondary literature, scholars have treated German-speakers in Argentina mostly as foreign migrants in an established republic, while conversely studying German-speakers in Namibia primarily within the context of German colonialism. I argue that it is historians who have created this division which overemphasizes the differences between the continents’ historically rendered trajectories, while hiding the connections and similarities from the viewpoint of nineteenth-century German-speaking migrants. I propose to study the everyday life experiences of nineteenth-century German-speakers on both sides of the South Atlantic within one single analytical field. I argue that even though the respective political circumstances varied, the everyday life experiences of these German-speakers on both sides of the South Atlantic were more similar than different. I analyze the writings and belief-systems of nineteenth-century contemporaries in order to overcome the dichotomy that historians have created as distinct and mutually exclusive types of global movement. What happened in the South Atlantic was “transnational colonization:” emerging nation-states were involved in the colonization process – Argentina in South America and Germany in Namibia – and civil servants helped further their growth. However, within these states, people who maintained a variety of European identities and origins, were active agents in the colonization process. My sources include texts produced by short- and long-term migrants, such as travel writings as well as community and government records currently held in archives in Germany, Argentina and Namibia...

La pneumonie acquise sous ventilation mécanique (PAVM) est la complication infectieuse principale des patients de réanimation. Le carrefour oropharyngé et sa colonisation semblent être l’une des clés de sa physiopathologie, et est la cible de leur prévention. Parmi les agents étiologiques des PAVM, Escherichia coli en est un prédominant. Cependant, le manque de données concernant son implication dans la colonisation oropharyngée, et dans les PAVM est criant. Cette thèse a pour objectif un abord multi-facettes de la PAVM à E. coli. Il s’agit d’abord d’actualiser les données épidémiologiques des PAVM, en plaçant les entérobactéries en général, et E. coli en particulier comme agent d’importance ; puis de décrire les caractéristiques génotypiques et phénotypiques des isolats d’E. coli responsables de colonisation ou d’infection respiratoire ; ensuite d’étudier la colonisation à bacilles à Gram négatif pathogènes dans différentes populations de gravités différentes ; et enfin de décrire les caractéristiques des isolats d’E. coli oropharyngés dans ces populations et de les comparer aux isolats rectaux concomitants.Ainsi, dans notre premier travail, nous confirmons l’importance des entérobactéries comme agents pathogènes de premier plan au cours des PAVM. Au sein des entérobactéries, nous mettons en évidence la place centrale d’E. coli en particulier en matière de résistance aux antibiotiques. La prédominance respiratoire des isolats d’E. coli de phylogroupe B2 a été confirmée dans un travail monocentrique mené dans notre service, et dans une cohorte nationale de patients de réanimation. De plus, le groupe B2 prédominait aussi au sein des prélèvements rectaux et oropharyngés. Nous avons confirmé la virulence extra-digestive des isolats en corrélant le contenu en facteur de virulence et la mortalité dans un modèle murin de pneumonie. Enfin, une large étude épidémiologique de la colonisation oropharyngée en général, et des caractéristiques d’isolats d’E. coli la composant en particulier, chez des patients de gravités différentes et chez des sujets sains est en cours.L’ensemble de ces données permettra une plus grande compréhension de la physiopathologie de survenue des PAVM, une meilleure connaissance de la population d’E. coli colonisant l’oropharynx et causant les PAVM. Ainsi, des mesures préventives ciblées pourraient être développées. / Ventilator associated pneumonia (VAP) is the main infectious complication in intensive care unit (ICU) patients. Its pathophysiology relies on oropharyngeal colonisation, and so does its prevention. Escherichia coli is one of its main responsible pathogen. Nevertheless, data on E. coli implication in this context is cruelly missing.We tend to a multi-facets approach of E. coli VAP. This thesis’ objectives are: to update current VAP epidemiology, with regard to enterobacteriaceae in general, and E. coli in particular; to describe phenotypic and genotypic characteristics of E. coli isolates responsible for respiratory colonization or infection; to study pathogenic Gram-negative bacilli oropharyngeal colonization in populations of various severity; and to describe phenotypic and genotypic characteristics of oropharyngeal E. coli isolates and compare them to their rectal counterpart.In our first work, we confirm the importance of enterobacteriaceae as first-line VAP pathogens. Among those, E. coli is of particular matter, with regard to antimicrobial resistance. Predominance of B2 phylogroup among E. coli respiratory isolates has been confirmed in a single-ICU study, and a wide national survey of ICU patients. Furthermore, B2 phylogroup has been shown to prevail in oropharyngeal and rectal E. coli isolates. Next, we confirmed extra-intestinal virulence with a correlation between virulence factor content and mortality in a mouse pneumonia model. Last, a large-scale epidemiological study of oropharyngeal colonization in general, and of E. coli characteristics which composes it, in patients of different severity and in healthy subjects is ongoing. This data will allow a deeper insight of VAP pathophysiology, a better knowledge of E. coli population of oropharyngeal colonization and causing VAP. Targeted preventive measures could therefore be evaluated.

This thesis presents a view of multiple human contacts with Australia, using a variety of data from the literature; linguistic, ethnographic, geographic, physical anthropology and art history. It will be shown that successive groups of people arrived in Australia before its settlement by Europeans. These people made their presence felt in various ways, which have been considered. Some in ancient and later times may have arrived from Africa, perhaps being blown off course and carried by the currents and winds of the Indian Ocean. Later migrations came from Asia, and finally technologically advanced peoples of Indonesia and China came to Australia. Some of these people left artefacts, practices and language that became part of some Aboriginal languages and some religious beliefs and practice, along with some physical biological traces. The peoples named “Aborigines” by European settlers were a diverse set of groups with a diverse set of physical and cultural influences. In particular the Batak people of Sumatra over a period of time contributed a large component of these diverse influences. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1274235 / Thesis (M.Sc.) -- School of Medical Sciences, 2007.

With the interest in studying nationalism, the writer initiated a study on the Taiwanese Nationalism in the Japanese Colonial Period (1895~1945), which she thinks is the most remarkable time in the Taiwan¡¦s 400 years of history and reveals exactly the essence of the nationalism theories. As a student in the field of Political Science, the writer takes it as a responsibility to make the theories she has learnt applied to the Taiwan¡¦s history, which has a lot to do with us. This graduate thesis is titled ¡§A Study of Taiwanese Nationalism in the Japanese Colonial Period, 1895~1945¡¨, and in the thesis three methods (literature analysis, history comparative analysis ) are mainly used for study on Taiwan¡¦s nationalism movements during the Japanese Colonial Period. The thesis is going to present the following aspects: first of all, to look into the interior significance of Taiwanese nationalism movements, what the Taiwanese people wanted and their ideologies during the Japanese Colonial Period; secondly, to clarify the differences among all the perspectives of the Taiwanese nationalism during that colonial time from the angle how they were influenced by factors, like the time, place and historical events; furthermore, we will talk about ¡§identification¡¨ which is the most important topic in the theories of nationalism. Therefore, in this thesis, we¡¦ll also learn about how Taiwanese people¡¦s identification shifted among Taiwan, China and Japan. The thesis does not assent to consider Taiwanese people¡¦s intention with pure ¡§Binary opposition¡¨ contention while discussing the Taiwanese nationalism in the Japanese Colonial Period. For the movement leaders or the public, identities such as ¡§Chinese ideology¡¨, ¡§Taiwanese ideology¡¨, ¡§Homeland faction¡¨, or ¡§Japanese Komin (Japanese Imperial Civilization)¡¨ are too illiberal, too strict and too simplified. Therefore, despite no historical resources can 100% reveals how the nationalism identification shifted under the same or different factors and time¡¦s effect, it is still undoubted that the movement leaders at that time wavered among the mainstreams (the Han nationality, China, Japan and Taiwan). We should not judge such identities right or wrong, because it¡¦s a question of values options. The writer thinks Taiwanese people¡¦s resistance against Japan government in the Japanese Colonial Period is the part worthiest of our attentions. At last, the thesis indicates that, Taiwanese people¡¦s orphanage consciousness in Japanese Colonial Period and they hardly had any alternatives, and that discussions of modern scholars on Taiwanese people¡¦s nationalism focus too much on their intention is absolutely not impersonal, for their perspectives were usually led into arguments on different ideologies. The charm of nationalism is to awaken the mysterious belonging and the power of returning to the start, lying deeply in people¡¦s mind. Everybody felt attached to the past, recalling ¡§long time ago¡K¡¨. This was the emotions and latent ideology the ¡§Homeland Faction¡¨ possessed during the Japanese Colonial Period and their ¡§China ideology¡¨ intention should not be erased. However, the Taiwanese were apart from their homeland under pressure for fifty years as the length of Japanese Colonial Period, and these years would surely lead to the transformation of Taiwanese people¡¦s ideologies, also we cannot deny if the so-called ¡§Taiwanese ideology¡¨ was born during this transforming process. When the Japanese put civilization into practice in Taiwan, the Taiwanese sensed the existence of ¡§another party¡¨ and then inspected internally to themselves. At that time, it was like the Taiwanese people got onto the train and claimed to find out who they were, and the destinations are China, Taiwan and Japan. Did they know where the train headed to? Not exactly, that was a question with no answers, because as written in Wu Cho-Liu's unprecedented and unrepeatable epic, the Taiwanese are the orphan of Asia.