text:
A/SRSG Stephanie Williams opening remarks at the first session of the Libyan Political Dialogue Forum in Tunis - 9 November 2020
Your excellency the President of the Republic of Tunisia Qais Said
I would like to thank His Excellency, the President of the Tunisian Republic, for his kind remarks here today, and for the hospitality of the Tunisian people and authorities during this challenging period.
I also wish to thank the Governments of Germany, Italy, the United Kingdom and the United States, as well as the European Union for their generous support.
I am speaking to you at a time of rare optimism. After 18 months of war, and many years of crisis, I believe there is finally a glimmer of hope…
I have just come from Ghadames, where we held a successful round of military talks, further reinforcing the ceasefire that was agreed to several weeks ago.
That these all-important military talks could take place on Libyan soil, in the beautiful and historic city where we had hoped to convene the National Conference before the drums of war drowned out those voices calling for dialogue and reconciliation, is heartening. Every day cooperation is increasing, and the transformation of the 5+5 into the "group of 10" is more than just a slogan; it is a reality.
And witnessing this assembly before me today is heartening. An assembly which brings you together to reflect the will of the Libyan people.
I praise you for your courage, determination and steadfastness in representing your constituencies and the public good.
All of you have signed a pledge to recuse yourselves from executive positions. You are united by your common bond to work wholeheartedly towards ending the current crisis, in a spirit of fraternity and solidarity.
To work together to reach compromises for the sake of Libya and the Libyan people, in pursuit of their wishes. To bring unity where there was division, and harmony where there has been discord.
In these talks here today we are completing the work that began over three years ago under former SRSG Dr Ghassan Salamé, with talks between the House of Representatives and the High Council of State here in Tunis.
Since then we have convened round after round of dialogue, spending thousands of hours in person and on the phone with Libyan interlocutors and international players trying to prevent violence and find solutions.
We have held consultations across the country in every location from the largest cities to the smallest towns as part of the National Conference Process.
I would like to thank those States who have set aside their differences to aid us in the pursuit of peace. We saw this culminate in the Berlin Conference in January.
And we saw the UN Security Council endorse the conclusions of this conference in Resolution 2510 (2020), which serves as the foundation of this meeting, and the mandate for our work here.
The roadmap which we will outline today is the fruit of all these consultations. What we have consistently heard from these dialogues is that the current situation cannot continue. The Libyan people are tired of fighting, instability and putting their lives on hold.
They are tired of electricity cuts and queuing for fuel; of being unable to visit friends and families on the other side of the country; of having to travel abroad to vaccinate their babies.
Those displaced want to go home; the children want to finish their education; the fighters want to put down their guns and never to have to pick them up again.
After these extensive consultations, and from all our past efforts, we have heard a clear call from Libyans of what they expect from us here today.
They want us to end the violence and hostility between fellow citizens who are naturally united.
They want us to come out of this dialogue with unified institutions, ending this absurd and wasteful division of Libyan sovereign offices.
They want these institutions to guarantee their safety, provide basic goods and services, and allow them to lead dignified lives.
And most of all, they want democratic elections, where women and men throughout the country can freely choose a future for themselves, and for their children.
The Libyan people collectively have a vision for pulling Libya out of this crisis. This vision, which we will present to you today, is the basis of a National Political Program.
It is not an agenda from a foreign party, but rather a gift that you today can give to your fellow citizens.
It ends with democratic elections to finish the seemingly interminable transition and it begins with the creation of a new and unified executive to lead the way to these elections.
In validating this National Political Program you will together start to rebuild the trust among Libyans.
The overriding aim of the National Political Program is to renew political legitimacy by holding national elections, within an agreed timeframe. There will be no more delays.
In order to achieve this aim, the executive authority that will govern Libya in the run-up to the elections must be restructured.
The new government will be tasked with putting in place the necessary conditions for these elections to take place. It will also seek to launch national reconciliation, combat corruption, and restore public services.
Women must form a core part of this government, and not in a purely symbolic way. Women should be represented in leadership positions of sovereign ministries, and the security, defense and financial administrations.
Its progress will be monitored; its work will be reviewed on a regular basis through mechanisms that can hold it to account.
We are here with you to chart a course towards renewed institutions imbued with legitimacy, and representative of the people.
You are here to take a determined and irreversible step towards democratic elections in the coming months that will unite the country and restore Libya to full sovereignty. We are here to give Libya back to the Libyans.
The international community and, more importantly the Libyan people have put their trust in you.
Let's not disappoint them, for they have been disappointed enough.
They have been disappointed in the failure of previous efforts to solve the crisis, and they have been disappointed by the self-interested actions of some in the Libyan political class, who have failed to unite the country behind them.
The LPDF will not resolve all of Libya's problems, but if we fail to solve any of them, future resolution becomes impossible.
We must be guided by the principles of inclusivity, transparency, efficiency, pluralism, collegiality, and patriotism.
You must talk;
You must unite;
You must reconcile;
You must participate;
You must agree;
We must take a step forward.
Libyan Political Dialogue Forum
 Scenes from the first day of the Libyan Political Dialogue Forum talks
 Scenes from the opening ceremony of the Libyan Political Dialogue Forum - 02


text:
28. edycja piłkarskiego Pucharu Armenii. W sezonie 2018/19 trofeum zdobył .

Uczestnicy
① Barcragujn chumb – 9 klubów;
② Araczin chumb – 3 kluby (nie biorą udziału drużyny rezerwowe).

Rozgrywki
 Pierwsza runda
Pierwsze mecze 19 i 20 września. Rewanże 3 i 4 października 2018.

 1/4 finału
Pierwsze mecze 24 i 25 października. Rewanże 7 i 8 listopada 2018.

 1/2 finału
Pierwsze mecze 3 kwietnia. Rewanże 22 kwietnia 2019.

Finał

Linki zewnętrzne
 Federacja Piłkarska Armenii

Puchar Armenii w piłce nożnej
2018 w piłce nożnej
2018 w Armenii
2019 w piłce nożnej
2019 w Armenii

redpajama_set_name: RedPajamaWikipedia


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text:
Q: Proof of the finiteness of integral (in option pricing) I would like to ask for help with proving the finiteness of the following double integral.
$$\int_{0}^{\infty}e^{\alpha+k}\int_{k+\zeta}^{\infty} (e^{-\zeta+x}-e^k)f(x)\  \mbox{d}x\  \mbox{d}k,$$
where $\alpha>0$, $\zeta\in\mathbb{R}$ and $f$ is probability density function such that $\int_{-\infty}^{\infty}e^{-\zeta+x}f(x) \mbox{d}x<\infty$.
Thanks in advance.

redpajama_set_name: RedPajamaStackExchange


Michael went to school in Clovis and graduated from Clovis High School with the class of 2014. He was a member of Faith Christian Family Church where he was also baptized. Michael worked at IHOP for 3 years. He really liked his job and loved the friends he had made there. Michael enjoyed messing around with his guitar and listening to music. He was a huge fan of Cheech & Chong and enjoyed watching scary movies. Michael had a love for dogs and wolves. He enjoyed playing video games, eating Puerto Rican rice and hot wings. We can't forget his car – he was so proud of his car!! He couldn't drive it but he enjoyed sitting in it just chilling out. Most of all Michael loved fishing with his dad and hanging out with his cousins. He was a young man of few words. Those who knew him totally understand. Michael was proud to be the tallest in our family, he was OUR gentle giant. We will miss him dearly.
He was a cousin I never had the opportunity to meet, but I KNOW this was a tremendous loss to our family. Got has invited him home and we know another angel is looking upon us. Great Grandma Fran, Cousin Illy and my Polk family are ALL "living their best life" awaiting the rest of our arrivals.
We love you Uncle Michael, Shirley and Felicia. May God continue to see you through to comfort you!
I will never forget my good old child hood friend you will always be missed brother sorry I wasn't able to be there when you got layed to rest I will regret not being there look over your family the the big giant you are R.I.P gone but never forgotten my friend.
I am so sorry to hear of your loss. My heart is breaking for you. Love, hugs, and prayers.
I love u Shirley, Felicia and Michael! I am so sorry for your loss!


text:
You're Blocked! Should Public Officials Be Allowed to Stifle Speech On Social Media?
By Peter Kourkouvis
Last May, the Southern District of New York ruled in Knight First Amendment Institute at Columbia University v. Trump (Knight Institute) that President Trump violated the First Amendment rights of seven individuals when he blocked them from the @realDonaldTrump Twitter account because of their critical comments.[1] Merely the highest-profile instance of a burgeoning phenomenon, people across the U.S. have complained about elected officials blocking them from their social media pages.[2] Since the Knight Institute decision, the Fourth Circuit became the first court of appeals to decide that such exclusion violates the First Amendment.[3] Lawmakers have been put on notice.[4]
However, the issue remains unsettled. Central to determining whether public officials' blocking of the public from their social media pages violates the First Amendment is determining whether a social media page can constitute a public forum. This Article examines this controversial issue by first discussing the Supreme Court's public forum doctrine in Part II. Then, Part III discusses how courts have applied forum analysis to public officials' social media pages. In Part IV, I argue that the approach taken by the Southern District of New York and the Fourth Circuit conforms with public forum analysis, makes sense given popular usage of social media, and best serves the policy of promoting robust discussion on social media, while also providing government officials guidance as to how to avoid violating the public's First Amendment rights.
II. Background
Public fora are properties owned or controlled by government that the government must make available for speech.[5] Traditional, or "quintessential" public fora are streets and parks, places that have historically been held in trust for use by the public to assemble, communicate ideas, and discuss public questions.[6] A principal purpose of such places is to facilitate the free exchange of ideas.[7] Designated public fora are created when public property that has not traditionally been considered a public forum is intentionally opened up by government for public exchange of ideas.[8] If government chooses to allow speech in such a place, it will be treated like a public forum.[9] Limited public fora comprise property limited to use by certain groups or dedicated solely to discussing certain topics.[10] The Supreme Court has found that a student activities fund could be a limited public forum, albeit in a "metaphysical" rather than a spatial sense.[11] Metaphysical, in this context, essentially means "virtual."[12]
Unlike in a public forum, there is no guaranteed public access to government property "which is not by tradition or designation a forum for public communication."[13] The government may regulate speech in such a "nonpublic" forum so long as the regulation is reasonable and viewpoint-neutral.[14] Just as a private property owner has freedom to use her property, government may preserve property it controls for its lawful dedicated use.[15] Similarly, there is no First Amendment protection of a right to access private property for speech.[16]
In addition, under the government speech doctrine, government officials engaging in their own expressive conduct are not restricted by the First Amendment, and a government entity has a right to speak for itself and to exclude based on viewpoint.[17] Without this right, government would have difficulty speaking for itself, and thus, functioning.[18] Even when government speech is funded by a private source, government may rely on the government speech doctrine.[19] Of course, although government speech is not restricted by the First Amendment, it may nevertheless be subject to restriction by law, regulation, or practice.[20]
Government regulation of speech in a traditional or designated public forum must survive strict scrutiny; speakers cannot be excluded absent a compelling state interest.[21] In contrast, restrictions on access to a limited public forum are permitted so long as they are reasonable and viewpoint-neutral.[22] Effectively, viewpoint-based restrictions of speech by government are rarely permitted.[23]
One commentator remarked that the subtle differences between designated and limited public fora sow confusion among lower courts seeking to determine which forum applies to a particular case, and what standard of review of government action is appropriate.[24] Similarly, distinguishing between a limited public forum and a nonpublic forum and between government speech and private speech is not clear-cut.[25] This is problematic because deciding which type of forum applies often determines the outcome of a case.[26]
III. Analysis
If forum analysis was already unclear, the advent of social media has sowed even greater confusion. The following cases examine the intersection of social media and the public forum doctrine.
a. Packingham v. North Carolina
In Packingham v. North Carolina, one of the first cases in which the Supreme Court examined the relationship between the First Amendment and the internet, the Court stated the '"vast democratic forums of the Internet" in general and "social media in particular" are the most important places for the exchange of views today; "on Twitter, users can petition their elected representative and otherwise engage with them in a direct manner."[27] The Court stated social media is, for many people, the principle source for "speaking and listening in the modern public square."[28] Social media allows a person to speak "with a voice that resonates farther than it could from any soapbox."[29]
Some lower courts and commentators have considered this a clear endorsement for treating social media spaces as public fora.[30] Justice Alito's concurring opinion, however, called the dicta "undisciplined" and criticized the majority's equating the "entirety of the internet with public streets and parks" without explaining the implications to free speech law.[31] To others, the dicta created uncertainty as to whether public forum analysis applies to social media.[32]
Following in Packingham's wake, Knight Institute and Davison together provide a three-step process for applying forum analysis to social media, asking whether: (1) a public official used their account in their official capacity; (2) the interactive components of the account constitute a public forum; and (3) the government impermissibly restricted speech on the basis of its viewpoint.[33]
b. Knight First Amendment Institute at Columbia University v. Trump
In Knight Institute, the Southern District of New York held President Trump, his Social Media Director Daniel Scavino, and other members of the Trump administration violated the First Amendment rights of seven individuals when the President and Scavino blocked the individuals from the @realDonaldTrump Twitter account based on the viewpoints they expressed.[34] The court concluded that President Trump and Scavino exerted government control over the interactive parts of the @realDonaldTrump account, which were a designated public forum.[35]
1. Public Forum Analysis
First determining that the blocked Twitter users were engaging in protected political speech, the court then identified the putative forum. According to the Supreme Court, this inquiry is guided by the access the speaker seeks.[36] Here, the plaintiffs sought access not to the entire account, but to "the contents of the tweets sent, the timeline comprised of those tweets, the comment threads initiated by each of those tweets, and the "interactive space" associated with each tweet."[37]
The court then considered the threshold issue that for a place to be subject to forum analysis, it must be owned or controlled by the government.[38] The court cited the Supreme Court for support that a privately owned space can be a forum if it is controlled by government.[39] Although the President and Scavino share control over the account with Twitter, they control the ability to block Twitter users from accessing @realDonaldTrump tweets and participating in the interactive space associated with those tweets through the blocked account.[40] Because the President presents the account as presidential, and uses it in his presidential functions, the court considered such control governmental.[41]
The court then analyzed whether forum analysis would be consistent with "the purpose, structure, and intended use" of the government-controlled aspects of the @realDonaldTrump account.[42] Forum analysis is appropriately applied only to spaces that can accommodate many public speakers without defeating the purpose of the space, or inevitably closing it.[43] Like a park, university student activity fund, public university building, and school system's internal mail facilities, the interactive space of an @realDonaldTrump tweet accommodates many users, as reflected by the sheer number of replies and retweets.[44]
The court noted the potential difficulty in discerning whether government intends to provide a forum for private speech or to speak for itself.[45] It considered the government's historical use of the relevant speech to convey state messages, the public's close association of such speech with government, and the extent the government directly controls the message conveyed in concluding that the content of the @realDonaldTrump account's tweets constitute government speech, but the interactive space associated with the tweets do not.[46]
2. Classification
In classifying the interactive space a designated public forum, the touchstone is governmental intent, inferred from objective factors, such as the government's "policy and past practice, as well as the nature of the property and its compatibility with expressive activity."[47] Here, the public's general access to the interactive space, the ability of (unblocked) Twitter users to reply and retweet, the holding out of the account as a means the President employs to communicate with the American public, and the expressive activity in the interactive space "strongly support" concluding the interactive space is a designated forum.[48]
3. Viewpoint Discrimination
Finally, the court concluded that blocking the individual plaintiffs because of their views constituted impermissible viewpoint discrimination.[49] The government did not contest that the President blocked the individual plaintiffs because of their critical tweets.[50] The court rejected the defendants' arguments that the blocking was permissible because the President has a First Amendment right to choose with whom to associate and the plaintiffs had no right to a government audience or to have government amplify their views.[51] Although legally correct, government goes too far when it actively restricts an individual's ability to speak freely.[52] The court compared muting with blocking on Twitter to illustrate key differences in ignoring speech and actively restricting it, with blocking preventing access to a broader audience beyond the blocking user.[53]
b. Davison v. Randall
In January, the Fourth Circuit became the first Court of Appeals to address whether a public official's social media page can constitute a public forum. In Davison v. Randall, it held that the interactive component of Loudoun County Board of Supervisors Chair Phyllis Randall's Facebook page constituted a public forum and that Randall violated the First Amendment rights of Brian Davison, "an outspoken resident of Loudoun County," when she banned him from her official Facebook page because of a critical comment he made.[54] The Fourth Circuit stated speech criticizing public officials "occupies the core of the protection afforded by the First Amendment."[55] After concluding that the interactive portions of Randall's page constituted a public forum, the Fourth Circuit declined to classify it further because Randall's ban constituted "viewpoint discrimination," which is "prohibited in all forums."[56]
1. Government Action
The district court had concluded that the best way to determine whether a social media account managed by a public official is governmental (and therefore subject to the First Amendment) is to examine whether the official acts under color of state law, or undertakes state action in maintaining the account.[57] Even though maintaining a social media account was not part of Randall's official duties and much of her social media activity occurred outside of working hours, the page's title included her official title, the page was described as that of a government official, and many posts were addressed to and sought to interact with constituents.[58] In all, the totality of the circumstances demonstrated Randall acted in her official capacity in maintaining the Facebook page and banning Davison.[59]
The Fourth Circuit concluded that the interactive aspects of Randall's page "bear the hallmarks of a public forum."[60] The court found important Randall's intentionally opening the public comment section of the Facebook page for unrestricted public interaction.[61] Invoking Packingham's comparison of social media to traditional public fora, the court concluded Randall sought an "exchange of views."[62]
Like the Knight Institute court, the Fourth Circuit cited the Supreme Court in rejecting Randall's argument that forum analysis should not apply to a privately-owned website.[63] Here, Randall had complete control over the interactive aspect of the page, as she could unconstrainedly ban people from accessing it.[64] The court reasoned that a bright-line rule limiting forum analysis to government-owned property would draw "arbitrary lines;" it "makes no legal sense" that the First Amendment would prohibit viewpoint-based discrimination at a municipal library branch operated on a building owned by the municipality, but not at a branch operated on leased space.[65] It would also be arbitrary to permit a municipality to discriminate on the basis of viewpoint at a public meeting held on a private webpage, when doing so during a meeting held in a government building would be unconstitutional.[66]
The court also rejected Randall's argument that forum analysis is inapplicable because the entire page constitutes government speech.[67] While Randall's comments and links to other sources comprise government speech, the interactive component of the page where the public can post comments, reply to posts and "like" content is "materially different."[68]
The court distinguished the facts in Pleasant Grove City, in which the Supreme Court held that government speech doctrine and not forum analysis applied when a municipality denied a religious group from erecting a monument in a city park because the municipality ultimately selected which monuments to approve for display and never gave that control to the public.[69] Randall retained no such "final approval authority" over the interactive space of her page, as she invited "'ANY' user to post on 'ANY' issues."[70] Moreover, while the monuments in Pleasant Grove City and Randall's posts constituted government speech, the park surrounding the monuments and the interactive component of Randall's page constituted public fora.[71] Further, posts and comments by the public were easily distinguishable from Randall's.[72]
c. Morgan v. Bevin
In Morgan v. Bevin, a Kentucky district court denied granting a preliminary injunction against Kentucky's governor after he blocked plaintiffs from his Facebook and Twitter accounts, which were maintained to communicate with constituents and receive feedback on specific topics of his choosing.[73] The court stated it intended to "tread[] lightly" in line with the Packingham concurrence's urge for caution.[74]
The court reasoned that a public official's use of social media accounts—owned by private companies with their own First Amendment rights—did not transform them into public property.[75] The court stated that although users could comment on the governor's posts, the social media pages were government speech.[76] In addition, if the governor could not block anyone from his accounts, he would be unable to communicate his message to constituents.[77] Just as the municipality in Pleasant Grove City could decide which monuments to display in its park, the governor could shape his desired message on his social media pages.[78] Finally, the court opined "the term "block" conjures an image much harsher than reality;" plaintiffs could still share their messages elsewhere on social media and had no right to a government audience.[79]
d. Other recent cases
Other district courts have found that the interactive portions of public officials' social media pages can be public fora.[80] In Davison v. Plowman, an action filed by the same plaintiff in Davison, the court found that a public official's Facebook page, though "metaphysical," was a limited public forum because the government's social media comments policy expressly encouraged public interaction.[81] Distinguishing the facts in Davison, another court found a public official's posting on her Facebook page while working insufficient to constitute state action.[82]
Courts have also distinguished interactive portions of social media accounts from government speech.[83] Disagreeing with Morgan, a court reasoned that posting on a public official's page asserts a right to speak rather than to be heard, and that a public official does not adopt as their own speech posts by others on their page.[84] Courts have also rejected arguments that social media accounts cannot be public forums simply because they are owned by private companies.[85]
In addition, courts have examined whether a public official's excluding a person from their social media page can constitute viewpoint-based discrimination.[86] The Plowman court was unconvinced that the plaintiff was banned for a single critical comment, rather than for repeated, off-topic posting that violated the County's social media comments policy.[87] Where government creates a limited public forum and imposes lawful restrictions, such as prohibiting personal attacks and off-topic remarks, it remains free to enforce them.[88]
IV. Recommendation
With an estimated sixty-nine percent of Americans using social media,[89] it is hardly controversial to say that social media are the "most important places . . . for the exchange of views."[90] Thus, it makes sense for the First Amendment to apply when government opens spaces on social media for public discussion. Knight Institute and Davison recognize the primacy of social media for expressive activity today and comport in their analyses with the Supreme Court's public forum doctrine.
Davison takes a balancing approach for determining whether government social media use is governmental that makes sense given the mixed public/private nature of social media. The purpose behind a public official's social media page, use of government resources in maintaining it, and inclusion of "the trappings of [public] office" factor into the analysis.[91] Weighing such factors against those suggesting private use allow a court to determine whether there was state action.
In addition, Knight Institute and Davison follow ample Supreme Court guidance in concluding public forum analysis is not limited to government-owned property. As Davison explains, a bright-line rule that forum analysis only applies to property owned by government leads to arbitrary results. It makes more sense that First Amendment protections apply when a government official controls access to a place dedicated to expressive activity via blocking/banning users; such ability to exclude given the nature of the space is operative, not ownership.[92]
Still, distinguishing between government speech and private speech presents challenges.[93] Davison and Knight Institute both contemplate government speech coexisting with public discourse on social media. While Morgan raises a valid concern about protecting government's ability to shape and share its message, finding that the government creates a forum for private speech on social media does not strip it of that power. Interactive parts of social media pages do not face the same spatial limitations that befall traditional public fora, like parks, and any visitor to the @realDonaldTrump account can easily distinguish presidential tweets from replies to those tweets and replies to those replies.
Furthermore, Morgan trivializes the harm of a block/ban and does not comport with the First Amendment, which "recognizes, and protects, even de minimis harms."[94] Considering the sheer volume of replies, retweets and favorites that each @realDonaldTrump tweet generates, the harm of depriving a user from replying no longer seems minimal.[95] Especially if the speech at issue is political speech in the "modern public square," such stifling undermines the First Amendment's "robust" protections.[96] Absent such protections, governments could too easily silence critics, distort their public image, and undermine democratic rule—a "familiar playbook for authoritarian regimes."[97]
In addition, First Amendment protections should not apply with less force just because technology provides alternative venues for speech.[98] Interactive comment threads on social media resemble what one commentator called "interstitial public forums," or public areas, like sidewalks, adjacent to privately-owned establishments.[99] The close proximity of such places to the targeted entity makes them especially effective for expressing critical speech (e.g., via picketing or protesting).[100] The comment threads under an @realDonaldTrump tweet are a special place for critical speech; Twitter users that have not been blocked can reply directly to the tweet, and have a unique opportunity to feature prominently in the comment threads based on the number of interactions their reply garners.
Granted, not every public official has millions of followers and receives thousands of replies to their tweets. Neither does every public official seek to open their social media pages for unrestricted comment, like in Davison. Knight Institute and Davison provide less guidance where viewpoint discrimination is not obvious. Plowman, however, indicates a well-crafted social media comment policy allows government to impose and enforce reasonable, content-neutral limitations in online public fora created for a limited purpose.
The emerging litigation around public officials blocking on social media, in a sense, vindicates the urge for caution in Packingham. Courts are grappling with whether and how to apply forum analysis to government social media pages. At the same time, public officials need clear rules so that they can engage with their constituents on social media without fear of violating their rights.[101] Knight Institute and Davison chart a path forward.
V. Conclusion
In Packingham, the Supreme Court took an inevitable step in recognizing the significance of the internet and social media for modern-day discourse. Knight Institute and Davison took the next logical step in applying the public forum doctrine when public officials use social media pages in their official capacities to interact with the public. Much remains unsettled, but finding the First Amendment protects users on social media from governments' excluding them from discourse on the basis of the content of their views comports with the notions of robust First Amendment protections, and promotes vibrant discussion on the internet.
[1]Knight First Amendment Inst. at Columbia Univ. v. Trump, 302 F. Supp. 3d 541, 577 (S.D.N.Y. 2018).
[2]Charles Ornstein, Trump's Not the Only One Blocking Constituents on Twitter, ProPublica, (June 7, 2017, 12:59 PM) https://www.propublica.org/article/trump-not-the-only-one-blocking-constituents-on-twitter.
[3]See generally Davison v. Randall, 912 F.3d 666 (4th Cir. 2019), (explaining how a government entity violated the First Amendment by banning an individual from posting on a government social media page, which was in a public forum).
[4]Mark J. Stern, Appeals Court Rules Lawmakers Cannot Block Their Critics on Social Media, Slate(Jan. 07, 2019, 5:39 P.M.) https://slate.com/technology/2019/01/social-media-block-critics-first-amendment.html.
[5]Erwin Chemerinsky, Constitutional Law: Principles and Policies,1189 (Wolters Kluwer, 5th ed. 2015); see also Cornelius v. NAACP Legal Def. & Educ. Fund, Inc., 473 U.S. 788, 801 (1985) (explaining that a speaker must seek access to public property or to private property dedicated to public use for forum analysis to apply).
[6]Perry Ed. Ass'n v. Perry Local Educators' Ass'n, 460 U.S. 37, 45 (1983).
[7]Cornelius, 473 U.S. at 800.
[8]Pleasant Grove City, Utah v. Summum, 555 U.S. 460, 469 (2009); see also Am. Civil Liberties Union v. Mote, 423 F.3d 438, 443 (4th Cir. 2005) (explaining how courts must determine whether justifications for exclusion satisfy the requisite standard of that forum).
[9]Chemerinsky, supra note 5 at 1200.
[10]Christian Legal Society v. Martinez, 561 U.S. 661, 681 (2010).
[11]Rosenberger v. Rector & Visitors of U. of Va., 515 U.S. 819, 830 (1995).
[12]Noah Feldman, Constitution Can't Stop Trump From Blocking Tweets, Bloomberg (June 7, 2017), https://www.bloomberg.com/view/articles/2017-06-07/constitution-can-t-stop-trump-from-blocking-tweets.
[13]Perry Ed. Ass'n, 460 U.S. at 46.
[14]Id.
[16]Chemerinsky, supra note 5 at 1210.
[17]Pleasant Grove City, 555 U.S. at 467.
[18]Id. at 468.
[19]Johanns v. Livestock Martketing Ass'n, 544 U.S. 550, 574 (2005).
[21]Perry Ed. Ass'n, 460 U.S. at 45-6 (explaining that a content-based exclusion by a state in a traditional and designated public forum must be necessary to serve a compelling state interest and narrowly drawn to achieve that end); Cornelius, 473 U.S. at 800; Christian Legal Soc'y, 561 U.S. 661 (2010); see also Christ's Bride Ministries, Inc. v. Se. Pennsylvania Transp. Auth., 148 F.3d 242, 247 (3d Cir. 1998) (explaining that content-based restrictions in a traditional or designated public forum must meet strict scrutiny).
[22]Christian Legal Soc'y, 561 U.S. 661, 679 (2010)
[24]Lyrissa Lidsky, Public Forum 2.0, 91 B.U. L. Rev.1975, 1988 (2011).
[25]Id. at 1980.
[27]Packingham v. North Carolina, 137 S. Ct. 1730, 1735 (2017).
[29]Id. quoting Reno v. American Civil Liberties Union, 521 U.S. 844, 870 (1997).
[30]See Brian P. Kane, Social Media is the New Town Square: The Difficulty in Blocking Access to Public Official Accounts,NATGRI J.(Oct. 2017) https://www.naag.org/publications/nagtri-journal/volume-3-number-1/social-media-is-the-new-town-square-the-difficulty-in-blocking-access-to-public-accounts.php (noting that Packingham endorses the legal premise that the Internet is a public forum); see also Knight Institute, 302 F. Supp. 3d at 575 (citing Packingham and considering the interactive space associated with a tweet by @realDonaldTrump a designated public forum).
[31]Packingham, 137 S. Ct. at 1738, 1743.
[32]First Amendment – Freedom of Speech – Public Forum Doctrine – Packingham v. North Carolina, 131 Harv. L. Rev.233, 238-9 (2017).
[33]One Wisconsin Now v. Kremer, 354 F. Supp. 3d 940, 949 (W.D. Wis. 2019).
[34]Knight Institute, 302 F. Supp. 3d at 580; see generally Stipulation, Knight First Amendment Institute v. Trump, No. 1:17-cv-05205 at ¶¶ 9–12 (S.D.N.Y. 2017) (explaining governmental control).
[35]Knight Institute, 302 F. Supp. 3d at 580.
[36]Id. at 565, citing Cornelius, 473 U.S. at 801; see also Perry Ed. Ass'n, 460 U.S. at 46-7 (considering case in which the plaintiff sought access to the internal mail system of a school, rather than the school itself); Lehman v. City of Shaker Heights, 418 U.S. 298, 300-01 (examining case where plaintiff sought access to advertising space on the side of city buses, not the buses in their entirety); Pleasant Grove City, 555 U.S. at 480 (explaining public park used for public discourse would be subject to forum analysis, but not when the access sought concerns the "installation of permanent monuments.").
[37]Knight Institute, 302 F. Supp. 3d at 566, citing Cornelius, 473 U.S. at 801. The court discounted "out of hand" the idea that plaintiffs sought to tweet as the President.
[38]Id. at 564–65, citing Cornelius, 473 U.S. at 801 and Pleasant Grove City, 555 U.S. at 480.
[39]Knight Institute, 302 F. Supp. 3d at 566, citing Cornelius, 473 U.S. at 800-1; Pleasant Grove City, 555 U.S. at 478; Christian Legal Soc'y, 561 U.S. at 679; Perry Ed. Ass'n, 460 U.S. at 46; Se. Promotions Ltd. v. Conrad, 420 U.S. 546, 547, 555; Rosenberger, 515 U.S. at 830.
[40]Id. at 566-7. The court noted that blocked Twitter users can still view replies to the blocking user's tweets and can reply to those replies through the blocked account, and a Twitter user comparatively lacks control over the comment thread beyond the content of the tweets, timeline, and first-order replies. Id. at 570. Therefore, the President's control over the account does not extend beyond the initial replies. Id.
[41]See id. at 567 (considering the presentation of the account as "registered to Donald J. Trump, '45th President of the United States of America,'" the treatment of its tweets as Presidential records created in the course of the President's official activities, and the use of the account in executive functions, including appointing and removing officers and conducting foreign policy). The court also rejected the argument that forum analysis should not apply because the @realDonaldTrump account was created in 2009, reasoning that past characterization is not dispositive and that the concept of a designated public forum contemplates the nature of a space changing for purposes of the First Amendment. Id. at 569.
[43]Id. citing Pleasant Grove City, 555 U.S. at 478.
[45]Id. at 571, quoting Pleasant Grove City, 555 U.S. at 470.
[46]See id. at 571-2 (explaining that replies are associated with the replying user and only the replying user maintains control over the content of the message conveyed after posting).
[48]Id. at 574–75.Per the last factor, the court invoked Packingham, noting Twitter allows the public to directly engage with their elected representatives.
[53]See id. at 576–7 (explaining that while muting an account allows a user to ignore speech without impacting that user's ability to see and reply to tweets by the muting account, blocking prevents the blocked user from doing so).
[54]Davison, at 672-6, 688.
[55]Id. at 688, quoting Rossignol v. Voorhaar, 316 F.3d 516, 521 (4th Cir. 2003)(quoting McIntyre v. Ohio Elections Comm'n, 514 U.S. 334, 346 (1995)).
[57]Davison v. Loudoun Cty. Bd. of Supervisors, 267 F. Supp. 3d 702, 711 (E.D. Va. 2017), aff'd sub nom. Davison v. Randall, 912 F.3d 666 (4th Cir. 2019).
[58]Id. at 712-14.
[60]Davison, 912 F.3d at 682.
[61]Id. (noting the page invited ""ANY Loudoun County citizen" to make posts to the comments section of the Chair's Facebook Page. . . . "on ANY issues, request, criticism, complement, or just your thoughts").
[62]Id. citing Packingham, 137 S.Ct at 1735.
[63] Id. at 682-3 citing Cornelius, 473 U.S. at 801; Christian Legal Soc'y, 561 U.S. at 679; Se. Promotions at 547, 555. The court also found persuasive Halleck v. Manhattan Community Access Corp., 882 F.3d 300, 306-8 (2d Cir. 2018) (holding that public access television channels constituted a public forum, even though they were operated by a private company, because New York state and federal governments retained sufficient control over the channels through extensive regulatory schemes; although no similar regulatory schemes apply to Randall's Facebook page, Randall exercised even more control than the aspect in Halleck that gave rise to the First Amendment claim—Randall could ban at will).
[65]Id. at 685-6 citing Lyrissa Lidsky, Public Forum 2.0, 91 B.U. L. Rev. 1975, 1996 (2011) (explaining that government can "rent" a social media page to promote discussion as much as it can rent a building for the same purpose; "government ownership is not a sine qua non of public forum status.").
[66]Id.at 685.
[69]Id. at 686 citing Pleasant Grove City, 555 U.S. at 464. In addition, the Supreme Court also noted that there is no traditional right to erect a monument in a park, and public parks are limited in the number of monuments they can accommodate. Pleasant Grove City, 555 U.S. at 478-9.
[73]Morgan v. Bevin, 298 F. Supp. 3d 1003, 1006, 1013 (E.D. Ky. 2018).
[74]Id.at 1009–10 citing Packingham, 137 S.Ct at 1744 (Alito, J., concurring).
[76]Id. at 1011–12.
[77]Id. at 1012 citing Pleasant Grove City, 555 U.S. at 479 (noting that forum analysis should not apply where creation of a forum could inexorably close the space).
[80]One Wisconsin Now,354 F. Supp. 3d at 949; Campbell v. Reisch, No. 2:18-CV-04129-BCW, 2019 WL 573433, at *4 (W.D. Mo. Feb. 8, 2019).
[81]Davison v. Plowman, No. 1:16CV180 (JCC/IDD), 2017 WL 105984, at *3 (E.D. Va. Jan. 10, 2017) citing Rosenberger, 515 U.S. at 830.
[82]German v. Eudaly, No. 3:17-CV-2028-MO, 2018 WL 3212020, at *6 (D. Or. June 29, 2018).
[83] See e.g., One Wisconsin Now, 354 F. Supp. 3d at 954–55 (agreeing with Knight and Davison that the interactive portion of a tweet or Facebook post is distinct from the rest of the account and not subject to the government speech exception); Leuthy v. LePage, No. 1:17-CV-00296-JAW, 2018 WL 4134628, at *11 (D. Me. Aug. 29, 2018), motion to certify appeal denied, No. 1:17-CV-00296-JAW, 2018 WL 4955194 (D. Me. Oct. 12, 2018) (finding unpersuasive a Governor's argument that his speech, and not the plaintiffs' was at issue, noting that posts on Facebook are labeled with the name of the person who posted them and thus the Governor's speech and private citizen posts are distinguishable).
[84]Leuthy v. LePage, No. 1:17-CV-00296-JAW, 2018 WL 4134628, at *15 (D. Me. Aug. 29, 2018), motion to certify appeal denied, No. 1:17-CV-00296-JAW, 2018 WL 4955194 (D. Me. Oct. 12, 2018).
[85]See One Wisconsin Now, 354 F. Supp. 3d at 954 (citing Cornelius to reject defendants' arguments that the defendants' Twitter accounts could not be public forums because Twitter is a private company); see also Leuthy v. LePage, No. 1:17-CV-00296-JAW, 2018 WL 4134628, at *14 (D. Me. Aug. 29, 2018), motion to certify appeal denied, No. 1:17-CV-00296-JAW, 2018 WL 4955194 (D. Me. Oct. 12, 2018) (noting that Facebook's being a private entity is not dispositive in making forum analysis inapplicable, citing Se. Promotionsand the Supreme Court's determination that a privately-owned theater under a long-term lease to a city was a public forum)
[86]One Wisconsin Now, 354 F. Supp. 3d at 949; Leuthy v. LePage, No. 1:17-CV-00296-JAW, 2018 WL 4134628, at *15-7 (D. Me. Aug. 29, 2018), motion to certify appeal denied, No. 1:17-CV-00296-JAW, 2018 WL 4955194 (D. Me. Oct. 12, 2018).
[87]Davison v. Plowman, No. 1:16CV180 (JCC/IDD), 2017 WL 105984, at *4 (E.D. Va. Jan. 10, 2017).
[89]Social Media Fact Sheet,Pew Research Ctr. (Feb. 5, 2018), http://www.pewinternet.org/fact-sheet/social-media/.
[90]Packingham, 137 S.Ct. at 1735.
[91]One Wisconsin Now v. Kremer, 354 F. Supp. 3d at 951, citing Davison v. Loudoun Cty. Bd. of Supervisors, 267 F. Supp. 3d at 712-14.
[92]See Sandvig v. Sessions, 315 F. Supp. 3d 1, 12 (D.D.C. 2018), citing Se. Promotions, 420 U.S. at 557 ("Each medium of expression, of course must be assessed for First Amendment purposes by standards suited to it, for each may present its own problems).
[95]Stipulation, Knight First Amendment Institute v. Trump, No. 1:17-cv-05205 at ¶¶ 23, 28 (S.D.N.Y. 2017).
[96]Packingham, 137 S.Ct. at 1732; New York Times Co. v. Sullivan, 376 U.S. 254, 270, (1964) ("[d]ebate on public issues should be uninhibited, robust, and wide-open, and [] it may well include vehement, caustic, and sometimes unpleasantly sharp attacks on government and public officials.").
[97]Brief of Amici Curiae First Amendment Legal Scholars in Support of Plaintiffs' Motion for Summary Judgment, Knight First Amendment Institute v. Trump, No. 1:17-cv-05205-NRB at 19 (S.D.N.Y. 2017).
[98]Davison v. Loudoun Cty., 267 F. Supp. 3d at 718.
[99]Dawn C. Nunziato, The Death of the Public Forum in Cyberspace, 20 Berkeley Tech. L.J. 1115, 1116 (2005), 1167-68.
[100]Id.
[101]Lidsky, supra note 24 at 1980, 2002.
CategoriesData, Privacy, Uncategorized TagsFirst Amendment, Government Speech, President Trump, Privacy, Public Forum Doctrine, Speech, Twitter
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text:
Walter Dias of Unique Choice in Doha new HiTA Tourism Ambassador
After appointing Hawaii Tourism Ambassadors in India, Singapore, and Colombia, the Hawaii Tourism Association (HiTA) is now expanding to the highest spending region on the globe with the appointment of Walter R. Dias partner of Unique Choice in Doha, Qatar. Mr. Dias is an Indian by origin and was born in Tanga, Tanzania. He holds a Portuguese nationality and has been living in the Middle East for the past 32 years. This unique combination of blended diversified cultures, along with traveling extensively throughout the world, has molded Mr. Dias into a dynamic personality. Mr. Dias is the IATA coordinator for Qatar long distant educational program, and he is a charter member of Toastmasters International, a worldwide leadership and communication organization and a member of the Indian Business&Professional Network (IBPN) under the aegis of The Indian Embassy, Qatar.
Unique Choice is a global travel network with branch offices in Saudi Arabia, Qatar, United Arab Emirates, Malaysia, Sri Lanka, and Australia, as well as associate offices in Switzerland, the UK, Hungary, Egypt, and the US. They are wholesalers of accommodation, destination management, cruises, tour packages, and car rentals, and also assist with transfers, European rail, and visas. Unique Choice has received numerous awards including Best Foreign Tour Operator for West Africa/Asia from Malaysia Tourism and the Quality Tourism from the Middle East award from the Tourism Authority of Thailand.
Juergen Thomas Steinmetz, HiTA President, traveled to Qatar last week to meet with Mr. Dias. Mr. Steinmetz said: I'm impressed with Mr. Dias and his organization. It's well suited to establish Hawaii as a new and potential market not only for Qatar, but also for Dubai, Kuwait, Oman, and Saudi Arabia. His pavilion stand at the Arabian Travel Market showed that he and his company are well suited to include Hawaii in their travel programs.
"The potential from the Gulf region is unlimited. For the most part, here, money is not a concern, and with a mix of nationals and ex-patriots from all over the world, plus access to numerous direct air links to the US, it makes it an easy task for Hawaii to establish itself in the region. I listened to Israel Kamakawiwo'ole being piped out over the music system while I had a cup of coffee at Starbucks in Doha, Qatar. All over the world people may not know exactly what 'aloha' means, but they have all heard about the 'aloha spirit' and wish to one day experience it for themselves."
Gulf visitors are used to spending an enormous amount of money when they travel. Emirates, Qatar Airways, Etihad Gulf Air, Saudi Airlines, and Oman Air all have direct access to US gateways. Emirates, for example, flies to Los Angeles nonstop from Dubai twice a day, once a day to San Francisco, and is starting daily service to Seattle soon. The same airlines connect to Hawaii through Japan, Korea, or Taiwan. It should be a priority for the Hawaii tourism to work with the private industry to prepare for this market.
HiTA is currently working with US commercial services to provide informational events for the Hawaiian visitor industry. Anyone in the visitor industry can work with HiTA and receive business from this lucrative market.
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Maverick Helicopters expands Hawaii operations
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text:
Die Chiropraktik (von  'Hand' und  'tätig') ist eine alternativmedizinische Behandlungsmethode mit dem Ziel, Funktionsstörungen an den der Bewegung und Stützung des menschlichen Körpers dienenden Körperteilen, besonders der Wirbelsäule, zu finden und durch einfache Handgriffe zu beseitigen. Chiropraktik basiert auf mehreren pseudowissenschaftlichen Ideen.
Therapeutische Wirksamkeit und Wissenschaftlichkeit der Methode sind umstritten. In Deutschland ist Chiropraktiker ein staatlich nicht anerkannter, nicht geregelter Beruf.

Ursprünglich wurde in der im 19. Jahrhundert von Daniel David Palmer begründeten Chiropraktik die These vertreten, dass verschiedene, auch nicht-orthopädische Krankheiten durch eine Fehlstellung der Wirbelgelenke verursacht würden und dementsprechend durch eine manipulative Korrektur (Manipulation) der Fehlstellung geheilt werden könnten. Diese Ansicht widerspricht modernen Erkenntnissen der Anatomie, Physiologie und Pathologie des menschlichen Organismus. ChiroSuisse, die Schweizerische Chiropraktoren-Gesellschaft, fokussiert die Chiropraktik nur noch auf die Behandlung von "funktionellen, reversiblen Störungen des Bewegungsapparats".

Die Manuelle Medizin geht unter anderem auch von Methoden der Chiropraktik aus.

Geschichte
Bereits in der Antike wurden (bei Hippokrates und Galenos) Praktiken geschildert, mit der bloßen Hand therapeutische Effekte zu bewirken.
Auch Guido Guidi beschrieb derartige "chiropraktische" Bearbeitungen des Rückens mit den Händen, dem Gesäß oder den Füßen bei Luxationen bzw. Verkrümmungen der Wirbelsäule. Begründer der heutigen Chiropraktik war Daniel David Palmer (1845–1913). Er wurde vermutlich von Jim Atkinson aus Davenport in Iowa in dieser Behandlungsmethode ausgebildet. Um sie selbst vermarkten zu können, erfand er den Namen "Chiropractic". Seine Gründungslegende lautet hingegen: "Harvey Lillard, der Pförtner des Rayan-Blockhauses, in dem ich meine Praxis hatte, war schwerhörig. Er hörte nicht mehr das Gerattere eines Pferdefuhrwerks auf der Straße und nicht mehr das Ticken seines Weckers. Ich wollte wissen, woher diese 'Taubheit' kam, da sagte er zu mir, dass er etwas Schweres gehoben habe, in einer verkrampften, gebeugten Haltung. Er hätte dann das Gefühl gehabt, dass etwas abgedrückt worden sei in seinem Rücken, und unmittelbar danach sei er taub geworden. Die Untersuchung ergab: Ein Wirbel war abgedrängt aus seiner normalen Lage. Ich dachte mir, wenn der Wirbel wieder richtig sitzen würde, dann müsste das Gehör des Mannes wieder funktionieren. Mit diesem Ziel vor Augen versuchte ich – in einem halbstündigen Gespräch –, Herrn Lillard davon zu überzeugen, dass er erlauben sollte, die Rückplatzierung vorzunehmen. Ich brachte den Wirbel in seine richtige Position, indem ich den Dornfortsatz (Proc. spin.) des Wirbels als Hebel verwendete, und kurz darauf konnte der Mann wie vorher hören. Daran war nichts Zufälliges, sondern es war die Vollendung eines bewussten Zieles, und das Resultat entsprach den Erwartungen."

D. D. Palmer erklärte das vermeintlich Neue an seiner Behandlungsmethode so: "Die Grundprinzipien und die Prinzipien der Chiropraktik, die sich daraus entwickelt haben, sind nicht neu. Ich beanspruche dennoch, der Erste zu sein, der einen verschobenen Wirbel unter Verwendung der Dorn- und Querfortsätze (Proc. spin. u. trans.) als Hebel benutzt, wodurch der ausgerenkte Wirbel wieder seine normale Position erlangt. Von dieser Grundtatsache ausgehend, wurde eine Wissenschaft geschaffen, die dazu bestimmt ist, die Theorie und Praxis der Heilkunst zu revolutionieren." (Übersetzungen: D. Oesch)

Nach Deutschland gelangte die Chiropraktik (ebenso wie die Osteopathie) durch den am 22. Dezember 1869 in Krachen/Schlesien geborenen, vorübergehend in den USA lebenden Pastor Gustav A. Zimmer, der nach Rückkehr im Jahre 1927 in Dresden eine Ausbildungsstätte für Chiropraktik und Osteopathie betrieb, die vor allem von Heilpraktikern besucht wurde. Zimmer beendete seine berufliche Tätigkeit im Jahre 1938 und starb am 17. Dezember 1939. Drei der von Zimmer veröffentlichten Bücher standen auf der "Liste des schädlichen und unerwünschten Schrifttums" und wurden von den Nationalsozialisten verboten. In den 1940er und 1950er Jahren befassten sich auch Mediziner wie Kurt Rüdiger von Roques (1938 von Werner Kollath in einem Brief auf die Chiropraktik als neue Therapieform aufmerksam gemacht), Werner Lempfuhl, Ludwig Zukschwerdt, Freimut Biedermann (1915–1983), Kurt Gutzeit, Albert Cramer und Karl Sell mit der Chiropraktik. Mit der 1950 von Roques erschienenen Übersetzung von Speranskis Schrift Grundlagen einer Theorie der Medizin, trug die ärztliche Chiropraktik zur Theorie der neuen Therapie bei. Nunmehr wurde nicht mehr von einer übergeordneten "Lebenskraft" ausgegangen, sondern die Diagnostik und Therapie sollte auf der Erkennung vertebraler und neurologischer Zustände beruhen. (Die esoterische Wirkungstheorie des Lebenskraftprinzip hatte zu einer Ablehnung der Chiropraktik durch das Reichsgesundheitsamt geführt). Nach dem Zweiten Weltkrieg und der Legalisierung einer bereinigten Fassung des Heilpraktikergesetzes vom 17. Februar 1939 nahm der Nürnberger Heilpraktiker Willi Schmidt seine im Jahre 1938 begonnene kollegiale Fachfortbildung wieder auf, darunter von 1951 an auch in Chiropraktik. Kurt Rüdiger von Roques gründete im Dezember 1953 die Forschungs- und Arbeitsgemeinschaft Chiropraktik (FAC) und wurde zu deren gewähltem Vorsitzenden. Im Jahre 1959 übernahm Schmidt die Leitung der Arbeitsgemeinschaft für Chiropraktik und Osteopathie in der DH mit Arbeitskreisen in allen Landesverbänden, einem jährlichen zentralen Fachfortbildungskongress in Bad Homburg und der Herausgabe von insgesamt 92 Ausgaben der Fortbildungsblätter der Arbeitsgemeinschaft Deutscher Chiropraktoren und Osteopathen in der DH, die von 1959 bis 1971 erschienen. Im Jahre 1952 veröffentlichte der Hamburger Heilpraktiker Werner Peper D. C., Absolvent der amerikanischen Palmer School of Chiropractic das Buch Technik der Chiropraktik.

Techniken der Chiropraktik

 Adjustierung: Diese Adjustierung wird durch speziell erlernte Handgriffe erzielt. Sie haben das Ziel, in der Chiropraktik so bezeichnete Subluxationen an der Wirbelsäule (an den Zygapophysialgelenken) wieder aufzuheben und damit den Druck auf die Spinalnerven (lateral) oder das Rückenmark (medial) zu beseitigen. Gelingt dies, dann verschwänden die Schmerzen in kurzer Zeit, z. B. bei einer Ischialgie (Ischiasreizung).
 Traktion: Bei der Traktion werden die Gelenkpartner durch Zug voneinander entfernt. Dies führe unter anderem zu Druckminderung, Entlastung und Schmerzlinderung. Außerdem verbessere sich durch die Dehnung der Bänder und der Gelenkkapsel die Beweglichkeit.
 Translatorisches Gleiten, auch Mobilisation genannt: Um das verlorengegangene Gelenkspiel, und somit auch die Beweglichkeit, wiederherzustellen, werden die Gelenkanteile parallel gegeneinander bewegt.
 Weichteilbehandlung: Durch Dehn- und Entspannungstechniken soll die Muskulatur so verlängert werden, dass sie sich dem neugewonnenen Gelenkspiel anpasst.
 Reflextechniken: Unter Ausnutzung von Nervenreflexen solle die Spannung der Muskulatur und die Schmerzwahrnehmung beeinflusst werden. Mittels Reflextherapien könne auch auf das zentrale Nervensystem eingewirkt werden, z. B. auf das vegetative Nervensystem und auch auf kognitive Bereiche.

Chiropraktik in Deutschland
In Deutschland bestehen keine speziellen Regelungen für die Ausübung des Berufs "Chiropraktor". Zur Ausübung des Berufs des Chiropraktors oder des Therapiefachs Chiropraktik muss man entweder Arzt oder Heilpraktiker sein (siehe Heilpraktikergesetz, 1. Durchführungsverordnung). Im Ausland qualifizierte Chiropraktoren müssen daher eine Heilpraktikererlaubnis erlangen, um in Deutschland zu praktizieren. In der Praxis haben Behörden regelmäßig dafür aber eine umfassende Kenntnisprüfung verlangt. In der jüngeren Vergangenheit haben einige Verwaltungsgerichte dies beanstandet und geurteilt, dass eine Ausbildung im Ausland anzuerkennen sei.

Der erste Absolvent einer amerikanischen Chiropraktik-Schule, der Palmer School of Chiropractic, eröffnete 1924 in Frankfurt/Main eine Praxis.
In den frühen 1950er Jahren wollte Werner Pepper, ebenfalls ein Absolvent der Palmer School, eine Zweigstelle der Palmer School in Deutschland eröffnen. Dies wurde seitens der Schulleitung abgelehnt.

Chiropraktik in der Schweiz
In der Schweiz ist der Chiropraktor eine anerkannte Medizinalperson, die in eigener Verantwortung Funktionsstörungen und schmerzhafte Zustände der Wirbelsäule und des Bewegungsapparates diagnostiziert und behandelt. Die fünf Medizinalberufe in der Schweiz umfassen den Chiropraktor, den Humanmediziner, den Zahnarzt, den Tierarzt und den Apotheker. In den folgenden Bundesgesetzen und den entsprechenden Verordnungen werden die Ausbildung und die Tätigkeit der Chiropraktoren sowie die obligatorische Kostenübernahme chiropraktischer Leistungen geregelt: Medizinalberufegesetz (MedBG), Krankenversicherungsgesetz (KVG), Unfallversicherungsgesetz (UVG), Militärversicherungsgesetz (MVG), Strahlenschutzgesetz (StSG).

Gesetzlich sind die Leistungen der Chiropraktoren als Pflichtleistungen von Medizinalpersonen anerkannt worden, als 1964 das Kranken- und Unfallversicherungsgesetz (KUVG) von 1911 teilrevidiert wurde. Seitdem werden die chiropraktischen Leistungen von der obligatorischen Grundversicherung der Krankenkassen gedeckt. Der Chiropraktor ist nebst dem Humanmediziner der einzige gesetzlich geregelte Erstkontakt für den Patienten.

In der Schweiz dürfen nur ausgebildete Medizinalpersonen Chiropraktik anbieten. 300 Chiropraktoren sind in ChiroSuisse, dem Verband der Schweizer Chiropraktorinnen und Chiropraktoren, organisiert.

Aus-, Weiter- und Fortbildung
In der Schweiz wird das Studium der Chiropraktik seit Herbst 2008 an der medizinischen Fakultät der Universität Zürich angeboten. Es dauert zwölf Semester zuzüglich Krankenhauspraktika und führt über das Bachelorstudium in Medizin (B Med) zum Masterstudium (M med. Chiro), optional weiter zum chiropraktischen Doktorat (Dr. med. chiro).
Die Schweizerische Akademie für Chiropraktik, die akkreditiert ist durch das eidgenössische Bundesamt für Gesundheit, ist für die Weiterbildung der Chiropraktoren zuständig. Ihr obliegt auch die Durchführung der Prüfung zum Fachchiropraktor.

Die Chiropraktoren sind wie alle Medizinalpersonen zur jährlichen Fortbildung von 80 Stunden pro Jahr innerhalb eines gesetzlich gegebenen Rahmens verpflichtet.

Gegenanzeigen und unerwünschte Wirkungen
Allgemein ist eine Abklärung bestimmter Wirbelsäulenschäden (beispielsweise Metastasen, Tumoren) erforderlich. Hierzu reichen – beim Kreuzschmerz – die Anamnese (Erhebung der Krankengeschichte) und die Untersuchung aus. Eine Bildgebung ist nicht erforderlich.

Chiropraktische Manöver an der Halswirbelsäule gelten als unabhängige Risikofaktoren für die Entwicklung von Schlaganfällen infolge von Dissektionen der Arteria vertebralis (Wirbelarterie).

Wissenschaftlichkeit und Wirksamkeit

Bei vegetativen Schmerzzuständen bei Osteochondrose und Subluxationen der Wirbelsäule wurden Erfolge verzeichnet, bei denen jedoch die Möglichkeit suggestiver Effekte denkbar ist.

In einem Übersichtsartikel zur Chiropraktik vom Mai 2008 kam der Leiter der Abteilung für Naturheilkunde der englischen Universität von Exeter, Edzard Ernst, nach Durchsicht wissenschaftlicher Artikel zum Thema zum Schluss, dass die Chiropraktik auf "mystischen Konzepten" basiere. Außerdem basierten die grundlegenden Konzepte der Chiropraktik wie Subluxation von Wirbeln und die spinale Manipulation nicht auf "solid science" (= "fundierter Wissenschaft").

Auch neuere Untersuchungen zeigen, dass es keinen Zusammenhang zwischen Krankheit und Subluxation von Wirbeln durch ungünstige Beeinflussung der angeblich betroffenen Nerven zu geben scheint.

Dem emeritierten Schweizer Professor für orthopädische Chirurgie Max Geiser zufolge hätten weder die Chiropraktik noch die "sogenannte manuelle Medizin" bis heute den Beweis geliefert, "ernsthafte, nicht spontan remittierende Affektionen des Bewegungsapparates beheben zu können und mehr zu leisten als alle übrigen Scheinbehandlungen der Alternativ- und Komplementärmedizin".

Eine systematische Übersichtsarbeit der Cochrane Collaboration aus dem Jahre 2003, die die Behandlung von Kreuzschmerz mittels spinaler Manipulation zum Thema hatte, zeigte keine Vorteile gegenüber anderen, nicht-kontraindizierten Behandlungsmethoden, wie allgemeinärztliche Behandlung, Schmerzmittel, Physiotherapie, Heilgymnastik oder Rückenschule. Die Autoren hielten es für möglich, dass die spinale Manipulation einer Placebo-Behandlung überlegen ist. In einer Übersichtsarbeit aus dem Jahre 2011 wurden bezüglich Schmerzreduktion und Funktionsverbesserung bei Patienten mit chronischem Kreuzschmerz keine klinisch relevanten Unterschiede der spinal-manipulativen Therapie zu anderen etablierten Therapien festgestellt. Schwerwiegende Komplikationen konnten in dieser Analyse auch nicht beobachtet werden. Ungeklärt blieb, ob eine Überlegenheit der spinalen Manipulation gegenüber Placebo besteht, weil sich nur wenige und typischerweise mit hohem Verzerrungsrisiko behaftete Studien diesem Aspekt widmen. Auch bei akutem Kreuzschmerz zeigte die spinal-manipulative Therapie weder gegenüber einer (empfohlenen) Standardbehandlung, einer Placebobehandlung noch als Zusatz einer anderen Behandlung Vorteile.

Nach Ausbruch von COVID-19 mehrten sich auf sozialen Medien wie Twitter Falschmeldungen über eine angebliche durch die spinal-manipulative Therapie vermittelte Steigerung bzw. einen "Boost" des Immunsystems. Es gibt jedoch keine seriösen Hinweise darauf, dass diese einen solchen Einfluss auf das Immunsystem entfalten könnte.

Siehe auch
 Osteopathie (Alternativmedizin)
 Manuelle Medizin

Historische Literatur
 Albert Baginsky: Zur Geschichte der Chiropraktik. In: Naturheilpraxis. 8, 1955, S. 138.
 Kurt Rüdiger von Roques: Über Notwendigkeit und Form des Einbaus der Chiropraktik in die Medizin. In: Neuralmedizin. 2, 1954, S. 156–161.
 Fred W. Illi: Becken und Chiropraktik. Neue Erkenntnisse und Behandlungsmöglichkeiten. Übersetzt aus dem Französischen von Kurt Rüdiger von Roques und Freimut Biedermann. Saulgau 1953.
 Wie ist die chiropraktische Behandlungsweise zu beurteilen? Welchen Heilwert hat sie? (= Briefkaster. Frage 48). In: Reichsgesundheitsblatt. Jahrgang 16, 1941, S. 218.

Weblinks

Einzelnachweise

Alternativmedizin
Physikalische und Rehabilitative Medizin
Manuelle Medizin


text:
Volume 15, Number 12—December 2009
Tick-borne Agents in Rodents, China, 2004–2006
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Lin Zhan1, Wu-Chun Cao1 , Chen-Yi Chu, Bao-Gui Jiang, Fang Zhang, Li-Qun Fang, J. Stephen Dumler, Xiao-Ming Wu, Shu-Qing Zuo, Pan-He Zhang, Hai-Nan Huang, Qiu-Min Zhao, Na Jia, Hong Yang, Jan H. Richardus, and J. Dik F. Habbema
Author affiliations: Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China (L. Zhan, W.-C. Cao, C.-Y. Chu, B.-G. Jiang, F. Zhang, W. Liu, X.-M. Wu, S.-Q. Zuo, P.-H. Zhang, H.-N. Huang, Q.-M. Zhao, N. Jia, H. Yang); Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (J.S. Dumler); University Medical Center, Rotterdam, the Netherlands (J.H. Richardus, J.D.F. Habbema)
A total of 705 rodents from 6 provinces and autonomous regions of mainland People's Republic of China were tested by PCRs for tick-borne agents (Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, spotted fever group rickettsiae, and Francisella tularensis). Infection rates were 5.5%, 6.7%, 9.1% and 5.0%, respectively. Eighteen (2.6%) rodents of 10 species were positive for 2 or 3 agents. Sequence analysis of PCR products confirmed the presence and genotypes of detected agents. These findings demonstrate that these tick-borne agents cocirculate and that a variety of rodent species may be involved in their enzootic maintenance.
Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, spotted fever group (SFG) rickettsiae, and Francisella tularensis are the causative agents of human granulocytic anaplasmosis, Lyme disease, spotted fever, and tularemia, respectively. These agents are naturally maintained in animal reservoirs and considered emerging or reemerging pathogens with serious public health implications. Although these agents could infect humans through various routes, ticks play a major role in transmission from animal hosts to humans.
Co-infection with these agents has been found in many tick species including Ixodes scapularis in northeastern United States, I. pacificus and I. spinipalpis in the western United States I. ricinus in Europe, and I. persulcatus in Asia (1). Patients co-infected with 2 tick-borne pathogens usually show more severe clinical signs of longer duration (1). Experimental concurrent infections with A. phagocytophilum and B. burgdorferi may suppress interleukin-2 (IL-2) and interferon-γ production, promote IL-4 response, increase pathogen load, and intensify Lyme arthritis (2–4). Natural infection and co-infection with these 4 agents have been reported in the People's Republic of China in various tick species (5–7) such as I. persulcatus, Dermacentor silvarum, Haemaphysalis concinna, H. longicornis, and H. warburconi, which are known to feed on small mammals as well as humans.
We hypothesize that multiple agents might be present in rodents from tick-infested areas. The purpose of this study was to identify A. phagocytophilum, B. burgdorferi, SFG rickettsiae, and F. tularensis in rodents from mainland China and to better understand the public health role of these emerging and reemerging pathogens.
Figure. Study sites (triangles) in the People's Republic of China where rodents were collected, 2004–2006. Numbers in parentheses are co-infection rates of rodents with 2 or 3 tick-borne agents.
During 2004–2006, rodents were collected at 6 study sites in Heilongjiang Province, Inner Mongolia Autonomous Region, Jilin Province, Zhejiang Province, Guizhou Province, and Xinjiang Autonomous Region (Figure) at various times according to peak seasons of tick species. The first 3 sites were forested highlands in the Small Xing'an Mountains and the Great Xing'an Mountains of northeastern China, where local residents worked and were exposed to rodents and ticks. The study sites in Zhejiang and Guizhou provinces were forested rolling hills with typical temperate zone vegetation; these regions attract hundreds of thousands of tourists per year. The study site in Xinjiang Autonomous Region was a forest with a rural resident population. Rodents were trapped by using peanuts as bait. After captured rodent species were identified, spleen specimens were collected and stored at –20°C until DNA was extracted.
Extraction of DNA
Total DNA was extracted from spleen samples by using Trizol agent (Invitrogen, Carlsbad, CA, USA) following the instructions of the manufacturer. Briefly, ≈300 mg of spleen tissue from each rodent was crushed in Trizol reagent, and DNA was separated from RNA by centrifugation. DNA was precipitated after washing twice in a solution containing 0.1 M sodium citrate in 10% ethanol. The DNA pellet was then washed in 75% ethanol and kept at room temperature for 10–20 min. After centrifugation at 2,000 × g at 2–8°C for 5 min, DNA was dissolved in 8 mmol/L NaOH and centrifuged to remove insoluble material. The supernatant containing DNA was removed and adjusted with HEPES buffer to a pH of 7–8.
Nested PCR was conducted with primers designed to amplify part of the 16S rRNA gene of A. phagocytophilum, as described (8). For amplification of B. burgdorferi DNA, a nested PCR was performed with primers derived from B. burgdorferi 5S–23S rRNA intergenic spacer (9). PCR was performed by using primers Rr 190.70p and Rr 190–701n to amplify a fragment of the gene encoding a 190-kDa outer membrane protein A (ompA) gene specific for SFG rickettsiae (10). Samples were tested for F. tularensis by a nested PCR specific for the outer membrane protein (fopA) gene, as described (11). All PCRs were performed by using a model 2700 thermal cycler (Perkin-Elmer, Waltham, MA, USA). PCR products were separated by agarose gel electrophoresis, stained with ethidium bromide, and examined under UV light. To avoid contamination, we performed DNA extraction, reagent setup, amplification, and agarose gel electrophoresis in separate rooms and included negative controls (distilled water) were in each amplification.
DNA Sequencing and Analysis
PCR products of positive samples were sequenced directly by using a dideoxynucleotide cycle sequencing method with an automated DNA sequencer (ABI PRISM 377; Perkin-Elmer). To limit errors in sequencing, we performed 2 sequencing reactions of each PCR product. When different sequences were obtained, additional sequencing reactions were conducted to generate a consensus sequence. Sequences obtained in the present study were compared with the corresponding sequences deposited in GenBank by using the BLAST program of the National Center for Biotechnology Information (http://blast.ncbi.nlm.nih.gov/Blast.cgi).
Chi-square or Fisher exact tests were used to compare proportions. p values <0.05 were considered statistically significant.
A total of 705 rodents were captured. The number of rodents tested and infectivity rates at different survey sites are shown in the Table. A. phagocytophilum was detected only in rodents captured in eastern regions of China (Heilongjiang, Jilin, and Zhejiang provinces) (Figure). B. burgdorferi was detected in rodents captured at all 6 survey sites. SFG rickettsiae were detected in rodents captured at all sites except Jilin Province. F. tularensis was detected in rodents captured only in northern China (Heilongjiang and Jilin provinces and Inner Mongolia and Xinjiang autonomous regions; Figure).
In Heilongjiang Province, all 4 agents were detected in rodents at similar frequencies (χ2 2.80, df 3, p = 0.424). No SFG rickettsiae were detected in rodents from Jilin Province. The infectivity rates for the 3 agents in Jilin Province did not significantly differ (χ2 2.23, df 2, p = 0.328). Infectivity rates for SFG rickettsiae were significantly higher than those for B. burgdorferi and F. tularensis in rodents from Inner Mongolia Autonomous Region (χ2 39.76, df 2, p<0.001). Infectivity rates for the 3 agents in Xinjiang Autonomous Region did not differ significantly (χ2 5.01, df 2, p = 0.082). Except for F. tularensis, the other 3 agents showed similar infectivity rates for Zhejiang Province (χ2 1.30, df 2, p = 0.523). Only B. burgdorferi and SFG rickettsiae were found in Guizhou Province, and the difference in their infectivity rates was not significant (p = 0.525, by Fisher exact test).
A total of 18 (2.6%, 95% confidence interval 1.4%–3.8%) rodents from all survey sites except Xinjiang Autonomous Region were positive for 2 or 3 agents, among which 15 were positive for 2 agents. A Clethrionomys rufocanus rodent from Heilongjiang Province was positive for A. phagocytophilum, B. burgdorferi, and SFG rickettsiae, and 2 rodents (Apodemus agrarius and Tamias sibiricu) from Jilin Province were positive for A. phagocytophilum, B. burgdorferi, and F. tularensis (Appendix Table 1).
Overall, except for 6 unclassified rodents, 23 species of rodents captured at the 6 survey sites were identified. Rodent species composition varied greatly at different sites (Appendix Table 2). Rattus norvegicus rodents were found at all survey sites except Xinjiang Autonomous Region. A. agrarius, A. peninsulae, Clethrionomys rufocanus, Mus musculus, and T. sibiricu rodents were found in northeastern China; A. sylvaticus, Niviventer confucianus, and R. losea were found mainly in southern China; and Meriones unguieulataus and M. musculus were found mainly in western China.
The dominant rodent species differed at various study sites. C. rufocanus (57.8%) was dominant in Heilongjiang Province, A. agrarius (36.2%) and A. peninsulae (27.1%) in Jilin Province, A. agrarius (29.7%) and Microtus maximowiczii (23.7%) in Inner Mongolia Autonomous Region, M. musculus (50.0%) and M. unguieulataus (34.1%) in Xinjiang Autonomous Region, N. confucianus (53,0%) in Zhejiang Province, and R. norvegicus (32.14%) and M. musculus (28.6%) in Guizhou Province (Appendix Table 2).
To confirm the presence and determine genotypes of detected organisms, PCR products were sequenced and analyzed. A 919-bp partial 16S rRNA gene fragment for A. phagocytophilum was obtained from each positive specimen (8). A. phagocytophilum sequences detected in rodents from Heilongjiang and Jilin provinces (GenBank accession no. DQ342324) were identical and differed from those from Zhejiang Province (GenBank accession no. DQ458808) by 2 bp, from those from ticks in United Kingdom and Sweden (GenBank accession nos. AY082656 and AJ242784.1, respectively) by 2 bp, and from other known A. phagocytophilum sequences by >3 bp.
Sequence analysis of the B. burgdorferi 5S–23S rRNA intergenic spacer showed that agents isolated from rodents in Heilongjiang Province, Inner Mongolia Autonomous Region, Jilin Province, and Xinjiang Autonomous Region belonged to the B. garinii genospecies, similar to agents detected in ticks (GenBank accession no. DQ150540) in northern China. Of 16 B. burgdorferi detected in Zhejiang Province, 12 belonged to the B. garinii genospecies and the other 4 belonged to the B. valaisiana–related group (GenBank accession nos. EU160458 and EU160459). The 2 strains found in Guizhou Province also belonged to the B. valaisiana–related group (GenBank accession no. EU247840).
For identification of SFG rickettsiae, partial nucleotide sequences of the ompA gene were obtained from positive specimens in Heilongjiang Province and Inner Mongolia Autonomous Region. All sequences were identical to those of the R. sibirica genotype (GenBank accession no. U43807). Nucleotide sequences of 35 specimens positive for F. tularensis were identical to each other and to published sequences for the F. tularensis subsp. holarctica strain (GenBank accession no. AF247642.2).
We detected A. phagocytophilum, B. burgdorferi, SFG rickettsiae, and F. tularensis in diverse species of rodents from different areas of China. Our findings and previous evidence (6,9,12–15) suggest that several tick-borne agents cocirculate in mainland China, and a variety of rodent species may be involved in enzootic maintenance of these agents.
This study was not intended to be a comprehensive survey on active infections with A. phagocytophilum, B. burgdorferi, SFG rickettsiae, and F. tularensis. Rather, it was designed to investigate the presence and extent of these agents in China. If one considers that human infections with A. phagocytophilum, B. burgdorferi, SFG rickettsiae, and F. tularensis have been reported in various regions of China (16–19), the presence of these agents in rodents in the study areas suggests a potential threat to humans, and the public health role of these findings should be further investigated.
Although infectivity rates varied at different survey sites (Table, Appendix Table 1), we could not determine the geographic diversity of these agents in rodents. The number of rodents examined was limited; therefore, infectivity rates in the current study could be biased. In addition, because intensity of circulation of any vector-borne agent fluctuates dramatically throughout the year and from year to year, even at the same location (20,21), we could not justify comparing infectivity rates between different sites on the basis of unsynchronized single collections over a 3-year period. A randomized sampling scheme and further collection of rodents are required to clarify this issue. Unfortunately, we did not collect the ticks from captured rodents for additional testing of the tick-transmitted agents. This limitation prevented us from understanding vector potential.
In this study, A. phagocytophilum was detected only in eastern China (Table, Figure), where it coexists with the other 3 agents (Appendix Table 1). A. phagocytophilum detected in Heilongjiang, Jilin, and Zhejiang provinces were closely related to each other by 16S rRNA gene sequence analysis, but less related to other known strains in other countries. B. burgdorferi was detected in rodents from all 6 survey sites. As observed in a previous study (9), B. garinii was the dominant genospecies in mainland China, and the B. valaisiana–related group was present in southern China.
SFG rickettsiae, including ≈20 species of rickettsiae, can be transmitted to animals and humans not only by ticks but also by other arthropods such as infected lice, fleas, and mites (10). In this study, we amplified the ompA gene, which is present in most SFG rickettsiae (10,22). The overall infectivity rate for SFG rickettsiae was highest (9.1%) among the 4 agents tested (Appendix Table 1). Sequence analysis identified the Rickettsia sp. detected in Heilongjiang Province and Inner Mongolia Autonomous Region as a genotype of R. sibirica, which is known to cause Siberian tick typhus (18). However, we did not sequence PCR products amplified from rodents at other study sites because of a limited amount of samples. Although sequence analysis of the ompA gene fragment is not sufficient to identify the agent (22), it is commonly used to recognize tick-borne Rickettsia spp. in field surveys (23).
F. tularensis was found only in northern China, which verifies our belief that F. tularensis is present only north of 30°N latitude. In many disease-endemic areas, ticks are known to play a role in transmitting F. tularensis from animal hosts to humans, although other arthropods such as deer flies, fleas, mites, and mosquitoes are known to carry the bacterium. Sequence analysis showed that all F. tularensis detected in this study belong to the subspecies holarctica.
Interference of infections among A. phagocytophilum, B. burgdorferi, SFG rickettsiae, and F. tularensis in rodent hosts is not clear. Our findings indicate that infection with A. phagocytophilum does not intensify risk for transmission of the other 3 agents and vice versa. B. burgdorferi in rodents appears to increase risk for infection with F. tularensis but does not increase the possibility of infection with SFG rickettsiae or A. phagocytophilum. Further investigations are needed to demonstrate positive or negative interactions of the pathogens and to establish whether this interference is associated with the animal species.
Of 705 rodents tested in this study, 15 were infected with 2 agents and 3 were infected with 3 agents. These findings indicate that mixed natural foci of tick-borne agents are present at the study sites. Because A. phagocytophilum, B. burgdorferi, SFG rickettsiae, and F. tularensis were found in ticks collected in the study areas (6–9,12–14), it is not surprising that multiple agents were detected in rodents. Coexistence of multiple agents might be caused by a single bite of a tick infected with several agents or multiple bites of ticks infected with at least 1 agent. The presence of 4 pathogens in the study areas demonstrates the risk for multiple infections in humans, which may lead to variations and exacerbation of clinical signs (1). Therefore, differential diagnoses should be made for febrile patients with a history of tick bites in these areas, particularly when clinical signs are atypical for 1 disease or a related disease.
Among 23 rodent species trapped in this study, 21 were infected with >1 agent (Appendix Table 2). Only 2 species (Cricetulus migratourius and N. fulvescens) were negative for all 4 agents. Which species is the main host of each agent remains unknown, because none of the agents are predominantly associated with 1 or a few related rodent species, regardless of their geographic origin. However, A. phagocytophilum, B. burgdorferi, SFG rickettsiae, and F. tularensis in various rodent species illustrate the potential roles of various rodents in maintaining these tick-borne agents. Systematic epidemiologic studies that investigate characteristics of natural foci and the role of small wild animals in transmission of these agents to humans are needed.
Dr Zhan is an epidemiologist at the Beijing Institute of Microbiology and Epidemiology. Her primary research interests are epidemiology and control of emerging and reemerging infectious diseases.
We thank Xiao'ai Zhang for technical assistance, Tian-Yu Guo for identification of rodent species, and Ding-Ming Wang, Jian-Bo Wang, and Rong-Li Dang for assistance in field surveys.
This study was supported by the National Science Fund for Distinguished Young Scholars (no. 30725032) and the National Natural Science Foundation of China (no. 30600506).
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Table. Infection rates for 4 tick-borne agents in rodents, People's Republic of China, 2004–2006
Appendix. Table 1. Co-infection rates for 4 tick-borne agents in rodents, People's Republic of China, 2004–2006
Appendix. Table 2. PCR results for 4 tick-borne agents in rodents, People's Republic of China, 2004–2006
DOI: 10.3201/eid1512.081141
1These authors contributed equally to this article.
Table of Contents – Volume 15, Number 12—December 2009
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Zhan L, Cao W, Chu C, Jiang B, Zhang F, Fang L, et al. Tick-borne Agents in Rodents, China, 2004–2006. Emerg Infect Dis. 2009;15(12):1904-1908. https://doi.org/10.3201/eid1512.081141
Zhan L, Cao W, Chu C, et al. Tick-borne Agents in Rodents, China, 2004–2006. Emerging Infectious Diseases. 2009;15(12):1904-1908. doi:10.3201/eid1512.081141.
Zhan, L., Cao, W., Chu, C., Jiang, B., Zhang, F., Fang, L....Habbema, J. D. (2009). Tick-borne Agents in Rodents, China, 2004–2006. Emerging Infectious Diseases, 15(12), 1904-1908. https://doi.org/10.3201/eid1512.081141.
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Sharonda designed her look by opting for a Black and White suit with a chinese collar that had a gold toggle in the middle for a button from Lord and Taylor. To complement the look, she wore a white shirt with a pink bowtie, a black Gucci belt with some Black fur lined Gucci mules. She was going for a clean, sharp modern look while keeping her femininity.
"Above everything, the woman I married is passionate," said Sharonda. "She is passionate about her career, her relationships, and any other thing she puts her mind to. She exudes confidence and her personality can hypnotize a room. She demands power which can often be intimidating."
The couple went to brunch on a Sunday afternoon after attending church when Sharonda suggested they take pictures in a nearby photo booth. What happened next was just picture perfect.
"After taking pictures in the Photo Booth twice Sharonda wanted to take them again and because I love a good picture for the memories I didn't think much about the request," recalled Kolandra. "As we're taking the pics she kept moving and I was like 'what are you doing and why can't you keep still?' Up and out the blue as we took the third picture, she pulled out a box that caught me so off guard because I thought it was her wallet which was the same color as the box. As the last picture snapped, I finally realized what was happening and I started crying! Needless to say, she did a really good job surprising me and the best part of it all is that we have pictures of that very moment when she proposed."
"The woman I married is very bullheaded, stubborn, loving, thoughtful, caring, artistic and most of all my one-of-a-kind wife," said Kolandra of Sharonda.
We absolutely love Sharonda's Kanye West-inspired cufflinks for her big day!
About 90 people attended the brides beautiful wedding.
"My dad walked me down the aisle," said Kolandra. "I chose my dad to walk me down the aisle because after talking to him and making sure he was on board with my life and my life choices I knew I wouldn't have it any other way."
"When I was at the altar looking into her eyes I couldn't believe how beautiful she looked and that we were finally doing it," said Kolandra.
"I'm not sure if it's possible but I was terrified yet calm all at the same time looking at Kolandra at the altar," said the bride. "I could feel everyone eyes on me but all I could see was her. Her familiar warm eyes calmed me, reassuring me I was making the best decision of my life."
We had a three-tiered cake that had an octagon shaped bottom. The bottom tier was marble and strawberry flavor. The other two tiers had different shades of blush and maroon with gold accents on it and were Hummingbird on the top layer and Coconut in the middle. We topped it off with a cake topper that said "Finally"!
"I love her confidence and promptness; she is organized and driven. But what I love most is the way she loves me."
"My Bouquet was done filled with hydrangeas, roses, peonies and other flowers with two types of greenery," said Kolandra.
Doesn't Sharonda just look great on her big day?!
"We decided to do a lock ceremony. a lock ceremony signifies that when the two locks are locked together the two shall become one. We are unique and wanted to do something different from what we had seen. The locks were also engraved with the date of the wedding and the date of our engagement."
"I chose to make Kolandra my wife because I knew I wanted to spend the rest of my life with her. I knew how great of a person she was and if I didn't make her my wife then someone else would notice and make the commitment. The deciding factor was when I was having a conversation one day and describe her as my girlfriend but knew she was so much more."
"I said yes because we have so much in common. We love boxing, shopping, shoes, art and we're foodies just to name a few. We always finish each other sentences or start a sentence the other is thinking. I'm her Sugar and she's my Spice. I said yes because I couldn't imagine spending my life with anyone else."
"What I love most about my wife is that she is very thoughtful and very good at anything she does because she is so creative and artistic," said Kolandra of Sharonda. "What I love most about her is that she's my warm when I'm cold and she's my umbrella when it rains. She's always there when I need her and when I least expect it."
"I knew she was the one when I realized I was the best version of myself when I was with her. She allows me to be myself but also helps me to grow and be better. She just makes living life and loving easier," said Sharonda.
Kolandra and Sharonda dated for 9 years before they tied the knot so the perfect wedding song for them was Janelle Monae's song, "Primetime" featuring Miguel.
"No, I didn't believe in true love," Sharonda admitted. "I believed 2 people could love one another but only true love was in the movies. But once true love hits, like a ton of bricks, it's no denying it."


> Great idea, thanks for pointing it out!
> #*$@(( system is done processing the last message it got.
Yes, incorporate a policy server which has rate limits.
so this will work well for you.
as the default included paths didn't work for me.
The command run is "make linux"
Do let "us" know how you made out!