Commonwealth of Independent StatesEurope, EasternUSSRTajikistanAzerbaijanIndependent State of Samoa: An island group and constitutional monarchy in the southwest central Pacific Ocean. The capital is Apia. The islands were jointly administered by England, the United States, and Germany 1889-99, with the chief islands of Savai'i and Upolu recognized as German until 1919. Western Samoa gained independence in 1962 and assumed its present formal name in 1997.Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of CORYNEBACTERIUM DIPHTHERIAE. It is characterized by the presence of a pseudomembrane at the site of infection. DIPHTHERIA TOXIN, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects.Micronesia: The collective name for islands of the Pacific Ocean east of the Philippines, including the Mariana, PALAU, Caroline, Marshall, and Kiribati Islands. (From Webster's New Geographical Dictionary, 1988, p761 & Room, Brewer's Dictionary of Names, 1992, p350)VirginiaDiphtheria-Tetanus Vaccine: A combined vaccine used to prevent infection with diphtheria and tetanus toxoid. This is used in place of DTP vaccine (DIPHTHERIA-TETANUS-PERTUSSIS VACCINE) when PERTUSSIS VACCINE is contraindicated.Guam: An island in Micronesia, east of the Philippines, the largest and southernmost of the Marianas. Its capital is Agana. It was discovered by Magellan in 1521 and occupied by Spain in 1565. They ceded it to the United States in 1898. It is an unincorporated territory of the United States, administered by the Department of the Interior since 1950. The derivation of the name Guam is in dispute. (From Webster's New Geographical Dictionary, 1988, p471)American Samoa: A group of islands of SAMOA, in the southwest central Pacific. Its capital is Pago Pago. The islands were ruled by native chiefs until about 1869. An object of American interest beginning in 1839, Pago Pago and trading and extraterritorial rights were granted to the United States in 1878. The United States, Germany, and England administered the islands jointly 1889-99, but in 1899 they were granted to the United States by treaty. The Department of the Interior has administered American Samoa since 1951. (From Webster's New Geographical Dictionary, 1988, p44)MassachusettsAustralia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.United StatesHealth Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.