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AAPD, ADA, and AGD Oppose CMS Plan to Rescind Access Monitoring Review Plans by State Medicaid Agencies
On September 13, 2019 the AAPD, ADA, and AGD (Academy of General Dentistry) wrote the Centers for Medicare and Medicaid Services (CMS) to comment on their proposed rule CMS-2406-P2, entitled Medicaid Program; Methods for Assuring Access to Covered Medicaid Services-Rescission.
The AAPD-ADA-AGD regulatory comment letter noted that Medicaid plays an essential role in our nation's oral health safety net, as over 23 million Medicaid enrollees receive dental services via Fee-for-Service (FFS) and an additional 5.3 million Medicaid enrollees receive them via combined FFS/managed care. These include pregnant women, children, the elderly, the disabled, and patients with a chronic and/or complex health condition. It is critical that these beneficiaries have access to quality services received in a timely manner. While acknowledging CMS efforts to strike a balance between maintaining access to care and providing states with flexibility, the groups opposed CMS' proposal to rescind the November 2015 Medicaid access rule. That rule required states to develop and submit an access monitoring review plan (AMRP). These AMRPs provide a means for CMS to measure access to care and reimbursement rates. Further, using a checklist developed by the ADA,[1] state dental associations review the AMRPs and ensure that the states have plans in place to ensure access to care for FFS beneficiaries. It is important that state dental associations and other stakeholders – such as state pediatric dentistry chapters with our Public Policy Advocates network- undertake this review.
Therefore, the comment letter urged CMS to develop a template and standardize AMRPs, and also utilize the ADA's checklist as a foundational tool for such standardization for the dental benefit within Medicaid FFS programs. Within the rule, CMS notes that it is developing a methodology for reporting Medicaid access data in lieu of AMRPs. The comment letter recommended that CMS should first issue criteria for improving the AMRPs before loosening the monitoring requirements: "Any methodology used in place of an AMRP must be built on sound data and analyses, must be reported by states to CMS on an annual basis, and must be in place before the AMRP requirement is rescinded." The ADA, AGD, and AAPD also requested the opportunity to participate in the review process. Ultimately, it was recommended that CMS should monitor rate reductions and maintain a process for beneficiaries and providers to provide input on the implications of rate reductions. While there is a lot of variation between states on Medicaid FFS reimbursement rates, the comment letter noted that on average in 2016, Medicaid FFS reimbursement was 49.4 percent of fees charged by dentists for children and 37.2 percent for adults.[2] This shortfall in reimbursement threatens access to care.
Click here for a copy of the letter.
[1]See American Dental Association Medicaid Toolkit, "Medicaid Fee-for-Service: Access Monitoring Plans Review Checklist,"
[2] See: Niodita Gupta, Cassandra Yarbrough, Marko Vujicic, Andrew Blatz, Brittany Harrison, American Dental Association Health Policy Institute Research Brief, "Medicaid Fee-for-Service Reimbursement Rates for Child and Adult Care Services for All States, 2016,"


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Looking back: Make-believe and castles
Posted: July 30, 2014 1542
Castle Marne in Denver
This summer on a trip to Denver with my daughter, I had the chance to recall a magical make-believe time from my childhood.
Most of the children of the 1930s Great Depression era didn't have much in the way of entertainment. This was a time long before television. Although, a few families had radios, many did not. As a small child, I found pleasure in a simple way. With only a box of Crayola's, a pencil, paper and scissors, I would sit at the kitchen table in the evenings designing clothes for my paper dolls. Some of those clothes were fit for royalty and so in my play world, my paper people often lived in castles.
I suppose you could say our family was poor, but then we were deep in a world depression, and just about everyone around us was cash poor. On a 10-acre chicken farm on old Manor Way in pre-Lynnwood's Alderwood Manor we had no close neighbors, thus most of the time my brothers and I did find our own entertainment. Mine was imagining, and often my imagination featured a world of elegant castles — far different from our rustic country home amid the stumps and snags left by the logging companies a few years before.
You will find that this article is sort of a "what I did during my summer vacation" story. In Denver, Colorado, for two days this summer, I had the opportunity to actually live in a castle. It may have been a bed and breakfast hostelry, but to me Castle Marne was perfectly named.
Castle Marne corner
Far different from the everyday hotels or motels where my daughter Marilyn and I usually stay during our travels, Castle Marne was a welcome novelty. Once we entered the door at Castle Marne, we stepped into a Victorian world. There was no elevator, and no television. Soon noticeable was one of the outstanding beauties of the castle; a seven-foot diameter stained glass window at the landing of the staircase between the first and second floors. Called "the Peacock Window," it is true artistry and by far the most outstanding of the castle's several stained glass windows.
Each of the nine rooms for guests is designed with a different décor. Mine was one with a bed so high; steps had to be climbed.
Castle Marne was built in 1889 on Denver's Capitol Hill, once home to the early-day barons of industry. The mansion has seen many changes since then; even once used as a processing center for parolees. Eventually the building succumbed to neglect, became empty and vandalized.
In 1989, Jim and Diane Peiker bought the stone building and with a lot of hard work restored it to its original glory. The Peiker family named the mansion, Castle Marne, and they have operated it as a bed and breakfast inn for 23 years.
Castle Marne Bed and Breakfast is a family enterprise; everyone takes part in welcoming guests. We had the opportunity to meet the entire family. However, the main inn keeper is Melissa, the daughter of Jim and Diane. Friendly and warm, she pampers the guests with tea and treats in the afternoon and at bedtime, a freshly baked cookie and a cup of sleepy-time tea.
Castle Marne breakfast
As you can imagine, in this elegant storybook setting, you are served a gourmet breakfast. Once the guests are seated and the food individually served, you will find it looks like a work of art — and it tastes as good as it looks.
Yes, I can definitely recommend Castle Marne as a place to stay if you are in Denver. Elegance, friendly people, good food and a peaceful night's sleep in a Victorian castle; what more can you want. Castle Marne, considered Denver's most recognized stone castle, is listed on the National Registry of Historic Places.
For me, after 80 years, a little girl's make-believe world of sleeping in a castle became a reality.
– By Betty Lou Gaeng
A long-time resident of Lynnwood, Betty Lou Gaeng is a genealogist, historian, researcher and writer who is active in volunteer work for Lynnwood's Heritage Park Partners Advisory Committee and the Alderwood Manor Heritage Association at Heritage Park. She is also a member of the League of Snohomish County Heritage Organizations (LOSCHO) and the South County Historical Society and Museum. Gaeng is the author of two books: "Etched in Stone," which is the history of the Edmonds Museum memorial monument, and "Chirouse" about a Catholic missionary priest who came from France to Washington Territory in 1847 and became a father figure and friend to the Puget Sound area's Native people.
Castle Marne breakfast setting
Marria Blinn says:
Excellent article, Betty. Your elegant writing style coupled with descriptive details and photos bring Castle Marne alive! This sounds like a gem waiting to be discovered. I am sure everyone will add Castle Marne to their list of amazing places to visit!
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Scott Davis Jan 21, 2020 at 12:28 pm on Community turns out to honor Dr. Martin Luther King Jr., recognize Shirley SuttonAll of this grandiose adulation just so Lynnwood can appear to be inclusive and make the wealthy people feel better
Anthony Aversano Jan 17, 2020 at 12:56 pm on Liias introduces legislation to help increase voter participation among young adultsThe main push to lower the voting age is not to expand rights or increase the strength of the voting
mike echelbarger Jan 16, 2020 at 9:22 am on Liias introduces legislation to help increase voter participation among young adultsHmmm. Kids aren't smart enough at 18 to vape or have a beer but are smart enough to vote? Puts
Matthew Appel Jan 15, 2020 at 12:13 pm on Updated: Schools, Edmonds CC closedUnfortunately the Lynnwood Food Bank is closed, too.
William Khadivi Jan 15, 2020 at 9:45 am on Monday: Former Lynnwood City Councilmember Shirley Sutton to receive Beloved Community Award at MLK Tribute in EdmondsCongratulations Councilmember Sutton! Thank you for serving our community.
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Q: Align two divs side by side I have three divs.. Container, Content_1 and content_2.
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HTML:

JSFiddle

A: Is this what you wanted?
jsFiddle Demo
.container {
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A: your divs closing tag is open: </div to

A: The problem is that you forgot the clearfix. There are a couple of ways to do a clearfix on google, but the one that will fix this problem is adding overflow:hidden to your container div.
Check out my example on http://cdpn.io/sEwfI
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redpajama_set_name: RedPajamaStackExchange


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Kostelec, Kounice, Community, Tradition
By Pivní Filosof October 10, 2014
The gentleman in the picture is Kárel Klusáček, owner of the Maltings and Microbrewery in Kounice. Far from an absentee owner, he looks after pretty much every aspect of the running of the company, and he's 83 years old.
I had the pleasure, and honour to meet him last Wednesday during a trip I had put together for a good friend of mine and two of his mates.
The trip started with lunch at Černokostelecký Pivovar, or rather, at Háje, where we took the 10AM bus there.
A few days before, I had talked to Milan Starec, a.k.a. Květák, to let him know we were going, and to ask him if they could help me with the visit to Kounice. It was no problem, he said, they could arrange everything, even a taxi, or something like that, to that town.
I called him when we arrived. He said that Vodoch, the owner, would meet me at the pub after lunch, and he would take care of everything.
Food was good, very good. Beers were even better, a 10° from Frýdlant and Černá Svině, the 13º black lager, brewed right there, by Minipivovar Šnajdr. Vodouch came over when we were half way down a pint of that beer, and his first question was how we liked it. Gorgeous, it was. Better than any other time I'd had it. An extraordinarily good batch of an already very good beer that they hope will become the norm, as Vodouch said. And we were lucky, it was the last keg.
Once the glasses were emptied, Vodouch showed us the whole place, letting us poke around, answering every question; a VIP tour, one could say. If everything goes as planned, the brewery they've been painstakingly restoring for more than a decade should come back to life at the beginning of next year. What these people are doing there is nothing short of remarkable—a story that I've promised myself to tell one day, soon.
After the tour, Vodouch told us the wait for him by a white van—he was going to drive us to Kounice, there were some empty kegs to take back there, after all. In the courtyard we met Hanz, Zlý Hanz. He was returning some stuff he had borrowed for a (very successful) presentation he and Kulový Líbor had the day before for their import business. (For those who still don't get it, this is what a real beer community looks like, people helping each other, expecting no more than a thank-you, or perhaps a pint, in return).
We got to Kounice in no time, it's only 13km away. On the way Vodouch talked some of the stuff they're working on. He also told me that he wants no more than 10 different beers for next year's Vysmolení and Vykulení; he believes there's not much of a point in having more, and I agree.
Mr Klusáček wasn't there when we arrived in Kounice, but he was on his way. To Kounická Hospůdka it is then. We didn't feel like standing outside in what turned out to be a beautiful autumn day.
Quite a nice place that village pub is, in an unpretentious, village way. The first round was the house's Světlý Ležák. Excellent, if a tad to gassy, it was like any proper Světlý Ležák should be, but with something else, something that no tasting note can fully describe. it was followed by Mouřenín, the Tmavý Ležák, though not as good as Černá Svině, was still a very fine tipple.
Mr Klusáček was already waiting for us at the gate of the maltings when we left the pub a few minutes later. He greeted each of us with a big smile and a firm handshake. He was glad, eager, to show us around.
The family business begun in 1860 when Mr Klusáček's grandfather, who came from a family with already a couple of generations in brewing, bought the brewery and maltings from the Liechtensteins. In 1900, he shut down the brewery—the building is still standing, on the left of the gate—when it was clear that it could compete with the modern lager breweries of the nearby bigger towns—Nymburk, Český Brod, Kostelec—and decided to focus instead on producing malts. After getting to absolute power in the late 1940s, the Communist regime evicted his son—Mr Klusáček's father—when it nationalised the company.
Mr Klusáček wouldn't see the inside of the facilities until they were restituted to him in the early 1990s. Recently retired, he did what any other sensible person in his position would do, take the wheel firmly and carry on the family tradition (proper tradition, in flesh and blood), right where his father had been forced to leave it. He had a bit of luck, too, the Commies had continued to produce high grade floor malts during the 40 years of their regime.
All this we were told, as well as how they make their floor malts, how the same cultivar of barley can have different properties when grown in fields 30km apart, and much more, as Mr Klusáček guided us around the malting facilities and then the brewery; never stopping to catch his breath, never excusing himself for slowing us down, because he wasn't. His only "complaint" was a comment he made when going down a steep flight of ancient wooden stairs: he had to be careful because he'd recently had spine surgery. Let that sink in for a moment.
At the brewhouse—a 5hl do—besides beer and brewing, he talked about the e-shop for brewing supplies—his malts and Weyermann's, hops, Czech and imported, and yeasts—bought by microbreweries from all over the country, the export business, his story with an Texan brewer, among other things. And in the cramped space of the fermenters and tanks, he confessed that the beer isn't brewed by him, but a Brew Master he's hired, but that he's learning.
We tasted all the beers of course, straight from their tanks. The IPA, the Ginger Beer, both excellent, and the Světlý Ležák, mind bendingly good, surprisingly better than a few metres away at the pub.
When the visit finished, and we said good-by to Mr Klusáček, we still had about half an hour to kill before we had to take the bus to Český Brod, where we would catch the train back to Prague. Back to the pub, it is. The stop was only a few metres away. While we drunk our pint—this time the IPA, one of the best I've had in this country—the conversation wasn't about the beer, but about this incredible 83 year old man. A person who loves, and is proud in what he does, with more life in him than most people half his age I know, myself included, many days.
I promised myself I will go back soon to Kounice, and sit down with Mr Klusáček to listen to his story in every detail. Like Vodouch's, or Sister Doris's and Sonja's, his is a story that deserves to be told at length.
Bits of Philosophy Breweries Kostelec Kounice Trips
Labels: Bits of Philosophy Breweries Kostelec Kounice Trips
Gunnar 11 October 2014 at 13:55
Thanks for a very good experience, meeting mr Klusáček was an unforgettable meeting with an extraordinary vital elderly man, with a true passion for his trade, and not willing to comprimise with quality in any step of the production of first class malts. His pride of every detail, even down to the computer controled software for drying of malts was a joy for all of us to experience first hand. Thanks again for having us share this story live !
Kjetil 11 October 2014 at 15:33
Ahhh!, Černá Svině, I miss that smooth dark lager! It was a great beer trip to the Czech countryside just a short bus/train trip outside Praha. Beer greetings to Max and Gunnar who arranged this beer-cultural trip.
It was all a well crafted lie
Coming soon: Česká Pivní Válka
On beer and the flies that love it
Local vs Good vs Outstanding


In AngularJS, some directives can be used to bind application data to attributes of HTML DOM elements.
ng-disabled It disables a given control.
ng-show It shows a given control.
ng-hide It hides a given control.
ng-click It represents an AangularJS click event.
ng-disabled directive:The ng-disabled directive binds AngularJS application data to the disabled attribute of HTML elements. In the below code, it binds a model to a checkbox.
ng-show directive: The ng-show directive shows or hides an HTML element. In the below code, it binds a model to a checkbox.
ng-hide directive: The ng-hide directive hides or shows an HTML element. In the below code, it binds a model to a checkbox.
ng-click directive: The ng-click directive counts the total clicks an HTML element. In the below code, it binds a model to a checkbox.


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RNG – Random Number Generator
All online casinos are using Random Number Generators, or for short RNG, to determine the outcome of their games. Most commonly this technology can be found in slot machines but is also used for table games, scratch cards, and other games. First, it is important to clarify the term "Random" before we start talking about the Random Number Generator. Randomness means that it is impossible or very difficult to predict in advance what the outcome of a particular action will be. In the case of casino games, this is, for example, predicting the next card that appears on the table, or the symbols for a spin in a video slot.
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How Does a Random Number Generator Work?
At online casinos, but also at video slots in physical casinos, Random Number Generators are used to get the most random result possible. An RNG can be software and/or hardware. When it comes to a software-driven RNG, we speak of a Pseudo-Random Number Generator, which we will also cover in this expert iGaming guide.
A hardware-driven RNG works by including certain external factors in determining a random sequence of numbers. This can be, for example, the temperature, atmospheric pressure, or the amount of a particular substance in the air. This factor gives a series of binary numbers that are converted through an algorithm into a particular move or card in a casino game. This is an optimally randomized method because it cannot be influenced and the factor is always different.
In addition, it is practically impossible to crack or hack a hardware RNG. This is because, firstly, the measured factor or factors is/are often secret. Second, it is impossible to know, for example, the amount of carbon in an online casino data center at a specified time. Third, the correct algorithm and operation of this sequence have yet to be discovered before predicting a move, outcome, or card. The disadvantage of a hardware RNG is that more processing time is required and therefore it works less quickly.
RNGs Ensure Fairness and Random Outcomes
The RNG also ensures that the chance of a win occurring is the same in every game round. For example, if you just finished a bonus round with free spins, the chances of the next spin triggering another round of free spins are just the same as they are a hundred spins later. In many ways, an RNG works like tossing a dice. For every toss, the chances of you getting six are the same, no matter what happened in the last toss.
Even though the games themselves are fair, you should always remember that they're fair in the sense that they work as intended. That being said, a slot machine is never designed to pay out all the bets it gets as winnings since the RTP is set to less than 100%. After all, the casino also has to make money somehow. In terms of slots, therefore, what fair means in the fair-gaming sense is that you're not at a disadvantage compared to other players. But, you will be at a disadvantage compared to the casino. This is why cashing out big wins is so important.
What is a Pseudo-Random Number Generator?
A Pseudo-Random Number Generator works via software and, therefore, cannot measure external factors and include them in the delivery of a random result. The Pseudo RNG is built into, for example, a chip and contains an algorithm that gives a certain result at certain times based on a key or an initial value. Since this software is not linked to an external factor, it can give the most random result of a casino game much faster. An internal factor, such as a clock, could be used, however.
The software Random Number Generator is based on the key value. When someone knows this key value, it is possible to predict the outcome at a specific time. The fact that there is some form of reproducibility in it is not necessarily a disadvantage in the case of casino games unless hackers take advantage of this. Due to the much higher speed and the fact that no additional hardware needs to be built into a video slot, for example, Pseudo RNGs are widely used in casinos, both online and offline.
How Do Casinos Provide Random Results?
There are several ways in which online and land-based casinos provide randomness. In table games, this can be done, for example, by manually shuffling the cards or by using a shuffling machine for this. This machine is made in such a way that the cards come out randomly. According to research by statisticians, you have to apply the "riffle shuffle" seven times or more or spread the cards out on the table and shuffle them together for about a minute.
At both online casinos and land-based casinos, only the live casino games work with manual randomness. The rest of the available casino games work via a (Pseudo) Random Number Generator. How this works exactly differs for each game and each game developer or online casino.
An example of a Random Number Generator comes from a well-known poker site. A semi-transparent mirror sometimes reflects the beam of a laser and sometimes it does not. A reflection gives a 1 and no reflection a 0. The second comes from the input of the players. The movements of the mouse, reaction time, clicks, and more information are converted into a binary code. By putting these numbers in order, combining them, and then passing them through an algorithm, a completely random sequence is created that can be converted into a specific card, which is then presented on the table.
What Is the House Edge?
RTP – Return to Player
Volatility in Casino Games


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Board of Directors 2020-21
Jeff Messer – President
Ken Tranter- Treasurer
Chris Jamieson- Captain
James Maniatis- Vice President
Directors – David Shaw, Mal Collins, Phillip Marinucci, Chris Biffin, Stacie Gull (appointed April 2020 casual Position replacing Graeme Harrison)
Chris Jamieson (Chair), Jenny Kelly (Women's Captain), Jeff Messer, David Shaw, Chris Biffin
Attendees Brett Scothern, Colin Winterton , John Dixon
Membership and Promotion Committee
James Maniatis, Phil Marinucci, Mal Collins, Stacie Gull
Attendees Brett Scothern, Sue Godsall, Lauren Truscott
Women's Vision 2025 Sub Committee
Stacie Gull, Mal Collins, Joe Schepis
Attendee Brett Scothern , Lauren Truscott
During October in 1901, 98 odd acres of land on the Maribyrnong River was sold to Thomas Williamson, a successful grazier with properties near Yea in Victoria. The property was intended to be used to fatten cattle prior to sale in the Melbourne markets. Due to the illness of his son, also Thomas, Mr Williamson (Snr) has to move his family to a warmer climate, and left the property in the care of his four daughters who remained in Melbourne.His daughters were not interested in maintaining the property, so when Tom (Jnr) returned to Melbourne some 15 years later, after his father's death, he found the land covered in boxthorns and noxious weeds. It took him over 12 months to effectively clear the land, which was required by law at the time.
In 1934, while at the Footscray Bowling Club, the Williamsons were involved in a discussion about the shortage of sporting opportunities in the Western Suburbs. The Williamsons were trying to work out what to do with the land, and the idea of a golf course was mentioned.
After this discussion Tom Williamson contacted Stanley Green, a solicitor and member of the Kingston Heath Golf Club, and the Morcom Brothers (greenkeepers at the Royal Melbourne Golf Club), with the idea of forming a new company and constructing a golf course on the land. Stanley Green, originally from Maidstone on the Medway River in Kent, England, named the new company and golf course "Medway" in memory of his English origins. During December 1934, Medway Golf Pty Ltd was formed for the purpose of developing the land in Omar Street, Maidstone, into a "temporary golf course". In January 1935 the Morcom Brothers were commissioned to build the course, which was completed during July, 1936.
Thomas Williamson became the first manager of Medway Golf Pty Ltd, collecting green fees, and storing machinery and buggies in the old bluestone dairy of the original farming property. The Medway Public Golf Links (with hardly a tree on the property) opened for play on 31 August, 1935, at a cost of two shillings for 18 holes of golf. On the opening of the course, Eric Duffy, a young professional from the Yarra Yarra Golf Club, was appointed the first professional.
As was often the case, the regular players at the course decided to form a club, for the organisation of regular competitions and for social purposes. By the end of 1936 the club had 66 men and 9 women members.
Medway's first pennant team commenced competition in 1936, playing in the "B" grade pennant of the Victorian Golf League, which comprised clubs such as Elsterwick Park, Rosanna, Brighton and Altona Beach (later Kooringal). The final of the "A" pennant between Elsternwick and Altona was played at Medway that year – an honour for such a new golf course. By 1940 Medway fielded teams in the "A", "B" and "C" grade pennant.
Early in 1946, after the Second World War, the owners of the golf course, Medway Golf Pty Ltd wanted to cease operating the course and sought an arrangement for the golf club to takeover the course or let it go to residential sub-division. Despite an absence of financial support from local councils, the club members took on the challenge of raising sufficient funds and managing the course, which it rented from the owners for £1,000 per year. The Medway Golf Club officially commenced operation on 6 April, 1946. In order to finance this arrangement the club aimed to increase membership to 400 men and 150 women, charging two shillings six pence per week for men, and half this amount for women (at the time a machine operator earned under £6 per week for 44 hours of work). The old farmhouse was used as the clubhouse and the for the curator's accommodation.
During 1947, after the successful commencement of the new club, the committee of the day appealed to members to take out debentures with the club to enable the 98 odd acres of the course to be purchased. An average of £70 per member was required. One Footscray businessman loaned the club £200 interest free to assist with the purchase. In June 1949 the trustees of the club signed a contract to purchase the land for £22,300.
After many years of operating a "canteen" on the course, the club was granted a liquor license in 1956. In the same year a new debenture scheme was initiated with the primary intention of building a new clubhouse. £18,000 was promised by members almost straightaway, and by 1958 the club had raised £37,000 from debentures.
Construction of the new clubhouse commenced during 1957, at a cost of £30,000. It would replace the old farmhouse that was built around 1850. The new clubhouse was officially opened in 1958. Major extensions and renovations have since been completed in 1983 and in the late 1990's.
During 1978 a comprehensive and partially automated reticulation system was installed to water fairways and greens. In 1985 a weir was built near the 7th tee to capture water from drains before pumping it into a newly constructed dam in front of the 11th tee. Construction cost for the weir and dam amounted to $110,000.
Around the turn of the 21st century, a major project to convert all fairways and surrounds to santa ana couch was completed. The new turf was selected due to its drought tolerance and first class playing surface, which was timely given that an extended period of drought commenced during 2002.
Pics below- 2009-10 dam Building


Luigi is Mario's younger brother. To unlock him, complete the target test with all eight starting fighters.
These attacks are based on the player facing right.
Luigi throws a green fireball. Unlike Mario's fireball, Luigi's doesn't touch the ground after being fired but rather stays afloat before disappearing or hitting an opponent.
If done when directly beside an opponent, it will inflict a great amount of damage and can send the opponent a great vertical distance. Otherwise, it only does minimal damage.
Similar to Mario's Tornado, but an opponent is sent flying when he or she touches Luigi when he is executing this move, instead being pulled into the middle of the cyclone and taking multiple hits.
This page was last edited on 27 July 2009, at 14:21.


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Inspiring Future Physicians and Scientists
During the 2018-2019 academic year, the Feinberg School of Medicine Office of Diversity and Inclusion welcomed 16 Northwestern undergraduate students on their spring break for the second year of the NU DOCS program.
Northwestern hosts a variety of programs that engage young learners in STEM (science, technology, engineering and math) education activities and help them explore the many career opportunities in medicine and biomedical research.
"The path to medical school can be challenging for even the most supported students," says Clyde Yancy, MD, MSc, vice dean for Diversity and Inclusion and chief of Cardiology in the Department of Medicine. "Building a pipeline of diverse learners from many different backgrounds is critical to ensure tomorrow's medical and scientific professionals mirror the communities in which we serve."
NU DOCS
NU DOCS is a Feinberg pipeline program designed to mentor aspiring Northwestern University undergraduate students from underrepresented groups who are interested in a career in medicine. The program, organized as an alternative spring break learning activity, provides students with a full week of premedical advising, skill-building workshops, clinical experiences, and discussions with faculty members.
NM Discovery Program
The mission of Northwestern Medicine Discovery is to create a pathway for the next generation of Northwestern Medicine leaders by drawing on the talents of the incredible team of healthcare professionals at Northwestern Medicine to provide STEM career exposure throughout two years of a student's high school career. Throughout the two-year program, students are exposed to a broad range of activities designed to encourage their interest in healthcare careers.
Northwestern Medicine Scholars Program
The Northwestern Medicine Scholars Program at George Westinghouse College Prep is a four-year pipeline program founded in 2010 to address the "pipeline" concerns in STEM education among African American, Latino and low-income students. Each summer, the Northwestern Medicine Scholars spend four weeks on campus in didactic and interactive lectures and experiences. This unique program targets under-resourced students from George Westinghouse College Prep, a Chicago Public High School.
Women's Health Science Program
The Women's Health Research Institute at Northwestern University fosters the next generation of female leaders in science and medicine through the Women's Health Science Program, which provides hands-on laboratory and clinical experiences to young women who are considering careers in science and medicine.
Cancer Undergraduate Research and Education Program
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text:
// Copyright (c) 2012 The Chromium Authors. All rights reserved.
// Use of this source code is governed by a BSD-style license that can be
// found in the LICENSE file.

#include "content/browser/appcache/appcache_url_request_job.h"

#include <vector>

#include "base/bind.h"
#include "base/bind_helpers.h"
#include "base/command_line.h"
#include "base/compiler_specific.h"
#include "base/location.h"
#include "base/single_thread_task_runner.h"
#include "base/strings/string_util.h"
#include "base/strings/stringprintf.h"
#include "base/threading/thread_task_runner_handle.h"
#include "content/browser/appcache/appcache.h"
#include "content/browser/appcache/appcache_group.h"
#include "content/browser/appcache/appcache_histograms.h"
#include "content/browser/appcache/appcache_host.h"
#include "content/browser/appcache/appcache_service_impl.h"
#include "net/base/io_buffer.h"
#include "net/base/net_errors.h"
#include "net/http/http_request_headers.h"
#include "net/http/http_response_headers.h"
#include "net/http/http_util.h"
#include "net/log/net_log_event_type.h"
#include "net/log/net_log_with_source.h"
#include "net/url_request/url_request.h"
#include "net/url_request/url_request_status.h"

namespace content {

AppCacheURLRequestJob::AppCacheURLRequestJob(
    net::URLRequest* request,
    net::NetworkDelegate* network_delegate,
    AppCacheStorage* storage,
    AppCacheHost* host,
    bool is_main_resource,
    const OnPrepareToRestartCallback& restart_callback)
    : net::URLRequestJob(request, network_delegate),
      host_(host),
      storage_(storage),
      has_been_started_(false),
      has_been_killed_(false),
      delivery_type_(AWAITING_DELIVERY_ORDERS),
      cache_id_(kAppCacheNoCacheId),
      is_fallback_(false),
      is_main_resource_(is_main_resource),
      cache_entry_not_found_(false),
      on_prepare_to_restart_callback_(restart_callback),
      weak_factory_(this) {
  DCHECK(storage_);
}

AppCacheURLRequestJob::~AppCacheURLRequestJob() {
  if (storage_)
    storage_->CancelDelegateCallbacks(this);
}

void AppCacheURLRequestJob::DeliverAppCachedResponse(const GURL& manifest_url,
                                                     int64_t cache_id,
                                                     const AppCacheEntry& entry,
                                                     bool is_fallback) {
  DCHECK(!has_delivery_orders());
  DCHECK(entry.has_response_id());
  delivery_type_ = APPCACHED_DELIVERY;
  manifest_url_ = manifest_url;
  cache_id_ = cache_id;
  entry_ = entry;
  is_fallback_ = is_fallback;
  MaybeBeginDelivery();
}

void AppCacheURLRequestJob::DeliverNetworkResponse() {
  DCHECK(!has_delivery_orders());
  delivery_type_ = NETWORK_DELIVERY;
  storage_ = NULL;  // not needed
  MaybeBeginDelivery();
}

void AppCacheURLRequestJob::DeliverErrorResponse() {
  DCHECK(!has_delivery_orders());
  delivery_type_ = ERROR_DELIVERY;
  storage_ = NULL;  // not needed
  MaybeBeginDelivery();
}

base::WeakPtr<AppCacheURLRequestJob> AppCacheURLRequestJob::GetWeakPtr() {
  return weak_factory_.GetWeakPtr();
}

void AppCacheURLRequestJob::MaybeBeginDelivery() {
  if (has_been_started() && has_delivery_orders()) {
    // Start asynchronously so that all error reporting and data
    // callbacks happen as they would for network requests.
    base::ThreadTaskRunnerHandle::Get()->PostTask(
        FROM_HERE, base::Bind(&AppCacheURLRequestJob::BeginDelivery,
                              weak_factory_.GetWeakPtr()));
  }
}

void AppCacheURLRequestJob::BeginDelivery() {
  DCHECK(has_delivery_orders() && has_been_started());

  if (has_been_killed())
    return;

  switch (delivery_type_) {
    case NETWORK_DELIVERY:
      AppCacheHistograms::AddNetworkJobStartDelaySample(
          base::TimeTicks::Now() - start_time_tick_);
      // To fallthru to the network, we restart the request which will
      // cause a new job to be created to retrieve the resource from the
      // network. Our caller is responsible for arranging to not re-intercept
      // the same request.
      NotifyRestartRequired();
      break;

    case ERROR_DELIVERY:
      AppCacheHistograms::AddErrorJobStartDelaySample(
          base::TimeTicks::Now() - start_time_tick_);
      request()->net_log().AddEvent(
          net::NetLogEventType::APPCACHE_DELIVERING_ERROR_RESPONSE);
      NotifyStartError(net::URLRequestStatus(net::URLRequestStatus::FAILED,
                                             net::ERR_FAILED));
      break;

    case APPCACHED_DELIVERY:
      if (entry_.IsExecutable()) {
        BeginExecutableHandlerDelivery();
        return;
      }
      AppCacheHistograms::AddAppCacheJobStartDelaySample(
          base::TimeTicks::Now() - start_time_tick_);
      request()->net_log().AddEvent(
          is_fallback_
              ? net::NetLogEventType::APPCACHE_DELIVERING_FALLBACK_RESPONSE
              : net::NetLogEventType::APPCACHE_DELIVERING_CACHED_RESPONSE);
      storage_->LoadResponseInfo(manifest_url_, entry_.response_id(), this);
      break;

    default:
      NOTREACHED();
      break;
  }
}

void AppCacheURLRequestJob::BeginExecutableHandlerDelivery() {
  DCHECK(base::CommandLine::ForCurrentProcess()->HasSwitch(
      kEnableExecutableHandlers));
  if (!storage_->service()->handler_factory()) {
    BeginErrorDelivery("missing handler factory");
    return;
  }

  request()->net_log().AddEvent(
      net::NetLogEventType::APPCACHE_DELIVERING_EXECUTABLE_RESPONSE);

  // We defer job delivery until the executable handler is spun up and
  // provides a response. The sequence goes like this...
  //
  // 1. First we load the cache.
  // 2. Then if the handler is not spun up, we load the script resource which
  //    is needed to spin it up.
  // 3. Then we ask then we ask the handler to compute a response.
  // 4. Finally we deilver that response to the caller.
  storage_->LoadCache(cache_id_, this);
}

void AppCacheURLRequestJob::OnCacheLoaded(AppCache* cache, int64_t cache_id) {
  DCHECK_EQ(cache_id_, cache_id);
  DCHECK(!has_been_killed());

  if (!cache) {
    BeginErrorDelivery("cache load failed");
    return;
  }

  // Keep references to ensure they don't go out of scope until job completion.
  cache_ = cache;
  group_ = cache->owning_group();

  // If the handler is spun up, ask it to compute a response.
  AppCacheExecutableHandler* handler =
      cache->GetExecutableHandler(entry_.response_id());
  if (handler) {
    InvokeExecutableHandler(handler);
    return;
  }

  // Handler is not spun up yet, load the script resource to do that.
  // NOTE: This is not ideal since multiple jobs may be doing this,
  // concurrently but close enough for now, the first to load the script
  // will win.

  // Read the script data, truncating if its too large.
  // NOTE: we just issue one read and don't bother chaining if the resource
  // is very (very) large, close enough for now.
  const int64_t kLimit = 500 * 1000;
  handler_source_buffer_ = new net::GrowableIOBuffer();
  handler_source_buffer_->SetCapacity(kLimit);
  handler_source_reader_.reset(
      storage_->CreateResponseReader(manifest_url_, entry_.response_id()));
  handler_source_reader_->ReadData(
      handler_source_buffer_.get(),
      kLimit,
      base::Bind(&AppCacheURLRequestJob::OnExecutableSourceLoaded,
                 base::Unretained(this)));
}

void AppCacheURLRequestJob::OnExecutableSourceLoaded(int result) {
  DCHECK(!has_been_killed());
  handler_source_reader_.reset();
  if (result < 0) {
    BeginErrorDelivery("script source load failed");
    return;
  }

  handler_source_buffer_->SetCapacity(result);  // Free up some memory.

  AppCacheExecutableHandler* handler = cache_->GetOrCreateExecutableHandler(
      entry_.response_id(), handler_source_buffer_.get());
  handler_source_buffer_ = NULL;  // not needed anymore
  if (handler) {
    InvokeExecutableHandler(handler);
    return;
  }

  BeginErrorDelivery("factory failed to produce a handler");
}

void AppCacheURLRequestJob::InvokeExecutableHandler(
    AppCacheExecutableHandler* handler) {
  handler->HandleRequest(
      request(),
      base::Bind(&AppCacheURLRequestJob::OnExecutableResponseCallback,
                 weak_factory_.GetWeakPtr()));
}

void AppCacheURLRequestJob::OnExecutableResponseCallback(
    const AppCacheExecutableHandler::Response& response) {
  DCHECK(!has_been_killed());
  if (response.use_network) {
    delivery_type_ = NETWORK_DELIVERY;
    storage_ = NULL;
    BeginDelivery();
    return;
  }

  if (!response.cached_resource_url.is_empty()) {
    AppCacheEntry* entry_ptr = cache_->GetEntry(response.cached_resource_url);
    if (entry_ptr && !entry_ptr->IsExecutable()) {
      entry_ = *entry_ptr;
      BeginDelivery();
      return;
    }
  }

  if (!response.redirect_url.is_empty()) {
    // TODO(michaeln): playback a redirect
    // response_headers_(new HttpResponseHeaders(response_headers)),
    // fallthru for now to deliver an error
  }

  // Otherwise, return an error.
  BeginErrorDelivery("handler returned an invalid response");
}

void AppCacheURLRequestJob::BeginErrorDelivery(const char* message) {
  if (host_)
    host_->frontend()->OnLogMessage(host_->host_id(), APPCACHE_LOG_ERROR,
                                    message);
  delivery_type_ = ERROR_DELIVERY;
  storage_ = NULL;
  BeginDelivery();
}

void AppCacheURLRequestJob::OnResponseInfoLoaded(
    AppCacheResponseInfo* response_info,
    int64_t response_id) {
  DCHECK(is_delivering_appcache_response());
  if (response_info) {
    info_ = response_info;
    reader_.reset(
        storage_->CreateResponseReader(manifest_url_, entry_.response_id()));

    if (is_range_request())
      SetupRangeResponse();

    NotifyHeadersComplete();
  } else {
    if (storage_->service()->storage() == storage_) {
      // A resource that is expected to be in the appcache is missing.
      // See http://code.google.com/p/chromium/issues/detail?id=50657
      // Instead of failing the request, we restart the request. The retry
      // attempt will fallthru to the network instead of trying to load
      // from the appcache.
      storage_->service()->CheckAppCacheResponse(manifest_url_, cache_id_,
                                                 entry_.response_id());
      AppCacheHistograms::CountResponseRetrieval(
          false, is_main_resource_, manifest_url_.GetOrigin());
    }
    cache_entry_not_found_ = true;
    NotifyRestartRequired();
  }
}

const net::HttpResponseInfo* AppCacheURLRequestJob::http_info() const {
  if (!info_.get())
    return NULL;
  if (range_response_info_)
    return range_response_info_.get();
  return info_->http_response_info();
}

void AppCacheURLRequestJob::SetupRangeResponse() {
  DCHECK(is_range_request() && info_.get() && reader_.get() &&
         is_delivering_appcache_response());
  int resource_size = static_cast<int>(info_->response_data_size());
  if (resource_size < 0 || !range_requested_.ComputeBounds(resource_size)) {
    range_requested_ = net::HttpByteRange();
    return;
  }

  DCHECK(range_requested_.IsValid());
  int offset = static_cast<int>(range_requested_.first_byte_position());
  int length = static_cast<int>(range_requested_.last_byte_position() -
                                range_requested_.first_byte_position() + 1);

  // Tell the reader about the range to read.
  reader_->SetReadRange(offset, length);

  // Make a copy of the full response headers and fix them up
  // for the range we'll be returning.
  range_response_info_.reset(
      new net::HttpResponseInfo(*info_->http_response_info()));
  net::HttpResponseHeaders* headers = range_response_info_->headers.get();
  headers->UpdateWithNewRange(
      range_requested_, resource_size, true /* replace status line */);
}

void AppCacheURLRequestJob::OnReadComplete(int result) {
  DCHECK(is_delivering_appcache_response());
  if (result == 0) {
    AppCacheHistograms::CountResponseRetrieval(
        true, is_main_resource_, manifest_url_.GetOrigin());
  } else if (result < 0) {
    if (storage_->service()->storage() == storage_) {
      storage_->service()->CheckAppCacheResponse(manifest_url_, cache_id_,
                                                 entry_.response_id());
    }
    AppCacheHistograms::CountResponseRetrieval(
        false, is_main_resource_, manifest_url_.GetOrigin());
  }
  ReadRawDataComplete(result);
}

// net::URLRequestJob overrides ------------------------------------------------

void AppCacheURLRequestJob::Start() {
  DCHECK(!has_been_started());
  has_been_started_ = true;
  start_time_tick_ = base::TimeTicks::Now();
  MaybeBeginDelivery();
}

void AppCacheURLRequestJob::Kill() {
  if (!has_been_killed_) {
    has_been_killed_ = true;
    reader_.reset();
    handler_source_reader_.reset();
    if (storage_) {
      storage_->CancelDelegateCallbacks(this);
      storage_ = NULL;
    }
    host_ = NULL;
    info_ = NULL;
    cache_ = NULL;
    group_ = NULL;
    range_response_info_.reset();
    net::URLRequestJob::Kill();
    weak_factory_.InvalidateWeakPtrs();
  }
}

net::LoadState AppCacheURLRequestJob::GetLoadState() const {
  if (!has_been_started())
    return net::LOAD_STATE_IDLE;
  if (!has_delivery_orders())
    return net::LOAD_STATE_WAITING_FOR_APPCACHE;
  if (delivery_type_ != APPCACHED_DELIVERY)
    return net::LOAD_STATE_IDLE;
  if (!info_.get())
    return net::LOAD_STATE_WAITING_FOR_APPCACHE;
  if (reader_.get() && reader_->IsReadPending())
    return net::LOAD_STATE_READING_RESPONSE;
  return net::LOAD_STATE_IDLE;
}

bool AppCacheURLRequestJob::GetMimeType(std::string* mime_type) const {
  if (!http_info())
    return false;
  return http_info()->headers->GetMimeType(mime_type);
}

bool AppCacheURLRequestJob::GetCharset(std::string* charset) {
  if (!http_info())
    return false;
  return http_info()->headers->GetCharset(charset);
}

void AppCacheURLRequestJob::GetResponseInfo(net::HttpResponseInfo* info) {
  if (!http_info())
    return;
  *info = *http_info();
}

int AppCacheURLRequestJob::GetResponseCode() const {
  if (!http_info())
    return -1;
  return http_info()->headers->response_code();
}

int AppCacheURLRequestJob::ReadRawData(net::IOBuffer* buf, int buf_size) {
  DCHECK(is_delivering_appcache_response());
  DCHECK_NE(buf_size, 0);
  DCHECK(!reader_->IsReadPending());
  reader_->ReadData(buf, buf_size,
                    base::Bind(&AppCacheURLRequestJob::OnReadComplete,
                               base::Unretained(this)));
  return net::ERR_IO_PENDING;
}

net::HostPortPair AppCacheURLRequestJob::GetSocketAddress() const {
  if (!http_info())
    return net::HostPortPair();
  return http_info()->socket_address;
}

void AppCacheURLRequestJob::SetExtraRequestHeaders(
    const net::HttpRequestHeaders& headers) {
  std::string value;
  std::vector<net::HttpByteRange> ranges;
  if (!headers.GetHeader(net::HttpRequestHeaders::kRange, &value) ||
      !net::HttpUtil::ParseRangeHeader(value, &ranges)) {
    return;
  }

  // If multiple ranges are requested, we play dumb and
  // return the entire response with 200 OK.
  if (ranges.size() == 1U)
    range_requested_ = ranges[0];
}

void AppCacheURLRequestJob::NotifyRestartRequired() {
  on_prepare_to_restart_callback_.Run();
  URLRequestJob::NotifyRestartRequired();
}

}  // namespace content

redpajama_set_name: RedPajamaGithub


text:
Researching Early Modern History
A blog for professionals and students
Home » Uncategorized » Early modern "anti-vaxxers" and public health debates: reflections on the 1721 Boston smallpox epidemic, RBE 36 – TD Jacobs
Early modern "anti-vaxxers" and public health debates: reflections on the 1721 Boston smallpox epidemic, RBE 36 – TD Jacobs
The outbreak of the COVID-19 pandemic has inspired numerous conspiracy theories, which have appeared in various forms on different social media platforms. From pathetically anti-Semitic memes on Facebook, to the equally predictable and utterly unsubstantiated claims in Reddit forums that the virus was lab grown, to sadly amusing Twitter threads about Bill Gates's burning desire to track our trips to the Piggly Wiggly via injectable microchips. However, one conspiracy theory found instant success: the YouTube video, "Plandemic," which claims 'Big Pharma' is in cahoots with doctors to keep people sick. In part, the popularity of the fake documentary derived from how it plays off the views held by established conspiracy groups concerning the safety and effectiveness of vaccines. The danger to public health represented by the misinformation campaign caused Facebook and Twitter to remove the video from their respective platforms in May, but not before it had been viewed an estimated 1.8 million times. And fears are growing among scientists and public health experts that anti-vaxxers will prolong the pandemic. Indeed, governments such as Germany's are already having to make assurances that any future vaccine to combat COVID-19 will only be administered voluntarily.
While the impact of the anti-vaxxer movement on the current pandemic remains to be seen, it has had a demonstrable effect on public health with regard to other illnesses. Studies have linked anti-vaxxers to a rise in outbreaks of other preventable, infectious diseases. Remarkably, impetus for the movement can largely be traced back to a single scam artist: Andrew Wakefield. In 1998, he published a study claiming a causal relationship between the MMR (measles, mumps and rubella) vaccine and autism. Wakefield's paper was retracted by The Lancet after his results were unable to be substantiated. Moreover, it was revealed that he had mistreated patients and that he stood to gain financially from his fraudulent research. As a result, Wakefield was barred from practicing medicine in the United Kingdom. And even though studies have since disproven any causal link between the MMR vaccine and autism – including a notable Danish study of over half a million children – Wakefield's claims continue to find adherents. Measles, which had been declared eradicated in the United States in 2000, began to reappear as parents refused to vaccinate their children. In 2019, the Centers for Disease Control reported that there had been over 1,200 measles cases across 31 states, leading to at least sixty cases that resulted in serious complications.
And while they banned 'Plandemic', social media platforms have done little to combat anti-vaccination groups in general. For example, anti-vaxxers have been permitted to run rampant on Facebook, harassing vaccine advocates and even threatening them with death – actions the platform recognizes as violations of its community guidelines, but says it can do nothing about. Moreover, a recent study tracking discussions on vaccines on Facebook found that anti-vaxxer views are growing unchecked, and will dominate the platform within a decade. Results from the investigation found that anti-vaxxers discuss their views more frequently, and actively target groups and individuals, so despite being smaller in number than those that support vaccines, they are more effective in spreading their beliefs. But was this the case with a similar controversy in the eighteenth-century?
In 1721, Boston was rocked by an outbreak of smallpox, and the debate over how best to stop the spread of the disease played out in the press. At the time, severe epidemics were simply a part of life. During a measles epidemic in 1713-15 that swept the North American coast line, a Boston minister, Cotton Mather chronicled the outbreak in his diary. It reached the city in mid-October, and five individuals in his own household began showing symptoms on the same day, November 4. His wife died just five days later, then his maidservant, and three of his children. On November 23, Mather wrote: "My poor family is now left without any infant in it, or any under seven years of age." In his own house, measles had killed 5 of the 11 people infected, a fatality rate of 45%. While the lack of uniform colonial records regarding populations at the time makes it difficult to say how many people died in total during the outbreak, a recent study using data from New France estimated a fatality rate of between 20 and 30% among infants and young children – those considered most susceptible to the disease. And indeed, Mather's own observations regarding what part of his household was most affected by the measles would appear to confirm those findings.
It seems only natural that anyone who had experienced at first hand the deadly toll extracted by infectious diseases would seize upon any and all means to combat them. Nevertheless, when smallpox arrived in Boston in April of 1721, community leaders were strongly divided over whether to adopt inoculation. Looking back from our current climate, with all the reports of conservative Christian pastors unwittingly spreading COVID among their flocks, it may be tempting to ascribe their eighteenth-century predecessors' reluctance to some kind of religious superstition. However, that is not at all an accurate reflection of the divisions at the time. For one thing, clergymen were among the most outspoken participants on both sides of the debate, and one group of Puritan ministers formed the core of the pro-inoculation party. Their intense involvement is understandable considering that there were few actual physicians in the English colonies, and ministers regularly dispensed medical advice and served on the frontlines in any epidemic. Moreover, professional doctors were also divided on the issue. Indeed, William Douglass, who actually held a medical degree, was the loudest opponent of inoculation. His position may strike us incongruous now, but two factors must be taken into consideration: first, inoculation was a relatively unknown practice in Europe and in the American colonies. Second, inoculation – unlike vaccination – could result in death from the very disease it was meant to combat.
Modern vaccination typically uses a dead or inactivated form of a microbe, and cannot cause the disease in question. Rather, it primes the immune system to recognize the live microbe if and when it appears. But vaccines as we now understand them did not begin to develop until the end of the eighteenth century through the innovations of Edward Jenner. Inoculation, on the other hand, involves taking live, infected material from a patient and introducing it by various means into a healthy person. In this way, a milder, survivable form of the disease would be induced. Sometimes, however, the inoculated subject developed severe symptoms and died. Moreover, the inoculated subject was contagious and could spread the illness unless placed in strict quarantine. The practice had been employed in China since the fifteenth century but it was not promoted in Western Europe until the early eighteenth century via the work of Emmanuel Timonius, Mary Wortley Montague, and a somewhat more unlikely figure: the aforementioned Cotton Mather, now better known for his involvement in the Salem Witch Trials.
By the time of the smallpox epidemic, Mather had learned of inoculation from one of his own slaves and by questioning others, and he had read Timonius's accounts in the Philosophical Transactions. Convinced that inoculation was effective, he laid plans to implement the practice in case of an outbreak. When the disease appeared in 1721, he immediately began to marshal his forces and lobby the Boston medical community. However, inoculation was met with fierce resistance – primarily in the form of James Franklin's New-England Courant.
In fact, it has been argued that the Courant's entire raison d'être was to capitalize on the inoculation controversy. It is certainly no coincidence that the paper was founded in August of 1721, months after the outbreak of both the disease and the debate, and its first issue focused on smallpox. But those involved in the venture had varying reasons for taking part. As David Copeland has argued, the printer and his backers were not just motived by concerns over public health. Rather, the paper – and the debate on inoculation – was used to try and discredit the Puritan community to the advantage of Massachusetts's Anglican contingent, which wanted to see the Church of England established as the colony's official state church. And Douglass, as James Schmotter has pointed out, had a further motivation: establishing medicine as an actual profession in the colonies. This entailed challenging theories and practices that originated outside of the medical community.
The anti-inoculation pieces in the Courant made use of a wide variety of arguments and discursive strategies, some of which probably sound familiar to us now. For example, references were made to a conspiracy to take down the local government and strengthen the authority of the English crown in the colony. Then too there were the exhortations that inoculation thwarted the will of god. The medical arguments were numerous, and essentially summed up by Douglass's editorial in the first edition of the Courant titled "At the request of several gentlemen in town: a continuation of the history of inoculation in Boston." The doctor, identified as "a Society of the Practitioners in Physick," wrote that inoculation was:
"entirely new, not in the least vouched or recommended (being merely published, in the philosophick transactions by way of amusement) from Britain, tho' it came to us via London from the Turk, and by a strong viva voce evidence, was proved to be of fatal & dangerous consequence."
Douglass went on to deride Mather and his associates as "six gentlemen of piety and learning, profoundly ignorant of the matter" who were making the case for inoculation on the basis of naught but their character for they certainly had no credentials. Lastly, he reported on one case in which a person who had been inoculated nearly died.
When it came to swaying the Boston public to his point of view, Douglass employed a shotgun approach. He made active use of xenophobia and racism by summoning the boogeyman of "the Turk." He argued from authority and went after the credentials of those promoting inoculation. He misrepresented Timonius's publications concerning inoculation. He tried arguing from anecdote rather than data. In fact, Douglass's only scientifically sound arguments – that inoculation indisputably caused illness, and could possibly help spread it – were rapidly passed over with the briefest of references to "strong" yet unspecified evidence obtained by word of mouth.
For their part, the pro-inoculation camp tended to focus on direct observations and the data, such as it was. By the time the Courant was established, Mather had convinced a locally trained physician, Zabdiel Boylston, to begin inoculation. Boylston initially inoculated ten people over several weeks and his results were reported in another local paper, the Boston Gazette, that July. According to John Blake, during the course of the city's epidemic, Boylston and other physicians inoculated a total of 287 persons (not all voluntarily) six of whom died – 2.1%. Meanwhile, 5,889 people had caught the disease naturally from a total population of 10,567, 842 of whom died – 14.6%. These fatalities made up more than three quarters of the total deaths in Boston that year. I have found no information concerning the relative rates of smallpox's long-term effects (severe scarring and blindness) among the survivors in either population, but inoculation was undoubtedly better when it came to survivability.
To return to the question asked at the start of this essay, it is difficult to say what effect the arguments of either camp had upon the attitudes and actions of Bostonians in general. As is typical for early modern publications, we have little insight into audience reception. However, the vitriolic coverage in the Courant led – at least according to Franklin – to his being accosted in the street. And whoever threw a bomb into Mather's house in November of 1721, attached a note referencing the inoculation controversy. Mather had no doubt who was to blame for his troubles, writing in December that:
"Warnings are to be given unto the wicked printer, and his accomplices, who every week publish a vile paper to less and blacken the ministers of the town & render their ministry ineffectual. A wickedness never parallel'd anywhere upon the face of the earth."
On the other side of the debate, it is harder to tell what impact pro-inoculation reports in the Gazette had. Boylston later published an account of his activities and patients, and while it isn't immediately clear how he and his colleagues found the vast majority of their test subjects, one passage indicates that it was largely via personal testimonies, as opposed to the presentation of carefully framed scientific arguments in the press:
"These gentlemen came from Roxbury into Boston to be inoculated […] and their recommendation of this practice, at their return prov'd to be of great service to that town, in carrying the inhabitants soon thro' that distemper, and in saving many lives"
At the same time, however, Boylston indicated that the "idle, unjust, and ridiculous stories and misrepresentations" published by anti-inoculators had been effective in influencing people against the practice.
Naturally, the public discourses surrounding the smallpox outbreak of 1721 and the COVID-19 pandemic of 2020 are not entirely comparable. Apart from the differences in scale and the kind of media in which debates have taken place, there are massive societal changes that need to be taken into account. Not least of which is that the residents of the industrialised West generally have less direct experience of virulent, infectious diseases. As has been pointed out elsewhere, modern medicine has become the victim of its own success. The necessity of vaccination becomes less apparent when the communicable illnesses that drove the science to produce solutions are no longer as familiar. Smallpox was officially eradicated in 1977, and the last outbreak of polio in the United States occurred in 1979. Then too, COVID-19 – often conflated with the seasonal flu – does not inspire the same visceral response in comparison to smallpox, or two diseases still extant: measles and the bubonic plague. All of which graphically advertise their presence upon their victims' bodies. The odd case of "COVID toes," on the other foot, are easily hidden from sight. These basic differences may help to explain why people question the existence of COVID-19, while the historical record doesn't seem to contain references to Bostonians denying that there was a smallpox epidemic.
Nevertheless, there do seem to be some common features: conspiracy theories; effective, multi-faceted discursive strategies used by 'science deniers;' and ineffectual scientific communication. To this must be added the issue of impartiality in the framing of the debate by the platform on which it was held. James Franklin asserted that his paper was neutral. For example, in the eighteenth issue, he wrote:
"The Courant was never design'd for a party paper. I have once and again given out, that both inoculators and anti-inoculators are welcome to speak their minds in it."
However, upon closer examination this appears to be the wordier, eighteenth-century equivalent of Fox News's 'fair and balanced' slogan. Yes, the pro-inoculation party was given some space in the paper, but from my own observations it was nowhere near the amount provided anti-inoculators. Moreover, the pro-inoculator viewpoints were rarely presented in their entirety. Rather, they often took the form of snippet references to articles published in other papers and advertisements for pamphlets like this one:
"Just publish'd the Second Edition of Several arguments, proving that inoculation of the small pox is not contained in the Law of Physick, either Natural or Divine, and therefore unlawful. Together with a reply to two short pieces, one by the Rev. Dr. Increase Mather, and another by an anonymous author, intituled, Sentiments on the small pox inoculated. And also, A short answer to a late letter in the New- England Courant. By John Williams"
What the advertisement fails to mention is that Franklin was both printer and seller of this booklet – and several others. He had a clear financial stake in the continuation of the controversy, not its resolution. Just like Facebook, the money the platform has made on ads that specifically target anti-vaxxers possibly explains why the company is unable to do anything about them.
Closer examination of such debates in the past, their framing, their outcomes, and what discursive strategies worked, could aid us in finding a way to combat modern misinformation campaigns. At least one aspect of the 1721 case seems to reflect the findings of the aforementioned study regarding the on-line competition between anti-vaxxer and pro-vaccination narratives, namely the effectiveness of multiple narratives vs. a largely monothematic, data driven argument that can seem too theoretical. Researchers are currently discussing ways scientists and doctors can improve this aspect of their communication to combat anti-vax misinformation over the long haul, such as taking the time to address the concerns of individual patients. But the height of a global pandemic possibly requires an approach that is both more concrete and more diffuse – such as the dissemination of testimonials by those directly impacted by both disease and treatment across the same social media networks anti-vaxxers make active use of. Such a personal, anecdotal form of science communication seems counter-intuitive, but the above – admittedly preliminary investigation – suggests that it was somewhat effective in the inoculation fight during the midst of the 1721 smallpox epidemic.
New-England Courant, nos. 1 and 18, 7.8.1721 and 27.11.1721.
CDC, "Measles Cases and Outbreaks," consulted 1.7.2020. https://www.cdc.gov.
Travis M. Andrews, "Facebook and other companies are removing viral 'Plandemic' conspiracy video," The Washington Post, 8.5.2020. https://www.washingtonpost.com.
Philip Ball, "Anti-vaccine movement could undermine efforts to end coronavirus pandemic, researchers warn," Nature, 13.5.2020. https://www.nature.com.
John. B. Blake, "The inoculation controversy in Boston: 1721-1722," The New England Quarterly 25, no. 4 (1952): 489-506.
John B. Blake, Public health in the town of Boston, 1630-1822 (Cambridge: Harvard University Press, 1858).
Zabdiel Boylston, An historical account of the small-pox inoculated in New-England (London: Printed for S. Chandler, 1726).
Shawn Buhr, "To inoculate or note to inoculate?: The debate and the smallpox epidemic of Boston in 1721," Constructing the Past 1, no. 1 (2000). ttps://digitalcommons.iwu.edu.
Elizabeth Cohen, "Facebook vowed to investigate horrific abuse by anti-vaxxers. Nine months later, no one was penalized," CNN, 21.6.2020. https://edition.cnn.com.
David A. Copeland, Debating the issues in colonial newspapers: primary documents on events of the period (Westport: Greenwood Press, 2000).
David A. Copeland, The media's role in defining the nation: the active voice (New York: Peter Lang, 2010).
Stephen Coss, The fever of 1721: the epidemic that revolutionized medicine and American politics (New York: Simon and Schuster, 2016).
Joan Donovan, "Vaccines stop diseases safely – why all the suspicion?" Nature, 22.7.2020. https://www.nature.com.
Neil F. Johnson, et al., "The online competition between pro- and anti-vaccination views," Nature, 13.5.2020. https://www.nature.com.
Ryan Mazan, et al., "The measles epidemic of 1714-1715 in New-France," PSC Discussion Papers Series 21, no. 4 (2007). https://ir.lib.uwo.ca/pscpapers/vol21/iss4/1.
Kreesten Meldgaard Madsen, et al., "A population-based study of measles, mumps, and rubella vaccination and autism," New England Journal of Medicine 347, no. 19 (2002): 1477-482.
David M. Morens, "The past is never dead – measles epidemic, Boston, Massachusetts, 1713," Emerging Infectious Diseases 21, no. 7 (2015): 1257-260.
Loveday Morris and William Glucroft, "Prospect of a coronavirus vaccine unites anti-vaxxers, conspiracy theorists and hippie moms in Germany." The Washington Post, 3.7.2020. https://www.washingtonpost.com.
James W. Schmotter, "William Douglass and the beginnings of medical professionalism: a reinterpretation of the 1721 Boston inoculation controversy," Historical Journal of Western Massachusetts 6, no. 1 (1977).
Julia Carrie Wong, "Revealed: Facebook enables ads to target users interested in 'vaccine controversies," The Guardian, 15.2.2019. https://www.theguardian.com.
By earlymodhistorian in Uncategorized on July 28, 2020 .
← "Free debate" has hidden costs – TD Jacobs The Great Plague and diplomatic news networks, part 1, RBE 37 – TD Jacobs →


text:
Countries Fact List
22 Interesting Facts About Costa Rica
Here are 22 interesting Costa Rica facts.
1-5 Costa Rica Facts
Image credit: en.wikipedia.org
1. A bridge built in 2003 in Northern Costa Rica is colloquially known as 'Backstab Bridge'. It was paid for, designed and built by Taiwan only for Costa Rica to cut off ties with Taiwan in favor of China. – Source
2. There is a territory in Costa Rica called Territorio De Zaguates (Land of the Strays) which is basically a huge no kill dog shelter where you can hike for free with the dogs. – Source
3. An error of Costa Rica's border on Google Maps led to an invasion of Costa Rica by the army of Nicaragua. Google responded, saying that their Maps "shouldn't be used as a reference to decide military actions between countries". – Source
4. During the peak of Ebola news in 2014 people started to avoid Liberia airport in Costa Rica thinking that it was the country in Africa. – Source
5. Since Costa Rica was not at the Treaty of Versailles, they have been at war with Germany since WWI, and are technically still at war. – Source
6-10 Costa Rica Facts
6. Costa Rica abolished its military and redirected the military budget toward healthcare, education, and environmental protection over 65 years ago. – Source
7. Costa Rica is home to 10% of the world's known butterfly species. – Source
8. Costa Rica is the only Latin American country to ban hunting for sport. – Source
9. In San Jose, Costa Rica, you are allowed to drive only 6 days a week by law. The last letter/number on your license plate corresponds to your banned day (Monday-Friday). – Source
10. In the 30's, workers in Costa Rica unearthed almost perfectly round stone spheres. No one is sure exactly when or how they were made, or by whom, or for what reason. The largest is 16 tons. – Source
11-15 Costa Rica Facts
11. 50 of the 338 known species of Hummingbirds are located in Costa Rica. Their heart rates can exceed 1,200 beats per minute and they eat half their body weight in food every day. – Source
12. In 1884, San Jose in Costa Rica was the 5th city in the world to be lit with incandescent light-bulbs. – Source
13. It has not snowed anywhere in Costa Rica since the 19th century. – Source
14. National parks cover more than 25% of Costa Rica's area. – Source
15. As a 'gift' to Costa Rica, China supplied the materials, funded and built the Estadio Nacional de Costa Rica (Costa Rica's national soccer stadium). In return, Costa Rica severed its economic ties with Taiwan and made China its 2nd biggest trading partner. – Source
16. The turquoise river in Costa Rica gets its color from a sulfur and calcium carbonate reaction. – Source
17. Costa Rica aims to become the first carbon neutral country by 2021. – Source
18. When Intel closed their factory in Costa Rica the nation's exports fell 17.5%. – Source
19. In Costa Rica, streets aren't named and houses aren't numbered. – Source
20. Fanta Kolita is Costa Rica's exclusive flavor and it is technically not available as a purchasable drink in the United States. – Source
21. The legal smoking age in Costa Rica is 10 years. – Source
22. A wasp from Costa Rica has certain toxins that when used on an orb weaver spider it essentially becomes a "zombie slave" and living host for its offspring. – Source
5 Life Pro Tips of the Week – Part 92
25 Interesting Shower Thoughts – Part 77
37 Interesting Facts About Taiwan
30 Interesting Facts About Google Earth and Maps
25 Kickass and Interesting Facts About Central America
20 Interesting Facts About Paraguay
40 Interesting Facts About Bridges
18 Amazing Facts About The Great Wall of China
#19 is based on a ten-year-old article [source], and in the article, it states that the government was in the process of assigning street names, house numbers, and zip codes.
Kymm says:
Nice work Costa Rica #8


Research resources can be, but not limited to, the Internet, books, maps, newspapers, magazines, and interviews with experts in the field.
Newspapers can serve as a good place to read about others' opinions in the editorial section. You can also find useful information in their archives, or back issues. Larger newspapers keep their past issues online.
Maps show locations, directions, and capital cities.
Books, whether in print or online, can give you more in-depth information since they can go into detail.
Interviews with experts or the important people involved in an event, can prove to be a very useful tool when writing.
Time4Writing provides practice in this area. Sign up for our Middle School Essay Writing course or browse other related courses below to find a course that's right for you.


text:
ATLANTA — S. E. Region News
CONTACT: CARRIE WILLIAMS 404-397-7667
RESTAURANT TOWN HALLS TO TAKE PLACE
ON "SWEET AUBURN"
Series Explores Justice and Race in America
Cascade Publishing House announces Atlanta's Sweet Auburn Seafood will be its host location for a fall series of town halls/book discussions on the topic of justice and race in America. Sweet Auburn Seafood is located in the historic "Sweet Auburn" Avenue business district of Atlanta (171 Auburn Ave. 30303).
Sweet Auburn Seafood Atlanta's new premier seafood restaurant
The "Sweet Auburn" town hall-styled gatherings will be convened by author Harold Michael Harvey. His latest book, Justice in the Round: Essays on the American Jury System (Cascade Publishing House, 2015), is a starting point for the town hall dialogue.
A premier seafood eatery in downtown Atlanta, Sweet Auburn Seafood is named for the historic, one-mile stretch that was once home to more black financial institutions, educators, entertainers and politicians than any other street in the South.
The first in the town hall/book discussion series will be held on Tuesday, September 15, 2015 from 5:00 pm until 7:00 pm. The second Town Hall will be held on October 19, 2015 from 6:00 pm until 8:00 pm, with an interview format gathering held by author Harold Michael Harvey with other local political journalists.
Harvey explains: "Sweet Auburn Seafood on 'Sweet Auburn' Avenue is the perfect venue for this discussion. The role that 'Sweet Auburn' played during the economic development of black America from 1880 to around 1965 was a unique cultural contribution. Sweet Auburn Seafood's willingness to host these timely discussions is a testament and tribute to the businesses that lined this avenue when Atlanta society was legally segregated."
Known for his casework when he worked as a trial lawyer, the award-winning journalist/author/publisher speaks to the impetus behind "Justice In The Round":
"One salient fact shapes my frame of reference in these essays: All jurors bring to the jury room their genetics and their sundry environments. By virtue of this fact, we are all subconsciously race-conscious. No one can divorce themselves from their genetic make-up, but we can, if we choose, overcome the environmental conditions that will enable us to be fair to people with different genetics and social standing."
Harvey sees the intimacy of Sweet Auburn Seafood's setting as a unique and ideal environment for what he terms as critical, pressing dialogue for Americans. It is time, integration pioneer and veteran journalist Harold Michael Harvey asserts, that America address and consider reparatory justice.
"Justice in the Round", through this town hall discussion series, begins that thoughtful inquiry September 15th.
Harold Michael Harvey is the author of the acclaimed legal thriller "Paper Puzzle". He writes on legal and political issues at haroldmichaelharvey.com. He earned a Bachelor of Science Degree in political science from Tuskegee University and a Juris Doctorate from Atlanta Law School. He is the winner of the "Outstanding Work in Newspaper Journalism Award" from the National Newspaper Publishers Association and has twice won the Political Pundit Prize for his journalism.
For "Justice In The Round" reviews, visit:


The big Power Systems announcements came out in February, but IBM always has some things that need to get done. And last week, it wrapped up a few loose ends with some nips and tucks in the product line.
In announcement letter 118-030, we learned all about them. First off, IBM has expanded the storage capacity of the Power-based CS822 servers, which are special version of the Power S822 based on Power8 chips that are designed to support the hyperconverged storage stack from Nutanix. We told you all about the CS821 and CS822 servers for running the Nutanix Enterprise Computing Platform back in July 2017. IBM is selling Power versions of the Nutanix stack, which creates a virtual SAN of sorts that spans the same cluster as the compute – and does so on the same virtualized substrate – but only with flash storage. Nutanix offers its wares on clusters that have a mix of disk and flash where some performance can be sacrificed and much more capacity is needed. With the updates, the capacity on the CS822 nodes for Nutanix have been expanded by a factor of three from their prior maximum of 15 TB per node to 45 TB per node. This is done by having up to a dozen SSDs per node. IBM has two different configurations that have been updated; both have 512 GB of main memory in the system and one has a dozen 1.92 TB flash drives (with a system cost of $139,000) and another that has a dozen 3.84 TB (with a system cost of $211,000). Those prices include the cost of the Nutanix HCI storage software.
Interestingly, we also learn in this announcement that IBM is offering a four-core variant of the Power8-based Power S812, which clocks at 3.03 GHz, that runs AIX and also supports the little endian versions of Red Hat Enterprise Linux 7.4 and higher, SUSE Linux Enterprise Server 12 SP3 and higher, and Ubuntu Server 16.04.3 and higher.
The Linux-only Power S821LC and Power S822LC for Big Data systems, which IBM launched last year, now have three new 2.5-inch SATA flash drives. The 480 GB unit costs $665, the 960 GB unit costs $1,261, and the 1.92 TB unit costs $2,293.
Finally, even though IBM has created special versions of the Power9 "ZZ" entry servers specifically for running SAP HANA in-memory databases, IBM is for some reason now committing that the more generic Power L922 system will also be allowed to run SAP HANA in production mode with the little endian variants of Red Hat Enterprise Linux 7.4 and SUSE Linux Enterprise Server 12 SP3 in little endian mode.
There will probably be more at IBM's Think 2018 conference in Las Vegas this week, so stay tuned.


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Why You Should Talk Openly About Sex
Sex is an integral part of our lives, it's hard to ignore because it is everywhere in our culture; online websites, TV shows, movies, celebrity magazines etc. However, sex is one thing you shouldn't ignore when you're in a committed and loving relationship. Although not the most important part when it comes to relationships, it's still something that every couple should learn to talk about openly and honestly.
Even though sex is a huge part of society, it's still considered a topic of taboo and can be a sensitive subject to talk about. The basics of sex should be relatively easy, however, surprisingly it's a very difficult topic to talk about, especially with your loved one. Talking about sex openly with your partner is just as important as the act itself and should be communicated about clearly. Talking about it can benefit more than just your sex life, it also strengthens your communication and connection. Here are reasons why you should talk openly about sex and how.
Openly talking about your sex life and sexual needs is a great way to increase your confidence levels both within the relationships and life, in general. Being able to explore each other intimately gives you both a boost of morale and allow you to enjoy your sex life even more now that you know what each other like and dislike.
Start building your confidence with the support of your partner and talk about your sex life openly and effectively.
BOND WITH YOUR BODY
This may seem like a funny point, however, talking openly about sex also refers to being in tune with your own body. Exploring your body and figuring out what you like and dislike starts with knowing yourself first. Bond with your own body before you start bonding with another.
Sex is a very powerful thing in relationships, not only does it provide physical pleasure, but it also increases romance and creates an amazing connection between you and your partner. Your body changes all the time, so always be in tune with your body and learn to love it as much as your partner does.
If you're in a new relationship, there could be some confusion when it comes to sex. Your previous partner may have loved something or hated something however with your new partner, it might be the complete opposite. Sitting down and putting it all out there on the table is the most effective way to communicate. Don't wait till a few months into the relationship where you're unhappy with your sex life.
Again, if you're new in a relationship, the topic of being safe in sex goes unsaid. Statistics show that in just one decade, syphilis cases have tripled and chlamydia has increased by 43%. As uncomfortable as it may be to have this conversation, it's extremely important and can possibly be life-altering. Safety comes first when it comes to communicating openly about sex.
Sure, sex can be a topic of taboo, even in this day and age. However, you shouldn't let it wear you down. You should have the confidence to speak about it and don't ever be afraid to ask questions either.
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