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Posted on March 12, 2015 by Wyman
1 After we were brought safely through, we then learned that the island was called Malta. 2 The native people showed us unusual kindness, for they kindled a fire and welcomed us all, because it had begun to rain and was cold. 3 When Paul had gathered a bundle of sticks and put them on the fire, a viper came out because of the heat and fastened on his hand. 4 When the native people saw the creature hanging from his hand, they said to one another, "No doubt this man is a murderer. Though he has escaped from the sea, Justice has not allowed him to live." 5 He, however, shook off the creature into the fire and suffered no harm. 6 They were waiting for him to swell up or suddenly fall down dead. But when they had waited a long time and saw no misfortune come to him, they changed their minds and said that he was a god. 7 Now in the neighborhood of that place were lands belonging to the chief man of the island, named Publius, who received us and entertained us hospitably for three days. 8 It happened that the father of Publius lay sick with fever and dysentery. And Paul visited him and prayed, and putting his hands on him healed him. 9 And when this had taken place, the rest of the people on the island who had diseases also came and were cured. 10 They also honored us greatly, and when we were about to sail, they put on board whatever we needed. 11 After three months we set sail in a ship that had wintered in the island, a ship of Alexandria, with the twin gods as a figurehead. 12 Putting in at Syracuse, we stayed there for three days. 13 And from there we made a circuit and arrived at Rhegium. And after one day a south wind sprang up, and on the second day we came to Puteoli. 14 There we found brothers and were invited to stay with them for seven days. And so we came to Rome. 15 And the brothers there, when they heard about us, came as far as the Forum of Appius and Three Taverns to meet us. On seeing them, Paul thanked God and took courage. 16 And when we came into Rome, Paul was allowed to stay by himself, with the soldier who guarded him.
I suppose one of the most humorous hospital visits I ever made was to an elderly man named Ike Chambless. I received a phone call that Mr. Ike was in the emergency room of a hospital in Albany, Georgia. He had been bitten by a baby rattlesnake in his front yard. He had been working in the yard and put his hand down in a hole to remove an obstruction and, when he pulled the hand out, a baby rattlesnake was hanging from his finger. That is not the funny part! In fact, it was terrifying!
I rushed over the emergency room and found Mr. Ike sitting up in his bed, his hand badly swollen but the IV doing its job as it helped the antivenom into his body. I relaxed when I saw that Mr. Ike was ok and that he was in good spirits. We talked and even laughed about it while we sat down cheering the medicine on in its task of combating the venom!
The funny part came some moments after I had been there when the doctor, who had apparently not seen him yet, came into the room. He asked Mr. Ike to tell the story of what had happened to him. Ike did so. When he was finished the doctor said, "Well, what did you do with the snake?" To which Ike responded, "Oh it's right there behind you." The doctor and I both turned and looked at the counter behind the doctor. There, laid out on top of a plastic grocery store bag, was the snake!
The doctor jerked backwards away from the counter and my heart lept into my throat! Mr. Ike chuckled and said, "Oh, don't worry. It's dead." The doctor, composing himself said, "Let me get somebody to put this thing in a sealed container!"
It was a funny moment! Ike and I had a good laugh about it. I do not recall the poor doctor cracking a smile!
Paul had his own snake story, though it was much more important than Mr. Ike's. Paul's story demonstrated in a miraculous way the power of God (not, I should add, that Mr. Ike's didn't!). It stands as a most interesting little story demonstrating some wonderfully big truths in the midst of an amazing life!
The power of God working in Paul's life confounded the pagan theology of the world and drew nonbelievers to Christ.
It happened on the island of Malta where Paul and the crew of the ship found themselves after their frightening ordeal at sea.
1 After we were brought safely through, we then learned that the island was called Malta. 2 The native people showed us unusual kindness, for they kindled a fire and welcomed us all, because it had begun to rain and was cold.
"The native people" referred to in verse 2 is a translation of the Greek word barbaroi which is sometimes translated as "barbarous people." Our word "barbarian" is a transliteration of the word barbaroi. Jaroslav Pelikan points out that this is "a term that in modern English probably carries more pejorative connotations than it does in Greek, where it means, with relative neutrality, 'non-Greek,' as it does in other appearances in the New Testament."[1] Thus, no slight is intended by the term. They were simply the island inhabitants, pagans, to be sure, but considering the kindness they showed the shipwrecked crew they were obviously a benevolent people. Even so, their spiritual blindness became evident in their reaction to something surprising that happened to Paul.
3 When Paul had gathered a bundle of sticks and put them on the fire, a viper came out because of the heat and fastened on his hand. 4 When the native people saw the creature hanging from his hand, they said to one another, "No doubt this man is a murderer. Though he has escaped from the sea, Justice has not allowed him to live." 5 He, however, shook off the creature into the fire and suffered no harm. 6 They were waiting for him to swell up or suddenly fall down dead. But when they had waited a long time and saw no misfortune come to him, they changed their minds and said that he was a god.
Well, that is surprising indeed! Paul is bitten by a snake that he appears almost to casually shake off into the fire. A Snake being mistaken for wood is not unheard of. James Montgomery Boice has passed on a somewhat similar story from Lawrence of Arabia.
T.E. Lawrence, better known as Lawrence of Arabia, described something like this in his book Revolt in the Desert about the desert campaign in the World War I. It was cold. The Arabs had gathered sticks for a fire. One of the sticks turned out to be a snake that was revived by the fire's warmth and slithered away into the dark night, in this case without biting anybody.[2]
What was unique about the instance involving Paul on Malta is the fact that he was bitten then shook the snake off with no ill effects.
Ben Witherington notes that critics of this story point out that there is no record of there ever having been venomous snakes on the island of Malta. However, he points out that "it may…be the case that Luke has not used the term echidna with precision" and that, furthermore, "there is a snake, which has long been found on Malta, belonging to the species Coronella austriaca, which is a type of constrictor. This is thought to better fit the description of a snake fastening itself on Paul's hand." Furthermore, Witherington points out that "Pliny the Elder indicates it was a common belief, even among the educated, that all snakes were poisonous and that they were often agents of divine vengeance."[3]
Regardless of the arguments of detractors, Luke has proven himself to be an accurate historian throughout Acts and his testimony should be sufficient enough proof: Paul was bitten. The bite led the inhabitants to conclude that Paul must be a murderer or some terrible criminal. They appear to have thought that Dike, the goddess of justice, was punishing Paul for some crime.[4] In reasoning thus, they demonstrated that they held to a belief in what we would call today "karma," a belief in cause-and-effect justice that is hardwired into the universe itself. However, Paul shook the snake off with an indifferent shrug. As a result, the islanders swung to the other extreme and called Paul a god!
Such is the nature of pagan theology: it understands neither God nor man. It is deficient in both its theology and its anthropology. Paul's example in the episode with the snake confounded their theology and shattered its categories. In fact, Paul was living proof that their simplistic understanding of justice did not have a category for that which makes gospel good news: grace. After all, Paul was a murderer, but he had been declared righteous by the righteousness of Christ that he received by grace through faith. He was no god, but he knew the God of the universe. Thus, the snake served as an illustration to the watching islanders that what they thought they knew about God (or, as they would have put it, the gods) and man was deeply deficient.
Then, God worked powerfully through Paul to draw people to Himself.
7 Now in the neighborhood of that place were lands belonging to the chief man of the island, named Publius, who received us and entertained us hospitably for three days. 8 It happened that the father of Publius lay sick with fever and dysentery. And Paul visited him and prayed, and putting his hands on him healed him. 9 And when this had taken place, the rest of the people on the island who had diseases also came and were cured. 10 They also honored us greatly, and when we were about to sail, they put on board whatever we needed.
Paul's ministry on Malta consisted of a miraculous blocking of poisonous death on the one hand and miraculous healings on the other. His instrument for demonstrating His power in both cases was Paul, His missionary champion. He used Paul to heal the father of the power man on Malta, Publius. Then, He used Paul to heal the crowd that thronged to him.
We are provided a cursory sketch of these events. Luke does not permit us to hear Paul's words on Malta. Regardless, we can be sure that Paul made much of Jesus, that he used all of these circumstances to promote the gospel. We can be sure of this because this is what Paul always did. God was creating missionary moments for Paul, both through the situation with the snake and through the healings of the sick.
It is evident, then, that Paul remained a mighty and powerful instrument in the hands of God. That makes what happened next that much more moving.
And the power of God working through the Church encouraged and strengthened Paul.
Having touched so many lives through Paul and his ministry, God now touched Paul's life through the life and ministry of the Church. As Paul approached Rome, he suddenly found himself the object of the Church's acceptance, love, mercy, and compassion.
11 After three months we set sail in a ship that had wintered in the island, a ship of Alexandria, with the twin gods as a figurehead. 12 Putting in at Syracuse, we stayed there for three days. 13 And from there we made a circuit and arrived at Rhegium. And after one day a south wind sprang up, and on the second day we came to Puteoli. 14 There we found brothers and were invited to stay with them for seven days. And so we came to Rome. 15 And the brothers there, when they heard about us, came as far as the Forum of Appius and Three Taverns to meet us. On seeing them, Paul thanked God and took courage. 16 And when we came into Rome, Paul was allowed to stay by himself, with the soldier who guarded him.
How very touching this is! "On seeing them, Paul thanked God and took courage." T.C. Smith writes, "Paul, the man who had been comforting others on the voyage, was now comforted…The strongest Christian also needs the sympathy, compassion, help, care, and concern of others."[5] That is so true and so well said!
Show me a great Christian, a brave Christian, a strong Christian, a champion of the gospel, a luminary in the Church, a man through whom God has done mighty works and through whom He has touched innumerable lives, and I will show you a man who still needs the encouragement of the Church, the love of the Church, the compassion and understanding of the Church.
Nobody…nobody…is beyond the need for encouragement. This is evident from Paul's reaction to seeing these believers come to meet him as he begins to approach Rome. It also demonstrates that we need to be sensitive to those around us, especially those we consider to be strong and boundless sources of energy. We must begin to understand that our fellow believers are a mission field for the ministry of encouragement. It is a great gift that we can give to one another.
Will Willimon put it beautifully when he said this:
In a narrative filled with accounts of power, miraculous deliverance, and divine intervention, this is perhaps the greatest power the Christian faith puts at the disciple's disposal – the power of brothers and sisters in the church. In struggles with injustice, cruelty, and life's difficulties, one of the church's greatest gifts to us is the church. If Luke seems preoccupied with the church, it is perhaps because Luke knows that the church has become the content of the gospel proclamation. Jesus came preaching, not simply a new philosophy of life but a new way of living…The Acts question is not merely the intellectual one of "Do you agree?" but the political and social question, "Will you join up?"[6]
Yes, the Church, when it is the Church, represents a new life and a new way of doing life together. The Church's movement toward Paul was a movement of affirmation not only of how the gospel had taken root in Paul's life in such powerful and dramatic ways but also of how the gospel had likewise taken root in the life of the Roman church.
Our text is therefore a powerful and memorable display of how God worked through Paul to touch the lives of numerous people and then of how God worked through numerous people to touch the life of Paul.
God longs to work powerful through us as well: through us to the outside world and through us to our fellow Christian as well.
Be the instrument that God intends for you to be.
[1] Jaroslav Pelikan, Acts. Brazos Theological Commentary on the Bible. (Grand Rapids, MI: Brazos Press, 2005), p.290.
[2] James Montgomery Boice, Acts. (Grand Rapids, MI: Baker Books, 1997), p.418.
[3] Ben Witherington III, The Acts of the Apostles: A Socio-Rhetorical Commentary. (Grand Rapids, MI: William B. Eerdmans Publishing Company, 1998), p.777-778.
[4] T.C. Smith, "Acts." The Broadman Bible Commentary. Vol.10. Clifton J. Allen, gen. ed. (Nashville, TN: Broadman Press, 1970), p.149.
[5] T.C. Smith, p.150.
[6] William H. Willimon, Acts. Interpretation. (Louisville, KY: John Knox Press, 1988), p.186-187.


I can't remember the exact moment we realized we were getting tired. It's like it slowly crept up on us. We stopped being amazed by the beautiful temples surrounding us. New foods were no longer appealing and that cooking class we'd wanted to take, well, we just weren't interested anymore. Instead, we craved some tastes from home, and spent our time watching one too many episodes of Castle on our laptop. Travel fatigue got us good.
We would always respond with a very confident "NO". We were ready for this journey, longing for this journey actually. We wanted to live out the year with just the clothes on our backs, literally. The idea of waking up in new beds and new cities excited us to no end. Steven and I spent most of our time together before this trip, so we weren't worried about getting tired of each other's company.
Travelling to new cities and countries as quickly as we have has been like a boot camp for our senses. Every week, a new city, new language, new foods, new smells and new beds. When we finally spent that month in Chiang Mai, it caught up with us. We had the time to rest our feet for a bit and instead of easing into the whole "taking it easy" thing, we just went full out. But it didn't end when we left Chiang Mai. We still felt it during our three weeks in Vietnam and then again during our week in Kuala Lumpur. When we made it to Hanoi in Northern Vietnam, we weren't even overly excited to do our Halong Bay cruise. It was like everything was losing its appeal. Don't get us wrong, we still had an amazing time in Vietnam and to see Halong Bay was something special that we won't soon forget. Our stay at the JW Marriott Hanoi Hotel was like a dream come true. We were just becoming more interested in hanging around our accommodations, and less interested in seeing and doing things.
When we moved on to Kuala Lumpur, we found an awesome Airbnb just outside the city centre with a gym and infinity pool. Instead of exploring the city, we spent most of our time hanging around the condo. We spent our last two nights in KL at the JW Marriott Kuala Lumpur, which was located right next to all the hotspots and gave us the chance to explore everything that we wanted to see (stay tuned for a post on our stay there).
Up until this week, we'd been feeling guilty about this overall lack of excitement and motivation. It felt like we were taking so many things for granted. We've since realized that we shouldn't be so hard on ourselves and after seven months of non-stop travel, it is perfectly ok to want some downtime. More importantly though, we've finally identified and learned to accept OUR travel style.
Our biggest lesson here is that we all have different ways of travelling. While some people need a break after one week, others can go for months without stopping. Steven and I fall somewhere in between those two!
Oh, and if you're wondering, our answers to the questions above are still no!
Next week, we're island hopping and head to Lombok and Gili Air and are looking forward to more of what we've been up to here in Ubud, just with a beach and pool added in. We're also planning to catch up on the rest of our Vietnam, KL and Singapore posts while we are there! Next month, we head back to our favourite place in the world, Australia. We're pretty sure if we've got any travel fatigue lingering, Australia will be the cure!
Have you ever dealt with travel fatigue? What do you do to get your travel mojo back?
Yes, we start our OZ trip in Perth! We've visited the East Coast before, but never Western Australia…we can't wait!
Btw, if you have any questions or need help just ask away!
Thanks! We haven't started planning our Perth trip yet but will definitely let you know! What are your favorite beaches in the area?
Sorry forgot to reply! cottesloe beach is the best – lots of cafes and pubs along the beachfront so you can make a day of it. Easy to get to for tourists as well – train from perth to cottesloe station, then 1km walk to beach! Another good beach is Leighton beach, also on train line to "north fremantle" station. For surfing wAve beaches (if conditions are right) then Trigg and Scarborough beach. No trains though im sure there are buses. My fave is Cottesloe, because i take my daughter to the playground there, then we get icecream at Red spoon (best flavors there!) then after mummy and daddy can go to a cafe for a coffee!
You don't have to feel guilty for feeling tired from travelling, it happens to everyone at some point and it's perfectly normal. We have been on the road for about two and an half years now and believe me we had to deal with travel fatigue many times.
Eventually we realized that the best way of travelling that suites us better and that doesn't make us super tired, it's going slow, housesitting, spending longer period of times in places to exploring them at our own pace instead of rushing from one city to the other (like we did sometimes).
Glad to know we aren't the only ones! At the start of our trip, we were moving every 3-4 days…as the time goes on, we feel like we need at least a week everywhere we go! I'm sure after 2.5 years on the road, you definitely need to take it slower! Hope you guys are enjoying your new housesit (if you have started yet?)!
We definitely have gone through periods of travel fatigue. Our first bout happened about 7 months in while in Thailand. We didn't see any temples in Chiang Mai because we just couldn't be bothered! We ended up staying one full month in a hut on Koh Lanta island and did pretty much nothing which was exactly what the doctored ordered. Just like you guys we've found our own travel style and understand better when we need to just settle somewhere for a while. Get in touch when you get to Melbourne!
We will definitely get in touch when we get to Melbourne next month! Would love to grab a drink (or two!).


"The textures of Na'ama's work overlap and coat one another, hard edges and softer washes..."
A morning of revelation. Na'ama Zisser on Soundcloud. Untitled long. And a near-breathless 12 minutes and 18 seconds is followed by days of wondering why sounds so new to me seem so familiar.
I encountered Na'ama's music for the first time this year at the Tête à Tête Opera Festival held at King's Place. Performed by my beloved CHROMA, The Last Seed - one of two miniature operas being performed that night - speaks of Narcissus, delicious and doomed. This most influential of ancient mortals - the spiritual leader of the Cult of Selfie - realises that he has not truly lived until he eats the last pomegranate seed. Unafraid of silences, the voices of Richard Bryan, Meili Ii, Craig Jackson, Tristan Landymore and Amar Muchhala crash against the instrumental drones. Waves and undulations. Na'ama conjures a fragmented and fragile sound world, yet one that throbs and hums insistently from the very beginning of its existence.
Narcissus, delicious and doomed. What an apt description for The Last Seed. It made me think of those majestic short stories that are doomed - at least in the publisher's eye - from the outset. Too short to be published in anything other than a large, marketable collection, they wither away on the author's bookshelf, glowing brightly for a while amongst much larger, decorated novels before breathing a final, beautiful breath. I hope this work avoids that fate. It stands alone and glorious, much like poor, tortured Narcissus in his brief, sickeningly beautiful life. The Last Seed groans with the voice of a larger, weightier work in the body of something young and momentary.
Na'ama seems to paint sound. In Drowned in C, Na'ama scrapes her sound like the thickest, most unctuous of oils onto her canvas. A granular canvas, cracked with age, a base so dry that as the notes flood down onto it, as we perceive the sound, it seems as though we absorb it. As I listen to it I am reminded of Auerbach's "Head of J.Y.M. II" and of Kosoff 's "Head of Mother"… two works that make me both thirsty and sated at the same time, and happy in a way that only a work that is truly content in itself can make me.
In the sampled and acoustic sounds of Strings 2010, I am reminded of Kiefer's trees. Lead, wood and plaster sharing space with oil, emulsion, acrylic and charcoal. The textures of Na'ama's work overlap and coat one another, hard edges and softer washes. This is a work that, based on one recording alone, I can imagine being performed site-specifically. One part of it, acoustically, the other part by a sound-designer nurturing the "live" sound for the space. The late Jonathan Harvey once told me that he dreamt of music that treated the acoustic and the electronic as equals. I cannot help feeling that he spoke of music like Na'ama's in that moment.
Kiefer's work has often focused on myths associated with trees and wood, such as that of Yggdrasil, the Norse 'World Tree' that shelters the universe and with this final reference I come back to Untitled long. Maybe that is the key to why I feel as though Na'ama's sound is so familiar to me. It is an ancient sound, full of mythology and tales. There are the washes of fragmented lullabies hiding behind the sounds of what we must have first heard when we came into this world.
I wait for more music by Na'ama, I wait to hear it in galleries and abandoned spaces and packed Opera Houses. For now, I will listen to it on my iPhone. For now.


It's official. He's coming home on Saturday.
Momma says we are gonna be best friends.
She says that maybe it would be nice if we let him make some other Blogville friends and let him be in the blog too.
Next thing you know, she'll want me sharing my treats and toys with this goofball too!
Hewwwow Blogville. Your Director of Parks & Recreation here, wanting you to head on over to Madame Mayoress's blog where you can find…an interview with me! Hope you enjoy it!
Damn, I am cute! And, for your related pleasure, sitting in the dog park I mention in the interview!
I wanted to get out a bit on Monday, and I decided we were going for a walk. I tried a few parks in the neighborhood, but they were all still buried in snow, so I decided to walk the road into and out of the local campground. I parked alongside the road, near another car. Finn just wanted to climb up on the snow piles, which was fine by me, so wound up staying relatively close to the cars. When the man in the other car was ready to leave, he rolled down his window and let Finn come over for a sniff. He told me about his golden who he had for 13 years. After rubbing Finn's head for a little bit, he looked straight at me and said, "She's better than mine was. Now that's a disposition money can't buy. Enjoy your time together." Needless to say, I let Finn climb a little extra longer than I had planned on after he said that.
Fellow citizens of Blogville, I need to inform you of the recent betrayal that I experienced.
At the hands of my peeps.
Yes, that's right. Over the weekend, they LEFT ME at home while they went to a nearby shelter to DROP OFF a DONATION. Likely story. They came home smelling, and I mean DRIPPING IN SCENT of dogs. One dog in particular though was all over them, their clothes, their coats, their hands, everywhere! Seems while they were there, they decided it would be FUN to play with the puppies. Ok, given how irresistible I was at the puppy stage, I can understand this. But then, THEN, one dog caught their eye.
Look at this! I mean TAKE A LOOK AT THIS – that is MY MOMMA's HAND gently stroking another doggie's face. She said she was just seeing if he would TAKE TO HER. YEAH, LOOKS LIKE HE IS PRETTY DARN COMFORTABLE WITH YOU WOMAN.
They took that dog outside and played with him and ran around with him and petted him and everything. All weekend long they have been talking about his PERSONALITY and WOULD I LIKE A YOUNGER BROTHER?
Help me friends. I don't know what to make of my world anymore. Do you THINK they will actually GO THROUGH WITH THIS?!
Finnie, what's that? Why are we up so early? It's a Saturday!
Well, dunno if everyone has heard yet, but I had such a good time at the ball that I said YES to being Wally's girlfriend!
Yes, Finnie, we are all very excited for you.
So MOMMA, he is taking me to the circus today for our second date. Can you teach me how to juggle???
Well, Finn, you aren't going to PARTICIPATE in the circus, you are going to go and watch all the performances and sample some of Sasha's food from her food cart, and play some of the games. You aren't going to be up on stage, you are going to watch and have fun!
Oooooooh, so no training then. I can just play with my squeakie balls as usual?
Yes, go ahead and squeak as normal. Errr…wait, I think Wally's here to pick you up..
OMD I AM SO EXCITED ABOUT TONIGHT.
As you know, I have been asked to the big ball tonight by my dear friend Wally! I am a little nervous too, because it has been a long long time since I have been on a doggie date.
Momma said we had to do some preparations, so she made me take a bath.
She spoke to me about being a little lady.
Legs and mouth closed Finnie.
And then she told me to have a good time.
So I am patiently waiting to be picked up for the ball. Oooooohhh….when is he coming to pick me up?!!?


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Infant, neonatal, and postneonatal mortality trends in a disaster region and in Japan, 2002–2012: a multi-attribute compositional study
Ai Tashiro ORCID: orcid.org/0000-0001-6056-27751,
Honami Yoshida2 &
Etsuji Okamoto3
The reductions achieved in infant mortality in Japan are globally regarded as remarkable. However, no studies in Japan have classified infant mortality trends into neonatal and postneonatal or considered regional issues. This study aimed to explore trends in neonatal and postneonatal deaths, both overall for Japan and in a region affected by a natural disaster.
Drawing on national infant death data, we used a multi-attribute compositional study design to examine all infant deaths occurring in a region affected by a disaster (Tohoku, which consists of Iwate, Miyagi, and Fukushima) between 2002 and 2012. We used conjoint analysis to clarify the associations between infant and maternal characteristics and age of infant death.
We obtained data of a total of 31,012 infant deaths between 2002 and 2012, which included 1450 from Tohoku. Infant mortality rates in Japan overall declined over the period but increased in 2011. There were more postneonatal (29–364 days post-birth) than neonatal (0–28 days post-birth) deaths. Infant deaths in Tohoku declined slightly overall, with a fluctuation in 2011. In Tohoku, the trends in postneonatal death rates were similar; the overall rates for males increased, but those for females decreased in 2011. We found that the cause and place of infant death differed by gender for neonatal and postneonatal deaths in both Japan in general and Tohoku. The conjoint analysis showed that most variables affected the age of postneonatal death. The factor with the largest influence on the variation in infant death age was gestational week (55.5%). A maternal gestational week ≤36 was linked to an average age at death of 43.4 days, and > 37 was linked to an average of 83.7 days.
In Japan, infant death rates have declined steadily over the past 10 years. The recent trends indicated that postneonatal death rates were higher than neonatal rates, especially in Tohoku. However, not much attention has been focused on postneonatal deaths in Japan. Our findings may help health planners to prioritise work on the factors that are linked to infant deaths in the neonatal and postneonatal periods.
Infant mortality is considered a sensitive measure of the overall health of a population, although its precise interpretation has been debated. Subnational regional disparities related to infant mortality have been studied globally [1]. Japan's infant mortality in the pre-war period was equal to or higher than that of most of today's developing countries, where reducing infant mortality is an urgent challenge [2]. However, infant mortality rates in Japan have declined continuously since the 1990s, in line with the contributing factors of improvements in medical advancements, such as the universal use of the Boshi Kenko Techo (maternal-child health handbook), and in paediatric facilities and medical institutions [3, 4]. In 2019, the infant mortality rate in Japan dropped to 1.96 per 1000 live births, which was the second lowest in the world (227 out of 228 countries; range: 1.85–106.3, average: 21.6 per 1000) [5].
However, such achievements in improving defunct facilities and institutions were reduced to a poor physical infrastructure in 2011 [6,7,8]; on 11 March 2011, a magnitude 9.0 earthquake and a tsunami struck northeast Japan. In 2011, 162 infants died in the disaster areas (Iwate, Miyagi, and Fukushima prefectures) [9]. Studies assessing the health effects of this event on the infants are ongoing. Even though scholars have long debated that a poor physical infrastructure and public health infrastructure with weak governance are a primary cause of infant mortality [10, 11], Japan has not utilised previous disaster experiences and responses, such as Hurricane Katrina, Sumatra, and the Christchurch earthquake, as lessons for evaluating and developing effective measures [12, 13].
As such, an understanding of the patterns of human casualties, which is developed over a long period, is required for disaster mitigation and management plans. However, only a few studies have attempted to quantify the impact of infant mortality in the aftermath of natural disasters over a long duration. Pregnant women and infants have unique health concerns following a natural disaster [11], but the few previous studies did not provide robust evidence for the macro trends of the mortality patterns of infant casualties, which is necessary for developing effective protection plans against large natural disasters [14, 15]. Thus, we suggest that the needs of pregnant women, infants, and breastfeeding mothers are addressed in order to change their mindset between the disaster preparedness (normal span) and disaster response (abnormal span).
The present study aimed to describe the infant mortality patterns in Japan and in the three most severely damaged prefectures in the Tohoku region between 2002 and 2012. It is useful to examine infant mortality in the Tohoku region to explore whether it differs from Japan as a whole and to assess the effects of regional issues. This is the first study on infant mortality that has focused on social and environmental determinants of infant mortality and suggests the need for health policies and interventions in the community.
One study [16] has suggested that perinatal mortality increased in Fukushima as a result of the Fukushima nuclear power plant accident, but few studies have examined infant deaths using the causes of death or a framework of the period survived; that is, neonatal (0–28 days at death) and postneonatal (29–364 days at death). Postneonatal death rates have exceeded neonatal rates across Japan, which is not consistent with an earlier study. Ogasawara and Kobayashi [2, 17] studied trends in infant mortality in Japan in 2002 according to the neonatal and postneonatal periods but did not examine factors related to gender or region. Regarding these factors, we examined whether the regional characteristics that may reduce the risk of infant mortality vary widely between disaster-affected areas and the rest of the country and in populations within the country. Thus, this study contributes to providing insights into infant mortality reduction during normal as well as abnormal periods, such as in the event of future earthquakes or other natural disasters.
Aim, study design, and setting
This study aimed to explore trends in neonatal and postneonatal deaths, both overall for Japan and in a region affected by a natural disaster, and to examine the association between infant death age and related characteristics.
This study used a factor control study design that included all infant deaths in the Tohoku region (Iwate, Miyagi, and Fukushima) and in Japan between 2002 and 2012. The definition of infant death used was the death of a child in the first year of life (0–364 days of age). Infant deaths were further classified into neonatal (0–28 days of age) and postneonatal (29–364 days of age).
We obtained data of 31,012 infant deaths from the official census forms in Japan [18]. The death forms included all women and their infants in Japan and were approved by the Ministry of Health, Labour, and Welfare (MHLW) [9, 19]. The forms were prepared by municipal governments based on death notifications and sent to the ministry via the prefecture. The items on the death forms were kept in written logs. The materials received for this report covered each calendar year included in this survey. The written logs contained notification of foetal death, including the prefectural code (1–47), gender, delivery date, foetal death date, maternal age, number of previous pregnancies, number of gestational weeks, birth weight, location of death (hospital, clinic, midwifery home, home, other), single or multiple birth, and cause of death. Following translation, causes of death were coded to match the 10th Revision of the International Classification of Diseases (ICD-10) [20].
Infant death rates
Trends in the annual death rates (overall, by gender, and for the Tohoku region) were examined in the groups of all infants, neonates, and postneonates [18]. The denominator data were based on official annual statistics reports that included all prefectural birth rates and infant mortality rates for 2002–2012 [20, 21]. The birth data were obtained from vital statistics from the MHLW to calculate infant mortality. The annual death rates were used for the period. The neonatal and postneonatal mortality rates were compared by gender and region. The Tohoku region was considered to include Iwate, Miyagi, and Fukushima, and it was compared to all of Japan.
Study sample and statistical analysis
The analysis included all of the infant death data in Japan for the period of 2002–2012. The leading causes of mortality (overall and by gender) were examined for both neonatal and postneonatal deaths.
Metric conjoint analysis [21, 22] was used to identify the factors that were most strongly linked to the age of infant death. To explore potential heterogeneity in the infant deaths, we fitted a regression model for infant death age so that every infant had a unique set of regression coefficients or utility scores. A utility score characterizes the relative importance of each attribute. The importance of an attribute for the preference change results from the utility range of several values of the attribute. It can be interpreted as how much difference each attribute could make in the total utility of a value. That difference is the range in the attribute's utility values. To examine the associations between age of infant death and infant and maternal characteristics, we included interaction terms, a dummy variable, and each of the seven individual variables in the regression models.
Six individual variables were categorised as either 1 or 0 in the dataset. These included infant gender (males = 1, females = 0), gestational weeks at delivery (22–36 weeks = 1, 37–42 weeks = 0), and birth weight (< 2500 g = 1, ≥ 2500 g = 0). In addition, women whose first infant died were defined as primiparous (0) and those who had given birth before as multiparous (1). Maternal age was categorised into two groups: 15–34 (1) and 35 years or older (0). We used a dummy variable to indicate whether there had been an earthquake with an intensity of over six and a magnitude of at least six at least once during the year in which the child was born (occurred in the year = 1, none = 0) between 2002 and 2012. The regional domain variable was given a value of 1 for Tohoku and 0 for other areas. The exposure variable was the infant death age (less than 1 year, 0–364 days old).
Metric conjoint analysis models use a simple main-effects analysis of variance (ANOVA) with some specialised output. This model was used to perform a trend analysis of the infant death factors over time. The attributes were the independent variables, the judgements were the dependent variable, and the part-worth utilities were the βs, which were the parameter estimates from the ANOVA model. The following formula shows the model for the six variables:
$$ {y}_i=\mu +{\beta}_{1i}+{\beta}_{2i}+{\beta}_{3i}+{\beta}_{4i}+{\beta}_{5i}+{\beta}_{6i}+{\varepsilon}_{i.} $$
$$ \sum {\beta}_{1i}=\sum {\beta}_{2i}=\sum {\beta}_{3i}=\sum {\beta}_{4i}=\sum {\beta}_5i=\sum {\beta}_{6i}=0. $$
The yi term is the subject's infant death age with i and the dummy of each variable (i = 0, 1). The mean is μ, and the error is ɛi. The predicted utility for the i product is:
$$ {\hat{y}}_i=\hat{\upmu}+{\hat{\beta}}_{1i}+{\hat{\beta}}_{2i}+{\hat{\beta}}_{3i}+{\hat{\beta}}_{4i}+{\hat{\beta}}_{5i}+{\hat{\beta}}_{6\mathrm{i}.} $$
The R-square increases during every iteration until convergence, when the change in R-square is essentially zero. The R-square for a nonmetric conjoint analysis model is always greater than or equal to the R-square from a metric analysis of the same data. A smaller R-square in the metric conjoint analysis is not necessarily a disadvantage since the results should be more stable and reproducible with the metric model [23]. We computed these equations using Stata 14.1 [23]. To compare the contribution of the six attributes, the relative importance of each was computed using the following steps: (i) the multicollinearity was examined using a variance inflation factor (VIF) to observe if this factor was around 1.0, (ii) the collation among the independent variables was checked, (iii) the total range was derived, and (iv) the relative importance of each attribute was calculated. All analyses were performed with a significance level of p < 0.01.
Trends in annual death rates by region
Between 2002 and 2012, there were 31,012 infant deaths in Japan and 1450 in Tohoku. The trends in the infant, neonatal, and postneonatal mortality rates for Japan and Tohoku during this period are shown in Fig. 1.
Infant, neonatal, and postneonatal mortality rates for Japan and Tohoku, 2002–2012. Note. Infant (< 1 year), neonatal (0–28 days of age), and postneonatal (29–364 days of age). The p-value is based on a t-test. p < 0.001
The overall infant mortality rates declined over the period. The postneonatal mortality rate exceeded the neonatal mortality rate from 2006 onwards. In Tohoku, however, the infant mortality rate fluctuated across the period and was higher than in Japan except in 2004, 2006, and 2007. In 2011, the rate in Tohoku was 1.6 times higher than that in Japan (3.9 vs. 2.3, p < 0.001). The postneonatal mortality rate was 3.3 times higher than the neonatal rate (3.0 vs. 0.9, p < 0.001) in Tohoku. The Great East Japan Earthquake and Tsunami (GEJET) seems to have had a greater effect on postneonatal deaths than on neonatal deaths. In 2012, there were no major differences in the death rates among neonates and postneonates in either Tohoku or Japan.
Trends in the annual death rates by gender
Figure 2 shows the trends in infant, neonatal, and postneonatal deaths by gender in Japan. The overall trend was that the infant, neonatal, and postneonatal rates by gender declined over the period. While the postneonatal male mortality rate exceeded the rate for neonates in 2007, neonatal mortality rates in both males and females continued to decline. The postneonatal mortality rates fluctuated, but the mortality rates by gender were all similar in 2012, except for the rate for postneonatal males. The neonatal male mortality rate was highest in 2002 and the rates among females also declined (p < 0.001).
Infant, neonatal, and postneonatal mortality rates by age for Japan, 2002–2012. Note. Infant (< 1 year), neonatal (0–28 days of age), and postneonatal (29–364 days of age). The p-value is based on a t-test. p < 0.001
Figure 3 shows the annual trends in the infant, neonatal, and postneonatal death rates by gender in the Tohoku region. These rates generally fluctuated. Unlike the death rate trends in Japan (Fig. 2), the postneonatal death rates for both genders were higher than the neonatal death rates during the period. The postneonatal death rates were higher for males than females in 2011, although the shape of the curves was similar.
Infant, neonatal, and postneonatal mortality rates by age for Tohoku, 2002–2012. Note. Infant (< 1 year), neonatal (0–28 days of age), and postneonatal (29–364 days of age). The p-value is based on a t-test. p < 0.001
Between 2002 and 2012, there were 31,021 infant deaths in Japan and 1450 in Tohoku. The top five causes of infant death are shown in Table 1. Across Japan, for male infants, the most common cause was sudden infant death syndrome (SIDS) (6.4%), followed by ill-defined or unknown cause (4.4%), trisomy (3.8%), congenital hypoplasia/dysplasia of the lung (2.9%), and hypoplastic left heart syndrome (2.4%). For female infants, the leading causes of death were trisomy (6.9%), SIDS (5.2%), ill-defined or unknown cause (3.6%), congenital hypoplasia/dysplasia of the lung (2.5%), and extremely low birth weight (2.4%). Table 1 shows that in Tohoku, trisomy, asphyxia, and extremely low birth weight were common causes of death in both genders.
Table 1 Infant deaths (< 1 year) in Tohoku and Japan, 2002–2012, by cause and gender
Table 2 shows that the causes of death for neonates differed by gender and across the two regions. SIDS was not in the top five causes of death for neonates of either gender; instead, congenital hypoplasia, trisomy, low birth weight, and severe neonatal asphyxia were the main causes of death. SIDS was the most common cause of death among postneonates across all genders and regions (Table 3). The other main causes of postneonatal death were trisomy, ill-defined or unknown cause, and asphyxia.
Table 2 Neonatal deaths (0–28 days) in Japan and Tohoku, 2002–2012, by cause and gender
Table 3 Postneonatal deaths (29–364 days) in Japan and Tohoku, 2002–2012, by cause and gender
Figure 4 shows the place of neonatal and postneonatal death in Japan and Tohoku by gender between 2002 and 2012 as well as in 2011, specifically. Between 2002 and 2012, we obtained data about the place of death for 27,431 infants in Japan and 1431 in Tohoku. More than 75% of infants died in hospital in both Japan and Tohoku. More postneonates than neonates died at home. The percentage of postneonates who died in other places in Tohoku was higher than for neonates in Tohoku or neonates and postneonates in Japan. For 2011, we collected data about the place of death of 2500 neonates, which included 166 in Tohoku. In Japan, over 90% of these children died in hospital, with the second largest group dying at home. In Tohoku, around 75% of neonates died in hospital (males = 73%, females = 78%), but around 50% of postneonates who were affected by GEJET died in other places (males = 44%, females = 42%).
Neonatal and postneonatal place of death (Japan and Tohoku) by gender (2002–2012 and 2011)
Characteristics related to the age of death of the infants
Table 4 shows the characteristics of the infants and their mothers according to the results of the conjoint analysis. Any data indicating over 43 weeks of gestation or where the weeks of gestation were unknown were removed from the dataset. The total number of observations was 27,002 in this model. The average VIF for each variable was 1.23 (1.01–1.65). There were no interaction variables. All six variables were, therefore, applied in this model with a standard significance level set at 5%.
Table 4 Attribution of the factors to the infant death age
Utility indicates average importance value on infant death age. These values provide a measure of the relative importance of the single factors for the determination of the utilities. The utility mean of the female infant death age was 2.4 days higher than that of males (64.6, 95% confidence interval [CI]: 63.1–66.1 vs. 62.2, 95% CI: 60.8–63.6). Infants of birth weight < 2499 g were on average 58.5 days old at death (95% CI: 57.1–60.0), and those of 2500 g or more were on average 70.9 days old (95% CI: 68.9–72.9).
Infants in the dataset whose gestational week was 37–42 (83.7, 95% CI: 81.9–85.3) lived on average 40.3 days longer than those whose gestational week was 22–36 (43.4, 95% CI: 41.7–45.0). Maternal primiparity (55.9, 95% CI: 54.4–57.5) was associated with an earlier age of death—on average, 13.0 days sooner than infants of multiparous mothers (69.1, 95% CI: 67.7–70.5). An earthquake of an intensity of less than six was associated with an average age at death 2.78 days later than one of greater intensity (65.1, 95% CI: 63.4–66.8 vs. 62.3, 95% CI: 61.0–66.8). The mothers' age and region were not statistically significantly different (p > 0.05).
Figure 5 presents the percentage of variation in age at infant death that can be attributed to particular characteristics (statistical significance level p < 0.05). The percentages indicate attribute importance values on infant death age. The higher the percentage, the more important factor in contributing to infant death age. As shown in this figure, 55.5% of the variation in age at infant death was most strongly attributed to gestational week (p < 0.001). The second most important factor was parity (18.0%, p < 0.001) and the third was birth weight (17.1%, p < 0.01). The contribution of a large earthquake during the year was much smaller (3.8%, p < 0.01), as was gender (3.3%, p < 0.05).
Percentage of variation in age at death that can be attributed to the characteristics. Note. gw = gestational week
To our knowledge, this is the first standardised statistics-based study of infant mortality with an official total sample size that has focused on the association between the infant death age and particular characteristics and that has covered both Japan in general and Tohoku. The infant, neonatal, and postneonatal mortality rates all gradually decreased in Japan from 2002 to 2012. In contrast, these rates in Tohoku region fluctuated. While the postneonatal mortality rates decreased during the period from 2002 to 2012 in Japan, mortality in the Tohoku region has increased since 2006 (Fig. 1, Fig. 2). Although it is proposed that postneonatal mortality is preventable, this study showed that the postneonatal death rates exceeded the neonatal death rates across Japan, which is not consistent with an earlier study [24,25,26]. One possible factor for this increase is GEJET and its associated events. Generally, rural areas have higher infant mortality than urban areas [27]. GEJET cased in Tohoku region where is a rural region in Japan. Moreover, Japan has only recently achieved the world's highest medical standard for mothers and infants at an early stage, so appropriate measures for disaster response and prevention for neonates and also postneonates did not exist at the time of the disaster. Hence, this oversight of the need to establish appropriate measures increased postneonatal death during the emergency in 2011. Even when obstetricians and gynaecologists, midwives, and paediatricians were dispatched to the disaster-affected areas, there were many isolated mothers and infants who were unable to receive adequate care [27]. Even if the perinatal facilities resumed in the afflicted area, some pregnant women and mothers with infants were not able to receive a newborn medical check-up in the afflicted area in 2011 [28].
We also found that the cause and place of infant deaths differed by gender and among neonates and postneonates and that such trends in the neonatal and postneonatal mortality rates changed in the last decade. Compared to Japan, more postneonates in Tohoku died outside of hospitals. This trend was remarkable in 2011. From these results, we can propose that it is necessary to provide appropriate care (e.g. access to healthcare, information, and maternal physical support that considers the vulnerability of the healthcare structure or health infrastructure) for postneonates in Tohoku during both a normal and an abnormal span.
In this study, we ranked the attribution of several infant and maternal characteristics to the variation in the age of infant death using conjoint analysis. The factor that made the most substantial contribution to the variation in age of infant death was the gestational week (55.5%). We found that a maternal gestational week of 36 or less was linked to an average age at death of 43.4 days, compared with 83.7 days for a maternal gestational week of 37 or later. This was the most extended death age in this model. Previous studies have suggested that the earlier the gestational week, the higher the infant's risk of death [28]. In terms of the biological mechanism, Matheus et al. reported that foetal development and gestational age had a linear correlation up to 34 gestational weeks [29]. They also suggested that foetal growth progresses rapidly between 20 and 38 gestational weeks. To expand related matters, Crump et al. suggested that early gestational age increases mortality in early childhood and young adulthood [30]. Considering these studies, the results of the present study suggest that birth during rapid progression would accelerate the risk of early death.
Low birth weight (under 2400 g) was the second largest contributor to a later date of death (70.9 days). Previous research has highlighted the effect of advanced maternal age on increasing the risk of infant death [15], but this factor was not statistically significant in our model (p < 0.05). Earthquakes were a stronger contributor to the variation in the age of infant death.
There have been several health promotion activities and action plans for the prevention of infant deaths in Japan; however, most have not focused on postneonatal deaths, and there is no framework for the prevention of postneonatal deaths. The increases in both the male and female postneonatal death rates were remarkable in the Tohoku region, which is characterised as a vulnerable earthquake disaster area.
In Japan as a whole, the infant death rates decreased in Tohoku across the period examined for this study, although there seem to have been few practical measures in neonatal/postneonatal care to improve the preparedness for natural disasters. While neonatal deaths are generally associated with the pregnancy and delivery periods, postneonatal deaths are more reflective of maternal physical condition and social conditions [31, 32]. In 2011, the number of postneonatal deaths outside of hospitals was higher than that of the other places of death in Tohoku. This result shows that it is necessary to pay more attention to differences in regional infant mortality trends and the effects of disasters. To reduce infant mortality, it is essential to develop supportive health policies and a community healthcare system for mothers. The healthcare system needs to provide appropriate care for newborns and infants, access to healthcare, and a support system for maternal health.
This study had several limitations. First, it covered only infant deaths. We were not able to compare this with infants who survived or to identify the odds ratio or relative risk among those who died or survived. The study also focused on Tohoku, which is an area that has been severely affected by earthquakes, particularly the GEJET disaster event. Further study is needed to compare this region and Japan as a whole with other regions that experience natural disasters. However, to the best of our knowledge, this is the first study to examine the cause of infant death in both the neonatal and postneonatal periods, and it has identified new age at death trends that are related to several maternal and infant characteristics in one particular region.
In Japan, the infant death rates declined steadily between 2002 and 2012, but the postneonatal death rates have recently become higher than the neonatal death rates, especially in a disaster-hit region. Little attention has been paid to postneonatal deaths in Japan, and most postneonatal deaths are preventable. Depicting regional differences in infant mortality as well as access to services and the coverage of interventions represents a powerful approach for assessing the inequities. Investigating the relationship between infant mortality trends and subnational or regional administrative units is critically important for understanding more proximal determinants and policy responses to the disparities [15]. Infant mortality reflects interactions between several regional factors, including the neonatal and postneonatal care in different locations, the vulnerabilities of public health systems, and the effect of natural disasters. Health planners should, therefore, draw on our study's findings to prioritise actions to resolve factors that are linked to age at infant death. Public health decision-makers should also consider regional characteristics when allocating medical and public health resources for both neonatal and postneonatal care.
The datasets supporting the conclusions of this article are officially available in the Infant Mortality of Vital Statistics Survey Death Form from the Ministry of Health, Labor and Welfare (MHLW) according to the Statistics Act (Act No. 53 of 2007). Access to the datasets is also limited unless appropriate permissions have already been obtained. In this study, the authors ordered infant death data logged in text files, including copies of Vital Statistics Survey Death Forms on magnetic media upon approval of MHLW in the official census forms in fiscal year between 2002 and 2012. Research involving anonymized records and data sets exist in the public domain. Therefore, it is not possible to identify individuals from the information provided. Furthermore, after this study concludes, those infant death forms are to be crossed out. Hence, the authors could not share our data since doing so is strictly prohibited by the vital statistical law in Japan. When an inquiry about the dataset is needed, an application is required for MHLW (https://www.e-stat.go.jp/surveyitems/surveyforms/01201).
GEJET:
the Great East Japan Earthquake and Tsunami
ICD-10:
10th Revision of the International Classification of Diseases
MHLW:
Ministry of Health, Labour, and Welfare
SIDS:
VIF:
variance inflation factor
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This article is derived from a common research project, Personal Health Record (PHR) sponsored by Japan Agency for Medical Research and Development and Health and Research on Health Security Control sponsored by Labor Sciences Research Grants.
The sponsorship was provided by the Japan Agency for Medical Research and Development, "Personal Health Record (PHR) Research Project, PHR Model for Supporting Pregnancy, Delivery, and Childbearing" (FY 2016-2018) and Health and Labor Sciences Research Grants (Research on Health Security Control) "Research on the Development of a Regional Collaborative Disaster Prevention System Including the Operation of Welfare Shelters for Those Who Require Assistance in Times of Disaster with the Central Focus on Pregnant and Nursing Women and Infants" (FY: 2013–2015); Grant No. H25-Kenki-Wakate-016. The views in this present work are merely those of the authors and do not reflect those of the funding organization.
Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi, 9800845, Japan
Ai Tashiro
Division of Establishment for Graduate School of Health Innovation, Kanagawa University of Human Services, 2F Bldg.2-A, 3-25-10, Tonomachi, Kawasaki-ku, Kawasaki, Kanagawa, 2100821, Japan
Honami Yoshida
Department of Health & Welfare Management, the University of Fukuchiyama, 3370, Azahori, Fukuchiyama, Kyoto, 6200000, Japan
Etsuji Okamoto
AT designed the study and methodology, conducted the analysis, and drafted the manuscript. HY conducted the analysis, partly drafted the manuscript, and assisted in manuscript revision. EO provided information about data sources and materials and assisted in manuscript preparation. All authors read and approved the final manuscript.
Correspondence to Ai Tashiro.
The consent for publication is not relevant to this study.
Tashiro, A., Yoshida, H. & Okamoto, E. Infant, neonatal, and postneonatal mortality trends in a disaster region and in Japan, 2002–2012: a multi-attribute compositional study. BMC Public Health 19, 1085 (2019). https://doi.org/10.1186/s12889-019-7443-4
Trends in infant mortality
Neonatal/postneonatal
Conjoint analysis
Great East Japan earthquake and tsunami

redpajama_set_name: RedPajamaCommonCrawl


text:
Les personnes lesbiennes, gays, bisexuelles et transgenres (LGBT) en Mongolie peuvent faire face à des difficultés légales que ne connaissent pas les résidents non-LGBT.

Bien que la législation ait évolué, décriminalisant l'homosexualité et protégeant les LGBT, des violences et des crimes sont toujours commis envers des personnes en raison de leur identité de genre ou leur orientation sexuelle.

Législation sur l'homosexualité
Au , les lois de Gengis Khan condamnaient à mort les hommes coupables de sodomie dans l'Empire mongol.

L'homosexualité est criminalisée en 1961. Elle peut être punie de prison jusqu'en 1989.

Toute mention à l'homosexualité disparaît du code criminel de la Mongolie en 1993, la légalisant de fait.

Les personnes LGBT sont protégées contre les discriminations à leur encontre. La discrimination à l'embauche envers les personnes transgenres reste cependant courante.

Reconnaissance légale des couples homosexuels
Les couples homosexuels ne bénéficient d'aucune reconnaissance légale. Les mariages homosexuels contractés à l'étranger ne sont pas reconnus.

Adoption homoparentale
L'adoption homoparentale n'est pas autorisée.

Tableau récapitulatif

Références

Annexes

Article connexe
 Droit mongol

Liens externes
 Mongolie : information sur la situation des minorités sexuelles, y compris les lois, le traitement réservé aux minorités sexuelles par la société et les autorités, la protection offerte par l'État et les services de soutien à la disposition des victimes, Refworld/UNHCR

LGBT
Mongolie
LGBT en Mongolie

redpajama_set_name: RedPajamaWikipedia


The Library is ready to deploy a new course reserve system called Ares, which is widely used in academic libraries throughout North America. Ares will streamline the reserves process for both faculty and staff through self-service, and the new system will be integrated with Nexus, allowing students to access items from within their Nexus courses. In anticipation for the system going live for the Spring 2017 session, the Library will host training sessions to orient staff, instructors, and faculty.
WHEN: 1C16B on Tuesdays between March 21st and April 18th from 12:30-1:30pm.
For more information, contact Michael Dudley.


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The Fed's Third Mandate: A Tool to Determine When Policy Pivots?
Co-Head of Investments Jeff Klingelhofer argues that the Fed's third mandate may help signal the timing of the next policy shift.
By Jeff Klingelhofer, CFA
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Beneficiaries of Europe's REPower Plan
As the European Union rethinks its energy supplies, we believe the shift away from Russian gas may create significant growth opportunities for investors.
By Joseph Santos & Ben Song, CFA, FRM, CIIA
Emerging Markets Confront Political Hurdles in the Near Term
Portfolio Manager Josh Rubin discusses significant political events in emerging markets that may impact investors.
By Josh Rubin
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Blockchain on the Brink of an Investment Revolution
Portfolio Manager and Managing Director Sean Sun explains the paradigm shift around blockchain technology and the opportunities it presents for investors.
By Sean Koung Sun, CFA
Navigating the Post-COVID Resurgence in Travel and Hospitality
As the storm that crushed the travel and lodging industries clears, we see post-Covid investment opportunities and pitfalls in the skies ahead.
By Julian Serafini, CFA
Is the Fed Gambling with Markets & the Economy?
Jason Brady believes "We're not going to see anything near the Fed's 2% target inflation… forcing the Fed to continue to be very hawkish."
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Louis XV style armchair with classic lines and beech wood structure. The armchair is upholstered with webbing and superior quality foam and has a comfortable padded seat cushion. The upholstery can be customised with nails, braiding, double welt or welt.


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Best is anything that carries the quality to touch our heart. Best thing is so secret that a man may not be able to realize so. Let us take an example: there was a man who was a farmer and didn't knew the value of diamond. He used to treat that as a stone.


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Passports and fake marriages: Politics on TV, Oct. 26 edition
Talking about e-passports, tenderized meat, and fake marriages
By Maclean's October 26, 2012
"We're cracking down on these fraudulent marriages."
Questions not answered
Why did it take the Public Health Agency seven years to do anything about the problem of contamination through tenderized meat?
John Baird:
John Baird was on Power & Politics to talk about the new e-passports unveiled this morning. Baird said that the new passports contain a computer chip as a counter-fraud initiative similar to one many other countries have also been using it. Baird said that the new images were those they felt would celebrate the country. When asked about the current situation in Syria, Baird said they were taking every diplomatic action necessary, that we have some of the toughest sanctions on Syria, and are providing humanitarian assistance.
Baird was also on Power Play, where he added that the Syrian economy has largely collapsed because of the sanctions, and that sanctions were also having an effect in an Iran after their currency collapsed. With regards to the UN, Baird said that he is calling for the resignation of the UN rapporteur who is calling for boycotts of Israel.
Marriage Fraud:
Don Martin spoke with Jason Kenney about his plans to crack down on fake marriages. New rules came into effect today, which means that there is a two-year probation period before marriages are considered legitimate for the purpose of permanent residency. Kenney said there is an industry of fake marriage sponsorships, and that this will create a real barrier to that kind of immigration fraud.
Kenney was also on Power & Politics, where he added that there is a 20 per cent rejection rate for foreign marriages, and there is a problem where they divorce upon arrival and sponsor their real spouse from their home country. Kenney said that immigrant communities asked him to fix this problem. When Thibedeau asked what happens if marriages break down legitimately before that two years is up, Kenney said that if there is domestic abuse, that will not count against them.
Tenderized meat:
With tenderized meat having been pointed to as one of the links with the E. Coli outbreak, Thibedeau assembled an MP panel of Kellie Leitch, Malcolm Allen, and Mauril Bélanger to ask if there was a need to add warning labels. Leitch intimated that it took so long for PHAC to address the situation because it takes forever to get something through the Commons, and that voluntary measures were more expedient. Bélanger said that a measure to address a risk to public safety would move quickly through the House, and that labels should be mandatory rather than relying on store signage. Allen said that labelling is done by regulations, and wouldn't need to come before the Commons.
International trade relations:
Power Play's strategists panel of Gerry Nicholls, Anne McGrath and Marlene Floyd talked about the Petronas decision with a week of added perspective. Nicholls said that he thought the Conservatives were about to be all for free trade and investment, so it's no wonder foreign companies are wondering what's going on. McGrath noted the drama around how the decision was handled, and that the government is scrambling as the file is getting away from them. Floyd pointed to the amount of global uncertainty with Canada being "open for business," and that there is no transparency or clarification that was promised two years ago.
Attawapiskat:
Martin spoke to NDP MP Charlie Angus about the First Nations community of Attawapiskat one year after they declared a state of emergency. Angus said that the community is a little further ahead, the trailers made a difference and the school is finally getting built, but there is still no plan. Angus noted that the community sat down with CMHC to build 30 homes on a rent-to-own basis, but the government spiked the deal. While Attawapiskat is no longer under third-party management and has been largely vindicated, Angus said there are other communities in similar circumstances, and there seems no momentum on fixing them.
Supreme Court:
Martin spoke with Constitutional lawyer Eugene Meehan about the busy docket at the Supreme Court. Meehan said that it's not unusual that the Court is overturning so many lower court decisions given their mandate. With regards to the split decision with Etobicoke Centre, Meehan said that dissents are generally very strong, and it's not common but certainly not rare for the Chief Justice to be in the dissent. He said that the Bedford appeal around prostitution laws is definitely a case that is in the public interest.
MP pensions:
With the MP pensions bill not whipping through the Senate as it did through the Commons, and Senator Grant Mitchell's concerns that the reduction in net pay for MPs as a result of these changes could open them up to bribery, Thibedeau asked the Friday Power Panel about it. Kady O'Malley noted that there was no debate in the Commons, so it's not really a bad thing that it'll get scrutiny in the Senate. Greg Weston noted that most people won't have sympathy for this, but agreed that no one was really allowed to debate this issue. Rob Russo felt that Senator Mitchell rather doused himself in "political gasoline," while Kelly Cryderman said that Senators can speak their minds more freely, and there is still the debate on how to attract quality candidates.
When Don Martin asked journalists Stephen Maher and Mia Rabson about this issue, Rabson said bribery shouldn't be out of the realm of the discussion, given what is taking place in Quebec, but that Mitchell's arguments won't get much traction. Maher agreed that in a way, the concern was legitimate but that people don't take bribes because of pay cuts, but because they're crooked – and then brought up how Mulroney took cash payments from Karlheinz Schreiber.
Reviewing the fighter jet procurement:
The news that the government is looking for another independent review of the fighter jet procurement process was also put to P&P's Power Panel. Russo said the military really doesn't want anything other than the F-35s, but the government needs to show the public they're on the right course, lest they lose the lustre they gained with the shipbuilding procurement process. Weston noted that we are ten years into this fighter jet procurement process, and that this new review is a PR exercise designed to convince the public there is some level of competition in play. O'Malley said the new call for the new review is worded in such a way that it seems to be asking for a "good news version" of the Auditor General's report.
FILED UNDER: Maclean's Politics POLITICS ON TV


I don't think I've ever truly known when to walk away from the work, think of it as done. This may explain why it takes me too long to finish a novel or a short story: this created planet, spinning on its axis, keeps falling into rhythms of day and night that I then eventually accept that's the way things are, that I have to continue living in the world long after I have to so that the story I've told feels authentic, alive.
Even today I thought of new ways I could make Lizzie grow into that house on Second Street, make it small like a pocket: there she is hiding dirty clothes in the walls; there rubbing her back against a door knob; there singing at the top of her lungs; there holding clandestine dinner parties while Andrew and Abby are at the Swansea property; there at night going up to the attic to watch Bridget sleep.
The same could be said for all the characters in See What I Have Done: they keep living in the house, keep knocking loudly on my dreams, keep telling me their stories, hoping I might add something, anything, to the novel and see how it pans out. Even Benjamin, the fiction character I have inserted into the overall Borden story, is such a strong presence in my everyday thoughts at the moment that I'm tempted to write a novella all about his missing years (if you ever do read the novel you'll know the years I refer to) just so that I can feel that I've explored every aspect of him as much as I can. I see him travelling along the East Coast of America, knocking on doors asking to be let in. I see him in punch up after punch up, collecting broken teeth, strange tooth fairy. I see him hide in woods, hunt deer, hunt revenge, see him as war soldier, a drifter. I see him.
I know other writers go through this and I know it won't be the last time I experience it either. What shocks me the most is how this world building has sustained itself even as I edge closer to the very last edits and proof reads of the novel. I am so over this novel that the very idea of writing anything more makes me want to slip from my skin.
What is this thing that I'm experiencing? Is this an inability to let go of something that has been a part of my life for so long? Could the novel genuinely do with more? Am I creatively afraid to move onto the next family in 'Blue Mountain' because I think I wont know how to write new people? Have I let Lizzie orbit around me for so long that I'm stuck with her?
Is this a type of love?
This afternoon I listened to an interview (podcast) with Michael Robotham at the Sydney Writers' Festival and was relieved to hear him speak about writers and obsession. Maybe I should just accept this and embrace it?


text:
La Serie A2 1980-1981 è stata la prima edizione del nuovo secondo livello della 50ª stagione della pallacanestro femminile in Italia.

Girone A
 Ginnastica Comense 1872 pt.44 --> Promossa in Serie A1
 Unicar Cesena pt.44
 Banco Ambrosiano Milano pt.40
 Busto Arsizio pt.40
 Abano Basket pt.30
 Alcione Rapallo pt.24
 Galli San Giovanni Valdarno pt.24
 Pallacanestro Crema pt.24
 Codroipo pt.20
 Ancona pt.20
 Annabella Pavia pt.18
 Libertas Bologna pt.18
 Pisa pt.14
 Edelweiss Albino pt.14

Girone B
Posizioni alla penultima giornata:
 Varta Pescara pt. 48
 Pasta Matic Napoli pt. 40
 Play Basket Barletta pt. 36
 Santa Marinella Basket pt. 33
 Corvo Palermo pt. 32
 CUS Chieti pt. 24
 Pall. Avellino pt. 20
 Scuderi Viterbo pt. 20
 Priolo Basket pt. 16
 Cong. Cagliari pt. 16
 Talbot Stabia pt. 16
 CUS Cagliari pt. 16
 S.Orsola Sassari pt. 12
 CUS Siena pt. 8

Verdetti
 Promosse in Serie A1:  Como e Pescara
 Retrocesse in Serie B:  Siena.

Note

Pallacanestro nel 1980
Pallacanestro nel 1981
1981


text:
Vol 9 No 2 (2019) /
Ichthyofaunal diversity of Ranjit Sagar Wetland situated in the northwestern Himalayas
Onkar Singh Brraich Department of Zoology and Environmental Sciences, Punjabi University, Patiala, Punjab, India
Sunil Kumar Saini Department of Biotechnology and Medical Sciences, Baba Farid College, Deon, Bathinda, Punjab, India
DOI: https://doi.org/10.14712/23361964.2019.14
Keywords: abundance, habitat loss, species richness, threatened species
Diversity of fishes was evaluated at the Ranjit Sager Wetland and its three adjoining streams. Factors like altitude, bed gradient, dominated substratum and habitat types of the streams have also been studied. These streams fall under Type-B category on the basis of habitat variability, gradient and sinuosity. 43 fish species represented by 6 orders have been reported from the study area. Out of all 43 fish species, 13 come under threatened categories of Red List of IUCN, out of which 2, 3 and 8 come under Endangered (EN), Vulnerable (VU) and Low Risk near threatened category (LRnt) respectively. It has been analyzed from the above pattern that maximum fish species reported from this wetland have fallen under different threatened categories.
Copyright (c) 2019 Onkar Singh Brraich, Sunil Kumar Saini
The journal applies the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0) to articles and other works we publish. If you submit your paper for publication by European Journal of Environmental Sciences, you agree to have the CC BY license applied to your work. The journal allows the author(s) to hold the copyright without restrictions.
Published by Charles University in Prague
Karolinum Press, Ovocný trh 3-5, 116 36 Praha 1, Czech Republic


text:
September 10, 2019-KB4514359 Cumulative Update for .NET Framework 3.5 and 4.8 for Windows 10 version 1903 and Windows 10 version 1909
.NET Framework 3.5 and 4.8
An elevation of privilege vulnerability exists when the .NET Framework common language runtime (CLR) allows file creation in arbitrary locations. An attacker who successfully exploited this vulnerability could write files to folders that require higher privileges than what the attacker already has.
To download and install this update, go to Settings, Update & Security, Windows Update, and then select Check for updates.
For a list of the files that are provided in this update, download the file information for cumulative update 4514359.
Last Updated: 3 Oct 2019
History of Cumulative Updates for .NET Framework for Windows 10, version 1903 and version 1909
January 12, 2021 — KB4586878 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903, Windows Server, version 1903, Windows 10, version 1909 and Windows Server, version 1909
November 10, 2020 — KB4580980 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903, Windows Server, version 1903, Windows 10, version 1909 and Windows Server, version 1909
October 13, 2020 — KB4578974 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903, Windows Server, version 1903, Windows 10, version 1909 and Windows Server, version 1909
September 16, 2020 — KB4576947 Cumulative Update Preview for .NET Framework 3.5, 4.8 for Windows 10, version 1903, Windows Server, version 1903, Windows 10, version 1909 and Windows Server, version 1909
September 8, 2020 — KB4576484 Cumulative Update for .NET Framework 3.5 and 4.8 for Windows 10, version 1903, Windows Server, version 1903, Windows 10, version 1909 and Windows Server, version 1909
August 20, 2020 — KB4570723 Cumulative Update Preview for .NET Framework 3.5, 4.8 for Windows 10, version 1903, Windows Server 1903 RTM, Windows 10, version 1909 and Windows Server, version 1909
August 11, 2020 — KB4562900 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903, Windows Server 1903 RTM, Windows 10, version 1909 and Windows Server, version 1909
July 21, 2020 — KB4562900 Cumulative Update Preview for .NET Framework 3.5, 4.8 for Windows 10, version 1903, Windows Server 1903 RTM, Windows 10, version 1909 and Windows Server, version 1909
July 14, 2020 — KB4565633 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM and Windows 10, version 1909 and Windows Server, version 1909
May 12, 2020 — KB4552931 Cumulative Update for .NET Framework 3.5 and 4.8 for Windows 10 Version 1903 and Windows Server 1903 RTM and Windows 10, version 1909 and Windows Server, version 1909
February 27, 2020 — KB4537572 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM and Windows 10, version 1909 and Windows Server, version 1909
January 14, 2020 — KB4532938 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM and Windows 10, version 1909 and Windows Server, version 1909
December 10, 2019 — KB4533002 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10 Version 1903 and Windows Server 1903 RTM and Windows 10, version 1909 and Windows Server, version 1909
October 24, 2019 — KB4522741 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10 Version 1903 and Windows Server 1903 RTM and Windows 10, version 1909 and Windows Server, version 1909
October 8, 2019 — KB4524100 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM
September 26, 2019 — KB4522738 Cumulative Update for .NET Framework 3.5 and 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM
September 10, 2019 — KB4514359 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM
August 30, 2019 — KB4511555 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903
July 9, 2019 — KB4506991 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM
June 25, 2019 — KB4502584 Cumulative Update for .NET Framework 3.5, 4.8 for Windows 10, version 1903 and Windows Server 1903 RTM
May 14, 2019 — KB4495620 Cumulative update for .NET Framework 4.8 for Windows 10, version 1903


text:
Paul McCartney and Nirvana's Krist Novoselic Helter Skelter
Paul McCartney's One on One tour made a stop in Seattle Sunday night. While in the birthplace of grunge, McCartney was joined by Nirvana bassist Krist Novoselic for a performance of the Beatles classic "Helter Skelter."
You can watch fan-recorded footage now on YouTube.
"Paul McCartney is the best!" Novoselic tweeted after the performance.
McCartney and Novoselic previously worked together on a song called "Cut Me Some Slack," which also featured Dave Grohl on drums. The track won Best Rock Song at the 2014 Grammys.
The One on One tour continues April 19 in Vancouver.
Missed Laurel Gary & Mark? Catch up by clicking play below and join us from 5:30AM every weekday!
This 3 Year Old Is A Way Bigger Led Zeppelin Fan Than You
Chris Isaak Live At Day On The Green
Patient Pup Walks Slowly So Elderly Owner Can Keep Up
JAMcast - April 18 2016