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Where compassionate conservation meets rewilding: An interview with Marc Bekoff
Paula Mackay is a freelance writer/editor, field biologist and communications consultant for conservation (USA); in this thought provoking interview with Marc Bekoff, she discusses the ethics associated with rewilding.
Marc Bekoff is the rare breed of scientist who doesn't shy away from probing the thorny realm of animal ethics and human behavior—in fact, he is renowned for his boldness in doing so.
As a Professor Emeritus of Ecology and Evolutionary Biology at the University of Colorado and a former Guggenheim Fellow, Marc's credentials as an ethologist and behavioural ecologist continue to shine. In 2000, he was awarded the Exemplar Award from the Animal Behavior Society for his long-term contributions to the field, and he serves as a scientific advisor to numerous institutions and non-profit organisations across the globe.
Marc has also published an astounding 31 books and over 1,000 articles on a wilderness of topics—among them, the behaviour of captive and free-ranging dogs, the emotional lives of animals, how we grieve our pets, social play in canids, the behavioural ecology of wild coyotes and wild Adelie penguins, his ongoing service with prisoners, and a touching celebration of his friend and colleague, Jane Goodall—with whom he co-founded Ethologists for the Ethical Treatment of Animals. Marc's skills as an observer enabled him to excel in his career as a biologist, but perhaps most impressive to me is his commitment to being a good and compassionate listener in a very noisy world.
I first met Marc in 1991, when he allowed me to attend (for free) his graduate seminar in animal behaviour at University of Colorado, Boulder. I told him I was planning to apply to graduate school myself and wanted to broaden my background in science. In hindsight, though, I think I was mostly seeking intellectual community around my deep concern for animals. I'll never forget Marc's curiosity and energy when he walked into that classroom, and his passion for dynamic conversation with students he clearly considered peers. He was there to teach, and he was there to learn.
Today, compassion lies at the heart of Marc's writing and advocacy work. He is a tireless promoter of "compassionate conservation," a new paradigm launched in 2010 at an international symposium hosted by the Born Free Foundation in Oxford, UK. In an article in the journal BioScience, Marc and co-author Daniel Ramp (Director, Centre for Compassionate Conservation) define compassionate conservation as "a rapidly growing international and cross-disciplinary movement that stipulates that we need a conservation ethic that incorporates the protection of other animals as individuals, not just as members of populations or species [often called 'collectives'] but valued in their own right."
Marc contends that conservation is ethically challenged when it comes to the treatment of nonhuman animals, but also maintains that compassion for animals isn't incompatible with preserving biodiversity and doing the best science possible. He describes the 4 principles of compassionate conservation as:
Do no harm.
Individual animals matter.
All wildlife has intrinsic value.
Promote peaceful coexistence.
During our recent phone interview for Trusting Wildness, Marc and I discussed the complicated ethics surrounding wildlife reintroductions, and his views on how rewilding can and must incorporate compassionate conservation in order to be successful.
PM: In Rewilding Our Hearts, you took the word "rewilding" to the personal level, encouraging people to deeply imagine the world from the perspective of wild beings. How do you feel about the movement to rewild entire landscapes by protecting core areas, reconnecting them via wildlife corridors, and restoring apex predators?
MB: I think it's great! I'm all for it. But I'm not happy about rewilding landscapes in ways that cause the deaths of animals. I need to be clear here. I really liked the reintroduction of wolves into Yellowstone and I think it's a successful program, but let's not fool ourselves by thinking that some wolves weren't killed or injured when they were wolf-napped up in Canada. And you're introducing predators who are going to kill prey—many of whom have never experienced wolves in their lives. You need to take that into account; I honestly go back and forth on the ethics of projects like this. But I have to say that the more I think about how they're done, the more concerned I become.
Gray wolf at Yellowstone National Park. Credit: Paula MacKay
What I don't go back and forth about are the ethical concerns that arise when you consider, say, wolves, and you break up a pack in Location A to move some individuals to Location B, because no one really understands the effects of the removal on the wolves in Location A. This is an important question, and we need solid answers for all studies in which animals are translocated.
I remember when I was at a meeting some years ago and I asked, "What ever happened to the groups of wolves from which individuals were taken to be moved south?" The room got quiet, a few people looked at one another as if to see if someone else could answer my question, and I felt like I'd stepped into unwelcome terrain. It turned out that no one really knew. I was somewhat surprised but I let it go. This is not a criticism, but rather a question we need to be able to answer. We shouldn't be robbing Peter to pay Paul.
So my take is that I'd like to rewild landscapes if it can be done without animals getting harmed or killed. And if it's a matter of reintroducing predators—if the reasons for putting these animals back in a habitat are good enough (it goes without saying that there are predators and prey out there, and I always feel sorry for the prey)—then, of course, I want the animals who are reintroduced to have total protection. If that's not the case, it's a triple whammy. You may injure or kill some wolves (or whichever predators we're talking about) in the process of moving them to an area; they will then kill prey; and they themselves are not protected and some will get killed for simply being who they are. I'm sure some philosophers might try to convince me that this is all okay, but I'm just not for it.
PM: In the "Born to Be Wild" chapter of The Animals' Agenda, you and your co-author, Jessica Pierce, draw a distinction between the "management" and the "conservation" of wildlife, with the former focused on the control of animals to meet human needs, and the latter, on balancing the needs of some animals against the needs of other animals or ecosystems for the sake of protecting endangered species or ecosystems. It sounds like you think there are cases in which the conservation-driven reintroduction of a native species is ethical and appropriate, but that it needs to come with proper protections. Is this accurate?
MB: Right. That's where compassionate conservation comes in. First do no harm, and the lives of every individual count. So, I'm potentially supportive if individuals aren't harmed or killed for the sake of other individuals of their own or other species. Killing is off the table.
PM: In situations where native animals are missing from an area because we killed them or otherwise caused their regional extinction, do you think we have an obligation to explore reintroduction?
MB: Yes. And the key word is explore. But once again, there are a lot of layers. We should never do a reintroduction without taking ethics into account. There might be good biological reasons for doing something—I can understand why people want to have native animals protected or returned to an area—but not at the expense of other animals. It doesn't work for me. The basis of compassionate conservation is basically that conservation is an ethical as well as a biological practice, and that compassion is a factor that must play a critical role in conservation decisions.
PM: You live in Colorado. Do you support the reintroduction of gray wolves to your state?
MB: I do. I'm actually on the scientific advisory committee. However, I'm only for it if wolves have total protection on the ground. No BS. We need to consider the biology and the ethics in tandem; they go hand in hand.
PM: In Washington, the state has killed 18 wolves due to conflicts with ranchers since wolves first returned to the region in 2008—15 of these on behalf of the same cattle operation. Here as in the Rockies, the wildlife officials involved argue that such killings are necessary to advance wolf recovery. Do you support this approach to wolf management?
MB: No. I don't see how one can be "for wolves" and allow them to be killed. Some people and organisations call such killings the "authorised removal" of wolves. Does anyone really think wolves who are removed with authority suffer less? Of course they don't. But, the phrase "authorised removal" sort of sanitises the blood bath, and I'm surprised that some people buy into this cover-up.
PM: Can you envision a scenario in which the lethal removal of a wild predator is, in the long run, necessary to advance the conservation of those animals? You could use a black bear, a wolf, a cougar, or a coyote as an example. How do you feel about situations where there's an obvious predator-human conflict and people are calling for the death of the predator or predators because of this conflict?
MB: Again, it doesn't work for me. For example, here in Colorado, wildlife officers kill coyotes around Boulder and Broomfield. They often say they think they got the right "problem" animal, but then they have the same problem over and over again because either they didn't really kill the right individual, or new coyotes come in when others are removed.
Roughly half a million coyotes are killed in the U.S. each year. Marc Bekoff believes that all wildlife has intrinsic value, and that every individual matters. Credit: William C. Gladish
Generically, the way I interpreted your question is, can you imagine a situation where you would kill a member or members of one species to save members of that same species, or kill members of one species to save members of another? I'm against it. Simple. People need to be educated and, if necessary, change their behaviour to accommodate nonhumans who have no place else to go.
PM: Many people would agree that wild nature does best when we leave it alone. But given our pervasive ecological footprint, nonnative and invasive species threaten plants and animals inhabiting native habitat. What should we do in the difficult situations where nonnative animals threaten the existence of native species?
MB: If we need to stop that from happening, we need to come up with nonlethal, humane ways of doing it from an ethical point of view. An animal who is nonnative doesn't suffer less than a native—it doesn't matter where they live. That sounds trite to some people, but it's a very important point.
Also, how do you define native and nonnative? There are nonnative animals who have been in certain habitats for a hundred and some odd years. It's all too easy to say such and such are nonnative, so let's get rid of them because they don't belong. But, in fact, nonnatives have become integral parts of numerous ecosystems, and ecosystems are dynamic and evolving entities.
Getting rid of so-called nonnatives isn't a panacea for returning an ecosystem to what it used to be. And, of course, we can't really return or restore an ecosystem to what it used to be because it has changed incrementally and synergistically over time depending on who was there and who wasn't during any given period. We can do our best to try to put back some of the pieces, but we can't go backwards in time.
The New Zealand government poisons millions of nonnative predators annually to try to save native birds. Credit: Paula MacKay
Because we can't go back to what was, I think, frankly, we just need to live with what we have. And if we want to start moving nonnative animals around in favour of natives, then we need to do it in humane and nonlethal ways. There's no way that most of the techniques used are humane. When people say we're going to humanely kill these wolves, or we're going to humanely kill five billion invasive animals in New Zealand with empathy and compassion—we're going to kill them "softly"—there's no way this will happen. It's a scam—a feel-good scam. The phrase "killing softly" is an oxymoron. And the good news is that slowly but surely, more and more people are coming out against these bloodbaths.
Similarly, sometimes people say they're going to "euthanise" the nonnatives, but of course it's not euthanasia, or mercy killing. The animals aren't terminally ill or in interminable pain. Using the word "euthanasia" is just a way to make the killing seem justified and less messy, and some people are fooled by this scam, just as some are fooled by the phrase "authorised removal."
PM: You also discuss the translocation of animals for mitigation purposes in your book—for example, I'm familiar with the translocation of desert tortoises in areas slated for development. Such translocations can be very risky for the animals involved. In cases like this, is there a tension between animal rights and animal welfare, with the former arguing that animals should not be killed or made to suffer on our account (e.g., because we want to develop an area), and the latter, that as long as we do our best to consider the animal's well-being, the ends sometimes justify the means?
MB: Yes, that's why we wrote our book, The Animal's Agenda! We're talking about protecting individual animals and not killing or harming them in the name of conservation or in the name of humans. It's a matter of protecting each and every individual, and that is what the science of animal well-being is all about and why we wrote our book. What it comes down to is that animals have inherent value. Each and every individual is important, and their lives are no less important to them than my life is to me. Decisions about who lives and who dies and why are often terribly difficult to make, but we can't continue killing individuals as possible solutions to problems at hand.
You sometimes see a tension between animal welfare and compassionate conservation because most conservationists are welfarists. They'll trade individuals of one species for those of another species or the same species; they play what I call the numbers game. There are a million brown rats, it doesn't matter if we kill 10,000. Well, there might be a million guys like me, but it would matter very much to me if they said to me, there are a lot of you, so you can't live.
Marc Bekoff looks for dingoes in the Barangaroo Reserve west of Sydney, Australia. Credit: Brad Purcell
When I talk to people about this in a rational way, they come to understand what the focus on individuals really means. If you have a Black Lab and there are a lot of Black Labs, are you going to let them kill your dog because there are a lot of Black Labs, so there can be more Yellow Labs? That's why I ask people, would you do it to your dog? Would you put your dog in a slaughterhouse, would you put your dog in a laboratory where they maim and kill animals, would you allow your dog to be moved into an area where they may not be welcome in order to have more dogs like that in that area? Thankfully, the answer is always "no."
Bringing dogs into the picture is a way to bridge the empathy gap, a point I make in my new book, Canine Confidential: Why Dogs Do What They Do. It's a way to extend empathy and compassion to other individuals of species with whom people are less familiar. And, I'm pleased to say it works.
PM: You've said that, in addition to being concerned about our own survival as a species, we should be concerned about the survival of other species, who deserve "freedom from extinction." What do you think of the Half-Earth approach that E.O. Wilson is promoting—that is, that we must protect at least half the Earth's land and water to stave off the mass extinction of species.
MB: Of course, my first response is that I love it and that we should go to three-quarters or the whole Earth. But what I like about Half-Earth is that it's gotten a lot of conversations going. People hear about the Anthropocene—which I call "the rage of inhumanity" rather than "the age of humanity"—and all these extinctions and the loss of animals and their homes, but many don't realise that there's essentially no place on Earth where we don't have an effect.
If you present that in a hysterical way, you lose people. But when you start talking to people about what we're really doing and you have a person like E.O. Wilson who's got a great reputation—and you also have something tangible to offer as a solution—you get their attention. I like it as an organising principle for getting the word out. I would like to know that it's going to happen. I would like to know that there are places where humans can't go and where nonhumans are allowed to work things out on their own.
Putting ideas out there that some people feel are outlandish, or with which they feel uncomfortable, gets much-needed discussions going so that individuals with different views are included. If we don't work for nonlethal solutions, they won't materialise and the killing fields won't go away. My goal is to help people who are arguing for nonlethal practices get their place at the table, and to make sure we're having honest and respectful discussions and debates. All animals depend on us for our goodwill and for being concerned with the life of each and every individual.
To learn more about Marc's work, please visit his website and check out the following links:
Canine Confidential: Why Dogs Do What They Do (Marc's latest book)
The Animals' Agenda: Freedom, Compassion, and Coexistence in the Human Age
Ignoring Nature No More: The Case for Compassionate Conservation
Compassionate Conservation Matures and Comes of Age
Rather Than Kill Animals "Softly," Don't Kill Them at All
Header Image: Marc Bekoff and his friend, Minnie. Credit: Tom Gordon.
Article first published in Wildlands Network Blog.
About the Author: Paula MacKay is a freelance writer/editor, field biologist, and communications consultant for conservation. For the past two decades, she has studied wild predators with her husband, Dr. Robert Long. Paula served as managing editor for Noninvasive Survey Methods for Carnivores, and earned an MFA in creative writing from Pacific Lutheran University in 2015. She has written for numerous nonprofits, books, journals, and magazines — including Wild Hope, Washington Trails, The Bark, E Magazine, Wild Earth, and Wildlife Conservation. MacKay currently manages Wildlands Network's blog Trusting Wildness, and is writing a conservation memoir about searching for wolverines and grizzly bears in the North Cascades.
Biodiversity ReWilding Species


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Away From The Dark Book Review
Away From The Dark by Aleatha Romig
Series: Light #2
Published by Self-Published on October 18th 2016
Format: eARC
Nine months ago, Sara Adams awoke with no memory. The man holding her hand told her she's a member of The Light, a tight-knit religious group led by the terrifying and charismatic Father Gabriel. As a woman in the community of The Light, her duty is to be unquestionably obedient and to submit to the will of her husband.
But as Sara's memory starts to return and she remembers her past, she sees that everything she's been told is a lie. The Light is an insidious and dangerous organization, and its corrupting influence reaches well beyond the confines of the remote campus where Sara is being held.
With everything at stake, Sara struggles to sort out her true memories from her indoctrination. The desire to escape consumes her, but who can she trust? And which other followers of The Light were forced into this life, brainwashed to believe they belonged? The more she remembers, the more it becomes clear that Jacob, the man who calls himself her husband, is keeping shattering secrets of his own.
But Sara cannot flee alone, leaving innocents behind. She must fight to extinguish The Light.
Q&A Review by Liezel & Angie
What did you love most about this series?
Liezel: I loved the intrigue, the suspense and the thrill and the fact that Aleatha Romig will keep you guessing until the very end!
Angie: I agree with Liezel 100%! I also love how Aleatha makes you feel so connected to her characters that you feel a loss when you are done reading a book by her. That's what I'm feeling right now. Loss.
Which character made the best impression in this book? Why?
Liezel: It was Stella who made the best impression in the Into the Light but in Away From
The Dark I would have to say it was Jacob hands down. I appreciated his dedication – how he went above and beyond the call of duty to put an end to the atrocities no matter the consequences. I also loved how committed he was to Stella. Despite how things looked he never lost hope.
Angie: I'm torn here. I love Jacob and he really shined in this book. His love and devotion spoke volumes for me. The things he did for Stella… that's true love. I also love Stella. She was so strong. She did what needed to be done and I admire her for that.
Do you have a favorite quote?
Liezel:
"I've loved you since the first time I saw you, and now, the more I learn about you, the more I love."
Just goes to show how perfect Stella and Jacob were together. That no matter if they were in the light or the dark that they would've have found each other
Angie:
"I pray that one day I'm able to call you by another name, but in the meantime, you're my wife, my Sara Adams, and while I do and will respect the boundary you placed on sex, right now I want to kiss my wife, and I plan on doing it. Do you want to stop me?"
Like Liezel said.. their perfect together and their love is real despite how they met. They're soulmates.
Did the story end as you wanted?
Liezel: Yes and no. I enjoyed this book so much I didn't want it to end! Don't get me wrong, it doesn't end in a cliffhanger. I just felt like there was so much more that could've been added onto their story. Not only with Stella and Jacob but the other characters as well. I honestly hope that the Aleatha decides to expand the series. I want more!!
Angie: Yes because we got some closure on some of the characters and the church but then there are a lot of unanswered questions that I can't post here. Aleatha really does leave it open for a spin-off series. Like Liezel said Away From The Dark is not a cliffhanger.
WHY would you recommend this book?
Liezel: I've mentioned in our last review how much impressed I was with the degree of complexity in each and every one of Aleatha stories and the second installment of The Light isn't any different.
The amount of detail that Aleatha Romig brings forth in this series is phenomenal. It's literally like a movie unfolding right before our very eyes. Everything about this book was fantastic. A definite 5/5 in my book.
Angie: Just the overall complexity and depth that Aleatha puts into her characters and writing should be enough to why you should read this book and all her books for that matter.
Like Liezel said it's like a movie unfolding in front of your eyes because it is. There's so much truth behind these two books that happens every day in our world that no one really pays attention too. I think that's why The Light Series are different from any other book because some of it is happening, it's just that we don't hear about it everyday. It is such a great series. Read it!!!
Shrill screams echoed throughout our dimly lit bedroom, accelerating my heartbeat and pulling me from the terrible nightmare. I waited for more, until the realization struck. The screams were my own.
"Jacob?" I called, my voice shaking with dread as I reached for my husband. Instead of reassurance, my fingers met cold empty sheets. He was gone—still away at another campus.
What just happened? Was it a dream?
I clung to the covers as I puffed my cheeks and slowly exhaled. While each breath helped to still the chaos, the exercise wasn't enough.
Who am I? Who is he?
Jacob's questions from months ago came back. They were my security. They'd worked before.
I am Sara Adams and my husband is Jacob Adams.
Pushing the images from my dream, or nightmare, away, I imagined Jacob's comforting embrace. Slowly I threw back the down comforter and willed the cool air to soothe my perspiration-drenched skin. From the way my heart galloped in my chest, I might have been running a marathon, not sleeping.
In my sleep I'd been battling to escape a vehicle, and then an explosion of heat.
It had been a dream, I reassured myself—a nightmare. The accident I'd had, nearly nine months before, had been different. I couldn't remember it, but I'd been told that I'd been injured and gone unconscious. In the nightmare I had been out and away from the wreckage.
It seemed so real.
In my dream I hadn't been able to see past the darkness, yet I'd known I wasn't injured.
My arms surrounded my midsection as the memories replayed like pictures in my mind. Someone was hurting me—purposely harming me, and there was a voice—a deep voice.
Jacob's voice?
No. He wouldn't hurt me.
My entire body shuddered as goose bumps peppered my skin. Sitting upright, I reached for the bedside lamp. With trembling fingers I turned the knob and my eyes adjusted as the soft light combined with the sun's perpetual summer glow.
I closed my eyes and tried to concentrate on Jacob's questions.
This time I said the words aloud, praying that if I spoke the truth, the images would disappear. "I am Sara Adams. He is my husband, Jacob Adams." I pulled myself from the bed and walked to the bathroom. Turning on the light and the faucet, I cupped the cool water and splashed my face. As I reached for the cup and began to fill it, a metaphoric dam that had been constructed to hold back my past burst.
My mind was flooded—no longer with simple images, but with scene after scene.
For the first time since I could recall, I knew the woman in the mirror.
I knew me.
About Aleatha Romig
Aleatha Romig is a New York Times and USA Today bestselling author who lives in Indiana. She grew up in Mishawaka, graduated from Indiana University, and is currently living south of Indianapolis. Aleatha has raised three children with her high school sweetheart and husband of nearly thirty years. Before she became a full-time author, she worked days as a dental hygienist and spent her nights writing. Now, when she's not imagining mind-blowing twists and turns, she likes to spend her time a with her family and friends. Her other pastimes include reading and creating heroes/anti-heroes who haunt your dreams!
Aleatha released her first novel, CONSEQUENCES, in August of 2011. CONSEQUENCES became a bestselling series with five novels and two companions released from 2011 through 2015. The compelling and epic story of Anthony and Claire Rawlings has graced more than half a million e-readers. Aleatha released the first of her series TALES FROM THE DARK SIDE, INSIDIOUS, in the fall of 2014. These stand alone thrillers continue Aleatha's twisted style with an increase in heat.
In the fall of 2015, Aleatha moved head first into the world of dark romantic suspense with the release of BETRAYAL, the first of her five novel INFIDELITY series that has taken the reading world by storm. She also began her traditional publishing career with Thomas and Mercer. Her books INTO THE LIGHT and AWAY FROM THE DARK were published through this mystery/thriller publisher in 2016.
Aleatha is a "Published Author's Network" member of the Romance Writers of America and represented by Danielle Egan-Miller of Browne & Miller Literary Associates.
Website | Twitter | Goodreads | Amazon
By Aleatha Romig
Twisted Is Live!
Ripples Book Review
Respect Cover Reveal
ALEATHA ROMIG ANNOUNCEMENT
The Infidelity World Review
5 Star Rating, Joint Reviews, Recent Reviews, Review by Angie, Review by Liezel

redpajama_set_name: RedPajamaCommonCrawl


The Irish Raptor Study Group has been granted permission to bring judicial review proceedings challenging a decision of An Bord Pleanála to grant planning permission for a 19-turbine wind farm located at Meenbog near Barnesmore Gap.
The proposed development site is located in an area which is specially designated by the National Parks and Wildlife Service as regionally important for the protection of Hen Harrier. While the developer in its application did not identify the presence of breeding Hen Harrier on the wind farm site IRSG volunteers had identified two pairs of breeding Hen Harrier in the same area.
Meenbog wind farm is in an area of South Donegal that supports up to seven per cent of the national breeding population of Hen Harrier in the Republic and the IRSG expressed serious concerns to An Bord Pleanála about the impact the proposed development would have on the species.
According to IRSG Chairperson Ryan Wilson-Parr the Group offered to show An Bord Pleanála exactly where these breeding sites were so that the impact on this threatened species could be fully assessed before a decision on whether to grant permission was made.
"However rather than resolving this crucial conflict of evidence, the Bord, proceeded to grant permission without regard to whether there would be an impact on the Hen Harrier breeding pairs that IRSG identified on the site," he said.
Mr Wilson-Parr was speaking following a decision by the High Court on Wednesday allowing the Group to bring judicial review proceedings challenging An Bord Pleanála's decision.
He added: "I would like to sincerely thank Fred Logue of FP Logue Solicitors, and David Browne BL for their excellent work on this case".
The Hen Harrier is Ireland's rarest declining resident breeding bird species and is strictly protected under the Birds Directive. These birds were once widespread in Ireland but their numbers have been declining largely due to habitat loss. There has been a 50% decline in numbers over the last 40 years.
The development, which has been proposed by Planree Ltd, will have a capacity of more than 50 MW and feature turbines with ground to blade tip heights of up to 156.5 metres (513.5 ft). The developers say the proposal has the potential to generate electricity for 29,000 households.
The project is a revision to a 49-turbine wind farm which was rejected by the Board in 2016.
Approval for the project, which had attracted strong local opposition, comes with a number of conditions, including shadow flicker requirements.


So, it is something about D1 timeframe and MAs (see article attached).
And we have some difficult cases concerning this system (see image attached). It is two buy signals which produce the losses. And I may have a lot of examples like this for sell and buy.
- use some indicator as a filter to filter the false signals.
I think this system is ok. It should be developed. A little concerning filtering.
And this idea about high and low prices (instead of closing prices) to calculate the SMA is also good.


Today, Rep. Scott Peters (CA-52) unveiled The Climate Playbook, a comprehensive plan he compiled of already existing legislation authored by both Republicans and Democrats, many of which have already earned bipartisan support.
Today, Reps. Scott Peters (CA-52), Lucy McBath (GA-06), and Lisa Blunt Rochester (DE-AL) are introducing H.R.
Today, U.S. Congressman Scott Peters (CA-52) questioned the Office of Management and Budget (OMB) Acting Director Russell Vought after President Trump released his Fiscal Year 2020 budget. The budget blueprint calls for major cuts to education, environmental protection, energy, health care, and housing programs. Rep.
Today, a bill co-sponsored by U.S. Congressman Scott Peters (CA-52) to close the loopholes in federal gun purchase background check laws passed the House of Representatives. The bill requires a background check for every gun sale in the nation.


text:
Im Projektmanagement ist ein Proof of Concept (PoC) ein Meilenstein, an dem die prinzipielle Durchführbarkeit eines Vorhabens belegt ist. Der positive oder negative Machbarkeitsnachweis ist das Ergebnis einer Machbarkeitsstudie. In der Regel ist mit dem Proof of Concept meist die Entwicklung eines Prototyps verbunden, der die benötigte Kernfunktionalität aufweist.

Argumente und Ziele
Mittels eines Proof of Concept können Risiken in der Entscheidung minimiert werden. In der Regel stehen folgende Argumente im Vordergrund:
 Risikominimierung für Entscheidungsgrundlagen und Budget
 Validierung kritischer Anforderungen an die Anwendung
 Akzeptanztest der Anwendung in Zusammenarbeit mit Herstellern und Partnern.
 Der Prototyp (Software) dient auch als Basis für eine bessere Kommunikation im Projektteam über konkrete Dinge (statt abstrakte Modelle).

Bereich IT
Bei Projekten zur Einführung neuer Unternehmenssoftware wird zuweilen ein Proof of Concept umgesetzt, was mit einer Installation der Software und Anbindung an ausgewählte Schnittstellen einhergeht. Dadurch erreicht man zunächst genau die Punkte, die in der Definition von Prototyping (Softwareentwicklung) beschrieben sind.

Ein Beispielprojekt ist eine komplexe Systemumgebung mit diversen Abhängigkeiten, z. B. Schnittstellen zu weiterer Anwendersoftware.

Zusätzliche Ziele sind einerseits die gemeinsame Erarbeitung einer belastbaren Anforderungsliste, während der Proof of Concept es andererseits ermöglicht, ausgewählte Anforderungen an die neue Software/Architektur bereits in dieser Projektphase zu testen.

Bereich Computersicherheit
Derselbe Begriff wird auch im Bereich der Computersicherheit verwendet. In diesem Umfeld wird als Proof of Concept angesehen, wenn eine Sicherheitslücke durch den Entdecker ausgenutzt wird, ohne dass eine Schadfunktion ausgelöst wird. Es wird dadurch bewiesen, dass ein Sicherheitsproblem besteht, so dass der Softwarehersteller dieses nicht beziehungsweise nicht weiter bestreiten kann. Der Hersteller wird dadurch unter Zugzwang gesetzt, die Lücke (durch einen Patch) zu schließen, eine schwerwiegende Sicherheitslücke kann einen sofortigen Hotfix erforderlich machen.

Ein Beispiel könnte sein, dass es gelingt, das Taschenrechner-Programm auf einem entfernten Computer zu starten, ohne dass man regulär berechtigt ist, dort Programme zu starten. Wenn dies gelingt, ist bewiesen, dass ein Programmstart möglich ist; ein bösartiger Angreifer könnte vermutlich auch andere Programme starten und damit Schäden auslösen.

Einzelnachweise

Projektmanagement

redpajama_set_name: RedPajamaWikipedia


Recent analysis from Alcatel Lucent says that new update (from November 15th) brings even more signaling load to mobile networks. Should facebook allow the user to trigger/ defined how "chatty" is the app and optimize Costumer Experience ?
On November 15, Facebook released new versions of their mobile app for Android and iOS. Prior to the new release, Facebook signaling and airtime already accounted for 10% and 15% of the overall load on 2G/3G networks, respectively. As users around the world updated and started to use this new version, we quickly noticed a dramatic increase of almost 60% in the signaling load and 25% in the airtime consumed by the Facebook application. During the same period, the number of Facebook users increased by only 4%.
Clearly, it is not the swelling of Facebook's community that intensified the load, but rather the introduction of new Facebook features for mobile users and underlying platform changes.
The effect on service provider networks was significant, driving up overall (total) signaling traffic and airtime consumption by 5-10%. An application design change by Facebook can be innocuous for fixed line and WiFi users, but can significantly boost the cost of delivery for mobile service operators. This 5-10% increase in signaling and/or airtime translates directly into a 5-10% increase in radio capacity requirement (i.e. CAPEX investment) to continue delivering the same service.
So this is obviously of concern to a mobile operator, but why should Facebook care? The simple answer – you! Higher signaling and airtime usage can directly affect battery life. While today, the increase is likely too small to impose noticeable threat to battery life, we did see a huge jump in signaling with this release. If signaling continues to increase at this rate in future releases, a large portion of users may start to notice that they need to charge up more frequently.
Another trend we detected was an increase in popularity of Facebook video traffic — a whopping 350% increase in volume since the November 15th launch — the most growth of all Facebook traffic. Unlike signaling where the updated software was responsible for the increase, this change is driven by more users enjoying new features such as sharing their news feeds. It is interesting that Facebook-chat traffic decreased during that same period (17% fewer users), indicating that users formerly using chat to communicate might be starting to use Messenger and embedded videos (+6% and +154% more users, respectively). While insignificant from a signaling perspective, the growing appetite for high bandwidth applications like video means service providers must account for bandwidth growth as the use of video continues to rise.
The bottom line – as we continue to feed our mobile applications habit, app developers will need to better consider the implications of their design decisions on the wireless network resources. Optimizing signaling has big benefits for both the service providers and consumers – including better user experience at a more reasonable price and a big one for all of us — longer battery life.


Preprints (earlier versions) of this paper are available at http://preprints.jmir.org/preprint/1694, first published Nov 23, 2010.
Background: Informing policy decisions about the cost-effectiveness of health care systems (ie, packages of clinical interventions) is probably best done using a modeling approach. To this end, an alcohol model (ALCMOD) was developed.
Objective: The aim of ALCMOD is to estimate the cost-effectiveness of competing health care systems in curbing alcohol use at the national level. This is illustrated for scenarios where new eHealth technologies for alcohol use disorders are introduced in the Dutch health care system.
Method: ALCMOD assesses short-term (12-month) incremental cost-effectiveness in terms of reductions in disease burden, that is, disability adjusted life years (DALYs) and health care budget impacts.
Results: Introduction of new eHealth technologies would substantially increase the cost-effectiveness of the Dutch health care system for alcohol use disorders: every euro spent under the current system returns a value of about the same size (€ 1.08, ie, a "surplus" of 8 euro cents) while the new health care system offers much better returns on investment, that is, every euro spent generates € 1.62 in health-related value.
Conclusion: Based on the best available evidence, ALCMOD's computations suggest that implementation of new eHealth technologies would make the Dutch health care system more cost-effective. This type of information may help (1) to identify opportunities for system innovation, (2) to set agendas for further research, and (3) to inform policy decisions about resource allocation.
Alcohol use disorders are a leading cause of disease burden [1,2] and are associated with substantial economic costs [3-5]. Therefore, curbing alcohol use has long been recognized as an important public health objective [6,7]. Health care systems play a crucial role in achieving this objective, but most health care systems offer room for improvement in terms of greater efficiency. This begs the question what type of health care system (ie, what mix of interventions) is optimal. We could provisionally define an optimal health care system in terms of meeting the following criteria: the health care system needs to be acceptable to its recipients, scalable to absorb increasing demands for health care, effective to generate the required health gains, and economically affordable to become sustainable over time. Public health planners need ways to design health care systems that optimize these criteria, compare the relative advantage of newly designed systems with the current one, and choose the most cost-effective system. This is a daunting but important task.
However, this task might be facilitated with a simulation model, which can compare a "base-case" scenario (eg, the current mix of clinical interventions) with an alternative (hypothetical) scenario consisting of new interventions or a different mix of interventions. In order for it to be helpful, the model should be able to evaluate the relative advantage of one system over another in terms of incremental cost-effectiveness and be used as an aid to decision-making.
With these aims in mind, we developed an alcohol model (ALCMOD) that can address the above issues. Developing ALCMOD was conducted within the framework of the World Health Organization's International Action Plan on Implementing eHealth Technologies for Substance Abuse. In this context, we wanted to shed light on the population-level cost-effectiveness of health care systems for alcohol use disorders before and after the introduction of new eHealth technologies in Belarus, Brazil, India, Mexico, and the Netherlands. ALCMOD is programmed in Microsoft Excel 2007, because Excel is available on most computers.
The purpose of this paper is to describe ALCMOD's input and output and to take an in-depth look at the model's throughput: its computational strategies, the underlying assumptions, and its limitations. One such limitation is ALCMOD's focus on short-term impacts. Restricting the time horizon to 1 year was a conscious choice because there are several alcohol use disorders (heavy, hazardous, and harmful use and alcohol dependence; see Textbox 1 for definitions) and a lack of empirical data that help to quantify the longer-term treatment effects and relapse rates for each of the alcohol use disorders. By contrast, simulation of short-term health and budget impacts is straightforward and requires fewer assumptions. Strengths of ALCMOD include its ability to evaluate combinations of interventions, its adaptability to different populations and settings, its capacity to handle uncertainty in input parameters, and the way it incorporates coverage and adherence rates for each of the modeled interventions.
We illustrate ALCMOD's computations for the base-case of usual care in the Netherlands versus an alternative scenario consisting of usual care augmented with three eHealth interventions: the DrinkTest, DrinkingLess, and an online therapist-led treatment for problem drinking, termed OnlineTreatment henceforth. The DrinkTest is a brief online intervention consisting of screening one's alcohol use followed by automated personalized advice. DrinkingLess is an online four-step cognitive behavioral intervention. The steps in DrinkingLess are: (1) exploring one's alcohol use, (2) goal setting, (3) behavioral change, and (4) maintenance. Both the DrinkTest and DrinkingLess have been evaluated in randomized trials and meta-analytically and were found to be effective in curbing alcohol use [9-12]. Both the DrinkTest and DrinkingLess are pure self-help interventions, but OnlineTreatment is a therapist-led intervention. Communication between participant and therapist is conducted over the Internet in seven synchronous written chat sessions of 45 minutes each. The sessions are thematically structured and cover themes such as goal setting, self-control techniques, monitoring, recognizing situations that incur a risk of relapse, and relapse prevention techniques.
OnlineTreatment has been evaluated in a randomized trial . Preliminary results (not yet published) indicate that OnlineTreatment is effective and cost-effective. It is worth noting that the three eHealth interventions increase in intensity and could be used in a stepped-care framework, thus starting with the least intensive intervention, the DrinkTest, and moving up to the more intensive levels of DrinkingLess and OnlineTreatment, if so required.
The emergence of evidence-based eHealth technologies offers opportunities for innovation in existing health care systems. The new technologies may help to reach population segments that were hitherto not reached because they live in hard to reach rural areas or because they may have shied away from face-to-face delivered health services out of fear of stigma. The new technologies are also very scalable, thus allowing people to access health care services in an unprecedented way. In addition, the new eHealth technologies could be cost-effective, especially when offered as well-structured self-help interventions or as interventions with (minimal) therapist support. Considering the global health gap with regard to the alcohol use disorders , these developments could become quite important. However, to date there is only limited evidence for the cost-effectiveness of eHealth interventions . For these reasons, it is opportune to conduct a population-level health-economic evaluation of the possible health gains and budget impacts of adding new eHealth technologies to the existing health care system for alcohol use disorders.
By way of input, ALCMOD requires data that describe key characteristics of the target population. Selecting the name of the country will automatically trigger ALCMOD to upload the age and gender distribution of the population of the selected country and the corresponding mortality rates. ALCMOD also needs to know the size of the target population, and in the Netherlands, the target population consists of 993,200 men and 222,800 women aged 18 to 69 years who could be classified as problem drinkers . Other required input is the preintervention profile of the target population based on the Alcohol Use Disorders Identification Test, the AUDIT [16-19]. The decision to base ALCMOD on the AUDIT was motivated by the idea that the AUDIT is globally used. Moreover, new eHealth interventions will screen participants with the AUDIT. Thus, even when a country has no AUDIT data yet, these data are likely to become available via eHealth interventions in the near future. In the Netherlands, data from the AUDIT are available and can be automatically uploaded in ALCMOD.
ALCMOD allows a description of the intervention mix representing the base-case scenario and the designing of an alternative scenario with a different mix of interventions or new interventions added to existing ones. In ALCMOD's default setting, a range of interventions—both face-to-face interventions and eHealth interventions—are shown for heavy, hazardous, and harmful alcohol use and alcohol dependence. Two parameters need to be set for each of the interventions: the coverage rate and the adherence rate.
When some of the interventions shown in ALCMOD's default setting are not available in a country, then their coverage rate has to be set to 0%. This is equivalent to saying that the intervention is not offered in a country. Other interventions might be available for every person belonging to the target population, and the coverage rate is then set to 100% (universal coverage). However, due to the many obstacles to full implementation, the coverage rate of most interventions is somewhere between 0 and 100% and can be set accordingly in ALCMOD.
Recipients of interventions might be less than willing or unable to fully comply with the intervention, and the degree of adherence is likely to moderate treatment response. Therefore, the adherence rate is an important parameter when evaluating the effectiveness of interventions. Adherence rates may be obtained from the literature, experts, or via focus groups in the target population.
The idea is that health care scenarios can be developed by changing the level of coverage for a series of interventions. Table 1 shows the settings for the three scenarios that we modeled: (1) the current Dutch health care system for alcohol use disorders without eHealth interventions (base-case scenario), (2) the Dutch health care system augmented with the eHealth interventions (alternative scenario 1), and (3) the Dutch health care system where face-to-face interventions have been substituted for 50% by the new eHealth interventions (alternative scenario 2).
a Brief face-to-face is modeled as a brief intervention consisting of screening followed by personalized feedback by a physician usually in a single session (< 10 minutes), occasionally in two sessions (one for screening, the other for personalized feedback).
b Online brief intervention is modeled as online screening and automated personalized feedback (DrinkTest).
c Behavioral intervention is modeled as eight to ten sessions of individual cognitive behavioral therapy (CBT) under the guidance of a therapist, followed by one booster session.
d Online self-help intervention (DrinkingLess) is modeled as four (range 3 to 12) sessions of online interactive CBT-based self-help preceded by referral by a general practitioner (GP).
e Online therapist-led intervention is modeled as eight sessions of online therapist-led CBT.
f Detox is modeled as 1-week ambulatory detoxification followed by clinical management with acamprosate.
g Aftercare and rehabilitation is modeled as participation in Alcoholics Anonymous (AA) over 12 months.
The choice of intervention mix was informed by Room et al and Benegal et al [17,19] and the Dutch multidisciplinary guideline for the treatment of alcohol use disorders . The choice of interventions was also motivated by two additional considerations: availability of evidence of the intervention's effectiveness in the meta-analytical literature  and the nonoverlapping independent nature of the interventions such that each intervention could be added to other interventions without creating overlap for a specific alcohol use disorder. Finally, the scenarios have been simplified by assuming that all interventions are associated with an adherence rate of 50%. This was done to ensure that differences in the cost-effectiveness ratios are due to fundamental differences in health technologies and not simply an effect of greater or lesser treatment adherence. However, it is possible to adjust adherence rates in ALCMOD. After all, some interventions might be associated with better or poorer adherence, and adherence itself might be amenable to intervention such as motivational enhancement. Changing the adherence parameters allows evaluation of these issues.
In the ALCMOD default settings, some of the intervention parameters have been preset and need not be changed but can be changed if so required. These parameters are the costs and the effects of the interventions.
ALCMOD's default setting makes use of the full economic cost price of each of the interventions. To be precise, the costs are the per-participant costs of delivering an intervention expressed in euros (€) for the Netherlands in the reference year 2009 (see Table 2). The costs are based on the amount of resources (labor, facilities, and supplies) used for offering the intervention during its postimplementation stage. We made our own costing tool to estimate the costs (in euros) of interventions in a systematic and uniform way that is in agreement with the Dutch guideline for costing health care interventions . For other countries, the per-participant costs of offering an intervention need to be assessed. These assessments can be carried out with the help of an auxiliary costing tool, for example Cost It, available from WHO's CHOICE website. Neither costs nor effects are discounted because ALCMOD takes a short-term (12-month) perspective.
Intervention effects are expressed as the standardized mean difference, also known as Cohen's d. This metric indicates how many standard units (on a scale of standard deviations) the experimental group has improved relative to a control group on a relevant outcome such a change in drinking behavior. The effect size d is often reported in the meta-analytical literature and gives access to a large body of scientific evidence. We extracted effect sizes at 6- or 12-months follow-up for all the interventions from the meta-analytical literature and our own research (see Table 3) and these values were used to populate ALCMOD with its default parameter settings.
b Online brief intervention (DrinkTest) modeled as 40% of target population (N = 1,255,000) reached with information about the website, 8% responding to AUDIT screener and receiving automated personalized feedback. Per-participant annual costs include website upgrading at € 50,000 research at € 50,000 and hosting at € 25,000.
d Online self-help intervention (DrinkingLess) is modeled as 15% of target population (N = 1,255,000) reached with information about the website 5% uptake rate, and 4 sessions (range 3 to 12) of online CBT-based self-help preceded by referral by a GP. Per-participant annual costs include € 75,000 for website upgrading, € 50,000 for research, € 25,000 for hosting, plus € 75,000 for moderating forum and technical assistance.
e Online therapist-led intervention is modeled as an average of 4 sessions (range 1 to 9) of 45 minutes each of online therapist-led CBT, preceded by GP referral. Per-participant costs include per annum costs of € 8000 for website upgrading, € 5000 for hosting, plus € 2000 for technical assistance.
f Detox is modeled as a 1-week ambulatory detoxification followed by clinical management with acamprosate under the supervision of a substance use disorder treatment specialist and a physician over 3 months.
g Aftercare and rehabilitation is modeled as participation in Alcoholics Anonymous at an average of € 500 (range € 250 to € 750) per patient for a year.
It is worth noting that ALCMOD uses two types of effects: the standardized mean difference, d, which was just discussed, and the impact of an intervention in terms of the percent reduction of pure alcohol intake in grams per day (g/day). The former effect (d) impacts on health-related quality of life (QOL) via changes in disorder severity. ALCMOD uses the percent reduction of pure alcohol intake to model treatment effects on mortality (see below for details). Although ALCMOD can handle different alcohol reduction rates for each of the modeled interventions, we have assumed a pre-post reduction of alcohol intake by 20% for all interventions [21,23], because reduction of alcohol intake was not always reported in the literature. This should not overly distort outcomes because the short-term effects of alcohol use on mortality are small, thus limiting their impact on disease burden as measured by disability-adjusted life years (DALYs). We say this on the understanding that alcohol-related mortality becomes an important, even a dominant, factor when disease burden is modeled out to full life expectancy, especially in the more severe alcohol use disorders.
Here we need to address a final point about the required input for ALCMOD. ALCMOD can be operated in two modes: deterministic and stochastic. In deterministic mode, ALCMOD does not take into account the uncertainty in parameters such as costs and effects. ALCMOD conducts all computations, but only once, and these calculations are primed on the mean value of all parameters. Much of ALCMOD's output, which is based on uncertainty, is then disabled. However, in stochastic mode, ALCMOD can handle uncertainty surrounding the cost (in euros) and effect (d) parameters. Our costing tool assesses the uncertainty in costs with the help of simulations of resource use (with 1000 iterations), and both randomized trials and meta-analyses of trials often report 95% confidence intervals of the effect size d. Thus we assume that costs are surrounded by an uncertainty range, and effects, by a 95% confidence interval, both having a lower and an upper limit. ALCMOD assumes a gamma distribution for costs and the normal distribution for the effect size d. Both distributions can be specified in ALCMOD such that the distributions fit within the lower and upper limits of costs and effects. In stochastic mode, ALCMOD then proceeds with drawing random values from these distributions, conducts all the computations, and repeats this process many times (maximum 10,000 times). This helps to capture uncertainty in the input parameters.
a Moyer et al\'s  meta-analysis of brief face-to-face interventions in approximately 4300 users meeting criteria of at least heavy drinking.
b Randomized trial of 450 participants presenting with either excessive alcohol consumption (> 20 units weekly) and/or binge drinking (> 5 units on a single occasion on least one day per week) in the past 6 months .
c Reanalysis of Beich et al's  meta-analysis of brief face- to-face interventions in 2989 users meeting criteria of hazardous drinking.
d Walters'  meta-analysis based on approximately 320 harmful users.
e Randomized trial of 261 excessive drinkers from the general population  where odds ratio (OR) converted into d using Chinn\'s equation .
f Randomized trial of 250 adults with mean AUDIT score of 20 at baseline with intervention was online treatment versus waiting list at 3 months and the AUDIT as outcome .
g Mann et al\'s  meta-analysis of 1670 people receiving acamprosate after detoxification where odds ratios converted into d using Chinn\'s method .
h Tonigan et al\'s  meta-analysis of 2097 harmful and dependent users where effect size r converted into d.
i Walters'  meta-analysis based on approximately 210 dependent users.
Modeling cost differences between two health care systems is straightforward once the per-participant costs of delivering all modeled interventions have been estimated and when the coverage rates of the interventions have been established. The number of people in the target group (stratified by alcohol use disorder) is then multiplied by the coverage rate of each intervention and multiplied by the appropriate per-participant full economic cost price. The cost analyses are always conducted for both the base-case and alternative scenario, such that the cost difference between two modeled health care systems can be computed and expressed as incremental costs.
The disability adjusted life year (DALY) is a measure of disease burden in a population. It combines two components of disease burden: morbidity and mortality. The first is related to lesser quality of life due to disability. Mortality arises when illness is associated with premature death. Thus, a DALY can be computed as the sum of years lost due to disability (YLD) plus years of life lost (YLL) due to mortality, hence, DALY = YLD + YLL.
The first term in the DALY equation, YLD, can be computed as the number of cases manifesting with an alcohol use disorder, N (point prevalence), weighted by a disability weight, DW. Thus, YLD = N × DW. DWs range from 0 to 1, where 0 is no burden (good health) and 1 refers to a health condition as undesirable as death. Although the literature offers advice for choosing DWs for the alcohol use disorders [29-33], ALCMOD makes no use of DWs that are directly associated with each of the disorder-specific health states. Instead, it computes the (downward) shift in DW as a consequence of the treatment effect d. As said, d is the standardized mean difference indicating how many standard units the treatment group has moved away from the group that received no care. Thus, d is essentially a "health improvement shift" due to intervention. The task at hand, then, is to "translate" the health improvement shift (of size d) into a corresponding shift in DW. This strategy has been developed by Sanderson et al  who used a panel of experts for obtaining a conversion factor of 0.18 (95% CI 0.16-0.20) to translate a shift in d into a shift in DW in alcohol use disorders. The change in DW is then multiplied by the appropriate number of people to arrive at an estimate of the number of YLD avoided. When running in stochastic mode, ALCMOD automatically conducts extensive uncertainty analyses around Sanderson's conversion factor.
The second term in the DALY equation, YLL, is calculated as the difference in life expectancy when people reduce drinking levels. We obtained estimates of the gender-specific relative risk, RR, of all-cause mortality attributable to pure ethanol intake (in g/day) using the expression , ln(RR) = b1*(ln(x+1)) + b2*ln(x) + e, where x = grams of pure ethanol intake per day and b1 and b2 are -0.1030 and 0.0035 for men and -0.0645 and 0.0029 for women, respectively (our own estimates from Gmel's paper ). Exponentiating ln(RR) gives the relative risk, RR, and the RRs are then combined with the gender and age-specific mortality rates of the country for which the outcomes are modeled. This produces estimates of changes in life expectancy due to changes in alcohol intake. Because ALCMOD takes a short-term perspective, treatment induced impacts on life expectancy were calculated as the number of avoided deaths in the present year.
The difference in YLD and YLL between the scenarios determines the difference in the disease burden as measured by DALY between two modeled health systems, the so-called incremental effects.
ALCMOD offers the use of a (downward) attenuation factor that reduces the carry-over effects from lesser drinking to lesser mortality and better health-related quality of life. After all, it can be assumed that former drinkers still have a higher risk of dying and poorer quality of life than people who never drank before or have been consistent moderate drinkers [36,37]. In other words, returning to less risky drinking levels is assumed to be beneficial but not as beneficial as a history of no drinking or moderate drinking. Hence this attenuation factor, which can be used to conduct sensitivity analyses for further evaluation of this issue. In all subsequent analyses we used a downward adjustment of 20% to be on the conservative side.
Once the treatment costs and the reductions in DALY disease burden have been computed for each scenario, then it is a small step to also compute the difference between the costs of both health care systems as Δ(C) = C1 - C0 and the difference between the effects as Δ(E) = E1 - E0. The ratio, Δ(C)/Δ(E), is the incremental cost-effectiveness ratio (ICER), which tells us if the alternative health care system offers better value for money than the current health care system.
As indicated, in stochastic mode, ALCMOD takes parameter uncertainty into account. The uncertainty is captured by drawing values from the cost and effect distributions of all interventions in a random way and basing the calculations on these randomly drawn values. This can be repeated n times (in practice 500 times appears to be sufficient) and the outcomes of each of the iterations is stored in vectors of size n of the costs and effects of each of the scenarios, their differences, and the ICER. Following standard health economic modeling routines , the vectors are then used to produce ALCMOD's output, such as the mean and the median of the outcomes and several ICER plots and graphs.
In November 2009 we obtained data from the DrinkingLess monitoring system on 1083 women and 2538 men who participated in DrinkingLess. Their mean age was 44.7 years (SD 10.7). Table 4 presents the observed AUDIT distribution for this population and the relative risk (RR) of premature death due to alcohol, as computed by ALCMOD.
We begin by comparing the current health care system (base-case scenario) with an alternative scenario where eHealth interventions are added to conventional care. In this comparison, it was assumed that the new eHealth interventions would attract a different segment from the target population—a segment that would otherwise not have been the recipient of conventional care. Making this (unrealistic) assumption is a conscious choice, and we will return to it in the "Discussion" section. The results are as follows.
The total health care costs in the base-case scenario are € 233 million. Adding new eHealth interventions would raise the health care expenditure to € 319 million, an increase of € 86 million. Under the base-case scenario, 5022 DALYs are averted; under the new scenario, this is doubled to 10,319 averted DALYs, an additional 5296 averted DALYs (including 32 alcohol-related deaths that are avoided under the new scenario). Thus, the alternative health care system delivers more population health albeit at higher costs. Figure 1 provides a corresponding visualization: the scatter of simulated ICERs (due to uncertainty in the input parameters) corresponding to the alternative scenario is placed more to the north (more costs) and more to the east (more health) than the scatter belonging to the current health care system. Now, investing € 86 million for averting 5296 extra DALYs (ie, € 16,053/DALY) raises the question whether that would be money spent wisely. In the Netherlands, the willingness to pay for one averted DALY is about € 80,000 with a lower bound of € 50,000. An even more conservative willingness-to-pay ceiling is customarily set at € 20,000/DALY for nonfatal and mild disorders. It follows that the estimated € 16,053/DALY falls well below any of the usual willingness-to-pay ceilings.
Figure 2, the ICER acceptability curve, represents a slightly different approach to the same issue. It depicts the probability that we must conclude that the new health care system is more cost-effective than the current system (vertical axis) for a range of willingness-to-pay ceilings (horizontal axis). For the simulated data, Figure 2 shows that the likelihood that the new health care system must be regarded as cost-effective increases sharply with increasing willingness-to-pay ceilings: the probability equals 0% when the willingness to pay for an additional health gain of one DALY averted is € 0, increases to 50% at € 16,000 and to 75% at € 20,000. Beyond € 30,000 the probability approaches certainty, and the conclusion that we must regard the new system as more cost-effective is no longer affected by higher willingness–to-pay levels. Again, accepting the threshold of € 20,000/DALY implies that the new health system compares favorably with the current system in terms of cost-effectiveness.
Assuming for a moment that the willingness to pay for averting one DALY is €50,000, then we could directly compare the costs of the health care system (in euros) with health gains (also expressed in euros) by multiplying the averted DALYs by €50,000. Figure 3, a cost/benefit chart, shows ALCMOD's simulation results. The chart shows that costs and benefits are just balanced under the current health care system, while the benefits clearly outweigh the costs under the new system. To be more precise, every euro spent under the current system returns a value of about the same size (€1.08, ie, a "surplus" of 8 euro cents), while the new health care system offers much better returns on investment: every euro spent generates €1.62 in health-related value.
To summarize, the new health care system, with eHealth interventions added, is associated with higher health care delivery costs overall, but it would be a health care system which is more efficient than the current one, offering better value for money.
We also simulated another comparison, this one between a base-case scenario that represents the current system and an alternative scenario with eHealth interventions added. In this case, however, the conventional face-to-face interventions are partly substituted by the new eHealth interventions. In this scenario, the coverage rate remains the same before and after the introduction of the eHealth interventions. Such a situation would arise if the eHealth interventions were to tap into the same target population seeking professional help, whether face-to-face, eHealth, or otherwise. In this scenario, the number of people who receive health care remains the same before and after the introduction of the new health technologies, and interventions are competing for the same target population and therefore partially substitute each other.
In this scenario, ALCMOD computes that the number of DALYs averted under both systems is virtually the same: 4984 DALYs under the current system and (exactly) 5000 DALYs under the new system. In other words, partial substitution of conventional face-to-face interventions by eHealth interventions does not have any appreciable impact on population health. However, the overall cost of the new system is much lower at €166 million than the cost of the current system of €234 million, resulting in a cost saving of € 68 million. Figure 4 relays the same information. Again assuming a willingness to pay of €50,000/DALY, the cost-benefit ratio indicates that for every euro invested the generated health revenues are worth €1.06 (ie, 6 euro cents surplus for every euro invested) under the current health care system. This improves to 52 euro cents surplus for every euro invested under the new scenario where the face-to-face interventions have been partly substituted by new eHealth interventions.
The main rationale for introducing eHealth technologies is to increase timely access to health services, to reduce the costs of delivering health care, and to make more efficient use of the health care workforce. Indeed, ALCMOD's simulation results suggest that widespread implementation of eHealth interventions for alcohol use disorders would help to substantially increase population health in the Netherlands, albeit at higher system costs, when eHealth interventions are added to the existing health care system and more people become the recipients of the expanded system. The cost-effectiveness of the Dutch health system would also substantially improve if the new eHealth interventions were partially replacing some of the current face-to-face interventions. Then, adding eHealth interventions becomes a cost-effective option, because it will produce the same level of population health for a significantly smaller health care budget. The "truth" might be found somewhere between both extremes, because it is unlikely that the new eHealth interventions will exclusively recruit people that would otherwise not have been the recipients of conventional health care (as assumed in the first comparison), while it is also unlikely that the new eHealth interventions will tap into exactly the same pool of health care users (as assumed in second comparison). At any rate, both extreme scenarios carry the message that widespread introduction of eHealth technologies would help to substantially increase the efficiency of the Dutch health care system overall, with a more favorable cost-benefit ratio either way.
One of the benefits of a simulation model is that it helps to organize vast fields of knowledge across several disciplines. In the case of ALCMOD, these disciplines encompass addiction epidemiology and health economics, while the evidence that supports effect parameters is drawn from randomized clinical trials, meta-analyses, and evidence-based clinical guidelines. In addition, a model makes all the necessary information available in a dynamic form, permitting "what if" analyses. This could be of assistance to policy formulation. ALCMOD is therefore best seen as a decision-making support tool, capable of giving almost instant feedback on policy-makers' attempts to find an optimal solution in the context of constrained decision-making in a complex environment. ALCMOD can also be employed for setting research agendas. After all, it helps to identify those parameters that have an impact on health gains and costs. When some of these parameters are surrounded by a nonnegligible degree of uncertainty, then empirical research is recommended, with the aim of reducing uncertainty in those parameters. Furthermore, ALCMOD can assist in identifying opportunities for system innovation by simulating hypothetical interventions, for example, an adjunctive intervention that helps to enhance treatment adherence. Among other strengths of ALCMOD are its adaptability to other countries, settings, and target groups and its capability to explicitly model treatment coverage and adherence rates. Finally, ALCMOD conducts automated multivariate uncertainty analyses to quantify uncertainty in costs, effects, and related parameters.
ALCMOD is subject to several limitations that need to be taken into account when interpreting ALCMOD's outcomes. First, ALCMOD's outcomes are modeled as steady-state population averages, and it is not clear when a health care system finds equilibrium after the introduction of new health technologies. This is unlikely to occur instantaneously and might take as long as several years. Second, it should be borne in mind that the introduction of new health technologies entails costs of its own, but the costs of introducing new technologies are not incorporated in ALCMOD's output. In fact, ALCMOD's output captures only the costs of offering a package of interventions once the interventions have been fully implemented. However, it will always take effort, time, and expenditure before the results of an improved health care system become visible in real life. Third, introduction of eHealth technologies may have unforeseen consequences that may increase longer-term health care costs, for example, by supply-induced demand for health care, thus attracting people to the health care system who otherwise would not have become dependent on (expensive, face-to-face delivered) health care. Fourth, it should be understood that ALCMOD focuses on short-term health impacts. Thus, ALCMOD ignores the longer-term impacts on quality of life, mortality, and health care utilization and it should be understood that longer-term impacts depend, in part, on a wide range of alcohol-related disorders that usually occur later in life. Since these longer-term effects are mainly related to the more severe alcohol use disorders, ALCMOD is unlikely to capture the full benefits of interventions for the severe disorders and may thus give undue weight to the less severe disorders. Fifth, ALCMOD is limited in that it only models clinical interventions while disregarding other alcohol-control options, such as banning alcohol advertising, taxing, restricting access to alcoholic beverages, and improving road safety, although these nonclinical interventions are likely to be (very) cost-effective . In the same vein, ALCMOD regards only the cost impacts incurred by the health care system, while disregarding costs and cost-offsets outside the health care system, such as patients' out-of-pocket payments to access services, changes in labor productivity, and costs incurred by the criminal justice system. To summarize ALCMOD's basic assumptions: ALCMOD only models incremental health gains and health care delivery costs over the shorter time horizon, assuming a steady state in the modeled health care systems. See Textbox 2 for a summary of ALCMOD's assumptions and their justifications.
It is not immediately clear if our findings are valid for countries other than the Netherlands. After all, in low-income countries, labor might be less costly than the capital inputs required for the new eHealth technologies. Also the population's access to the Internet could be an issue. Moreover, one could encounter cultural obstacles to using the Internet for alcohol use disorders. Such factors might impinge on coverage and adherence rates and mitigate impacts on population health, ultimately diminishing the cost-effectiveness of new health technologies. To illustrate, in the Netherlands, close to 90% of the population has access to the Internet, and Internet usage is distributed fairly evenly across demographic groups, but in other countries, Internet usage might be concentrated in only some population segments. In addition, it is worth noting that the emergence of mobile technologies may offer an opportunity to offer eHealth interventions for population segments that otherwise might be hard to reach. Therefore, the question as to whether eHealth will deliver the same benefits to other countries is best addressed per country, per setting, and per target group. Ante hoc assessment of the cost-effectiveness of innovations in health care systems may help to inform policy decisions. ALCMOD was created with exactly these aims in mind.
We recommend that ALCMOD be used in an iterative consensus building process that encompasses all pertinent stakeholders (eg, health care users, health care providers, health care financiers, and health policy planners) who can review and make amendments to modeled scenarios. Recently, we had an encouraging experience with such an approach while using a similar model for the treatment of depressive disorder. In any case, we would advise against using ALCMOD as an autopilot for policy making. After all, setting priorities for health care delivery is about acceptability and equity, as well as about cost-effectiveness considerations. As always, we need to base decisions on the best judgments and evidence available, but the evidence that informed ALCMOD points toward the conclusion that eHealth interventions can help to bridge the mental health gap by bringing scalable and cost-effective health services within reach of all who have access to the Internet—literally at their fingertips.
This work was conducted within the framework of World Health Organization's International Action Plan on Implementing eHealth Technologies for Substance Abuse. The authors acknowledge, with many thanks, financial support from the Netherlands' Ministry of Health, technical support by the Economics Advisory of PricewaterhouseCoopers, Amsterdam, and are grateful for the expertise that was kindly lent by the staff of WHO Headquarters. The views expressed in this paper are those of the authors alone.
Ezzati M, Lopez AD, Rodgers A, Murray CJL. Comparative Quantification of Health Risks: Global and Regional Burden of Diseases Attributable to Selected Major Risks. Geneva, Switzerland: World Health Organization; 2004.
World Health Organization. WHO Mental health Gap Action Programme: scaling up care for mental, neurological, and substance use disorder. Geneva, Switzerland: World Health Organization; 2008.
Meijer S, Smit F, Schoemaker C, Cuijpers P. Gezond verstand: evidence-based preventie van psychische stoornissen Common sense: evidence-based prevention of mental disorders De Bilt: RIVM, centrum Volksgezondheid Toekomst Verkenningen en Trimbos-instituut, centrum Preventie en Kortdurende Interventie. In: Gezond verstand: evidence-based preventie van psychische stoornissen. Bilthoven: RIVM; 2006.
Van Laar M, Cruts AAN, Van Ooyen-Houben MMJ, Meijer RF, Brunt T. Netherlands National Drug Monitor: NDM Annual Report 2009. Utrecht, the Netherlands: Trimbos Institute; 2010.
Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. The Alcohol Use Disorders Identification Test: Guidelines for use in primary care. 2nd edition. Geneva, Switzerland: World Health Organization; 2001.
Landelijk Kwaliteitsinstituut CBO & Trimbos Instituut. Multidisplinaire richtlijn stoornissen in het gebruik van alcohol Multidisciplinary Guideline Alcohol Use Disorders. Utrecht, the Netherlands: Trimbos Instituut; 2009.
Oostenbrink JB, Bouwmans CAM, Koopmanschap MA. Manual for Costing: Methods and Standard Costs for Economic Evaluations in Health Care (in Dutch). Diemen, the Netherlands: Health Insurance Board; 2004.
Walters GD. Behavioral self-control training for problem drinkers: a meta-analysis of randomized control studies. Behavior Therapy 2000;31(1):135-149.
Stouthard M, Essink-Bot M, Bonsel G, Barendregt J, Kramers P, Van de Water H, et al. Disabilty weights for diseases in the Netherlands. Rotterdam: Department of Public Health, Erasmus University. Rotterdam, the Netherlands: Department of Public Health, Erasmus University; 1997.
Murray CJL, Lopez A, Mathers CD, Stein C. The Global Burden of Disease 2000 Project: Aims, Methods and Data Sources. Geneva, Switzerland: World Health Organization; 2001.
Smit F, Van Laar M, Croes E, Busschbach J. Ziektelastgewichten voor misbruik, schadelijk gebruik en afhankelijkheid van alcohol en drugs Disability weights for abuse, harmful use and dependence of alcohol and drugs. Utrecht, the Netherlands: Trimbos Institute; 2008.
Briggs A, Claxton K, Sculpher MJ. Decision Modelling for Health Economic Evaluation. Oxford, England: Oxford University Press; 2006.
©Filip Smit, Joran Lokkerbol, Heleen Riper, Cristina Majo, Brigitte Boon, Matthijs Blankers. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.08.2011.


Leo Spanish is a fun and engaging program to teach younger learners simple Spanish words and letter pronunciation. This program includes 30 words and several coloring pages that reward learning and encourages creativity. Leo English is a fun and engaging program to teach younger learners simple English words and letter pronunciation. This program includes 30 words and several coloring pages that reward learning and encourages creativity. A fun math game for kids to practice math facts and monitor their learning progress.Recommended by teachers for addition,subtraction, multiplication, and division facts Monitor progress towards mastery with an interactive graph Exciting game play that makes practice fun! Teachers recommend Box Drop Math because it helps children master math facts. By answering math questions, players earn boxes and are then challenged to build a stack without knocking them over. Some boxes are special and add bonus points! A fun animation with sometimes unexpected results is played once a level is complete. Players earn top points for answering equations correctly within 3 seconds - a demonstration of mastery. A progress monitoring graph keeps players and parents informed as mastery is achieved. Box Drop Math starts with simple equations that get harder as mastery is achieved. The game tracks and keeps scores for up to 5 players. Box Drop Math is designed by Jeff Holmes, an experienced instructional designer and researcher of how kids learn with technology. Although we don't always want kids to "just learn the facts", there remain a few areas, such as basic math facts, where sustained practice and memorization is essential for success. Box Drop Math provides the right level of fun and motivation to keep learners practicing until they memorize these basic equations. The game is designed to reward early achievement but keeps the learning challenging by providing more difficult questions as players gain confidence in their math skills.


text: Q: How to configure ADFS with react js app for sso using passport-saml and express js? I've my reactjs application which needs sso. I've decided to have ADFS as my IDP. How to configure adfs with my react js application. How to use passport saml in reactjs for sso?can i have detailed steps to configure this since am new to this sso concept so feeling very tough to be executed. I've tried the steps given in this url but coudn't make any progress from my end. Saml request is not being genrated from my sp. Am clueless. Guidance for this query is much appreciated and thanks in advance.

redpajama_set_name: RedPajamaStackExchange


text:
30 май е 150-ият ден в годината според григорианския календар (151-ви през високосна). Остават 215 дни до края на годината.

Събития
 1431 г. – Стогодишната война: В Руан, Франция, 19-годишната Жана д'Арк е изгорена на клада от английско ориентирания трибунал.
 1498 г. – Христофор Колумб се отправя на третата си експедиция.
 1527 г. – Основан е Марбургския университет в Марбург, първият протестантски университет в света.
 1814 г. – Наполеоновите войни: Подписан е Парижкия договор, с който френските граници са върнати към състоянието си през 1792 г.
 1876 г. – Априлското въстание: Ръководителите на Трети революционен окръг се събират начело със Стоян Заимов във врачанската църква "Свето Възнесение Господне" и обявяват въстанието. Сформирана е малка чета.
 1876 г. – Априлското въстание: Четата на Христо Ботев води сражение на Милин камък.
 1876 г. – В Цариград е извършен държавен преврат, ръководен от Мидхат паша. Абдул Азис е детрониран, а за султан е провъзгласен Мурад V.
 1913 г. – Подписан е Лондонския мирен договор, с който се слага край на Балканската война. България получава пристанището Дедеагач.
 1917 г. – Александрос I става крал на Гърция.
 1918 г. – Народнолибералите на Добри Петков напускат правителството и то губи мнозинството си в XVII обикновено народно събрание.
 1922 г. – Във Вашингтон е открит Мемориал на Ейбрахам Линкълн.
 1934 г. – Политическият кръг Звено се саморазпуска.
 1941 г. – Втората световна война: Германската армия превземат остров Крит.
 1942 г. – Втората световна война: Британската авиация извършва бомбардировка над Кьолн с над 1000 самолета.
 1949 г. – Приета е Конституцията на Източна Германия.
 1966 г. – 300 самолета на САЩ бомбардират Северен Виетнам.
 1967 г. – Африканската държава Биафра обявява независимостта си от Нигерия.
 1968 г. – Бийтълс започват да записват своя Бял албум.
 1968 г. – Президентът на Франция Шарл дьо Гол разпуска парламента в обръщение по радиото. Непосредствено след това близо един милион негови поддръжници излизат на шествие по Шанз-Елизе в Париж.
 1971 г. – Програма Маринър: Изстрелян е безпилотният космически апарат Маринър 9, чиято главна цел е картографиране на повърхността на Марс.
 1975 г. – В София е открит Домът на съветската наука и култура.
 1980 г. – Йоан Павел II посещава Франция за пръв път от 1814 г.
 1982 г. – Испания става 16-а страна-членка на НАТО.
 1986 г. – Европейската космическа агенция изстрелва ракетата Ариана-2.
 1998 г. – Мощно земетресение в Северен Афганистан отнема живота на над 5000 души.
 2009 г. - По време на предаването Сървайвър един от участниците получава сърдечен удър по-късно е починал.

Родени

 1782 г. – Константин Полторацки, руски офицер († 1858 г
 1814 г. – Йожен Шарл Каталан, френско-белгийски математик († 1894 г.
 1814 г. – Михаил Бакунин, руски революционер († 1876 г.)
 1845 г. – Амадей I, Крал на Испания († 1880 г.)
 1846 г. – Петер Карл Фаберже, руски бижутер († 1920 г.)
 1876 г. – Жан Нику, шведски индустриалец († 1930 г.)
 1881 г. – Георг фон Кюхлер, немски фелдмаршал († 1968 г.)
 1893 г. – Стоил Стоилов, български режисьор, актьор и театрален деец († 1944 г.)
 1896 г. – Хауърд Хоукс, американски режисьор († 1977 г.)
 1901 г. – Христо Бръзицов, български публицист († 1980 г.)
 1907 г. – Антон Маринович, български театрален и кинорежисьор († 1976 г.)
 1908 г. – Ханес Алфвен, шведски физик, Нобелов лауреат († 1995 г.)
 1921 г. – Джейми Юис, южноафрикански режисьор, сценарист и продуцент († 1996 г.)
 1922 г. – Александър Матковски, историк от Република Македония († 1992 г.)
 1922 г. – Хал Клемънт, американски писател († 2003 г.)
 1928 г. – Густав Леонхард, нидерландски музикант († 2012 г.)
 1930 г. – Цвета Унджиева, български учен († 2000 г.)
 1934 г. – Алексей Леонов, съветски космонавт († 2019 г.)
 1937 г. – Любиша Георгиевски, театрален режисьор, писател и политик
 1940 г. – Дейвид Ейкройд, американски актьор
 1946 г. – Драган Джаич, сръбски футболист
 1949 г. – Симеон Симев, журналист от Република Македония
 1950 г. – Бертран Деланое, френски политик
 1958 г. – Мари Фредриксон, шведска поп-певица (Роксет) († 2019 г.)
 1961 г. – Иван Говедаров, български футболист
 1964 г. – Венко Андоновски, писател от Република Македония
 1964 г. – Ивайло Калфин, български политик
 1964 г. – Том Морело, американски китарист
 1971 г. – Петьо Гарвански, български инженер
 1971 г. – Станислава Армутлиева, български продуцент, председател на Управителния съвет на БАМП
 1972 г. – Юахим Рьонинг, норвежки кинорежисьор
 1980 г. – Йоахим Щандфест, австрийски футболист
 1980 г. – Стивън Джерард, английски футболист
 1981 г. – Андрей Аршавин, руски футболист
 1986 г. – Паша Парфени, молдовски певец
 1989 г. – Александра Дюлгеру, румънска тенисистка
 1990 г. – Юна, корейска певица

Починали

 339 г. – Евсевий Кесарийски, византийски историк (* 263 г.)
 1416 г. – Йероним Пражки, чешки учен (* 1379 г.)
 1431 г. – Жана д'Арк, френска героиня (* ок. 1412)
 1574 г. – Шарл IX, крал на Франция (* 1550 г.)
 1593 г. – Кристофър Марлоу, английски драматург (* 1564 г.)
 1640 г. – Петер Паул Рубенс, фламандски художник (* 1577 г.)
 1744 г. – Александър Поуп, английски поет (* 1688 г.)
 1770 г. – Франсоа Буше, френски художник (* 1703 г.)
 1778 г. – Волтер, френски философ (* 1694 г.)
 1808 г. – Луи-Шарл Орлеански, френски благородник (* 1779 г.)
 1903 г. – Дичо Андонов, български революционер (* 1882 г.)
 1905 г. – Богдан Югович Хайнц, войвода на сръбската пропаганда (* 1882 г.)
 1912 г. – Уилбър Райт, американски летец (* 1867 г.)
 1916 г. – Джон Сингълтън Мосби, американски военен деец (* 1933 г.)
 1920 г. – Стефан Паприков, български генерал (* 1858 г.)
 1941 г. – Иван Томов, морски капитан (* 1898 г.)
 1941 г. – Рама VII, крал на Сиам (* 1893 г.)
 1942 г. – Борис Сафонов, съвенски военен пилот (* 1915 г.)
 1949 г. – Марку Беза, румънски писател (* 1882 г.)
 1954 г. – Кларънс Оберндорф, американски психиатър (* 1882 г.)
 1960 г. – Борис Пастернак, руски писател, носител на Нобелова награда за литература през 1958 г. (* 1890 г.)
 1960 г. – Луи Йелмслев, датски лингвист († 1899 г.
 1963 г. – Невена Дончева, българска певица (* 1909 г.)
 1967 г. – Клод Рейнс, американски актьор (* 1889 г.)
 1978 г. – Тецу Катаяма, министър-председател на Япония (* 1887 г.)
 1979 г. – Илка Попова, българска певица (* 1905 г.)
 1981 г. – Зиаур Рахман, президент на Бангладеш (* 1936 г.)
 1985 г. – Григорий Майстрос, гръцки духовник (* 1917 г.)
 1993 г. – Сън Ра, американски музикант (* 1914 г.)
 2001 г. – Георги Божилов, български художник (* 1935 г.)
 2007 г. – Делчо Делчев, български генерал (* 1920 г.)
 2009 г. – Нончо Воденичаров, български певец (* 1955 г.)
 2012 г. – Андрю Хъксли, английски физиолог и биофизик, носител на Нобелова награда (* 1917 г.)

Празници
 Международен ден на предизвикателството
 Ангуила – Ден на Ангуила (1967 г., въвеждане на самостоятелна полиция, с ранг на национален празник)
 Украйна – Ден на работниците в издателствата, книгоразпространението и полиграфията
 Хърватия - национален празник

530


The Casper Mountain Fire District is located 10 miles south of Casper, Wyoming on Casper Mountain. The District covers Township 32 North, Range 79W, T32N, R79W,. This 6 mile by 6 mile area covers the central portion of the mountain, having close to 700 homes and cabins within its boundary.
Casper Mountain Fire Department (CMFD) initial response area is much larger than the fire district's boundary. The department responds to wildland and structural fire incidents on all of Casper Mountain, Muddy Mountain and areas south to the southern Natrona County line. CMFD shares initial response to fires with Natrona County Fire District and Casper Fire Department. Casper Mountain Fire Department does not respond to medical calls.