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OP-ED: The NRA Took My First Amendment Away
by: PhawkerPosted on: October 18, 2010 November 13, 2022
BY REP. TIM BRIGGS Harrisburg is not for the weak of heart. During my first term in the Pennsylvania House of Representatives, I have seen things that have made me think twice about running for re-election. If you are a wide-eyed idealist like me who believes in unicorns and reforming the Pennsylvania legislature, you need to be able to turn frustration and disbelief into passion for action.
For the better part of the last two years I have been able to take many things in stride: bitter partisanship, entrenched colleagues, a legislative process that moves slower than a catcher running to first base (no offense to Chooch). But last week I witnessed a circumvention of democracy so egregious that I could not sit idly by. What higher power was this assault launched in the name of? Who else but the almighty and omnipotent National Rifle Association.
At issue was H.B. 40, an expansion of the Castle Doctrine. Already common law in Pennsylvania, the Castle Doctrine deems it legally justifiable if you shoot and kill someone breaking into your home. While the right to stand one's ground is already protected, some of my colleagues don't believe this is good enough. They were promoting legislation that would make it easier for people to shoot first and ask questions later almost anywhere.
I fully support one's constitutional right to protect themselves from attack. But the expansions sought under H.B. 40 would allow cold-blooded murderers to falsely claim they shot someone because they were under attack. Eliminating the duty to retreat does not make us safer, it makes people more likely to shoot one another.
Agree or disagree with the bill, for it to become law it must go through the legislative process. It passed out of committee and came to the House floor for a vote. Along with colleagues from both sides of the aisle and the issue, I submitted an amendment to the bill in a timely manner as permitted under House rules.
My amendment, along with the others, should have been debated and voted on. But that did not happen. Instead, a motion was filed to move forward without considering any of the amendments. The motion passed.
Next we should have had a debate on the bill itself. We were prevented from considering the amendments, but at least we could still have robust debate before we voted, right? Guess again. A motion was filed to proceed to a vote without any discussion. The motion passed. There was no discussion, we voted and the bill passed.
We lost the vote; that I can accept. But suppressing elected officials' freedom of speech on the floor of the Pennsylvania House of Representatives is an affront to the Constitution that we all swore to uphold. As a democratically elected member of the oldest elected body in America, I was not allowed to speak on the merits of this bill or speak on behalf of the constituents whom I was elected to represent.
This practicing of parliamentary jujitsu was not in the name of justice or protecting innocent victims. It was in the name of cheap electoral hackery.
For two years now the NRA has been losing battles across our Commonwealth. Municipalities have been passing sensible firearm safety ordinances and resolutions because the majority of Pennsylvanians support them. Polls even show that a majority of NRA members support sensible safety legislation.
But the NRA still chooses to quash debate and the democratic process, lest we have any public debate in the Pennsylvania House on the issue. Hundreds of police chiefs, sheriffs, mayors and prosecutors support my colleague state Rep. Bryan Lentz in trying to close the loophole that let Marquis Hill, a hardened criminal whose Pennsylvania gun permit was revoked, get a Florida gun permit. Police allege that Hill shot an 18-year-old 13 times, killing him.
After getting tired of licking their wounds, the NRA forced the vote on H.B. 40 to get legislators on record before Election Day. To them, putting legislators on notice justifies perverting democracy.
U.S. Supreme Court Justice Louis Brandeis said that the remedy for bad speech is more speech, not enforced silence. The NRA may have silenced my voice on the House floor, but in the coming years they will not silence the speech of Pennsylvania citizens and a majority of their own members. The people are always ahead of their legislators, and hopefully soon the will of the people can control the direction of its own state government, not the NRA.
– Tim Briggs, a Democratic state representative for the 149th District and a member of the House Appropriations Committee, can be contacted at RepBriggs@pahouse.net. His website is www.pahouse.com/Briggs.
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Malaria incidence trends and their association with climatic variables in rural Gwanda, Zimbabwe, 2005–2015
Resign Gunda ORCID: orcid.org/0000-0003-1404-98791,
Moses John Chimbari2,
Shepherd Shamu3,
Benn Sartorius4 &
Samson Mukaratirwa5
Malaria Journal volume 16, Article number: 393 (2017) Cite this article
Malaria is a public health problem in Zimbabwe. Although many studies have indicated that climate change may influence the distribution of malaria, there is paucity of information on its trends and association with climatic variables in Zimbabwe. To address this shortfall, the trends of malaria incidence and its interaction with climatic variables in rural Gwanda, Zimbabwe for the period January 2005 to April 2015 was assessed.
Retrospective data analysis of reported cases of malaria in three selected Gwanda district rural wards (Buvuma, Ntalale and Selonga) was carried out. Data on malaria cases was collected from the district health information system and ward clinics while data on precipitation and temperature were obtained from the climate hazards group infrared precipitation with station data (CHIRPS) database and the moderate resolution imaging spectro-radiometer (MODIS) satellite data, respectively. Distributed lag non-linear models (DLNLM) were used to determine the temporal lagged association between monthly malaria incidence and monthly climatic variables.
There were 246 confirmed malaria cases in the three wards with a mean incidence of 0.16/1000 population/month. The majority of malaria cases (95%) occurred in the > 5 years age category. The results showed no correlation between trends of clinical malaria (unconfirmed) and confirmed malaria cases in all the three study wards. There was a significant association between malaria incidence and the climatic variables in Buvuma and Selonga wards at specific lag periods. In Ntalale ward, only precipitation (1- and 3-month lag) and mean temperature (1- and 2-month lag) were significantly associated with incidence at specific lag periods (p < 0.05). DLNM results suggest a key risk period in current month, based on key climatic conditions in the 1–4 month period prior.
As the period of high malaria risk is associated with precipitation and temperature at 1–4 month prior in a seasonal cycle, intensifying malaria control activities over this period will likely contribute to lowering the seasonal malaria incidence.
Malaria is one of the most prevalent parasitic diseases worldwide [1]. There were approximately 214 million malaria cases and 438,000 malaria deaths globally in 2015, with most of these cases (88%) and deaths (90%) occurring in Africa [2]. Malaria contributes to a large public health burden with over 75% of the global clinical episodes due to Plasmodium falciparum concentrated in Africa [3]. Malaria is a public health problem in sub-Saharan Africa and is a leading cause of morbidity and mortality [4,5,6].
Zimbabwe experiences seasonal malaria transmission which is potentially epidemic [7]. Resistance of the malaria vectors to insecticides [8, 9] as well as parasite resistance to anti-malarial drugs [10] contribute to the challenges affecting control of malaria in Zimbabwe and regionally. The majority of malaria cases in Zimbabwe (98%) are caused by P. falciparum and the primary vector is Anopheles arabiensis [11]. Plasmodium falciparum is associated with severe and fatal disease. The risk for transmitting malaria in Zimbabwe is predominant during the rainy season (November to April).
The link between climate variability and vector-borne diseases has been established [12, 13]. Climate variability has the potential to either work for or against efforts to control the disease. Results from a study by Ebi et al. [14] suggested that changes in temperature and rainfall could alter the geographic distribution of malaria and it is expected that areas that were previously unsuitable for malaria transmission may become suitable in the future as a result of these changes in climate. The number of malaria infections can be influenced by climate factors, leading to increases or decreases in malaria incidence under climate variability [15].
Climatic factors such as rainfall and temperature play an important role in malaria transmission. Rainfall is responsible for creating mosquito breeding sites while temperature regulates the rate of development of the mosquito larvae and influences mosquito survival rates [16, 17]. Higher temperatures favour rapid multiplication of the Plasmodium inside the mosquito [18]. These two climatic variables create conditions that favour malaria transmission in endemic countries. Although it is well documented that malaria transmission is sensitive to climate, the predictions that have been made so far on the expansion of malaria endemic areas in relation to climate change seem to be mismatched across different areas [19] with the reduction in endemicity over time [18].
An understanding of how malaria incidences vary as a result of climate variability (present and recent past) is important for planning for future malaria control programmes [20]. Data on trends of diseases is needed to judge success of interventions to determine whether adjustments are required [21]. It also provides essential information on the changing malaria situation [20]. Information on the association between malaria incidence and lagged climatic conditions can be used in the development of malaria early warning systems. Most previous studies have assessed disease trends at global, regional or national levels [22,23,24,25]. In most cases, these studies were based on unconfirmed cases of malaria. In Zimbabwe, there is paucity of data on trends of malaria incidences at district and ward levels over longer periods (10 or more years). This is the first study to assess trends of a single disease at ward level in Zimbabwe using confirmed incident malaria. The objective of this study was to assess the trends of the incidences of malaria in rural Gwanda, Zimbabwe in relation to climatic variables.
Study area and population
The study was conducted in Gwanda District, the capital of Matabeleland South Province in southeast Zimbabwe. Malaria is one of the leading public health challenges in Gwanda district. The district accounts for the second highest number of recorded malaria cases in the province [26]. Malaria transmission unstable and is confined to the southern parts of the district [27]. The total population for the district is 137,461 people with 116,939 (85%) residing in rural areas. There are 26,773 households in rural areas with an average household size of 3.6 individuals [28]. Rural Gwanda has 24 wards (administrative unit within district). Gwanda lies in the natural region V which is characterized by very low rainfall resulting in frequent droughts in the area.
This study was conducted in three rural wards namely Buvuma, Ntalale and Selonga (Fig. 1) with a population of 5523, 4591 and 4697 people, respectively [28]. These three wards have similar socio-demographic characteristics and their communities have similar economic activities. The selected wards all have at least a dam and an irrigation scheme. The wards were purposively selected as they had the highest cumulative number of reported cases of malaria over the study period. There are 29 health facilities in the district including one provincial hospital and one mission hospital with the rest being clinics.
Map showing the three study wards of Buvuma (ward 15), Ntalale (ward 18) and Selonga (ward 11) in Gwanda district, Matabeleland south province, Zimbabwe
All suspected malaria cases are tested using a rapid diagnostic test (RDT). In addition to the RDT, a blood slides are prepared for each case and sent to the district laboratory for microscopic examination for parasites. Uncomplicated cases for malaria are treated with artemether and lumefantrine (Co-Artem®). The drug is administered according to body weight of the patient. Each malaria patient is reviewed after 3 days. Complicated cases of malaria are treated parenterally with quinine and referred to a hospital. Treatment for malaria is free at all rural clinics in Gwanda.
Data from the District Health Information System (DHIS) and the health facilities in Buvuma, Ntalale and Selonga were collected retrospectively for the period 2005–2015 to assess trends in malaria incidence. The DHIS is an electronic database of all reported health conditions for the district. The DHIS contains aggregated data from health facilities. There is some specific information that can only be obtained from the health facility, such as specific ages of patients and malaria cases by month per facility. In this study, information from both the DHIS and health facility was used as these complemented each other. At each health facility, data from the malaria registers was extracted. Data on all reported malaria cases for the period at ward level was collected. This included both confirmed and unconfirmed cases. A malaria case was defined as any patient that tested positive for malaria during the 2005–2015 period. For each case data on sex and age were collected.
Climatic variables
Mean monthly maximum and minimum temperatures (land surface temperatures) and monthly precipitation figures for Buvuma, Ntalale and Selonga wards were obtained from remote sensing. For each month, minimum, maximum and average temperatures were calculated. The mean average temperature was calculated as the mean of the average monthly temperatures. global positioning system (GPS) coordinates were used to define ward boundaries Precipitation data for each ward was collected from climate hazards group infrared precipitation with station data (CHIRPS) database [29] while land surface temperature (LST) data was obtained from moderate resolution imaging spectro-radiometer (MODIS) satellite data [30, 31]. Climatic variables data were collected from satellites because they have been shown to have an even spatial distribution [32]. The spatial resolution for MODIS and CHIRPS was 1 and 5 km respectively.
Data analysed using SPSS 22.0 (SPSS Inc., Chicago, IL) and R version 3.2.4 (Team RC. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2017). Graphs to describe the trends of malaria incidence over the study period were generated. Time series correlograms stratified by ward to determine seasonality of malaria transmission in the three study wards were used. A linear regression was performed to assess the significance of the malaria incidence trends over time. The malaria incidence rates were correlated to climatic variables LST (°C) and precipitation (mm). LST was measured as mean minimum, mean maximum and mean average temperatures for each month. Pearson correlation coefficients were calculated to determine the association between malaria incidence and the climatic variables. The climatic variables were lagged at 0- to 12-month lag period to determine the maximum significant positive correlations.
As a sensitivity analysis, the correlation coefficients were estimated using the Spearman rank correlation coefficient (non-parametric equivalent which is less sensitive to distributional assumptions). The distributed lag non-linear models (DLNM) to was employed to assess the temporal lagged effect of monthly climatic variables on monthly malaria incidence. This approach has been employed previously to assess the temporal lagged association between the variables concerned [33,34,35]. A quasi-Poisson distribution was assumed to allow for over dispersion given the observed distribution of monthly incidence.
The excessive number of months with zero malaria case counts does present a problem for conventional modelling approaches. While the quasi-Poisson approach which was employed may account for dispersion issues, it may not sufficiently account for excess zero process observed in these data. Two problems exist in this data, which may preclude the use of a standard Poisson modelling approach to relate climate variables with malaria incidence. Firstly, if there is over dispersion and secondly, if the data exhibit excessive zero counts that is not suitable for the Poisson approach (as is the case in these data). The hurdle model is one class of model capable of capturing both properties [36,37,38]. The model comprises two-components. Firstly, a truncated count component, such as Poisson or negative binomial, is employed for positive counts, while secondly a hurdle component models zero vs. larger counts. For the latter component, a binomial model or a censored count distribution are commonly employed. The hurdle model in this analysis was tested by employing a negative binomial and binomial process for the two respective aforementioned components. The model output from the quasi-Poisson approach was compared with the hurdle model and significant differences were not observed.
Lags 0–12 months were modelled for each of the climatic explanatory variables. For each climatic variable a natural cubic spline basis (with 3 degrees of freedom) was employed to try and capture the non-linear effects and their lag dimensions. The models were implemented in R using the "dlnm" and "splines" packages.
Malaria trends
Most malaria cases were reported during the rainfall season (November to May), with major malaria incidence peaks occurring around the month of April. There were 246 confirmed malaria cases in the three wards with Buvuma, Ntalale and Selonga contributing 30, 19, 51% of the cases, respectively, for the period 2005 to 2015. Overall, the highest incidence rate (1.9/1000 population) was reported in Selonga in 2011. Mean monthly malaria incidence varied from 0 to a maximum of 1.9/1000 population across the three wards (Fig. 1). The majority of malaria cases (95%) occurred in the > 5 year age category. Temporal trends in malaria incidence for Buvuma and Selonga showed almost similar patterns with the highest peaks in 2011 and 2013. There were no reported cases of malaria in Ntalale for the period 2005–2008 resulting in the ward having the lowest number of malaria cases over the study period. However, there was a sharp increase in incidence in 2011 with a peak of 1.3/1000 population in February in that ward. After 2013, all three wards experience a general decrease in malaria incidence compared to the previous period. The trends shown in Fig. 2 are for the period 2010–2015 only as data for the previous years was not available for some of the months.
Trends of incidence rates for confirmed malaria cases reported for Buvuma, Ntalale and Selonga wards for the period January 2010 to April 2015
When trends of malaria incidence were analysed using a linear regression, the reduction in malaria incidence over the period 2005–2015 was statistically significant for Buvuma (F = 9.21, p = 0.004) and Selonga (F = 8.57, p = 0.005) wards. However, the same trends were not statistically significant for Ntalale ward.
Trends of confirmed and unconfirmed malaria cases
The results of this study showed no correlation between clinical malaria (unconfirmed) cases and confirmed malaria cases in all the three wards studied based on available data covering 2005–2010 (Fig. 3). The number of confirmed malaria cases was 0.67, 0.62 and 6% of all suspected (unconfirmed) malaria cases in Buvuma, Ntalale and Selonga respectively.
Comparison between the number of confirmed and unconfirmed malaria cases for Buvuma (graph A), Ntalale (graph B), Selonga (graph C) and combined wards (graph D) for the period 2010–2015
Precipitation and temperature trends
The mean monthly climatic variables for the three study wards (Table 1) showed that Ntalale ward had high mean monthly precipitation during the study period compared to Buvuma and Selonga. All the other variables were very closely related across the wards. The combined mean minimum, mean maximum and mean average temperatures for the three wards were 19.02, 40.09 and 29.55 °C, respectively.
Table 1 Mean monthly climatic variables for Buvuma, Ntalale and Selonga wards for the period 2005–2015
The monthly precipitation peaked between November and January for all the three study wards (Fig. 4). The precipitation trends followed the same general pattern with Selonga having slightly higher precipitation peaks compared to Buvuma and Ntalale. The highest peak for precipitation was in January 2013 for all the three wards. Notably, one of the three main peaks in malaria incidence during the 2005–2015 period was also in 2013. Mean minimum, mean maximum and mean average temperatures for the three wards showed slight variations. The mean monthly temperatures showed a fluctuating trend from 2005 to 2015 (Fig. 4). The highest mean temperature was recorded in 2011 (37.13 °C) in Buvuma ward. Overall, Buvuma ward recorded slightly higher temperatures than Ntalale and Selonga.
Trends for mean monthly precipitation and temperature for Buvuma, Ntalale and Selonga wards for the period 2005–2015
Relationship between malaria incidence and climatic variables
There was no significant correlation between malaria incidence and climatic variables at 0-month lag period except for mean minimum temperature in Selonga ward. There was a significant correlation between malaria incidence and the climatic variables in Buvuma and Selonga wards at specific lag periods (Table 2). Precipitation was significantly and maximally correlated with malaria incidence in all the three study wards at 1-month lag period. In Ntalale ward, only precipitation (1- and 3-month lag) and mean temperature (1- and 2-month lag) were significantly correlated with incidence. There was also no significant correlation between incidence and climatic variables in all the three wards at 6-month lag period. The maximum positive and significant correlation between malaria incidence and mean minimum temperature occurred at 2-month lag period in all the three wards. Overall, the maximum positive correlation between incidence and minimum temperature occurred at 2-month lag in Selonga (r = 0.365). Beyond the 6-month lag period, there were no significant positive correlation between malaria incidence and climatic variables.
Table 2 Association between malaria incidence and lagged climatic variables measured by the Pearson's correlation coefficient
A sensitivity analysis was performed to estimate the correlation coefficients using the Spearman rank correlation. This analysis gave similar results to the Pearson correlation coefficient. Use of time series correlograms (autocorrelation plots) stratified by ward suggests 12-month seasonality in Buvuma and Selonga but not in Ntalale, the latter being more sporadic (Fig. 5). Additional analysis highlights how the transmission of malaria is linked to seasonal climatic variables (by assessment of lag and distribution of correlation over a 12 month season).
Time series correlograms stratified by ward for Buvuma (a), Ntalale (b) and Selonga (c) wards
Overall, cross-correlation coefficients of time series of monthly climatic variables and monthly malaria incidence showed that the minimum monthly temperature at 2-month lag was a positive and strong predictor for an increase in malaria incidence (Fig. 6).
Cross-correlation coefficients of time series on monthly climatic variables (precipitation and temperature) and monthly malaria incidence at various lag periods. The grey shaded area represents the 95% confidence band for the autocorrelations. Blue dots represent autocorrelations of the lagged variables
The DLNM to assess the temporal lagged correlation between monthly malaria incidence and monthly climatic variables supported the optimal lag periods identified using the lagged cross-correlation coefficient analysis. The distributed lag curves between malaria incidence and the climatic variables is shown in Fig. 7. The model results suggest a strong and significant increase in monthly malaria incidence relative risk at lags 0 to − 2 for precipitation with peak at lag − 1 month. The association between lagged minimum temperature and monthly incidence occurred at lags – 2 to 4 months with a peak at − 3 months. Similarly association was observed for maximum and average temperatures though the strength of association was not as strong as observed for the preceding two climatic indicators (Fig. 7).
Distributed lag between precipitation, minimum temperature, maximum temperature and average temperature. The green line is the estimated distribution lag (month), while the shaded bands indicate the 95% confidence interval. The horizontal axis shows the relative risk (RR)
Data from most malaria surveys in Zimbabwe are aggregated at national or district levels and do not give detailed patterns of malaria at lower levels such as the ward. Our study used ward level data in a malaria endemic rural area of Zimbabwe. The study was based on confirmed cases of malaria and therefore gives a more accurate picture of the malaria situation in the area as opposed to using data from unconfirmed cases of malaria as done in some previous studies [39,40,41,42].
Results from this study shows that the preceding 1–4 months of climate is more correlated with current malaria incidence. Climatic variables at 1–4 months lag period can, therefore, be considered as early-warning indicators and can play a role in planning for malaria control. Most significant correlations were observed between minimum temperature (range 6.5–22.0 °C) and malaria incidence compared to average (range 19.2–37.1 °C) and maximum temperatures (range 29.3–52.7 °C). The minimum temperature was significantly associated with malaria incidence at 1- and 2-month lag periods in all the study wards. This seems to suggest that minimum temperatures have a greater influence on malaria transmission in the study area compared to higher temperatures. Similar observations were made in studies in Botswana [42] and Rwanda [43].
The results from this study show that malaria incidence is significantly associated with precipitation in all the three wards at 1-month lag period. This shows that precipitation can play an important role in malaria transmission in the study area at 1-month lag. The findings of this study on the influence of precipitation on malaria incidence were different from previous studies which showed that higher rainfall does not necessarily result in significant changes in malaria cases [44, 45]. Results from different studies on the relationship between climatic variables and malaria are quite varied, thereby indicating that this relationship is complex [46].
The results suggest 12-month seasonality of malaria transmission only in Buvuma and Selonga, but not in Ntalale. In order to explain this difference, there is need to study the role of other variables such as timing and types of malaria control activities specific to each ward. These variables were not included in this present study because of the unavailability of complete data on malaria interventions at the time of the study.
Several studies have shown the effect of climatic variability on malaria transmission [12,13,14,15,16,17,18,19, 32]. A study on climate and vector borne disease by Mondzozo et al. [15], showed that Zimbabwe's average annual changes of malaria cases per 1000 as a result of climate change was 98 cases between the years 1990 and 2000. That same study also showed that an estimated 1% increase in temperature per annum led to 12.65 more malaria cases, while an estimated 1% change in precipitation led to a − 0.53 change in malaria cases. Modelling has shown that optimal malaria transmission occurs at 25 °C and malaria transmission decreases at temperature above 28 °C [47]. Temperatures below 16 °C are also detrimental for survival of mosquitoes [48]. Maximum temperatures have been shown to frequently approach or exceed the upper limits of mosquito survival [49]. The mean minimum, mean maximum and mean average temperatures for the study area were 19, 40 and 29 °C, respectively. This indicates that the mean minimum temperature may have been in the range for survival of mosquitoes. However, the mean maximum and average annual temperature were outside the optimal range of temperature for malaria survival. Results from a previous study showed a strong positive association between malaria incidence in a given month and the minimum temperature of the previous month. This indicates that the minimum temperature is an influential climatic variable for malaria transmission [50].
The study showed that malaria incidences are higher (95%) in the > 5 years age category. Malaria control interventions in the country have mostly been targeted at pregnant women and children below 5 years as they are the most vulnerable. This has resultantly led to a decrease in incidence in these two social groups. This could possibly explain why our results show less infections in the below 5 years age category. Studies from Botswana showed similar findings [42, 51] in contrast to studies elsewhere [52]. A higher burden of malaria in older ages has economic implications, as the age group is the most economically productive. It is therefore critical for malaria control interventions to target all age categories for better impact. It has previously been reported in some studies that in areas of high transmission, the malaria burden mainly among children and infants, while in areas of low transmission, older ages carry the most burden [25, 52,53,54]. The results of this study concur with these previous findings.
Contrary to results from a previous study [55], we did not find a correlation between the trend of confirmed and unconfirmed (clinical) cases of malaria. This suggests that that the trend of clinical malaria cases may not be reliably used to represent the trend of confirmed cases. Thus, it is important to assess the trend of malaria using confirmed cases as opposed to clinical cases as the latter does not provide a true picture of the trend. It was noted that in all the study wards, the number of confirmed malaria cases was less than 10% of all suspected cases. Unconfirmed (suspected) cases of malaria are those that would have presented to the health facilities with fever. These fevers could be an indication of other health problems in the community that result in fevers [56]. A previous study showed that in Zimbabwe, clinical diagnosis over-estimates malaria cases by 73% [40]. Over-diagnosis of malaria will lead to failure to treat the alternative causes of severe infection [41] and may lead to drug resistance through treatment of uninfected people. Before 2011, all suspected malaria cases were treated for malaria since the rapid diagnostic tests (RDT) were not yet available at health facilities in the district. However, from 2011, the policy has been to test all suspected malaria cases with RDT thereby ensuring that only positive cases are treated. This new malaria treatment policy is, therefore, important in curbing drug resistance due to treatment of malaria negative patients.
This study had some limitations. Secondary data from health facilities was used and, therefore, there was a possibility of missing or incomplete data from some of the records. Health facility data has a potential for under-reporting malaria cases, as some may not have presented at the health facilities. Health facility-based data can be affected by many factors including accessibility of the facilities by patients, perceptions of care and whether or not self-treatment is available to the patients [57]. The other limitation was that some confounding factors might have influenced the results of the study. These include the impact of malaria control activities and other related interventions.
Data from the health information system were utilized to determine the trends of malaria incidence and their relationship with climatic variables at ward level in a rural community. The study found that precipitation and temperature play a role in influencing malaria incidence at specific lag periods and can, therefore, assist in prediction of malaria risk. As the period of high malaria risk is associated with precipitation and temperature at 1–4 month prior in a seasonal cycle, intensifying malaria control activities over this period will likely contribute to lowering the seasonal malaria incidence. Further monitoring of malaria incidence in affected communities has the potential to reveal future trends of malaria transmission thereby leading to improved control strategies.
°C:
degree celsius
%:
CHIRPS:
climate hazards group infrared precipitation with station
DHIS:
district health information system
MODIS:
moderate resolution imaging spectro-radiometer
RDT:
rapid diagnostic test
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Chirebvu E, Chandiwana SK, Masedza C. Practicability and acceptability of mosquito bednets in Honde Valley, a malaria endemic area in Eastern Zimbabwe. Malar Infect Dis Afr. 1995;2:39–44.
Punjabi NH, Taylor WR, Murphy GS, Purwaningsih S, Picarima H, Sisson J, et al. Etiology of acute, non-malaria, febrile illnesses in Jayapura, northeastern Papua, Indonesia. Am J Trop Med Hyg. 2012;86:46–51.
Byass P. Making sense of long-term changes in malaria. Lancet. 2008;372:1523–5.
RG, SS, MJC and SM conceived and designed the study. RG performed fieldwork and data collection. RG, SS and analysed the data. BS reviewed and critically edited the manuscript. RG wrote and compiled the manuscript. All authors read and approved the final manuscript.
This project received financial support from the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the Canadian International Development Research Centre (IDRC). This study also received financial support from the College of Health Sciences of the University of KwaZulu-Natal through Ph.D. studentship bursary awarded to Gunda R. Many thanks go to the Ministry of Health and Child Care Zimbabwe for supplying us with malaria data for Gwanda District. We would also like to acknowledge the Southern African Science Service Centre for Climate Change and Adaptive Land Use (SASSCAL) for funding the process of producing the manuscript through its Task 349 on capacity building.
School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Resign Gunda
College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa
Moses John Chimbari
Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe
Shepherd Shamu
Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Benn Sartorius
School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
Samson Mukaratirwa
Correspondence to Resign Gunda.
Gunda, R., Chimbari, M.J., Shamu, S. et al. Malaria incidence trends and their association with climatic variables in rural Gwanda, Zimbabwe, 2005–2015. Malar J 16, 393 (2017). https://doi.org/10.1186/s12936-017-2036-0

redpajama_set_name: RedPajamaCommonCrawl


Description: Based on his own extensive experience as a colon and rectal surgeon, the author has successfully sought to provide a reference book on lower gastrointestinal endoscopy that doubles as a teaching text for the endoscopy student and a reference text for the experienced endoscopist.
Purpose: This technique is a rewarding procedure that possesses easily identifiable clinical benefit. Central to the execution of the well-performed examination is personal experience; however, access to a solid reference in the basics and applications of the procedure is also a critical component. The author has succeeded in providing both.
Audience: The early chapters, illustrated with crisp, clear photos and figures, are very useful for the early practitioner who is interested in setting up or is adapting to an existing endoscopy lab. The middle chapters are useful for the student of endoscopy and the occasional practitioner as well as for the experienced endoscopist reinvestigating a seldom-used technique or wishing to add new tricks to his or her armamentarium, as in the chapter covering (among other topics) the use of adrenaline and dye, the application of laser, and the technique of clip application for bleeding and marking. The remaining chapters, also accompanied by beautifully reproduced endoscopic photographs, will be an excellent reference for the endoscopist at any level.
Features: In part one, six chapters address the basic techniques of lower GI endoscopy, describing the many types of endoscopes and accessories available, detailing how to set up and maintain an endoscopy room and finishing with a chapter on endoscopic indications and contraindications. Part two begins with a chapter on patient preparation and continues with several excellent, detailed chapters on techniques of the different forms of endoscopy and the treatment of polyps. Finally, part three provides an in-depth review of the many applications of lower GI endoscopy in a problem-based format. The illustrations are accompanied by complete, descriptive legends that make even browsing throughout the book educational.
Assessment: This enjoyable, complete, solidly fabricated, and excellently illustrated book belongs on every reference shelf as well as on the shelf of any practitioner of endoscopy.
Based on his own extensive experience as a colon and rectal surgeon, the author has successfully sought to provide a reference book on lower gastrointestinal endoscopy that doubles as a teaching text for the endoscopy student and a reference text for the experienced endoscopist. This technique is a rewarding procedure that possesses easily identifiable clinical benefit. Central to the execution of the well-performed examination is personal experience; however, access to a solid reference in the basics and applications of the procedure is also a critical component. The author has succeeded in providing both. The early chapters, illustrated with crisp, clear photos and figures, are very useful for the early practitioner who is interested in setting up or is adapting to an existing endoscopy lab. The middle chapters are useful for the student of endoscopy and the occasional practitioner as well as for the experienced endoscopist reinvestigating a seldom-used technique or wishing to add new tricks to his or her armamentarium, as in the chapter covering (among other topics) the use of adrenaline and dye, the application of laser, and the technique of clip application for bleeding and marking. The remaining chapters, also accompanied by beautifully reproduced endoscopic photographs, will be an excellent reference for the endoscopist at any level. In part one, six chapters address the basic techniques of lower GI endoscopy, describing the many types of endoscopes and accessories available, detailing how to set up and maintain an endoscopy room and finishing with a chapter on endoscopic indications and contraindications. Part two begins with a chapter on patient preparation and continueswith several excellent, detailed chapters on techniques of the different forms of endoscopy and the treatment of polyps. Finally, part three provides an in-depth review of the many applications of lower GI endoscopy in a problem-based format. The illustrations are accompanied by complete, descriptive legends that make even browsing throughout the book educational. This enjoyable, complete, solidly fabricated, and excellently illustrated book belongs on every reference shelf as well as on the shelf of any practitioner of endoscopy.


I know what this is about. But then you don't have to be Freud to gather the meaning here. As as the content guy, I have internalized a deep sense of responsibility for fueling our sales team with material they need. I worry about this. And while this anxiety may inspire odd nightmares, it's ultimately a productive concern. Sales teams need good content.
And, odd as it is, the dream provides a very helpful analogy: For sales reps, trying to make sales without content is like trying to run a marathon on an empty stomach. The right content fuels the full run. Giving them the wrong content is like feeding them a sad little Milk Dud.
I do my best to avoid feeding our sales team measly Milk-Dud content.
Of course, cooking up good content takes requires some thought. And the best content is ultimately a team effort. It may be obvious, but I am very invested in working with sales. Still, it's surprising how much content gets produced without any input from sales teams.
For me, it's a no-brainer: Marketing and sales should work together to create content. The sales team fields questions, listens to pain points, and spends quality face-to-face time with prospective buyers. They know which questions get asked repeatedly, and what challenges are shared across audiences. The entire point of content marketing is to provide answers to those questions and solutions. We answer those questions by providing valuable content.
What is missing from our organization's content collection?
What has one of my prospects needed to know for which I did not have a content piece to explain?
Yes—I mean sales. I know sales is busy—very busy. I just mean write up a draft or an outline of notes. Get the marketing team to create the final version.
A successful content strategy requires commitment from all departments, including sales. Each piece of content should answer a question, offer advice or add value to the buyer's journey in some way.
Share your organization's content resources with your social networks. Ask your colleagues to share your work. Offer to share their work. If your marketing department publishes a new guide — help distribute the content by putting your social signals to good use.
Finally, if you're not using content already, then you're running that marathon on an empty stomach. Your marketing team is cooking up some good stuff. Make sure to use it. From your first interaction to your last, content can be the glue that helps you bond with each prospect, lead and customer. Warm up your initial outreach with a relevant piece of content that will help your prospect in some way.
On a larger scale, as a sales rep, remember that your organization's collection of content tells the ultimate story about your brand as an industry expert and thought leader. It's documentation of your brand's reputation. This is a major initiative that requires all hands on deck. Round out what your company is talking about by offering your expertise. When it comes to understanding your audience, data is great, but numbers ain't got nothing on a seasoned sales rep. Nobody knows customers as well as the sales team.
If you're like to learn more about how to make sure your sales teams is getting the right content, feel free to get in touch!


We will meet at 5:00 p.m. on October 22 for our annual youth trip to Dell'Osso farm's corn maze. As Nick likes to say, it's going to be ah-maze-ing! We will explore the corn maze and haunted house (if you are brave enough!) and have dinner at Dell'Osso farm. Please bring $18, comfortable shoes, and a jacket in case it gets cold. We will meet at 5:00 p.m. at Asbury and return to Asbury at 8:00 p.m. Please RSVP to Chelsea by October 15 by using the Contact Us form here.


In this shiur we shall examine various aspects of the location of the city, reasons for its selection, the stages of its development, and the spiritual significance of its expansion.
Every ancient city had four main factors influencing the choice of its location: water, security, proximity to a road, and proximity to agricultural areas.
We shall now investigate how these factors influenced the choice of Jerusalem by its earliest Canaanite inhabitants .
a. Water – In the nearby Wadi Kidron, on the eastern slopes of the city, the Gichon spring flows all year round, undoubtedly capable of supplying the water needs of the city's inhabitants (in addition to cisterns that existed on private properties).
b. Security – the city is relatively well protected by Wadi Kidron to the east and the south, and the Middle Wadi in the west and the south. On the northern side of the city there is no natural protection , and therefore from this perspective its overall protection is incomplete.
c. Proximity to a road (see map A) - the city is not close to a road. The highway passed, naturally, over the watershed (Chevron Road up until the old railway station, center of town, the entrance to the city, and from there northward via Romema up to the area of French Hill). A narrative illustrating this fact quite clearly is the story of the Concubine in Giv'a. The man described in the story came with his concubine from Bethlehem in Yehuda, and on his way down to the bottom of the mountain of Ephraim he passed by Yevus and deliberated as to whether to turn off to this Jebusite city or not (Shoftim 19).
The formulation of the text tells us that the city was not located on the highway but rather at some distance from it . Thus, from this point of view, its location is not ideal.
d. Agricultural areas – there were no significant fields or broad valleys in proximity to the ancient city; this factor, too, is less than ideal.
We may summarize these factors in relation to Jerusalem by saying that the main reason for its ancient inhabitants choosing to settle there was the availability of water, and – to a significant extent – also the security factor (imperfect as it was). The other factors did not exist here. Our principal conclusion is, therefore, that King David chose Jerusalem despite its topographical conditions, rather than because of them. Although the natural conditions of the city were less than ideal, other – spiritual - reasons drew him to it. His motivation in choosing Jerusalem was the desire to unite, by means of his kingship, the tribes of Binyamin and Yehuda, representing the children of Rachel and Leah respectively. Hence, in this case, it is specifically an examination of the topography that proves that the reasons for choosing this city were based on the spiritual significance of the place.
Having examined the basic topographical conditions of the ancient city, let us now briefly review the stages of its development – particularly in light of archaeological findings.
The beginnings of the ancient city – in the Chalcolithic period – are to be found in the southern part of the eastern hill. Settlement began here around the spring and continued to spread westward. The boundaries were, as noted, Wadi Kidron in the east and to the south, with the Middle Wadi in the west and the south. The area of the city remained the same from its beginnings, throughout the Early and Middle Bronze Age (corresponding to the period of the forefathers) and the Later Bronze Age (corresponding to the period of the conquest and settlement of the land), up until the time of King David – including his reign (it was during the reign of David that the altar was established at the threshing floor of Aravna the Jebusite – on Mount Moriah).
The city expanded to include Mount Moriah to the north and the City of David to the south. During the time of Shelomo, with the construction of the king's palace and the House of God, the city expanded northward to include the Millo . Shelomo built a wall around the entire city, including the entire eastern hill.
A central question that occupied scholars for over a hundred years was during which period the city expanded westward so as to include the area of the Jewish and Armenian Quarters of today, and Mount Zion. After the Six-Day War the puzzle was finally solved, when Prof. Avigad conducted an archaeological dig in the Jewish Quarter and found a massive wall, which he dated back to the 8th century B.C.E. – the days of Chizkiyahu. The discovery of this wall immediately ended the decades-long debate .
We have reviewed the expansion of the city up until the end of the First Temple period. Towards the end of the Second Temple period, the city developed most significantly in a northern direction, but this process actually began at the end of the First Temple period, where – as far as we are able to ascertain – it overflowed northward beyond the existing wall. It may be that these are the areas outside of the wall referred to by the prophet Tzefanya (1:10) as "Geva'ot" ("Hills")  and by the prophet Yirmiyahu, perhaps, as "the hill of Garev" and "Go'a" (31:38).
We shall examine this subject from two different angles: the halakhic and the philosophical.
"How are the city boundaries expanded? The Beit Din offer two thanksgiving sacrifices and take the leavened bread from them, and the [people of the] Beit Din proceed after the two offerings, and the two offerings one after the other, and they stand with harps and lyres and cymbals at every corner and at every stone in Jerusalem, and declare: 'I shall extol you, Lord, for You have lifted me up…' – until they reach the boundary of the area that they are sanctifying, and they stop there. There they eat one of the breads of the two thanksgiving offerings, and the second is burned. The prophet determines which is to be burned and which to be eaten.
Likewise, if area is added to the Sanctuary, it is to be sanctified with portions of the mincha offering. Just as the thanksgiving offering that is eaten in [the new area of] Jerusalem causes it [the area] to be sanctified, so the Sanctuary – which is the only place where parts of the mincha offering may be eaten, is sanctified through them, and they are eaten at the boundary of the area that they sanctify."
The expansion of the city has various ramifications from the point of view of the sanctity of the city – such as the consumption of sacrificial foods of lesser sanctity, ma'aser sheni, etc. This law rests upon a perception that the Temple, the House of God, is the place where the Divine Presence rests. The city that is surrounded by the wall is built around the place where God's Presence rests. Therefore, its expansion symbolizes a spreading of God's Presence in the world, the expansion of the manifestation of God's Kingship, and therefore it is performed specifically by a prophet, the Sanhedrin, and the urim ve-tumim .
Chazal describe, in several different sources, how the Temple in particular and Jerusalem in general have an aspect to them that exceeds the physical measure of the place. In other words, this place has a quality that highlights its lack of dependence on physical space; it is above space.
The Midrash (Bereishit Rabba 5:8) tells us that in the case of both the Mishkan and Jerusalem, "The smaller bore the greater" – i.e., there is no significance to the area itself and its limitations, since even in a small area an enormous number of people could be accommodated. This itself, explains the Midrash, is an expression of the fact that God's Presence rests in this place: "Thereby you shall know that the Living God is in your midst" .
This special reality exists in modern-day Jerusalem and will continue to exist in the future.
The expansion of the city beyond its boundaries is fundamentally bound up with the Holy of Holies, the place of the Creation of the world: "The place of the Ark is not related to physical area" (Megilla 10b).
"When they stood, it was crowded; when they prostrated themselves, they had place."
Jerusalem as a whole is fundamentally connected to the place of the Creation of the world, and the inner meaning of this fact is that the limitations of space are suspended there. A place which, by its essence, is above space will not be defined or limited by considerations of space .
Jerusalem of the future is described as a city that bursts beyond all of its original boundaries. This phenomenon is described by various prophets, as well as by Chazal in great detail.
"Sing, barren one who did not bear; break forth into song and call out – she who did not travail in childbirth, for the children of the desolate one are more numerous than the children of the married one, says God. Enlarge the place of your tent and the let them stretch the curtains of your habitations, spare not; lengthen your cords and strengthen your stakes. For you shall burst forth to the right and to the left, and your seed shall possess nations, and cause desolate cities to be inhabited." (see also Yishayahu 49:21).
The instruction to Zion is to prepare a broad space so as to be able to absorb all of its children. The expansion of the boundaries of Jerusalem and of Eretz Yisrael, according to this prophecy, involves the land of the nations. Further on, this prophecy describes the rebuilding of the city with peace and justice, with glory, splendor, and precious stones. The enemies of the city will not be able to prevail over it, and God's covenant with David is destined to be renewed; the nations will obey Israel and will come to their land for the glory of God.
In other words, the beginning of the process described in the prophecy is the expansion of the population, causing the expansion of the city. This process of expansion will involve, at the same time, a possession of the nations living in the land, and these will ultimately recognize the Kingship of God. Thus the city will be rebuilt with peace, with the nations of the world recognizing God's absolute reign. This is itself the rebuilding of Jerusalem with peace .
What is common to the prophecies quoted above is that in the future there will be a new reality in the land as a whole, and in Jerusalem in particular, with a very great increase in population that will bring about a renewal of the city and its expansion beyond its original boundaries. The details of the expansion differ from one prophet to the next, in accordance with the period when each lived and the purpose of his prophecies.
In several instances the expansion of the city is bound up with a renewed Divine revelation upon the city, expressed in a change of its name. Thus we find that Yechezkel prophesies that its name will be "God is her name" (48:35); Yirmiyahu – "God is our righteousness" (233:16); Yishayahu foretells (62:2,12), "Nations shall observe your righteousness, and all the kings – your glory, and you shall have a new name that shall be determined by God's mouth" – in other words, God will be revealed once again upon Jerusalem, and will give the city a new name (that includes the name of God).
The expansion of the city, then, expresses the Divine destiny of the city – the city of God's Kingship. In this sense, the expansion of its boundaries is directly connected to the recognition by the nations of the world of God's Kingship, the cessation of their warfare, and the justice that God is destined to mete out to them. Since these are two sides of the same coin, the expansion of the city and its renewal are also bound up with a process on Israel's part of strengthening justice, righteousness and judgment within the city. This is a reality that gradually spreads throughout the world, finding physical expression in the expansion of the city to the point where it has no boundary and needs no wall, and where God's Presence dwells within it (as described explicitly by Zekharya).
Chazal, in several different places in various ways (Bava Batra 75b; Sifri Devarim 1; Pesachim 50a; Shir Ha-shirim Rabba 7; etc.) describe this phenomenon of the expansion of the city. In essence, this phenomenon parallels the creation of the world. It was from this Archimedean point, the "navel" of the world, from the point which God chose as the beginning of the Creation, that the whole world came into existence. It was by means of this that all of the world recognized God's Kingship.
In this sense, the expansion of Jerusalem in future days will express the spread of Divine manifestation throughout the world, as it did at the time of the Creation, and therefore the description also includes the physical spread of the city as well as its elevation up to the Throne of Glory.
It appears that from a spiritual perspective, the significance of the expansion of the area of the city to the entire world represents the spread of recognition of God's Kingship throughout the world, and therefore the very fact of its expansion is, in effect, the attaining of the Throne of Glory.
"Blessed be God from Zion, He Who dwells in Jerusalem, Halleluya" (Tehillim 135:21).
The essence of the blessing is the multiplying, numerous abundance that God grants to all of the world. This blessing is one of the expressions of the ongoing connection between the place from which the world was created and all of Creation.
In contrast to the blessing that constantly flows from Zion when the Divine Presence rests there, Yechezkel describes how, following its "banishment," as it were, from the Temple, the Divine Presence is found everywhere: "Blessed be the glory of God from His Place" (Yechezkel 3:12). The blessing emanates from God wherever He is – not from Zion.
Salvation emanates from Zion, as it is written, 'Oh that the salvation of Israel may come from Zion' (Ibid. 14:7)."
This Midrash expresses the spiritual and practical centrality of Jerusalem for the entire world, in the senses that it enumerates. Its centrality, here, means an influence that indicates the source of the blessing and abundance. In this sense, the blessing of Zion and its influence upon the whole world actually represents the continuation of the creation of the world, which was the first blessing that emanates from Zion to the world.
Jerusalem is chosen despite the fact that it lies relatively low. This choice expresses God's humility. Another reason for its choice despite its low altitude is as a contrast to the idolaters. The pagans deliberately chose high places, based on their perception of physical, material divinity. The Holy One – as the antithesis to their accepted view – specifically chooses Jerusalem, whose elevation is relatively not all that great.
Yishayahu foretells how, in the time to come, the city will change, and Mount Moriah will be uplifted. In the future reality the disparity between physical height and spiritual elevation will disappear, and all the world will "ascend' to worship at the mountain of God in Jerusalem – "For Torah shall emanate from Zion, and the word of God from Jerusalem."
The other topographical issue that remains to be discussed is the proximity of Jerusalem to the desert, and its significance. This will be the subject of the next shiur.
 According to archaeological findings, the city has existed from the earliest period of civilization, but the wall, fortifications and water works date back only to the Middle Bronze Age – the period of the forefathers; hence we specify "the earliest Canaanite inhabitants."
 We may say of Jerusalem, to borrow a phrase, that which Yirmiyahu said of Eretz Yisrael as a whole: "Trouble will start from the north" (Yirmiyahu 1:14), since this boundary has no natural protection.
 This fact has symbolic significance in that Jerusalem is attained not immediately but rather after some additional journeying – both in time and in terms of spiritual progress, when the nation is ready. We shall elaborate on this point in future shiurim.
 This subject will have a shiur devoted to it in its own right – the Period of Shelomo.
 This hill has many names; we shall review them briefly here: "The 'shoulder' (south side) of the Jebusites (Katef ha-Yevusi)" (Yehoshua 15:8; 18:16), seemingly also the "second quarter (mishneh)" (II Melakhim II 22:14; II Divrei Ha-yamim 34:22; Tzefanya 1:10), and perhaps the south-eastern portion was known as the "Makhtesh" (Tzefanya 1:10-11). This subject requires further study; we shall not pursue it any further in the present discussion.
 In the northern part of the ancient city (in the Christian and Muslim Quarters), in places where archaeological studies have been conducted, a layer of habitation dating back to the First Temple period has been discovered. There are also remains of a large trench to the north of the ancient city, in between the Damascus Gate and the Flower Gate, and to the north of it - along the length of the northern slopes of the Middle Wadi – there is a grand burial ground from the end of the First Temple period.
 An all-encompassing discussion of this aspect requires a shiur on its own; we shall therefore address here only the major source and its significance.
 The Amoraim known as Rav Huna and Rav Nachman are divided as to whether all of these conditions are necessary. This discussion is related to the question of whether the original sanctity bestowed on Jerusalem was temporary or permanent. The Rambam rules in accordance with the view of Rav Huna – that Ezra the Scribe merely made some earthly sign, since the original sanctity was bestowed on the city both "for its time" and for "the time to come." We shall not elaborate here.
 There is room to consider the spiritual significance of the expansion of Jerusalem following the Six-Day War as a direct fulfillment of the prophetic vision – we shall not elaborate here.
 There is room for discussion concerning the fact that "THE place" that God chooses, in order to rest His Presence there, is actually beyond the boundaries of physical space. What this means is that physical reality cannot contain the spiritual, which is beyond space and measure.
 This is a fascinating philosophical topic, it is related, more generally, to the phenomenon of the Temple, which embodies contradictions. We present here no more than a "reference" for further study of this profound subject.
 The expansion of the city is described by several prophets – for instance, Mikha 2:13, 14:8; Yirmiyahu 31:37-39. In Yechezkel's prophecy, the expansion of the city and the Temple is an integral part of the renewed dwelling of God's Presence.


text:
Moisés da Costa Amaral (19 May 1938 – 22 February 1989) was an East Timorese  politician in the Timorese Democratic Union.

Born in 1938 in Fahinihan, East Timor.

Moisés da Costa Amaral was an East Timorese leader. Since 1975 until his death, he was the President of the political commission of the Timorese Democratic Union.

Moisés da Costa Amaral was married and had one child.

On March 31, 1986, Moisés da Costa Amaral, as the UDT leader signed the terms of the formation of the Nationalist Convergence with Fretilin, an important and necessary step in defense of the right to the self-determination of the people of East Timor.

On August 12, 1988, and after several years of diplomatic struggle, finally a Timorese delegation had the opportunity to defend the right to the self-determination of the Timorese people within the United Nations. Moisés da Costa Amaral made the statement representing the nationalist convergence, a delegation composed also by Monsignor Martinho Lopes, apostolic administrator of Dili, Roque Rodrigues representing Fretilin and João Carrascalão representing UDT. Within the United Nations this was the first big step that led to the so desired independence of the Democratic Republic of Timor-Leste.

References

1938 births
1989 deaths
Timorese Democratic Union politicians

redpajama_set_name: RedPajamaWikipedia


Our Calgary branch is located in an area of the province of Alberta that services many different industries. With many of the oil and gas head offices located in the city, we make it easy for them to find the right solution to their cleaning needs. We also service many other industries, including automotive, transportation, construction and agriculture. The Calgary branch is unique in the sense that we cover it all, and we can find the right machine for you. Come visit us today!
When it comes to maintaining your assets and ensuring a job well done every time, it doesn't get more efficient than a pressure washer. To degrease your equipment and keep a job site spotless no matter how messy your industry, Hotsy Water Blast in Calgary provides pressure washer repairs and sales to fit your needs.
Broken equipment? Need an upgrade? The knowledgeable staff at our easily-accessible location can offer you advice on the best options for your industry, whether you're operating a large oilfield or a small-scale cleaning business. We offer over 100 models of industrial-grade pressure washers of all kind: hot or cold, mobile or stationary. If you're having trouble with your existing equipment, repairs are only a visit away. Can't make it to our location? We have an 18-truck fleet of maintenance vehicles that can go on location and help you right on site.
With experienced mechanics who take the longevity of your equipment to heart, Hotsy Water Blast is the destination for Calgary's pressure washer repair needs. We have an extensive 50-point inspection that is sure to find flaws in your equipment and help you get your business back on track in a timely manner.
The only way to survive in competitive industries is to innovate. When it comes to finding out new and efficient ways to use your equipment, don't let yourself be limited by what's available on the market. At our Calgary location, we are able to design and engineer equipment to your exact specification to help your fully realize the vision you have for your business and help you grow.
The Hotsy Water Blast team – with its 4 decades of experience in the field – knows pressure washers. Whether you're in the hydrovac business or require a complex hot water system for the particular degreasing needs of your oilfield equipment, our specialized team can make sure that your new system is set up and ready to go when you need it. From pre-installation on-site visits to training you on the proper use and maintenance of your system, we are dedicated to ensuring that your new equipment performs as expected the first time, and every time.
Whether you're looking to buy, repair, or manufacture your pressure washing system, our Calgary location can handle your needs. Schedule a service call, and installation, or come meet us to discuss your new purchase or your needs for a custom machine.


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Opt for Wood Spirit, a hard wearing porcelain floor tile with the beautifully diverse nature of real wood. wood Spirit uses the latest in manufacturing technology to create the perfect replication of wood with high definition detail. The three contemporary colours blend perfectly into the series. The functional characteristics outweigh that of real wood, with an anti-slip version, perfect for creating a seamless floor from room to room.


To guarantee a good seat, please make your dinner reservation by emailing reservations@theroyalroomseattle.com Advance tickets can only be purchased online. We do not sell advance tickets at the venue.
Israel is a master of Flamenco guitar from Granada, Spain. Born into a generational legacy of Spanish Romani Flamenco artists, Israel has distinguished himself as an exceptional performer and composer in his own right, having toured with the world's greatest living Flamenco singer, Diego El Cigala.
A versatile and unpredictable force of nature onstage, Jose 'El Niño' Uz is a consummate performer and improviser. His playful style and unending energy will having you craving more.
A mesmerizing and expressive performer, Amelia Moore dominates the stage with the exquisite musicality of her Flamenco dance.
Originally from Havana, Cuba, Samir Osorio has nearly 20 years of experience singing Flamenco and has become known as one of the few singers in the U.S. who can capture the raw essence of the Flamenco sound and feel.


The Christmas story comes alive as you journey through the Bethlehem Walk in Parksville. Stop wondering what it was like 2000 years ago and experience for yourself. Another fabulous Christmas event on Vancouver Island.
Hope, Joy, Peace and Love. Isn't that what Christmas is supposed to be about?
Christmas is a spectacular time of year, but often the hustle and bustle of the season can get a little carried away and we can miss the whole reason we even have Christmas to begin with. Just spend a Saturday in December at the mall and you'll soon be exhausted by the over-consumerism of it all.
This is why I absolutely love going to the Bethlehem Walk in Parksville with my family.
We return to the beginning of Christmas and enter the town of Bethlehem where Jesus was born so many years ago. And it's so much more than just seeing shepherds out in the fields and Mary and Joseph in a little stable with baby Jesus asleep on the hay. The town itself comes to life as you'er transported back in time.
Nothing has made Christmas come alive for me and my family more than spending time walking the streets of Bethlehem.
Surrounded by Roman soldiers making sure all the townspeople behave, watching a real blacksmith fire the iron and hammer it out, we join the sights and smells of this town's story.
We watch candle makers dip their candles in hot wax, sit for a quick cup of coffee at the local market coffee shop and even pet the local sheep, goats, and llamas. This interactive experience truly makes the story more real than any movie or book for kids and adults alike.
Though the Bethlehem Walk event is located at a church, it's not a "preachy" event. It's open to the public for only four nights and is well worth the drive from wherever you live on the island. Thousands of visitors are expected once again this year, so be sure to get there early.
The historical account is read and acted out, but mostly this walk is designed for you to immerse yourself in the culture and time of 2000 years ago.
The Bethlehem Walk brings new meaning to the Hope, Joy, Peace and Love of the Christmas season.
Oh and don't forget to leave time for hot chocolate, cookies and carolling indoors after you leave Bethlehem; a perfect ending to a fun, family, Christmas activity.
More Info: Visit the Bethlehem info page online.
Cost: FREE. You are welcome to bring a non-perishable food item or money which will be distributed directly to Parksville Salvation Army. In 2014, visitors donated multiple van loads of food and over $16,600 in donations.
What To Bring: There is usually a long line, so arrive early and bring umbrellas and weather appropriate attire (the wait is outside). The walk itself is outdoors, though completely sheltered from rain and wind.
Parking: for your convenience, there is a shuttle service starting at 5:30 from the Wembley Mall (826 Island Hwy, Parksville) Look for shuttle signs in the Wembley Mall parking lot.


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redpajama_set_name: RedPajamaStackExchange


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The Bowens in New York
Brooklyn Row House
Brooklyn, Willow Street
ROOM NAVIGATION
The Rest of the Year
The Bowen family spent several months each year in Woodstock at their summer home, Roseland Cottage. The rest of the year, they lived in Brooklyn, New York, and Henry traveled daily to Manhattan, where his newspaper and silk/dry goods businesses were located. Despite Henry's Woodstock roots, this was a Brooklyn family, happy to spend summers in the cooler, more relaxed country atmosphere, but their center of gravity was New York. Furniture for Roseland was made and shipped from New York. They were founding and faithful members of first Pilgrim and then Plymouth Churches in Brooklyn, for which they provided generous financial support. Lucy gave birth to all her children in Brooklyn. And the clubs and entertainments enjoyed by family members were centered in New York. Henry's involvement in the planning of Roseland Cottage, his interest in ecclesiastical architecture, and his belief in taking a responsible role in making towns attractive leave little doubt that his homes and offices in Manhattan and Brooklyn would be stylish buildings.
Brooklyn Ties
A Family Favorite
This lantern hangs in the hall of Roseland Cottage, and is a reminder of the family's attachment to Brooklyn. It commemorates the opening of the Brooklyn Bridge in 1883. The Bowens, who watched the building of the bridge from their Brooklyn home, took part in the parade across the bridge on opening day along with thousands of others. The lamp was made to be fueled by gas, but Woodstock and Roseland Cottage never had access to gas, so it was adapted by the family, probably to oil, and then adapted again to electricity when that technology reached Woodstock Hill.
Hicks Street
Gothic Revival Town House
Another Gothic Revival Tap IMAGE for info
Entrance Fit for a King
Gothic Railings
Masquerading as Casements
An Elegant Home
Corner of Willow And Clark
Brooklyn Heights was an enclave for many former New Englanders. Once Bowen & McNamee was solidly established, in 1854 the Bowens left the Hicks Street row house for 90 Willow Street. They purchased an impressive modified Greek Revival mansion thought to be one of the most elegant in Brooklyn. Henry and Lucy filled it with high style furniture and had elaborate frescoes and other decorations installed. The house, formerly owned by banker and financier David Leavitt, was built in 1844. It occupied half a city block and was known for its colossal Greek Corinthian portico which looked out over the harbor. In 1904, after the death of Ellen Holt, Henry's second wife, the house was sold, and razed to make way for a hotel which was never built. This view of the imposing columns is actually the back of the house, taken from Columbia Street.
The Hall Tap IMAGE for info
The Parlor
The Rest of the Parlor
Library, Continued
A Bedchamber Tap IMAGE for info
Clarence's Room
From Willow Street
Bowen & McNamee, Silk Importers
The businesses that sustained the Bowen family were located in Manhattan, and Henry took the ferry to Manhattan on a regular basis. His primary business for many years was a dry goods and silk importation business established in 1839, specializing "in silks, ribbons, and the best class of fancy dry goods, and Yankee notions," which he owned with another former Tappan clerk, Theodore McNamee. Bowen & McNamee was an immediate success, which came as no surprise to many. One commentator remarked, "No matter what a venture seems to promise in other hands, it is almost always a mine of wealth when Henry Bowen works it." Bowen and McNamee built one of the first "marble palace" stores in Manhattan. Before that, they opened shop at the corner of Beaver and Williams.
Image courtesy of Avery Architectural & Fine Arts Library, Columbia University
Bowen & McNamee Token Tap IMAGE for info
Token's Inverse
Store Interior
Principles Not for Sale


We're excited to announce that Colaz now offers Q-switched laser tattoo removal.
to be as effective and pain-free as possible.
Regardless of your reason for wanting to remove a tattoo, when you decide you want it gone, you want the procedure to be as effective and pain-free as possible.
We take your health and safety seriously and work with only top of the line equipment and qualified, well-trained staff. If you've read about the horrors of cheap tattoo removal machines sold on popular auction sites or expensive tattoo removal options that just don't work, rest assured our laser tattoo removal services meet the same standards you've come to know and trust in our laser hair removal and skin care treatments. Your skin is safe with us!
safest, most affordable and most effective method.
Results can be seen immediately after your first visit whereas tattoo removal creams can take months (if ever) and chemical peels never fully remove a tattoo. If patience isn't your virtue then removal creams and chemical peels are definitely not the right option for you.
Risk of any long term damage to skin is minimal whereas the option of dermabrasion removal can take months for the skin to heal and even then, not always completely. Though laser tattoo removal is not pain free, the healing process is faster and there is less chance of painful after effects.
Most alternative options are either so painful or ineffective that laser removal replaced them as soon as it became available.
When it comes to laser tattoo removal, there are no guarantees. Results vary. Every tattoo and skin type is different.
Circulation enhances results so you'll generally find that the further from your heart your tattoo is located, the longer it will take to see results. Tattoo removal at the extremities of arms and legs may take more removal treatments than ones on your shoulder or back.
Some tattoos will only show partial fading after multiple treatments, leaving you with a mottled impression of your former tattoo (aka a ghost tattoo) or sometimes even raised scarring. A new tattoo can cover an imperfect removal, but it is important that you discuss all eventualities with your laser treatment expert before you start the removal process. If you don't feel confident with one opinion, get two or more.
How many treatments will be required to remove your tattoo? That's not something that can be easily answered.
color, size, and location of your tattoo, as well as other factors related to your skin, etc.
removal and suffer from painful and/or long lasting side effects. A reputable technician will insist on proper wait times.
Be prepared to allow your body to heal between treatments.
It is not uncommon to experience swelling, redness, blisters or other temporary symptoms following a tattoo removal treatment. These symptoms are nothing to worry about unless they persist after a week or two.
These are less common, but it is important to be aware of them before starting any procedure.
Don't blindly enter a shop and start a removal process with no knowledge of the business or the qualifications of their staff.
Book a consultation and be prepared to ask questions particular to your unique self.
on who will remove your tattoo and what your removal method of choice will be.
The cost of removing your tattoo is estimated by first knowing how many sessions you will need.
removal. Depending on the scale of the area to be treated, the prices can range from £50 to £250 per session.
Each tattoo looks and responds differently to the laser so it's difficult to quote a general price without first seeing the tattoo.
other people cannot see it.
After each treatment, you need to take a break for the skin to recover so treatments are spread between 4-8 weeks apart.
how to do that just click the box below.
Feel free to call, email, or stop by any of CoLaz's locations.
If you would like an idea on a price then simply take an image of your tattoo and send it to us here. For instructions on how to do that just click the box below.


Inheritance is an important topic in most programming languages.
In the classical languages (such as Java), inheritance (or extends) provides two useful services. First, it is a form of code reuse. If a new class is mostly similar to an existing class, you only have to specify the differences. Patterns of code reuse are extremely important because they have the potential to significantly reduce the cost of software development. The other benefit of classical inheritance is that it includes the specification of a system of types. This mostly frees the programmer from having to write explicit casting operations, which is a very good thing because when casting, the safety benefits of a type system are lost.
Click here to keep reading (1.2MB; PDF).
Thanks to Laurel Ackerman and Simon St. Laurent at O'Reilly for the permission to share the sample chapter.


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Q: Set theme in tinymce editor in codeigniter How can we config tinymce editor in codeigniter like in wordperss. theme with all option

A: Have a look at this pretty neat tutorial: http://browse-tutorials.com/tutorial/integrating-wysiwyg-tinymce-codeigniter


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Shook, Hardy & Bacon's Gene E. Voigts recently received the 2004 Deans of the Trial Bar Award at the Kansas City Metropolitan Bar Assocation's Bench-Bar Conference at Tan-Tar-A-Resort in Missouri's Lake of the Ozarks.
This award is presented annually and spotlights individuals whose superb litigation skills and professional demeanor are viewed as exemplary by their peers. Recipients of the honor must have practiced for at least 30 years or have reached the age of 60.
Since 1976, Voigts has been a Partner engaged in firm litigation matters. He has appeared in various civil (products liability, professional liability and commercial litigation) and criminal cases in state and federal courts. He has also argued cases at all levels of the state and federal appellate systems, including the Supreme Court of the United States. In addition to his litigation practice, he is the firm's Vice Chairman and General Counsel and a member of the firm's Executive Committee.
Voigts served as Chairman of the Merit Selection Commission appointed by Senators Kit Bond and John Danforth, a member of the Law School Dean Search and Advisory Committee for the University of Missouri-Kansas City School of Law, the Supreme Court Committee on Approved Indictments and Informations, the Committee to Draft a Modern Penal Code, the Supreme Court Committee to Prepare a Trial Judges Bench Book and the Missouri Council on Criminal Justice. In 1992, he was nominated by then-President George Bush to be a judge of the U.S. District Court for the Western District of Missouri. He has been a speaker and participant in litigation and business litigation continuing legal education seminars sponsored by The Missouri Bar, the Kansas City Metropolitan Bar Association and the University of Missouri-Kansas City School of Law.