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Access to the conference
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The 5EDA organizers would like to express their gratitude to the sponsors which support have made the conference possible.
UNADEV
L’Union Nationale des Aveugles et Déficients Visuels (UNADEV) – The National Union of Blind and Visually Impaired was created in 1929 in Bordeaux, France. It is a registered association for assistance and charity. For over 90 years, UNADEV has grown nationwide through eight different regional centers and numerous local partner associations. Our actions focus on three missions: providing help and support to visually impaired people for their social and professional inclusion; raising awareness and informing the general public and decision-makers; supporting medical research and prevention of blinding diseases.
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Like all other European or American National Dermatology Societies, the French Society of Dermatology was born at the end of the 19th century, more exactly in 1889.
In addition to the dissemination of knowledge through presentations and publications, the Society also aims to support and promote clinical research and fundamental research in France. For more than 20 years, it has devoted a large part of its budget to the financing of unique and innovative projects. It has thus remained true to the purpose of its creators after more than 120 years of existence.
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IBM Center for The Business of Government
Donald E. Wynn, Jr.
Submitted by rgordon on Mon, 04/23/2018 - 14:35
Donald E. Wynn, Jr. is an associate professor in the School of Business Administration at the University of Dayton. He holds a PhD in Business Administration from the University of Georgia. His research appears in journals such as MIS Quarterly, MIS Quarterly Executive, the Information Systems Journal, Cutter IT Journal, the Journal of Organizational and End User Computing, Communications of the AIS, and the Journal of the Academy of Marketing Science.
Read more about Donald E. Wynn, Jr.
Making Open Innovation Ecosystems Work: Case Studies in Healthcare
Submitted by rgordon on Sat, 12/30/2017 - 20:19
Broadcast Date:
Renee M. E. Pratt
What is Open Innovation and is it Successful?
Case Studies Illustrating Open Innovation
Three Best Practices
Read more about Making Open Innovation Ecosystems Work: Case Studies in Healthcare
Submitted by rgordon on Wed, 09/16/2015 - 10:23
In the mist of tightening budgets, many government agencies are being asked to deliver innovative solutions to operational and strategic problems. One way to address this dilemma is to participate in open innovation. This report addresses two key components of open innovation:
Associate Professor, Management Information Systems, Operations Management, and Decision Sciences Dept
300 College Park Drive
Dayton, OH 45469-2130
wynn@udayton.edu
Donald E. Wynn, Jr. is an associate professor in the School of Business Administration at the University of Dayton. He holds a PhD in Business Administration from the University of Georgia. His research appears in journals such as MIS Quarterly, MIS Quarterly Executive, the Information Systems Journal, Cutter IT Journal, the Journal of Organizational and End User Computing, Communications of the AIS, and the Journal of the Academy of Marketing Science. He has published research articles in a number of areas, including open source software, behavioral information security, EHR software, technological ecosystems, and research methodologies.
Copyright © 2018 IBM Center for The Business of Government
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Subscribe to the IBM Center general e-Newsletter
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Ruth Wilson papers
The Ruth Wilson papers date from 1957 to 2002 and measure 2.5 linear inches.
The papers are comprised of correspondence and the book The Forty Best Exotic Trips on the Planet. The correspondence dates from 1957 to 1959, and contains letters to her parents from Germany where Wilson worked for the Stars and Stripes. The letters and postcards contain observations of Post-War Europe, and information concerning her professional life. The Forty Best Exotic Trips on the Planet is a compilation of journal entries and photographs of Wilson and her husband's many worldwide experiences between 1989 and 2000. The collection includes Wilson's obituary and a memorial testimony given by Joseph Gingery.
Wilson, Ruth, 1924-2002 (Person)
Copyright held by the donor has been transferred to The University of Iowa.
Ruth Wilson was born on July 11, 1924 in Wayne, Nebraska. She attended grade school in Wayne, until the Wilson family moved to Iowa so her father could receive his doctorate degree. While attending high school in Iowa City, Wilson was introduced to journalism and held several positions pertaining to the subject, including state president of the high school journalism group. Wilson attended the University of Iowa, and began working at the Daily Iowan. After graduating from the University of Iowa with a Baccalaureate of Arts degree, she was hired as the telegraph editor for the Cedar Valley Daily Times in Vinton, Iowa, and then at the Telegraph Herald in Dubuque, Iowa. Here she served as a reporter, assistant state editor, and then the state editor. Developing a desire to travel, Wilson obtained a position in Germany for Stars and Stripes, the Army newspaper. Wilson lived in Darmstadt where she gained experience and traveled the European continent. Upon returning to the U.S., Wilson was hired at the Milwaukee Journal, and remained there for twenty-five years, eventually working her way up to the contact editor position. Wilson married Joe Gingery, a widower with whom she had worked at the Milwaukee Journal, on August 31, 1980, and they both kept their original last names. They traveled around the world together between the years 1989 to2000, and together compiled a book, The Forty Best Exotic Trips on the Planet. Wilson died unexpectedly on July 16, 2002.
2.50 linear inches
Journalist who worked for the Stars and Stripes in postwar Europe.
The papers (donor no. 863) were donated by Bu Wilson and Joseph Gingery in 2002.
Other Descriptive Information
http://sdrc.lib.uiowa.edu/iwa/findingaids/html/WilsonRuth.htm#content
Darmstadt (Germany)
Gingery, Joseph
Nineteen fifties
Wilson, Ruth, 1924-2002
wa00012. Women and War
wa00012/wa00012.2. Women on the Home Front
Andrea Sheehan, 2003.
External Documents
Other URL
Ruth Wilson papers, Iowa Women's Archives, The University of Iowa Libraries, Iowa City.
Ruth Wilson papers, Iowa Women's Archives, The University of Iowa Libraries, Iowa City. http://aspace.lib.uiowa.edu/repositories/4/resources/2425 Accessed January 17, 2021.
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Microsoft word - v15-1_all_2005-b.doc
Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems Health worker confidence in diagnosing and treating mental health
problems in Papua New Guinea
Betty E. Koka, Frank P. Deane and Gordon Lambert
Illawarra Institute for Mental Health University of Wollongong Abstract
Confidence in identifying different diagnostic categories of mental disorders by general health workers who provide the bulk of Papua New Guinea's (PNG) mental health care is vital for the country's provision of mental health care. Making a psychiatric diagnosis is complicated by PNG's diverse culture and estimated 800 distinct languages. These cultural-linguistic factors influence help-seeking behaviour and continued use of traditional treatment despite the introduction of western approaches to mental health care. The aim of this study was to determine the confidence of health workers in identifying and diagnosing different categories of mental health problems in this complex environment. A sample of 209 Papua New Guinea health workers from four geographic regions completed a questionnaire that assessed background levels of training and confidence in diagnosing a range of modern and culture specific diagnoses. Overall, respondents reported relatively little prior mental health training. Consistent with this were the relatively low levels of confidence for culture specific diagnoses (e.g. sorcery), but significantly higher levels of confidence with modern diagnoses (e.g. depression). The implications of the findings for training and provision of mental health care are discussed. Traditional treatments based on cultural beliefs about the causes of mental illness remain an important part of health care in developing countries including Africa (Jeiyeoba, 1988; Roberts, 2001), Asia (Razali & Najib, 2001; Zhang, 2001), the Middle East (Al-Krenawi, Graham, Ophir & Kandah, 2001) and India (Banerjee & Roy, 1998; Chadda, Agarwal, Singh & Raheja, 2001). Even in highly developed countries like the United States of America, migrant populations continue to seek traditional alternatives prior to using western treatment (Flaskerud, 1986; Kim, et al., 2002). This suggests that traditional medicine plays an important role in both developed and developing countries where economic and cultural factors affect access to western mental health care. It also suggests that deep-seated cultural beliefs may be a major barrier to the uptake of western psychiatric treatment (Razali & Najib, 2000). • Traditional beliefs concerning causes of mental illness ("longlong" in Pidgin or "Kavakava" in the Motu language or "Kiakaenge" in the "Enga" language) and other physical illness in Papua New Guinea (PNG) are widely centred on sorcery, South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems witchcraft, spirit possessions/supernatural agents, violation of social norms and "taboos", and illnesses due to no known cause (Sinclair, 1957; Burton-Bradley & Julius, 1965; Langness, 1965; Burton-Bradley, 1973; Lewis, 1975; Robin, 1979; Frankel, 1986; Hamnett & Connell, 1981; Lepowsky, 1990; Stavovy, 1996). Spirits and supernatural agents are believed to cause illness when an individual or a group has violated social taboos and norms or have failed to fulfil culturally expected obligations. Alternatively, illness caused by sorcery and witchcraft is thought to be related to frustrations, jealousy of achievements of others, anger, and revenge/payback. Chronic illness and death are almost always attributed to sorcery. Sorcery is commonly used both to explain the cause of illness and as a form of treatment. • Illnesses attributed to both sorcery/witchcraft and spirit possession/supernatural agents are commonly known as illnesses of the settlement/village or "sik bilong ples" (Hamnett & Connell, 1981). Illness not attributed to sorcery/witchcraft and spirit possession/supernatural agents are commonly known as just an illness or "sik nating." These include simple acute illness and seasonal or environmentally associated illnesses such as the common cold, diarrhoea and fever during fruit/nut season (Hamnett & Connell, 1981). "Sik nating" also includes abnormal behaviours of excessive laughing, singing and self-decorating during the mushroom season ("mushroom madness") and during pundanus nut season ("pundanus madness") (Reay, 1960, 1965). Persons affected by the seasonal illnesses usually recover without treatment. Illnesses believed introduced to PNG as a result of western contact are known as "illness of the white man" or "sik bilong waitman." These include problems associated with lifestyle changes such as diabetes, heart disease and cancer. In the case of mental illness factors associated with immigration from rural areas into urban centres have created major lifestyle problems including the break down of cultural norms, unemployment, increased consumption of alcohol and use of substances such as cannabis (PNG Department of Health, 2000). Beliefs about causes of psychological and physical illness also influence help-seeking behaviours. Traditional treatment is usually sought prior to western treatment. For example, a study by Stavovy (1996) found that patients with a diagnosis of schizophrenia sought traditional treatment at some point during the course of their illness. Other studies have reported the use of traditional treatment prior to and alternately with western treatment despite the introduction of formal western health care in the 1950's (Burton-Bradley, 1965, 1973; Pulsford & Cawte, 1972; Hamnett & Connell, 1981; Frankel, 1986; Lepowsky, 1990; Stavovy, 1996; Decock et al., 1997). Another interesting distinction is that western treatment is seen as cure for symptoms whereas traditional treatment is seen as a cure for the cause of the illness (Hamnett & Connell, 1981; Frankel, 1986). Traditional treatment involves four main types of healing processes: medicines, spells, rituals and counselling (Stavovy, 1996, p.135). The medicines used include a range of herbal plant parts such as leaves, stem, roots, flowers and seeds. Animal sacrifices in part or whole are also included as medicine. A form of words repeatedly chanted during the healing process represents the spell. The ritual involves a traditional specialist, using medicine and the words of the spell, carried out as a whole healing process or act. These healing practices are also used for protection against sorcery, spirits and supernatural agents that cause illness and misfortunes. The fourth type of treatment involves counselling the concerned individual and others who may be seen as contributing to the problem by either the head of the family, elders or the chief of the clan or tribe. The outcome of the counselling session usually ends with the counsellor telling the client(s) what to do to help solve the problem. The type of treatment applied is dependent on the varied cultural South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems beliefs regarding the cause of the illness. The most widely practised traditional treatment described in the literature appears to be sorcery. Sorcery is used to treat illnesses believed caused by sorcery. Sorcery practice can also be performed for prevention and protection from illness and other misfortunes. Sorcery beliefs and practices in relation to; cause of illness, diagnosis of sorcery as a form of culture specific diagnosis, use of sorcery as a form of treatment, prevention, and protection are influenced by strongly held cultural beliefs and languages. Cultural beliefs and languages are inseparable and are likely to resist change. Sorcery involves the art of black magic or spells by a sorcerer or witch. It is also known as "posin" (or poison) in Neo Melanesian Pidgin or "puripuri" in motu. Sorcery is also identified as poison because sorcery and poisoning tend to overlap in some cultures. Similarly, the sorcerer is described as "man bilong workim posin" in Pidgin. How the sorcery is believed to be performed by the sorcerer or witch varies among individuals and cultural-linguistic groups (Stavovy, 1996). For example in some cultures the sorcery or magical ritual may occur directly by administering certain types of poison in drinks or food, it may also be performed using body parts of the victim such as hair, or using scraps of left over food from the victim and/or the victims clothing. Hair, clothing, left over food and other belongings of the victim may be buried in cemeteries where dead spirits can have access and make the victim mentally ill ("longlong"). In some cultures it is believed that spirits can be sent to the victim by the sorcerer to make the victim ill. These provide just a few examples of widely varying sorcery practice in PNG. Most people fear sorcery and witchcraft and do not discuss such issues for fear of illness and misfortune. Sorcery attributed illnesses appear to be linked with anger and revenge or "payback" for insults or death, and jealousy of others' achievements. However, not all sorcery is bad, a sorcerer can also perform sorcery to promote health and protect one from illness and misfortunes (often invoked by sorcery and witchcraft). Sorcery can also be used for matchmaking and love potions. Spirit possession is usually thought to involve evil spirits and spirits of dead family members or ancestors. Spirit possession is often believed to occur as a punishment for crime, or misbehaviour such as violation of social "norms" or "taboos". Violation of norms or taboos might involve trespassing restricted areas where ancestral spirits and evil spirits dwell or not fulfilling socially required obligations such as looking after parents when they are old. For example, if a sibling has not been good to the parents while they were living, then the spirits of the dead parents are believed to come back to punish the offspring and make him/her mentally unwell. Whilst there are some common beliefs about spirit possession and sorcery across cultures, beliefs about different types of spirit possession and sorcery that lead to mental illness also vary across cultures in PNG and between the different cultural-linguistic groups (Stavovy, 1996). Sorcery and witchcraft are the most widely practiced and feared traditional practices that are believed to cause both psychological and physical illness and form the basis for most traditional treatment (Sinclair, 1957; Burton-Bradley & Julius, 1965, Burton-Bradley 1965, 1973; Pulsford & Cawte, 1973; Frankel, 1986; Lepwosky, 1990; Stavovy, 1996). Sorcery and witchcraft beliefs and practices are feared for their powers even among some educated Papua New Guineans. For example, a study by Burton-Bradley (1990) found 84 percent (n = 110) tertiary education students believed sorcery practice has the power to cause illness. Stavovy, (1996, p.103) also found that patients suffering from schizophrenia believed sorcery and spirits possession to be the cause of their illness. These and a number of other studies support the reports that there is wide practice and belief concerning sorcery to be the cause of mental illness as well as other chronic and serious physical illness (Hamnet & Connell, 1981; Frankel, 1986; Stephen, 1987; Lepowsy, 1990). The strength of these beliefs and their high resistance to change are important considerations when caring for persons with both psychological and physical illness Stephen (1987) warns "to ignore beliefs in sorcery is to ignore an important dimension in any problem" (Stephen, 1987, p.1). South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems However, the Papua New Guinea Health Department in its recent policy to promote traditional medicine for the next decade has excluded sorcery and witchcraft related practices as forms of traditional treatments (PNG Department of Health, 2000). The rationale for this decision is based on one factor that they are inherently dangerous practices and should not be given legitimacy (PNG Department of Health, 2000). However, there are no data to distinguish between dangerous and non-dangerous forms of sorcery and witchcraft practices. While a number of studies have examined the beliefs about causes of mental illness and individual psychotic reactions in different cultural-linguistic groups in general population (Sinclair, 1957; Reay, 1960; 1965; Rodrique, 1963; Newman, 1964; Burton-Bradley & Julius, 1965; Langness, 1965; Salisbury, 1967; Hoskins et al., 1969; Lewis, 1975; Stavovy, 1996), little is known about the knowledge and confidence of general clinical health workers in the use of both modern and cultural mental health approaches to the treatment of mental illness in such a complex environment. There are several factors that are likely to impinge on what general clinical health workers know about mental health issues and their ability to diagnose mental health problems/disorders. Perhaps foremost is the amount of training they have received. However, there are also substantial differences in the reliability of "classification" related to culturally specific disorders and Western systems of diagnosis. For example, the common culture specific "diagnoses" identified and included in the present study also overlap considerably with beliefs/perceptions concerning the causes of both mental illness and physical illness. Thus, they may not be seen as a diagnosis in the same way as defined by Western classification systems. With traditional culture specific mental illnesses in most instances there is little distinction between causes and the "diagnosis". Thus, the conceptualisation and classification, particularly of culturally specific mental health problems are greatly influenced by culture, language, and beliefs (Sinclair 1957; 1964; Burton-Bradley, 1963, 1973, 1990; Burton-Bradley & Julius, 1965; Stavovy, 1996) as well as training. In PNG the specialist mental health workforce is very small. There are only five qualified psychiatrists with a sixth in full time management and part time clinical work and one senior registrar still under training (a ratio of one psychiatrist per every one million people and all psychiatrists were located in Port Moresby). There are approximately seventy-four professionally trained psychiatric nurses (a ratio of one psychiatric nurse to every 67,567 people) and one tertiary referral psychiatric hospital (located 15 kilometres outside Port Moresby). Only four provincial hospitals out of eighteen hospitals have acute psychiatric units and these specialist units are located in Port Moresby, regional and provincial centres serving the minority of the population (18%). The majority of the population (82%) live in the rural areas of PNG. This means that a substantial amount of mental health assessment and treatment falls to general health workers. However, there are almost no data regarding the capacity of this important workforce in providing mental health care. The aim of the present study was to explore and provide a preliminary description of the background mental health training of general health workers. In addition, it will describe their confidence in providing aspects of traditional culturally based assessment and treatment and modern Western based approaches to mental health treatment. This study was part of a larger study that investigated mental health issues in PNG. The research protocol was reviewed and approved by the Medical Research Advisory Committee of the PNG Department of Health and the University of Wollongong Human Ethics Committee. Health workers
The study focused on three broad categories of health workers in PNG: Health Extension Officers
(HEO), Nursing Officers (NO), and Community Health Workers (CHW). Health Extension
South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems Officers have a basic training period of three years at the College of Allied Health Sciences in Madang followed by one-year internship. Their place of employment is in supervisory levels at health centres, health sub-centres and in management in health department, provincial health office and district health offices. They perform clinical, management and community health duties. Some HEOs also work in health training institutions and hospitals in specialised areas after completing relevant post-graduate training programs. Nursing Officers (NO), have three years basic training in nursing and they are employed in hospitals, health centres, and health sub-centres and urban clinics. Few NOs are taking up management responsibilities at the provincial and district levels. Community Health Workers (CHW) have a two-years basic training and are trained to work in aid-posts in villages with limited facilities. They are primary health care workers who identify common illnesses and refer patients to health centres or health sub-centres for further management. Some CHWs are employed in hospitals, health centres, health sub-centres and urban clinics. The length of time allocated for mental health during basic training for each of these three categories of general clinical health workers is discussed further in the results and discussion section of this study. These three categories of health workers were significant because they allow for a further identification of workers on the basis of their assumed level of basic knowledge (the more years spent in basic training the higher their level of knowledge and in theory the greater their ability to diagnose and treat the different types of mental disorders). They also allow for a further identification of workers on the basis of their exposure to traditional medicine. (The more remote the health care setting the higher the likelihood of exposure to traditional medicine and its influence on them as western trained health workers with their own cultural-linguistic backgrounds). Participants
The sample comprised all 209 general clinical health workers who attended a series of four
regional mental health training workshops conducted by the PNG Department of Health. Health
workers held the following positions: 70 HEOs, 95 NOs, and 44 CHWs representing 2.4%
(209/8895) of the total workforce in these health worker categories in PNG (Department of
Health, 1998). There were 129 male and 80 female health workers with ages ranging from 22 to
53 years (M = 34.67, SD = 6.88). Their educational background ranged from elementary to grade
12 (less than grade 9 = 11; grades 9 to 10 = 148 and grades 11 to 12 = 50). Their length of service
in the health department ranged from 1 to 32 years (M = 11.48; SD = 7.96), with most being in
service for 1 to 11 years (62%). Participants were most commonly employed in health centres (n
= 96, 46%) followed by district hospital (n = 25), health sub-centre (n = 21), aid posts (n = 17),
provincial hospital (n = 13), urban clinics (n = 13), while the remainder were from a range of
other settings (n = 18). The participants also represented all 20 provinces within the four regions
of PNG (Southern Region, n = 66, Momase Region, n = 54, Highlands Region, n = 58, New
Guinea Islands Region, n = 31). Provincial and institutional supervisors nominated health workers
for the training. Prior to participation in the training workshops all attendees were provided with
information about the study and the opportunity to participate in the research.
The questionnaire items used in the present article comprised the first part of a larger three-part
study. This first part focused on health worker characteristics and confidence in assessment and
treatment of various forms of mental illness in PNG.
The second part involved retrospective review of three of the most recent patients treated by the health workers in the community. The third part focused on pre-post mental health workshop training outcomes (e.g. knowledge change). South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems The English version of the questionnaire was translated into the Neo-Melanesian language (Pidgin) and then back translated by two PNG health workers for verification. The questionnaire was pilot tested on a sample of eight university students from PNG to identify ambiguous or confusing items but this resulted in no changes. The present study assessed participants' level of confidence in diagnosing six common mental disorders (schizophrenia, depression, personality disorder, anxiety disorder, substance use disorder and somatization) based on ICD-10 (WHO, 1993) and DSM-IV (American Psychiatric Association, 1994). The assessment of confidence level also included assessing confidence in diagnosing five culture specific diagnoses (sorcery, witchcraft, magic, spirit possession and amok syndrome) commonly recognised throughout PNG (Sinclair, 1957; Burton-Bradley & Julius, 1965; Meggitt, 1965; Pulsford & Cawte, 1973; Burton-Bradley, 1973, 1990; Hamnett & Connell, 1981; Flaskerud, 1986; Frankel, 1986; Lepowsky, 1990; Stavovy, 1996; Noble, 1997; Mai, 1997). As noted, these culture specific diagnoses are also beliefs concerning causes of mental illness. However, they are also used as diagnoses and in some cases (e.g. sorcery) may also be used as a form of treatment. The item stem stated, "Health workers are confident in diagnosing the following". The modern diagnostic categories and cultural specific illnesses were then listed with a confidence rating provided for each of the eleven disorders. Each disorder category was rated on a 4-point Likert scale ranging from, (1) strongly disagree to (4) strongly agree. The scale also provided a "don't know" option. Participants were instructed to consider the term "health worker" as the same category of health worker in which they were currently employed. Using the same response scale, seven additional items were included to expand on confidence ratings for both modern and culture specific disorders. For both modern and culture specific mental health problems they were asked: "health workers understand the difference between above mental illnesses". For modern diagnostic categories they rated the degree of agreement to, "health workers use the above diagnostic categories to make a diagnosis when they see a person with mental illness", "health workers know when and where to refer a mentally ill person who needs specialist mental health care". For culture specific diagnoses they were asked to rate, "health workers are confident in consulting and working with a traditional healer regarding treatment of patients with culture specific mental illnesses", "health workers are familiar with specific symptoms of these culture specific diagnoses", and "health workers are familiar with cultural beliefs concerning the causes of mental illnesses". The questionnaire also had a range of items to determine levels of training in mental health. These included the number of weeks devoted to mental health training at both undergraduate and postgraduate levels. Several items also asked about health workers capacity to speak the local language since it was suspected that this maybe related to familiarity and use of more traditional cultural approaches to mental health assessment and treatment. Other additional items in the study included ratings on use of both traditional treatment and medication using a 4-point response format (1 = Not at all, 2 = A little bit, 3 = Somewhat, 4 = A great deal). Participants were asked "do you use modern medication e.g., chlorpromazine", "are you confident in prescribing modern medication", "do you get enough supplies of psychotropic drugs to meet your needs", "are you familiar with the different types of traditional treatment for mental illness used in your area", "do you have access to traditional treatment". The results of these additional items are reported in the results section. Procedure
A letter was sent from the PNG National Health Department to all the Provincial Health Advisors
South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems informing them of the regional mental health training workshops and of the study being carried out during the workshop. The provincial officers were requested to nominate individuals for training and to inform them about the potential to participate voluntarily in the study. Due to communication and geographical difficulties it was impossible to send information packages and consent forms to the participants prior to the study. Participants were given information on the study and consent forms during registration on the first of the 5-day training workshop. The researcher (BK) reviewed the information package with the participants, highlighting the voluntary nature of participation and confidentiality. All workshop participants agreed to participate in the study. Training workshops and the study were conducted in four regional locations: Port Moresby for Southern Region (n = 66), Madang for Momase Region (n = 54), Mt Hagen for Highlands Region (n = 58) and Rabaul for New Guinea Islands Region (n = 31). The workshops were conducted between September 2001 and December 2001. Data for the present study were gathered prior to commencing training on the first day of each training workshop. Table 1 provides the mean confidence levels in diagnosing a range of mental disorders. The mean level of confidence ranged from substance use disorder (M = 2.65) to amok syndrome (M = 1.85). In general, the modern diagnostic categories had higher mean levels of confidence (with the exception of schizophrenia) while participants showed lower mean levels of confidence for the culture specific diagnoses. Table 1 Mean level of confidence in diagnosing a range of mental disorders Substance Use Disorder 11% (n = 20) 6% (n = 12) Anxiety Disorder 12% (n = 22) Personality Disorder 14% (n = 25) Spirit Possession 23% (n = 39) 34% (n = 52) 17% (n = 30) 24% (n = 40) 23% (n = 38) 16% (n = 29) 26% (n = 30) *1=Not at all, 4 = A great deal A number of participants chose the "don't know" option. This lead to "missing data" for the calculation of mean scores on the modern and traditional categories. To check the potential effects of this missing data, t-test comparisons were made by calculating the mean of available items (e.g. 4 of the 6 diagnoses in the modern category) compared to using the means only when all items were available (i.e., 6 of 6 diagnoses in the modern category). Using the mean only when all items were completed, there was a significant difference between confidence in making modern diagnoses (M = 2.19, SD = .61) and culture specific diagnoses (M = South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems 1.95, SD = .59; t (77) = 3.21, p < .01). When using the means of available items (i.e., some missing items) the pattern of findings was the same, with confidence in making modern diagnoses (M = 2.43, SD = .67) significantly higher than for culture specific diagnoses (M = 2.13, SD = .70; t (187) = 4.67, p < .001). Differences between confidence ratings for modern and culture specific diagnoses were significant with or without the inclusion of missing data, in that, participants believed health workers were significantly more confident in diagnosing modern categories of mental disorders than culture specific diagnoses/illnesses. Participants were also asked how much they agreed with the statement that health workers understood the difference between the modern subset of diagnoses and the traditional subset of diagnoses. For modern diagnoses, 22% agreed that health workers understood the differences and 78% disagreed. For culture specific mental health problems, 38% agreed and 62% disagreed that health workers understood the differences between the culture specific problems. A paired t-test indicated that respondents felt significantly less confident at differentiating between modern diagnoses (M = 1.98, SD = .71) than between culture specific diagnoses (M = 2.23, SD = .76; t (157) = -3.99, p < .001). Table 2 also provides the proportion agreeing and disagreeing with additional items regarding understanding and confidence of health workers regarding different mental health problems. In general, the results indicate a lack of confidence and understanding regarding differential diagnosis. Despite some uncertainty about the differences between cultural diagnoses just over half indicate that they were familiar with cultural beliefs concerning the causes of mental illness. Most agreed that they know when to refer to a specialist. Table 2 Agreement about understanding and confidence of health workers regarding different mental health problems Understand difference between modern diagnoses 42 Use modern diagnosis Know when and where to refer for specialist mental health care Understand difference between culture specific diagnoses 63 Confident in consulting and working with traditional healer Familiar with symptoms of culture specific diagnoses 60 Familiar with cultural beliefs concerning causes of mental illness Note. Sample sizes for each item vary due to "don't know" ratings. * Agree ratings were 4 (strongly agree) and 3 (agree). Disagree ratings were 1 (strongly disagree) and 2 (disagree). Health worker training in mental health
Respondents indicated that they received a mean of 2.63 weeks of training devoted to mental
health/psychiatry during undergraduate and postgraduate training. This ranged from no training to
10 weeks (Median = 2.00, SD = 2.53). Some of the participants indicated they could not recall if
they had any training in mental health.
Most respondents indicated 2 weeks training (n = 57), followed by; 0 week (n = 47), 1 week (n = 36), 6 weeks (n = 33) 8 weeks (n = 8), 5 weeks (n = 6) and 3 and 10 weeks (n = 4). South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems Ninety-five of the 209 respondents indicated that they had a postgraduate qualification. However, 85% (81/95) indicated that none of their postgraduate training was dedicated to mental health topics. Four respondents indicated they received 40 weeks of postgraduate training and this group comprised specialist psychiatric nurses. The remaining 10 participants with postgraduate qualifications had received between 1 and 2 weeks training in mental health. A one-way ANOVA assessing undergraduate weeks mental health training between HEO, NO and CHWs showed significant differences among the groups (F(2,206) = 50.60, p < .001). All Post hoc comparisons used Least Square Difference method. NO's received significantly more weeks of mental health training (M = 4.2, SD = 2.88) than either HEOs (M = 1.6, SD = .89) or CHWs (M = .89, SD = 1.15). As noted the numbers of years general training for health worker positions are 3 years for HEO, 2 years for NO and 1 year for CHW, but results suggest that NOs receive more training related specifically to mental health. Given the wide range of mental health specific training and difficulties some participants had recalling the amount of mental health specific training they had received, we chose to analyse confidence by health worker position. A one-way ANOVA assessing confidence in diagnosis between HEO, NO and CHWs was conducted. This revealed significant differences between health worker type and levels of confidence in diagnosis for modern disorders (F (2,199) = 8.58, p < .001), and culture specific disorders, (F(2,188) = 4.54, p < .05). Specifically, CHW's were significantly less confident with diagnosis of modern disorders compared to both HEOs and NOs, whereas for culture specific disorders, HEOs were significantly less confident than NOs. Similarly, CHWs were less confident using modern medications than both HEOs and NOs. The assumption that a health worker speaking the local language is more familiar with the cultural beliefs concerning causes of mental illness and therefore more confident in making culture specific diagnoses was assessed. Sixty per cent (n = 125) of participants could speak the local language of the area where they worked, whereas 40% (n = 83) could not speak the local language. However, there were no significant differences between those who spoke the local language and those who did not with regard to confidence in diagnosing modern or culture specific disorders. Use of different treatments
Table 3 provides mean ratings regarding use, confidence and familiarity with both modern and
traditional culture specific treatments. The percentage of those rating "not at all" is provided in
the far right column. These data suggest that modern medication is used by most with some
degree of confidence, but 15% of respondents have difficulty with supply of psychotropic
medications. Over half are not familiar with the traditional treatments used in their local area and
76% do not have any access to these treatment approaches.
South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems Table 3 Mean use, confidence on familiarity with medication and traditional treatments (N = 209) Use of modern medication Confident in prescribing modern medication Get enough supply of psychotropic medication Familiar with traditional medicine used in your area Access to traditional treatment Items were rated using a 4-point response format (1 = Not at all, 2 = A little bit, 3 = Somewhat and 4 = A great Deal). One-way ANOVAs revealed no significant differences between health workers type (HEO, NO, CHW) and either familiarity or access to traditional culture specific treatments. However, there were significant differences between health worker types with regard to the amount they used modern medications (F(2,206) = 13.73, p < .001). HEOs indicated they used medications significantly more than both NOs and CHWs. NOs used medications more than CHWs. There were also significant differences between health workers with regard to their confidence in prescribing medications (F(2, 206) = 29.16, p < .001). CHWs were significantly less confident prescribing medications than both HEOs and NOs (all p < .001). However, these findings may have in part been influenced by access to supplies of medications and/or levels of training in mental health. There was a significant difference between health workers with regard to problems of supplies of medication (F (2, 206) = 28.80, p < .001) with HEOs' reporting significantly greater access to supplies of medication than both NOs or CHWs. CHWs' reported the most difficulty with supplies of medication. Finally there was a correlation between weeks of undergraduate training in mental health and confidence in prescribing medication with respondents receiving more training also reporting being most confident (r = .30, p < .001). Discussion
The findings of this study indicate that health workers have relatively low levels of confidence in diagnosing both modern and culture specific mental disorders. Respondents also indicate a general lack of understanding and confidence in differential diagnoses or the difference between different types of modern and culture specific mental disorders. Despite some uncertainty between different culture specific diagnoses, over half the sample indicated they were familiar with cultural beliefs concerning causes of mental illness. A majority of respondents also indicated a lack of confidence in consulting and working with traditional healers but agreed that they knew when and where to refer to a specialist. The data may suggest that while health workers are aware of general cultural beliefs in the population regarding causes of mental illness, they are not confident about differential types of culturally bound mental health problems. This may in part be due to the wide range of idiosyncratic beliefs and presentations from community to community, or simply due to the lack of clear differential characteristics. Whilst this may have flow on effects in terms of their confidence working with traditional healers, this lack of confidence may also be a function of the at times secretive and taboo nature of some traditional healing practices. Low levels of confidence in diagnosing mental illness are likely to be at least in part due to the South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems complexities created by the culturally diversity of PNG where there are an estimated 800 language groups. Such cultural-linguistic factors are likely to play an important role in influencing concepts, perceptions and experience of symptoms that flow on to making a diagnosis and treatment decisions. Sinclair (1957) and others (Burton-Bradley, 1973; Robin, 1979; Stavovy, 1996) found that the beliefs of Papua New Guineans' concerning the causes of mental illness complicate the diagnostic process thus making it difficult to arrive at a specific diagnostic formulation (Ng, 1997). For example, low levels of confidence in diagnosing schizophrenia may be explained by cultural phenomenon such as dreaming and visions that complicate the establishment of symptoms such as hallucinations and delusions. A further potential contributing factor is the general lack of distinction between various forms of psychotic illness classified in Pidgin as "longlong" meaning "crazy" In addition to the above factors, the results of this study indicate the need for more comprehensive preparation and training of health workers during basic/undergraduate training. Current undergraduate training programs for HEO, NO and CHW devote very little time to modern and traditional mental health issues. These inadequacies are reflected in the low level of health workers' confidence in distinguishing between different types of mental disorders, a lack of confidence in making a diagnosis, and a lack of knowledge of alternative treatment approaches. As a consequence it is more likely that the patient will be referred to a limited range specialist services or they will be left to their family to provide care. In many cases families manage to maintain and care for their mentally ill relative in their communities without assistance from the health care system. It is only when the individual concerned becomes aggressive or violent that referral to specialist services is needed. When this happens the patient is almost always referred to the local hospital for management and in extreme cases to Laloki Psychiatric Hospital in Port Moresby. Respondents also reported that they use modern medication more frequently than traditional treatments. However, use of modern medication differs by health worker types. HEOs are confident in using medication and prescribe medication more frequently than both NOs and CHWs. HEOs also have greater access to supplies of medication and as a consequence are more likely to use them. Nursing Officers are less confident in prescribing and using medication than HEOs but they are more confident than CHWs. This may be in part due to different levels of training of the groups with NOs receiving significantly more training in mental health than either HEOs or CHWs. Finally, CHWs are least confident in prescribing and using medication and also have significantly less training in mental health and indicate they have the poorest access to supplies of medication. As mentioned above, more than half the respondents reported they were familiar with culture specific diagnoses yet they were not confident in approaching traditional healers. This may be attributed to a number of factors. Firstly, traditional healers may be reluctant to collaborate with health workers who they may view as competitors. The practice of traditional healing is an important means of income and therefore traditional healers may be reluctant to share their expertise with others. Secondly, the use of some forms of traditional healing such as sorcery, witchcraft and magic is explicitly prohibited by government policy. This may create barriers for mental health workers in cases where traditional healers also practice sorcery and witchcraft. Finally, health workers may be reluctant to refer patients to traditional healers because of fear that they may suffer some form of misfortune as consequence of, for example, violating a taboo. In summary, the absence of specialist mental health resources at a provincial and district level means that general health workers will continue to be called upon to deliver the bulk of mental health care in Papua New Guinea. This situation is unlikely to change in the short term. As a consequence there is a pressing need to better prepare health workers to manage mental health problems in their basic training and to follow this up with ongoing support and supervision once South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems they have entered the workforce. A major finding of the study is that CHWs who have arguably the most contact with people suffering from mental illness in their local communities, also have the least mental health training and poorest access to medical supplies. Based on the findings of this study, it is suggested that CHWs training should be improved to carry out mental health promotion and prevention activities at the primary care level. The training should include; detection of early signs and symptoms of mental disorders, basic skills in psychiatric first aid and provide guidelines on working with families, traditional healers and when to refer to specialist services. The results of this study indicated low levels of confidence in identifying and diagnosing different categories of mental illness by general health workers. Whilst health workers seemed most confident with diagnosing modern versus traditional culture specific disorders, they had more difficulty with differential diagnosis amongst the modern disorders. Just over half agreed that they were familiar with cultural believes concerning causes of mental illness but only 20% felt confident in working with traditional healers on mental health issues whereas around 77% agreed they knew when to refer for specialist mental health care. The relative lack of confidence with regard to many aspects of assessment of mental health problems may have been a function of highly variable levels of mental health specific training amongst the different categories of health worker. In general, CHWs received the least mental health specific training and tended to be less confident than both HEOs and NOs with regard to a range of mental health assessment and treatment activities. CHWs tended to use modern medication less than other health workers but this may have been related not only to their training, but poor access to adequate supplies of medications. There were few differences between health worker types with regard to familiarity or access to traditional culture specific treatments. The study highlights the need for ongoing training of health workers in mental health assessment and interventions. In particular, there is a need for clearer guidelines regarding incorporation of modern systems of diagnosis with cultural understandings of mental illness for clinicians in the field. Similarly, more detail is needed about how to collaboratively work with family and traditional cultural healers and at the same time integrate psychotropic medications into a comprehensive treatment approach. General health workers will continue to provide a significant level of care for Papua New Guinea's mental health needs. Consistent with the recommendations of the WHO (1982) there remains a need to retrain general health professionals where existing mental health services and other resources are limited. The PNG Health Department's policy on promoting traditional medicine can also be supported by making a focus of this training on how to best integrate psychopharmacological and traditional culturally based mental health approaches. References
Al-Krenawi, A., Graham, J. R., Ophir, M., & Kandah, J. (2001). Ethnic and gender differences in mental health utilization: The care of Muslim Jordanians and Morocco Jewish Israeli out-patient psychiatric patients. International Journal of Social Psychiatry, 47, 42-54. American Psychiatric Association, (1994). Diagnostic and statistical manual of mental disorders, Fourth Edition. Washington, DC. Author. Barnejee, G., & Roy, S. (1998). Determinants of help seeking behaviour of families of schizophrenia patients attending two teaching hospitals in India: An indigenous explanatory model. International Journal of Social Psychiatry, 44, 199-214. Burton-Bradley, B. G. (1965). Cross cultural psychiatry. Australasian Bulletin, 6, 12-18. Burton-Bradley, B. G. (1973). Longlong! Transcultural psychiatry in Papua New Guinea. Port Moresby: PNG Department of Health. Burton-Bradley, B. G. (1990). History of medicine in Papua New Guinea: Vignettes of an earlier period., Kingsgrove, NSW, Australia. Australasian Medical Publishing Co. Burton-Bradley, B. G., & Julius, C. (1965). Folk psychiatry of certain villages in the central South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems district of Papua. Technical paper No.146, Noumea, South Pacific Commission. Chadda, R. K., Agarwal, V., Singh, M. C., & Raheja, D. (2001). Help-seeking behaviour of psychiatric patients before seeking care at a mental hospital. International Journal of Social Psychiatry, 47, 71-78. Chakraborty, A. (1991). Culture, colonialism and psychiatry. The Lancet, 337, 1204- 1209. Decock, A., Hiawalyer, G., & Katz, C. (1997). Talking health: The wisdom of the village. Port Moresby: Health Promotion and Education Unit, Population and Family Planning project, PNG Department of Health. Flaskerud, J. H. (1986). The effects of cultural compatible intervention on utilization of mental health services by minority clients. Community Mental Health Journal, 22, 127-141. Frankel, S. (1986). The Huli response to illness. Cambridge, UK. Cambridge University Hamnett, P., & Connell, J. (1981). Diagnosis and cure: The resort to traditional and modern medical practitioners in the North Solomons, Papua New Guinea. Social Science and Medicine, 15, 489-498. Hoskins, J. O., Cuthbertson, G., & Cawte, J. E. (1969). Community psychiatry in the Islands Region of New Guinea: I. Epidemiology. Australian and New Zealand Journal of Psychiatry, 3, 376-382. Hoskins, J. O. (1969). Community psychiatry in the Islands Region of New Guinea: II. A Design. Australian and New Zealand Journal of Psychiatry, 3, 383-389. Jeiyeoba, A. D. (1988). Notes on the utilisation of traditional and modern/western mental health practices among the Yoruba, Nigeria. International Journal of Nursing Studies, 25, 179-184. Kim, M., Han, H., Kim, B. K., & Duong, D. N. (2002). The use of traditional and western medicine among Korean American elderly. Journal of Community Health, 27, 100-120. Langness, L. L. (1965). Hysterical psychosis in the New Guinea highlands: A Bena Bena example. Psychiatry, 28, 258-277. Lepowsky, M. (1990). Sorcery and penicillin: Treating illness on a Papua New Guinea Island. Journal of Social Science and Medicine, 30, 1049-1063. Lewis, G. (1975). Knowledge of illness in a Sepik society. A study of the Gnau, New Guinea. University of London: The Athlone Press. Meggitt, M. J. (1965). The lineage system of the Mae-Enga of New Guinea. London: Oliver Mai, M. (1997). The practice of forensic psychiatry in Papua New Guinea: A Review. Unpublished thesis submission. University of Papua New Guinea. Moi, W. (1976). Growing up in Ambasi. Papua New Guinea Medical Journal, 19, 14-18 Newman, P. (1964). Wild man behaviour in a New Guinea highlands community. American Anthropologist, 66, 1-19. Ng, C. H. (1997). The stigma of mental illness in Asian cultures. Australian and New Zealand Journal of Psychiatry, 31, 382-389. Noble, F. S. (1997). Long-term psychiatric care in Papua New Guinea. Psychiatric Bulletin, 21, 113-116. Papua New Guinea National Department of Health. (1998). National inventory of health facilities 1998. Port Moresby, Author. Papua New Guinea National Department of Health. (2000). National health plan 2001-2010. Health vision 2010: Program policies and strategies, Volume II. Port Moresby, Author. Pusford, R. L., & Cawte, J. (1972). Health in a developing country: Principles of medical anthropology in Melanesia. Melbourne, Jacaranda Press. Razali, S. M., & Najib, M. A. (2000). Help-seeking pathways among Malay psychiatric patients. The International Journal of Social Psychiatric Services, 46, 281-289. Reay, M. (1960). Mushroom madness in the New Guinea highlands. Oceania, 31, 137-139. Reay, M. (1965). Mushrooms and collective hysteria. Australian Territories, 5, 18-28. Roberts, H. (2001). A way forward for mental health care in Ghana? The Lancet, 357, 1859. Robin, R. (1979). Psychopathology in Papua New Guinea: A collection of four papers. University of Papua New Guinea Printery. South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42) Koka, Deane & Lambert Health Worker Confidence in Diagnosing and Treating Mental Health Problems Rodrigue, R. (1963). A report on a widespread psychological disorder called Lulu seen among the Huli linguistic group in Papua. Oceania, 33, 274-279. Salisbury, R. (1966). Possession on the New Guinea Highlands: Review of literature. Transcultural Psychiatric Research Review, III: 103-108. Sinclair, A. J. M. (1957). Field and clinical survey report of the mental health of the indigenes of the Territory of Papua New Guinea. Port Moresby: Government Printer. Stavovy, T. (1996). Idioms of psychosis in Papua New Guinea: Thesis submitted for Masters degree of Psychological Medicine, Monash University. Carlton, Victoria. Stephan, M. (1987). Sorcerer and witch in Melanesia. Melbourne University Press. World Health Organisation. (1982). Primary health care training manual for developing countries. Manilla, Unpublished Paper. Author World Health Organisation. (1993). The ICD-10 classification of mental and behavioural disorders. Diagnostic criteria for research. Switzerland. Author Zhang Feng, (2001, February 21). China Daily, China daily staff; New York, pp. 2-3.
The authors would like to thank the following people for their support: Dr Uma Ambihaphar, PNG
Department of Health for funding the training workshops, Getzo Yamale, Dr G. Tienang, Dr M.
Angali, Dr N. Sharma, M. Magaru, Dr Gilbert Hiawalyer, Mr Kanu Jiko, Dr Tania Stavovy, Dr Janice
Skillen, Dr Jessica Grainger and all of the staff who participated in the workshops.
Authors' Note
Correspondence concerning this article should be addressed to Ms. Betty E. Koka, Illawara Institute
for Mental Health, University of Wollongong. E-mail: [email protected] or
Manuscript originally submitted February 2003.
Revised and accepted July 2003.
South Pacific Journal of Psychology, Volume 15(1), 2004 Article (29 - 42)
Source: http://spjp.massey.ac.nz/issues/2004-v15/v15_koka.pdf
descargas.revistamexicanaintegralensalud.com.mx
Investigación Captopril por vía oral y sublingual en pacientes con urgencia hipertensiva Captopril orally and sublingually in patients with hypertensive urgency 1Arquimides Mackelin Ortega Vázquez, 2Norma Elena Corona Amador. 1Adscripción: UMF 56 León; Guanajuato. 2Adscripción: HGZ/UMF 21 León; Guanajuato. Resumen Introducción La Urgencia hipertensiva se presenta generalmente en enfermos con hipertensión arterial sistémica. El 1% de los pacientes hipertensos tendrán crisis hipertensiva de la cual el 76% será Urgencia hipertensiva y 24% emergencia ( Papaduopulos D,2010). Objetivo Evaluar si el Captopril sublingual es mejor para el control de la urgencia hipertensiva que el captopril vía ora en los pacientes atendidos en urgencias de la UMF 56 de Julio a Diciembre del 2013. Material y métodos Se realizó un estudio cuasi experimental, el tamaño de la muestra se calculó de la diferencia entre dos proporciones, con un nivel de confianza del 95%, con 40 pacientes en cada uno de los grupos (sublingual Vs oral); por casos consecutivos y de forma aleatoria se asignó al grupo oral o sublingual, en ambos casos se administró molida la tableta de captopril. La población de estudio fueron los derechohabientes que acudieron al servicio de urgencias de UMF 56 de Julio a Diciembre del 2013, y que cumplieron los criterios de diagnóstico de urgencia hipertensiva. Resultados Captopril molido sublingual mostro mayor rapidez en cuanto el control de la Tensión Arterial Media ≤ 100mmHg y disminución TAM ≥ 20%, Comparando los promedios de control de las TAM de ambos grupos encontramos una diferencia estadísticamente significativa de P= 0.0035. Conclusión Observamos que el 16.25% de la muestra desconocía ser hipertenso. El 82.35% (42 pacientes) de los pacientes descontrolados son manejados con un anti-hipertensivo. Encontramos una relación directamente proporcional del índice de masa corporal y al grado de descontrol de hipertensión a su ingreso.
seu.edu.ge
Einstufungstest (B2): 1. Leseverstehen Lesen Sie zuerst die 10 Überschriften. Lesen Sie dann die fünf Texte und entscheiden Sie, welcher Text (1–5) am besten zu welcher Überschrift (a–j) passt. Tragen Sie Ihre Lösungen in den Antwortbogen bei den Aufgaben 1–5 ein. Neue Richtlinie für Zertifizierung von Medikamenten für Kinder
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City pushes free tax prep, underused tax credit
by Holly Bieler Queens Ledger
Feb 04, 2015 | 5425 views | 0 | 191 | |
With tax season in full swing, government officials gathered Monday at the Bed-Stuy Restoration Corporation’s Volunteer Income Tax Assistance (VITA) site to discuss the free tax preparation, as well as the Earned Income Tax Credit (EITC).
The EITC is a refundable tax credit for low-income individuals and families which an estimated 1 in 5 eligible households across the city still don’t receive.
“In the last administration they spent approximately $165,000 on bus and subway ads to let people know about [the EITC],” said Department of Consumer Affairs (DCA) Commissioner Julie Menin. “We did not think that was enough.”
Monday’s event was the latest in an unprecedented $3 million campaign targeting the estimated 250,000 EITC-eligible households in New York City who don’t file for the credit each year. The campaign aims to raise the number of filing households by 50,000 this year over last.
“Our challenge is to reach all eligible workers to make them aware of the EITC,” said Louis Morizio, Territory Manager of Stakeholder Partnerships, Education and Communication of Internal Revenue Service. “There’s millions of people a year who miss out on the credit they deserve.”
This year’s campaign included a phone bank last Saturday, in which 2,000 volunteers fluent in three languages called an estimated 270,000 New Yorkers to help spread awareness of the EITC.
The DCA will also invest nearly $2.3 million to expand the core services of the partners offering free tax preparation, and will add 60 VITA sites this year over last, totaling 200 citywide.
“Some New Yorkers are eligible for up to $10,000 that they’re just leaving on the table,” said Menin. “The average [EITC credit] is $2,500. We’re talking about really significant amounts of money.
“Through this new outreach that the city is doing, we’re expecting that we can give $260 million back in terms of refunds and saved tax preparation fees,” she added. “That’s $260 million that’s going to go back to New Yorkers.”
Joining Menin were representatives from the office of Senator Kirsten Gillibrand, the IRS and Food Bank for New York City, which runs the Bed-Stuy VITA site.
“The EITC, combined with the refund, is the biggest check low-income workers are going to get in the year,” said Triada Stampas, vice president of Research & Public Affairs of Food Bank For New York City. “We know when they get that check people’s food purchases increase, and the quality of food they’re able to afford increases as well. Protein and produce are the two categories that low-income people buy more of in the months when they get their tax return.”
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The Best Brand of Fidget Spinner
My middle daughter has been begging to get a fidget spinner, which is a little gizmo that (according to the marketing) cures ADHD, anxiety, and stress. In fact, it’s just a small central bearing around which spins an evenly-distributed weight made of plastic or metal. And while the jury is still out on their healing properties, they are undeniably fun to play with and pretty darn cool.
If you have children, you’re no doubt already familiar with fidget spinners, and you’re probably also aware that there are about a metric gajillion of them for sale on Amazon that look more-or-less the same, all sold by companies no one’s ever heard of.
So how does a dad go about finding the best brand of fidget spinner for his daughter? Well, it’s actually pretty simple.
If you’re like most people, when you read “the best brand of X,” you interpret that to mean “the best X.” And finding “the best” of something requires a discussion about what criteria and specifications make one X better than another X. But “the best X” is not the same thing as “the best brand of X”.
In my case, finding “the best fidget spinner” would have required locating some authority (TheWireSpinner.com?) who had evaluated all of the options and determined which one was objectively “the best.”
But “the best brand” of fidget spinner is something different. A brand is how you feel about a thing, so finding “the best brand of fidget spinner” meant what I actually had to find was the one I felt best about buying and giving to my daughter.
I could have spent an hour (or more) trying to sort through the options on Amazon, paralyzed by choice and worrying that I’d end up with a piece of junk from a no name company I had to exchange a week later after it broke. But doing that would have made me feel miserable.
So instead, I got in my car and drove five minutes down the road to Geppetto’s, an awesome local toy store chain. And lo and behold — they had a rack of fidget spinners right behind the counter. Also behind the counter was an exceedingly helpful associate who is evidently the world’s leading expert on fidget spinners and helped me choose between the three types of spinners Geppetto’s offers.
I chose a fidget spinner confident that Geppetto’s (a store I trusted) wouldn’t stock a junky product, and that even if the spinner I bought went bad, I could easily return to the store and exchange it with no questions asked.
Sure, I paid a little more for it than I might have on Amazon, but in exchange I feel great about my purchase and my daughter loves it. Warm feels all around.
And that, simply put, makes the spinner I bought the best brand of fidget spinner for me. (Ironically, I don’t even know the name of the company that makes it.)
If you’re a maker, it’s easy to obsess about the thing you’re making and its characteristics, thinking your thing need to be “the best” for anyone to want it. But the truth is none of us ever buys “the best X,” even when we claim we are. We’re always buying “the best brand of X,” and sometimes that’s just right around the corner.
Brand Bit: Auditorium Toy Co.
From time to time, I’m going to highlight some of my favorite brand builders — large and small — to point out some of the delightful things they’re doing.
I especially love people and companies that build brands using details. You know what they say (with apologies to someone who is not Ludwig Mies van der Rohe), “Brand is in the details.”
In this first post, I want to give props Brad Denboer’s late, great Auditorium Toy Co.. I bought one of their Boattail Racers back in the day, and loved everything about it.
The slower you put things together, the slower they fall apart. Auditorium Toy Co.
Auditorium promoted its products as “heirloom toys”, and the motto used in the Boattail Racer’s sales material was “the slower you put things together, the slower they fall apart”. These toys weren’t hunks of plastic crap you’d throw out in next week’s trash. These were toys that would last, and that you’d want to pass down to your children to give to their children.
This ethos was expressed by the toy itself, which was beautifully crafted and manufactured, but the detail that caught my eye was the printed “ownership record” included in the (also beautifully crafted) box. This ownership record included the date of manufacture, the serial number, and a series of “given by/received by” entries you could use to record when and to whom the toy was bestowed. The thirteen pre-printed entries had date entries with century prefixes that began in the 21st century and stretched out to the 24th century.
Such a simple, delightful thing. The date entries could have been left blank and the century prefixes not included. But with that little detail, Auditorium reinforced its “heirloom toy” brand, and made my emotional connection to the brand that much stronger as I imagined my great-great-great-great-great-grandchildren playing with the toy. And they didn’t have to spent a single extra cent to do it.
Peter Drucker on brand
In my last post, I concluded with this: “all businesses, including yours, exist solely to build a brand.”
Whenever I write or say this, it provokes a response, and this time was no exception. “How can you say building a brand is the sole purpose of my company?”, the responses go. “What about earning a profit/delivering value to shareholders/creating a great product/acquiring customers/et cetera?”
My answer is that all of those things are important, but they all depend on a strong brand, and so building a brand is more fundamental to the purpose of business.
The difficulty, perhaps, is that we often talk about brand without actually using the word “brand”. Consider this quote from Peter Drucker:
The purpose of business is to create and keep a customer.
Once you understand that your brand is how a person feels about you (I’m going to stop saying “you/your company/your product”), you see that Mr. Drucker is really talking about brand.
How do you create a customer? You establish a emotional connection between you and them that’s positive and prompts them to use your services (and hopefully give you money for the opportunity). And how do you keep a customer? You nurture and grow the emotional connection between you and the customer to make it enduring.
Everything else we do in our businesses either contributes to this (creating a great product that meets your customer’s need builds a positive emotional connection with them), or is derivative to it (with passionate customers and a good business model, you’ll earn a profit and deliver value to your shareholders).
By definition, to create and keep a customer, you must create and grow a brand. Ergo, the purpose of business is to create and grow a brand. Q.E.D.
Thinking bigger than product
It’s a cautionary tale that’s so familiar it spawned an archetype: the brilliant engineer who invents game-changing technology that never succeeds in the marketplace because (as every good product manager knows) a technology is not enough. Technology is but one thing needed to build something bigger — a product. The archetypical engineer has a blind spot that hides from her this larger truth. Enter product managers, gifted with insight into the holy product, who swoop in to save the day. (Having been a product manager myself, I can poke fun.)
Now, while there is some truth to this story, fortunately the understanding that a technology is but one part of a successful product has become widespread (including, it must be said, by lots of those “stereotypical” engineers). But ironically, there’s yet another blind spot that affects those most convinced they see the full picture. In this new blind spot looms something bigger than product. What looms there is brand.
Just as the stereotypical engineer focuses too much on technology and fails to appreciate product, the stereotypical product manager focuses too much on product and fails to appreciate brand. Yes, technology is not enough and is but one thing needed to build a product. But just as true is that a product is not enough. Product is but one thing needed to build something bigger — a brand.
Successful teams and companies understand this and orient all of their activities towards creating this greater asset. They understand this fundamental truth: all businesses, including yours, exist solely to build a brand.
Starting simply
I’m a big fan of simplicity in design. Given the human propensity to complicate and do more, simplicity remains vastly underrated despite its obvious appeal and value. One of my favorite articulations of this in the context of product design comes from Brian Christensen: “Most people need less done well, not more done poorly.”
But recently I’ve been thinking a lot about simplicity in the context of brand design. Specifically, I’m pondering John Gall’s famous comment on systems design, sometimes called Gall’s Law, which states:
A complex system that works is invariably found to have evolved from a simple system that worked. A complex system designed from scratch never works and cannot be patched up to make it work. You have to start over with a working simple system.
I’ve come to believe a similar “law” is at play with creating great brands. I’d state it like this: A strong and complex brand that works is invariably found to have evolved from a strong and simple brand that worked.
By “simple brand” I don’t mean something akin to Al Ries’ “Law of the Word” where FedEx = Overnight delivery, Kleenex = tissue, etc. I think that’s overly simplistic, and is one of the rigid ways of thinking that lead people astray from a real understanding of brand.
Powerful brands are rich and complex things, and the best of them are organic and alive. But any rich and complex emotional connection must start with, and be grounded in, a simple emotional connection. That’s what I mean by a “simple brand”.
Think of the relationships in your life. If you’re married, think of how you came to love your husband or wife. That relationship didn’t appear fully formed with all the richness and complexity that comes with years of shared experiences. Rather, it started with something simple. Maybe you noticed her hands, or her eyes, or the way she laughed. And from that initial connection, a richer relationship developed.
I’ve taken away two key insights from my pondering:
First, take care to not overdefine your brand at the start. Don’t limit yourself to one word, but neither indulge the temptation to have 12 “core values”. Focus on your core, and articulate that in a simple way others can connect to.
But second, don’t make the mistake of limiting yourself to that initial brand definition. Allow your brand to grow and develop as your customers develop a more rich and complex connection to it.
Grounding your brand in a simple core, but allowing your brand to change and grow, is the path to creating something powerful and enduring.
Seeing the invisible
It’s one thing to understand that a brand is how people feel about a thing, but it’s another thing to fully grasp the implications of that and fit it into one’s worldview. One thread I’ve been pulling on for a long time is to find the perfect metaphor for brand. It’s been a fun but frustrating mental exercise.
To fully capture the concept of brand, we must represent not just the thing, but how people feel about it. It’s the reaction to the action, the context to the text, the ground to the figure. Yet those comparisons are imperfect, since a brand exists in some sense independently of its stimulus.
I’ve cycled through a lot of metaphors — echolocation, chemical reactions, the electromagnetic spectrum, holograms, dark matter — and it’s been fun to think about, but I haven’t nailed it yet. I’ll keep trying.
But suffice it to say this: to fully understand brand, you need to see not just what’s there, but the effect it has on the world around it. And when that clicks, you’ll look at everything a bit differently. You’ll see there’s McDonald’s, and there’s how you feel about McDonald’s; there’s the trusty Honda you drive to work each day, and there’s how you feel about your Honda; there’s your family, and there’s how you feel about your family.
Once you have the ability to see the world that way, you have the power to influence it. And that’s when the fun begins.
A definition of brand
I’ll confess to a deep cynical streak about certain things. One of those things is business writing, especially writing about marketing and brand. Most of this “content” seems designed by its “contributors” to do nothing more than create “engagement” for the web behemoths publishing it to attract eyeballs to pay the bills. What’s worse, this word spew often serves to confuse more than illuminate.
A prime example of this is kind of writing is writing about brand. With rare exceptions like Marty Neumeier’s books, most brand writing consists of some a combination of anecdotes about ranchers, cattle, Nike sneakers, and Tide laundry detergent, with some version of the phrase “your brand is what your customers say it is” thrown in for good measure. It’s not that this writing is wrong, per se, just that it ends up obfuscating what I believe is actually a simple (even primal) concept.
Here’s how I define brand: a brand is how a person feels about a thing. Defined this way, a few things become clear.
First, we all instinctively understand brand, because all of us (with the possible exception of one Dr. Sacks’ patients) feel about things.
Second, almost everything has a brand. Barack Obama has a brand; golden retrievers have a brand; the park bench has a brand; your grandmother has a brand; 7th grade has a brand; because you feel something about all of those things (although in the case of some things like the park bench, it may amount to little or nothing).
Third, every thing has as many brands as there are people to feel something about it. My brand for golden retrievers is not exactly the same as your brand (although in all likelihood there’s a lot of similarity between our two golden retriever brands, unless you’re some kind of monster).
Now, saying that brand is a simple concept and that we all understand it instinctively, is not to say that we all are conscious of it and its effects on the world around us. But that can be gained with a change your perspective and the courage to take the red pill.
The Universe is one of those things that begs the use of the phrase “mind blown” without irony or hyperbole. 91 billion light-years in diameter (that we can observe, the totality is likely much larger), 13.8 billion years old (give or take), filled with perhaps as many as 10 trillion galaxies, each with 100 billion or so stars. (That’s 100 octillion stars in total, but who’s counting?)
The Universe is so vast and filled with stuff that we have a hard time looking at nothing. If we point our most powerful telescopes at the parts of the sky that seem absolutely empty, after enough time we find that, in fact, that part of the sky isn’t empty at all, but is as filled with galaxies as the parts that shine brightly with stars.
But of all the unfathomable facts about the Universe, perhaps this is the most mind blowing (see?) of all: by our best estimates, everything we can see and observe — all the matter — accounts for only 15% of the total. The other 85% is something that neither emits nor absorbs light or any other electromagnetic radiation and we can’t directly detect in any way. The vast majority of the matter in the Universe is not matter at all, it’s dark matter.
Dark matter makes up the vast majority of our Universe, and yet we can’t see it at all; we can only infer its existence from its effect on what we can see. And that, dear reader wondering why you’re reading about the Universe on a site dedicated to brand strategy, brings us to brand.
There is so much sturm and drang in the business and tech worlds, and all of it focused on what we can see and directly observe. Very little attention is paid to that which we can’t see, but which has a profound (even dominant) influence on everything around us. Product, sales, customer support, growth hacking, et al — these are the matter of the business world. But brand…brand is the dark matter. More on this in the days to come.
In the Beginning, there was Brand
I didn’t start out as a “brand guy”. I was an engineer, and not even one of the software persuasion. I was a mechanical engineer, steeped in Newtons and torques and shear strengths. Yet while those things filled my head, my heart found purchase in design methodology. How do you meet a person, understand their problem, and conceptualize and ultimately build something that provides them a solution? I made this question my course of study, and it served me well not only in physical product design, but later as I moved on to software products and — ultimately — brands.
“Wait”, you say. “I can follow your step from physical to software products, but…brands?” Indeed. Because while designing physical products, I learned the value of empathy — the ability to put one’s self into the shoes of another, to feel their emotions, and through it gain an understanding of their problem and how it might be solved. And as I would come to discover, empathy is at the core of creating powerful brands.
This might seem an odd statement to you if your understanding of brand is garnered from articles with breathless titles like “How Your Brand Can Use Instagram To Supercharge Sales Growth”. That endless parade of words makes a brand sound like something fleeting and insecure that must ever reinvent itself to take advantage of the newest thing. But that understanding is wrong. Because a brand is not something fleeting and new. Created well, even a “new” brand is grounded in something powerful and old. Very, very old.
I define “brand” as simply this: how a person feels about a thing. And as emotions are as old as humankind, to create brands is to work with a stuff primal to our being. To create a good brand, one must understand the emotional state of (i.e., one must empathize with) those who experience it.
Whether one seeks empathy to create great products or create great brands, the task is the same, only the level of abstraction of the output changes. In fact, I say we are all brand builders. Whether engineers, or product managers, or copywriters, or graphic designers, or salespeople, or customer support…in the end, we shape the emotional state of those who experience what we make.
When considered in this way, you realize this is what humans have done with one another from time immemorial, and it’s what we each have done since our earliest days. In the beginning, there was brand, and we were brand builders. We remain brand builders still, even if most of us don’t realize it yet.
Why We ❤︎ Brand
© 2021 Bez Brand. All rights reserved.
Made with pith and punch in sunny San Diego.
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Composers Association of New Zealand
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ISCM 2020
Creative New Zealand/Jack C. Richards Composer-in-Residence at the New Zealand School of Music 2010/2011
The appointment is jointly funded by the New Zealand School of Music, and Creative New Zealand (subject to annual confirmation) with additional sponsorship from Dr Jack Richards. It has been created to foster New Zealand musical composition by providing the appointee with the opportunity to write full-time within an academic environment for the period of tenure. Applicants should be composers of proven merit and be New Zealand citizens or hold New Zealand residency. There is no restriction on the occupation of applicants, but they should not be employees of Creative New Zealand or Victoria University or Massey University (Wellington campus), or have been employed by Victoria University or Massey University (Wellington) in the twelve months prior to the closing date. Students working towards the completion of a tertiary qualification (in the year of the residency) are also ineligible. Individuals who have been a composer in residence in a Creative New Zealand financially supported residency within the previous twelve months are not eligible (this does not include recipients of grants). In extenuating circumstances, the panel may waive this restriction.
The Victoria University appointment will be for twelve months from 1 July 2010 to 31 June 2011. The appointee will be resident in Wellington for that time and will be attached to the New Zealand School of Music as a Victoria University employee. While there is no obligation of formal teaching, some contribution is expected to be made to Victoria University and to the New Zealand School of Music’s cultural and academic life, in a manner appropriate to the personal strengths and preferences of the appointee, in agreement with the Head of School. Victoria University will provide access to administrative, library and other facilities.
Salary is expected to be NZ$45,000-$50,000 for the twelve-month period + 8% holiday pay to be paid when the term of appointment ends. Limited assistance may be given towards payment of travel and removal expenses, but neither the University nor Creative New Zealand can provide living accommodation. However, in collaboration with the Lilburn Residence Trust, the former home of Douglas Lilburn at 22 Ascot St. Thorndon, is available for the appointee’s use, at a modest rental, for the term of the residency. This is subject to approval by the trust.
Further enquiries may be made to Michael Norris, New Zealand School of Music, tel 04 463 7456 or email Michael.Norris@vuw.ac.nz
Closing date for applications is 13 November 2009.
For further information and to apply online please visit: http://vacancies.vuw.ac.nz/
This entry was posted in Opportunities, Residency on 14 October 2009 by CANZ.
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Posts filed under wrigley field guide
Wrigley Field – Past, Present, & Future Of Wrigley Field Cubs World Champions!
Wrigley Field in Chicago, Illinois, is the second oldest ballpark in baseball, close behind Fenway Park in Boston (home to the Red Sox). Nicknamed ‘Friendly Confines,’ it still retains the authenticity of the old days. When fans come to cheer the Cubs, they don’t miss out on spotting a few highlights, like the marquee located outside their home plate entrance, ivy covered outfield walls, their classic hand-operated scoreboard, and more.
History Of Wrigley Field
The existence of Wrigley Field dates back to before the beginning of World War I, when Charles Weeghman acquired the Chicago Whales. He formed a new team in the ballpark, which was then located in an undeveloped side of Chicago. He hired Zachary Taylor Davis to plan the development of Wrigley Field, and it was thereafter named ‘North Side Park.’ It was later named after Charles as the ‘Weeghman Field.’
The construction of the ballpark started on March 14, 1914, and ended on April 23, 1914, which also marked the first game played by the Whales. It turned into a 14,000 seat ballpark, with one exclusive V-shaped Grandstand and wooden bleachers all around. The original dimension of Weeghman Field was 310 ft. to the left, 356 ft to the right, and 440 ft in the middle. It was also the first ever ballpark to have fixed concession stands. The Chicago Whales would only play for two years because the Federal League soon went bankrupt.
The Cubs used to play on the West Side Grounds from 1893, but by 1915 they were struggling for an audience. Charles Weeghman acquired them later that year and shifted the team to his field for the following season. Their first game was on April 20, 1916, and the ballpark was renamed ‘Cubs Park’ after Weeghman sold his acquisition to William Wrigley Jr.
During the early months of 1923, the park went through renovations. The Grandstand moved 60 ft back and there were new installations of wooden bleachers. This increased the capacity of the park to 20,000. It was further renovated in 1926, and the park was finally named ‘Wrigley Field’. There was then a double deck for the Grandstand, bleachers were moved from the left field, the playing area was lowered and the capacity reached 38,396.
There were more implementations by 1937, and bleachers were constructed in the outfield. This was also when their renowned 27 by 75 ft hand-operated scoreboard was planted right behind the centerfield seating. The other highlight of ivy was also incorporated at this time. The lights were installed before the season of 1942, but were donated to the government for World War II.
Post World War II Scene
After the 1940s, there was little change in the field to keep a note of. In 1981, the Cubs were acquired by the Tribune Company and in 1982, there was an electronic board installed under the old scoreboard:
After many disapprovals and threats, the Cubs were allowed to install lights on the field. The first night game took place on August 8, 1988. There were private boxes constructed in 1989, on a mezzanine level which was initially used for broadcasting and the press. There was another one constructed in the upper deck right behind home plate.
There were 200 seats added right behind home plate after the 2003 season which brought the audience closer to the field. There was a further addition of 1,800 seats in 2005, increasing the capacity to about 41,000 people.
Wrigley Field was previously known to have a bad grass field because the infield crown extended 40 ft towards the outfield. Players ran up and down a hill during their games! This problem was resolved in 2007, with the help of a reformed drainage system. The playing field was then replaced with artificial grass.
Present Scene For the Wrigley Field
Wrigley Field is now the only existing Federal League ballpark. However, with all the lights and video board, it retains that old fashioned feel. One amusing fact about the field is that they don’t allow advertisements. However, many can be found on the sides of buildings in the neighborhood.
Wrigleyville, the vicinity around Wrigley Field, bustles with ballhawks on game days. They wait at Waveland Avenue to catch home run balls. Lots of people sit on top of the building located behind the field to watch the game action. The ivy still overshadows the brick walls, while the scoreboard is manually operated. The neighborhood usually makes parking difficult for the games. Fans often opt to ride the CTA red line train to the Addison stop and then get to the field.
Wrigley Field is the home of the Cubs, but it was also home to the Chicago Bears from 1921-1970 before they moved to Soldier Field. This historic area is currently undergoing a massive change, which is likely to revamp it like never before.
Current Renovations At the Wrigley Field
After the renovations of 1937, the next big transformation is to overhaul all the facilities. It started after the 2014 season and is called the ‘1060 Project’. With a requirement of $575 million, it is all set to be complete in 2019.
Every section of Wrigley Field will be upgraded, and it has already started with the outfield. The Cubs moved the exterior walls into Waveland and Sheffield Avenues to expand bleachers, which will add 300 more seats, and add concessions. One of the most striking additions is the HD video board of 95 x 42 ft to the left. There will also be another 2,250 square feet video board to the right.
Chicago Cubs Achievements
The Chicago Cubs took part in 11 World Series so far. In 1906, they lost to the White Sox 4 games to 2, but made it back to the World Series in 1907 and 1908, being the first team to play 3 straight years back to back. They were also the first team to win twice, but after that they went 108 years without a World Series win. It was the longest occurrence in all of the American sports.
The Chicago Cubs were termed ‘Lovable Losers’ with multiple losing seasons. With superstars like Anthony Rizzo and Kris Bryant, the team accomplished their first World Series Championship since 1908, in 2016, after winning against the Cleveland Indians. Certain players on the Cubs were inducted into the Hall of Fame. They include Ernie Banks, Greg Maddux, Ryne Sandberg, Ron Santo, and others.
Posted in Sports and tagged chicago cubs history, history of chicago cubs, wrigley field guide
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LGBTR, a new acronym, a new flag
Submitted by Anonymous on Sun, 2019-05-05 09:21
Nicolas Bruno
We all know that Brazil has not been going through good times since Bolsonaro became president. With the press being constantly threatened and attacked by the Bolsonaro government and its allies and citizens' rights being violated every day by disastrous public policies and a political party involved in controversies, with its members divided into several strands, the population is adrift.
According to the website Grupo Abril's Exam, Bolsonaro stated: "Brazil can not be a gay country; we have families. " It is clear the ignorance and the offenses that the president has against the diversity, present in the Brazilian population. Even so, gay tourism grew by 11%, according to the newspaper O Globo.
On several occasions it may be noted that Bolsonaro governs following his own ideologies and those of his constituents, forgetting that he occupies a public office and governs a country in which blacks, whites, gay, heterosexual, cis or trans and a great variety of people, pay taxes and contribute to the development of the country, as well as paying their salary as president of the republic.
Failing such egocentric attitudes of a person unprepared for public office, the same is mirrored in Donald Trump, president of the United States, who divides opinions of his own party.
Given that in the United States the LGBT community has chosen to include black and brown colors on the flag as a way of representing races and fighting racism, several entities in Brazil are also adopting this stance. The key factor for such a change came when Bolsonaro vetoed a Bank of Brazil advertisement that portrayed sexual, gender and racial diversity, according to news published by Veja's website.
On this occasion, I become a public novelty. The abbreviation LGBT that can mean Lesbian Gay Bisexual Transgender Resources or Lesbian Gay Bisexual Transgender Races, but in Portuguese can be adapted for Lesbian, Gay, Bisexual, Transvestite, Transsexual or Transgender, Races is the most appropriate for the reality of Brazil.
It can not be accepted that a government, paid with public money, destroys important public policies for all Brazilian society.
Live the Diversity! Viva LGBTR!
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Labels and zombies
Tag clinical communication . labels . psychiatry
It’s like clockwork. My Twitter timeline regularly contains references to what people who receive psychiatric treatment should be referred to. I think it’s time to write the ‘label post’ again.
For me, it’s started with the tweet by Allen Frances
I prefer to go even further:
'A patient who meets criteria for schizophrenia'.
'Schizophrenia' is just a construct- not something you can have. https://t.co/RXiu1MVQUR
— Allen Frances (@AllenFrancesMD) September 12, 2020
who responds to a tweet suggesting that there are no ‘schizophrenic patients’, there are ‘patients with schizophrenia’. To this Frances says: I prefer to go even further: ‘A patient who meets criteria for schizophrenia’.
Is Dr Frances right? Of course, he is. Have we now found the best way to talk about patients in mental healthcare? Not even close. All those discussions are not more than irritating; lip service paid to incessant and largely irrelevant debates on language in psychiatry, all justified by the ‘language matters’ slogan. And all, again, serving no particular point or goal.
Incidentally, it’s worth reading the responses under Allen Frances’ tweet. Some people cheer and agree, some still are unhappy with the label being ‘slapped’ onto a person. After all, if you use the word ‘schizophrenia’, you’re using ‘the label’ and that’s bad. After all, we must consider the questions whether mental illness exists, as discussed by another website I’ve never heard of. Needless to say, Dr Frances’ point that schizophrenia is only a construct not a ‘real thing’ doesn’t matter, after all he’s a shrink, so he must wish you ill.
I do despair…..
Let me repeat: I consider such discussions pointless and moot. Yes, there are certainly people who think that they are important, they find being called ‘patient’, or even the use of words such as ‘schizophrenia’ offensive. But there are also people who don’t mind, in fact, there are people for whom such ‘labels’ are important, useful, and are used to build at least part of the person’s identities around them. Can everyone win? No, of course, they can’t. Both standpoints, together with a spectrum between them, are valid. And you can continue arguing till you’re blue in the face. Incidentally, as I don’t think any compromise is possible, I think it’s better to move on.
The second reason why I find those discussions irritating is because of the arguments that the preferred label reflects the true nature of things. So, we discuss them to hone our description of true reality. Such arguments are nonsense. Each language use, including those damned labels, carry a host of ideological assumptions and people choose those labels because of those assumptions, regardless of whether they are aware of them or not.
Finally, such discussions consistently assume that the change of phrases (labels) will result in a changed reality. Eternally happy people will live in a world of everlasting peace from the day of the change day onward. Needless to say, nothing of the sort will happen.
In fact, let’s imagine that tomorrow the WHO changes, for example, the label ‘borderline personality disorder’ (I must admit that I find the ‘personality disorder’ labels particularly unhelpful and problematic) and calls it, let’s say, for the sake of argument, ‘behavioural pattern A’. What exactly would change? Would any psychiatrist behave differently? Would the any health service change anything? Would there be different recommendations? Would the attitudes towards patients change (on many occasions I heard psychiatrists admit that they don’t like BPD patients)? I’m afraid not. Nothing would change. In fact, I think that ‘behavioural pattern A’ would at first be identified as ‘former BPD’, and in time it would become as stigmatising as BPD was. In fact, this is precisely what history of psychiatry teaches us. Psychiatry can be seen as a history of label change. And what happened? Nothing. Zilch. Nada. The new phrases take on the stigmatising capacity of those which were replaced. And so, what exactly is the fight all about?
A reservation: we might still want to change BPD into BPA, but only because of the ideological baggage the former carries, or, simply, because we like it better. It creates a better picture of the world. And that’s fine. But the change will result in nothing that is claimed about it. Those diagnosed with behavioural pattern A will continue to be in a very undesirable situation. If you want to help them, stop thinking about language (and I do know many people really dislike me for saying this).
Now, let me offer a few more linguistic comments on the discussions about labels. Their significant weakness is that the discussants ignore the fact that they are not discussing dictionary entries, but they are supposed to be discussing the way certain people (patients, clinicians, administrators or, indeed, Twitter users) communicate. So, mostly, it is unclear what the discussions are all about. Let me give a couple of examples for what they can be about (the list is far from exhaustive).
1. Is the discussion about words referring to a group of people receiving healthcare? Just like we refer to doctors or nurses, we (probably) must have a way to refer to those on the side of the metaphorical (or not) stethoscope. As I said above, because of the diversity of people in psychiatric treatment, it is as unlikely as it can be, that there will ever be a consensus about how to refer to such a group of people. Someone will always be happy, someone will always be unhappy. Is there a point in discussing? In my view, not really. Will it stop the incessant debate? Hardly.
Do note that at this level, it’s pointless to ask people what their preference is, or that they should be called by their names etc. Here we are referring to an entire group of people. Like it or not, we need a label, be it because we need a way to say that there is a group of people who are entitled to social support, benefits, leave from work etc. etc.
And no, formulation (for some a strategy which will also cure cancer) will not be a way forward, we need some population-level criteria. Nor will be discussions whether mental illness exists or not. It doesn’t matter what your view is, if you can get, say, disability benefits because you suffer, you need criteria. Call it what you will, but you are likely to have to call it an illness, because in today’s societies, it is illness or disability that give you such benefits (with all their arbitrariness, ideologies underpinning, social constructs and what have you).
And I am yet to hear an idea how to deal with this.
My own personal view is that life is way too short to be bothered by it. I accept, however, that for some people it is considerably more important than it is for me. In a way, I regret this is the case. Yet, label change is extremely unlikely to bring out any change in practice. And while it is likely to make some people happy, others will be made unhappy.
2. The second context invoked by discussions is that of clinical interaction. This gets a bit more complicated.
I’ve been asked what I would like to be called only once. I said “Professor Galasinski” (I must admit I wanted to see what would happen) and the medic did not call me that even once. He avoided calling me anything altogether, which I think is very interesting, and worthy of a separate blogpost. In any case, I find such questions an imposition, there is no reason to ask them, clinicians should assume that normal social graces apply and should go for normal everyday formality.
In my view, doctors calling their patients by their first names take liberties and the only way to preserve a bastion of symmetry is when I call you by your family name and you reciprocate. Of course, I realise that I am still likely to call you using your professional title, still it’s better than nothing. Incidentally, over the years, I have tried to address doctors using “Mr” or “Mrs”, or ‘Ms’, and both doctors and, in particular, receptionists balked at that. I was immediately corrected. That in itself suggests how important forms of address are and that symmetry is only pretence.
Should doctors use illness labels? Well, the argument from the previous point applies. The issue is how you present this. I would imagine that simply saying: “you have schizophrenia” is unhelpful and insensitive. There are all sorts of ways in which to say this in an empathic, understanding manner, accepting that a person might reject such a diagnosis.
Before I finish, I would like to end with a reference to a tweet from a person I follow on Twitter. She listed, among others, the following observations on her hospitalisation: no real therapy; uncaring staff; disgusting environments; boredom; intimidating ward rounds and others. Someone else, quoting the tweet, added: over-medicating; coercion, even assault; damaging power dynamics; seeing others in distress and others.
This is a pretty damning picture of mental health services, and psychiatric hospitals in particular. It’s also a picture I recognise. When I was doing research and visited a number of hospitals, there are still things I wish I hadn’t seen. For example, I have seen mindless and brutal coercion, I have seen open and cavalier lack of respect. And as I recall such scenes or events, I start thinking: are you for real? Are you really still arguing about what is the best way to call a patient? Do you really think that the patient whom two orderlies shoved a bottle into his mouth to wash the medication down, as they pinned him down on the floor with a knee, gives a single flying f….about what label you use to refer to him?
If you can afford wondering discussing the bloody labels, you must really think that everything else is just hunky dory. Psychiatric hospitals are those wonderful places where people are offered empathy, support, respect….., psychiatric consultations are communicative events of love and joy, while psychiatric medication is commonly regarded as happy pills. So, now you can wonder about the minutia like the labels.
For me, I still can’t get rid of an image which has haunted me for years. I was waiting (I can’t remember what for) in a closed ward, just mindlessly looking ahead, when all of a sudden, I saw a figure or a woman. She was dressed in heavy duty hospital pyjamas. She was heavily distended, so her belly was clearly seen as the trousers were tightly wrapped around it. She had long hair which was obviously unwashed for a significant period of time, greasy strips of hair on her front and back. But the most haunting were her eyes. Her eyes were empty, unseeing. Hollow. She shuffled her feet with effort, moving very slowly along the corridor. That young woman, drugged out of her mind into a psychiatric zombie, also didn’t care about what label was used to refer to her.
As this image keeps haunting me, I do refuse to engage with labels. And I really don’t care how many people think they are the most important thing psychiatry should deal with. They’re not, period.
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Superfund: Implementation and Selected Issues
Prepared for Members and Committees of Congress
Superfund is the federal government’s principal program for cleaning up the nation’s
contaminated waste sites and protecting public health and the environment from releases of
hazardous substances. Enacted into law as the Comprehensive Environmental Response,
Compensation, and Liability Act of 1980 (CERCLA, P.L. 96-510), the program became known as
Superfund because Congress established a large trust fund—originally supported by taxes levied
on specific petroleum products and chemicals—to provide the majority of the program’s funding
needs. Although the 26-year-old program has seen less attention compared with earlier years,
Superfund issues continue to generate debate. This report provides a background and overview of
the Superfund program and examines four topics that received interest in recent years.
The first issue concerns Superfund program funding: who should pay for the program, general
taxpayers or a dedicated tax on industry? The program was originally funded by a tax on industry
that expired at the end of 1995. Without dedicated taxes, and with a relatively small balance in the
trust fund, Congress has been using general revenues for a larger percentage of cleanup funds.
Members introduced bills to reinstate the taxes in the current and past three Congresses, but so far
these efforts have lacked the necessary support.
The second issue regards Superfund program appropriations. Recent evidence indicates that
appropriations from the past several years have fallen short of program needs. The
Administration’s FY2007 budget proposal for Superfund also fell below levels that, according to
some estimates, are needed to meet program obligations. Without reinstating the Superfund taxes,
any increased appropriation would be funded through General Treasury revenues.
The third issue involves Superfund interaction with abandoned and contaminated hardrock mines.
The number of hardrock mining sites requiring cleanup in future years, particularly those without
identifiable responsible parties, could play an important role in the Superfund funding debate.
There is also a concern that the threat of CERCLA liability may act as a cleanup disincentive for
“good samaritans” who might offer cleanup assistance at abandoned hardrock mines.
The fourth issue concerns Superfund’s role at animal feeding operations. Stakeholders argue
about whether these operations should be required to report ammonia air emissions, primarily
resulting from animal waste, as hazardous substance releases. This issue also concerns the
responsibility for releases of animal waste that reach water bodies.
Legislative Background...................................................................................................................1
Superfund Program Implementation...............................................................................................2
Responding to Releases.............................................................................................................2
Site Assessment...................................................................................................................3
The National Priorities List.................................................................................................3
The Removal Program........................................................................................................4
The Remedial Program.......................................................................................................5
Cleanup Standards..............................................................................................................6
CERCLA Liability....................................................................................................................7
Natural Resource Damages.......................................................................................................7
Federal Superfund Sites............................................................................................................8
The State Role in the Superfund Process..................................................................................8
Selected Superfund Issues...............................................................................................................9
Superfund Trust Fund and Taxes...............................................................................................9
Superfund Program Funding Needs and Appropriation Levels..............................................12
Abandoned Hardrock Mines...................................................................................................15
Backgr ound ....................................................................................................................... 15
Mining Sites and the National Priorities List....................................................................16
Federal Land Issues...........................................................................................................17
Good Samaritan Issues......................................................................................................17
Legi slation ........................................................................................................................ 19
Releases from Animal Feeding Operations.............................................................................19
Conclusion ..................................................................................................................................... 20
Figure 1. Removal and Remedial Program Annual Appropriations Compared With Total
Superfund Annual Appropriation, FY2003-FY2007....................................................................5
Figure 2. Superfund Trust Fund, Beginning Year Balance, FY1994-FY2007..............................10
Figure 3. Superfund Appropriations: FY2001-FY2007 Enacted and FY2008 Requested
Versus Resources for the Future Projections of Funding Needs................................................13
Figure 4. Administration Budget Request Versus Enacted Superfund Appropriation,
FY2004-FY2008 ........................................................................................................................ 15
Table 1. CERCLA and Amendments...............................................................................................2
Author Contact Information..........................................................................................................21
he Superfund program had its 25th anniversary in 2005. Although Superfund debate has
lessened, as compared with past years, particular aspects of the program continue to
generate debate. Policymakers are faced with broad programmatic concerns, as well as T
more specific issues concerning program implementation. This report discusses some of these
questions: Who should pay to clean up the nation’s most contaminated sites if responsible parties
cannot be found? Is the program receiving enough funding to meet its current and future
obligations? How does the statute interact with abandoned hardrock mining sites and animal
feeding operations? To supply the context for these issues, this report first provides a background
and overview of the Superfund program.
On December 11, 1980, Congress enacted the Comprehensive Environmental Response, 1
Compensation, and Liability Act (CERCLA, P.L. 96-510) to create the hazardous substance
cleanup program. The program became known as “Superfund” in reference to the trust fund
established by the law. The fund was originally supported by taxes levied on specific petroleum
products and chemicals, and a corporate environmental income tax. Until recent years, the
Superfund taxes provided the majority of the funding for the needs of the program.
At the time of CERCLA’s enactment, other federal environmental statutes provided federal
agencies with only limited authority to address contamination at abandoned sites. CERCLA gave
the federal government the authority to take direct action to respond to instances involving
uncontrolled releases of hazardous substances (or pollutants and contaminants) that may endanger
public health or the environment. CERCLA also enables the Environmental Protection Agency
(EPA) to compel the persons responsible to clean up their contaminated sites. If the potentially
responsible parties (PRPs) cannot be located, or they are unable (generally for financial reasons)
to perform cleanup, EPA is authorized to use monies from the Superfund Trust Fund to clean up
the site.
CERCLA was expanded and reauthorized by the Superfund Amendments and Reauthorization 2
Act of 1986 (SARA, P.L. 99-499). Amendments after SARA have been narrowly focused. In
1992 and 1996, Congress enacted legislation allowing for easier transfer of military bases with
contaminated areas to local entities. In 1996 and 1999, Congress provided conditional liability
exemptions for financial institutions and recycling facilities. In 2002, Congress enacted the Small
Business Liability Relief and Brownfields Revitalization Act (P.L. 108-118), which added further
liability relief and authorized the Brownfields Program. Table 1 lists the various CERCLA
amendments.
1 CERCLA, as amended, is codified at 42 U.S.C. 9601-9675.
2 SARA also created other authorities, most notably SARA Title III, otherwise known as the Emergency Planning and
Community Right-to-Know Act (EPCRA).
Table 1. CERCLA and Amendments
(codified generally as 42 U.S.C. 9601-9675)
Year Act Public Law Number
1980 Comprehensive Environmental Response, Compensation, and Liability Act P.L. 96-510
1986 Superfund Amendments and Reauthorization Act P.L. 99-499
1990 Omnibus Reconciliation Act (extended authorization) P.L. 101-508, §§ 6301, 11231
1992 Community Environmental Response Facilitation Act P.L. 102-426
1996 Defense Authorization Act of Fiscal Year 1997 P.L. 104-201, § 334
1996 Asset Conservation, Lender Liability, and Deposit Insurance Protection Act P.L. 104-208, Division A, Title II, Subtitle E
1999 Superfund Recycling Equity Act P.L. 106-113, appendix I, title VI
2002 Small Business Liability Relief and Brownfields Reauthorization Act P.L. 107-118
The National Oil and Hazardous Substances Pollution Contingency Plan (NCP) contains the 3
procedures and regulations for implementing the Superfund program. Generally, EPA leads the
response to releases on land and in inland waters, whereas the Coast Guard leads the response in
coastal waters of the United States.
Actions under the Superfund program are triggered by a release (or threat of release) of a
hazardous substance into the environment. The CERCLA “environment” includes all media:
water (surface and groundwater), soil, and air. CERCLA defines “hazardous substance” to include
all the materials identified as hazardous under the Resource Conservation Recovery Act (RCRA),
the Clean Water Act (CWA), the Clean Air Act (CAA), and the Toxic Substances Control Act
(TSCA). CERCLA also authorizes EPA to respond to releases of “pollutants or contaminants,”
which are broadly defined to include virtually anything that can threaten the health of “any
orga nism.”
Petroleum is specifically excluded from the definition of hazardous substance and pollutant or
contaminant. This means that neither CERCLA authority nor trust fund monies may be used to 4
respond to releases of petroleum. However, the 2002 Brownfields law authorizes the cleanup of
some petroleum-contaminated sites.
3 The NCP is codified at 40 CFR Part 300.
4 Petroleum spills are covered under other statutes, such as the Oil Pollution Act of 1990. For more information
regarding oil spills, see CRS Report RL33705, Oil Spills in U.S. Coastal Waters: Background, Governance, and Issues
for Congress, by Jonathan L. Ramseur.
The Superfund cleanup process starts either with a site discovery or with a notification to EPA of
a potential hazardous substance release. Sites of concern can be discovered by various parties:
citizens, state agencies, or EPA Regional offices. CERCLA § 103 requires release notification.
Facilities must notify the National Response Center if there has been a release of a hazardous 5
substance above a certain threshold, termed a reportable quantity (RQ).
Since the inception of the Superfund program, EPA has catalogued more than 47,000 potentially
contaminated sites in the agency’s database: the Comprehensive Environmental Response, 6
Compensation, and Liability Information System (CERCLIS). After a site has been identified, 7
EPA or a state agency performs a preliminary assessment to judge the site’s potential hazards.
After further screening, EPA uses the Hazard Ranking System (HRS) to score the site’s
contamination and its risk of exposure to surrounding communities.
Sites that score high enough on the HRS are eligible for the National Priorities List (NPL), which
is generally considered the official list of the most hazardous sites in the nation. Only a small
percentage of the sites assessed are placed on the NPL. Over Superfund’s history, EPA has placed
1,569 sites on the NPL (as of October 1, 2007). Of these sites, 321 have met cleanup goals and
have been subsequently removed (deleted) from the NPL. At an additional 1,030 sites all physical
construction activities have been performed, and operation and maintenance (such as treatment of 8
contaminated groundwater) is ongoing. These sites are referred to as “construction complete.”
The NPL has been described as the centerpiece of the Superfund program, and thus it has been a
focal point for Superfund criticism. As noted in a comprehensive report prepared by Resources 910
for the Future (RFF) (hereafter referred to as the RFF Report):
The expense and pace of cleaning up NPL sites has been, and continues to be, a contentious
topic among followers of the Superfund program.... [E]ven though more than half of all NPL
sites have been deemed “construction complete”—meaning that all physical remedies are in
place and immediate risks posed by the site have been addressed—there remain hundreds of
sites placed on the NPL during the early years of the program where cleanup remedies have
still not been fully implemented.
Some interest groups have questioned the listing process itself and the slow pace of cleanup at 11
NPL sites. The decision to list a site on the NPL is ultimately at EPA’s discretion. Many factors,
5 40 CFR § 302.6. EPA codified the list of hazardous substances and their respective RQs in 40 CFR § 302.4.
Hazardous substance RQs can range from 1 pound to 5,000 pounds.
6 http://www.epa.gov/superfund/sites/products/archinv.htm, visited October 3, 2007.
7 In practice, this activity is often carried out by a contractor.
8 http://www.epa.gov/superfund/sites/query/queryhtm/npltotal.htm, visited October 3, 2007.
9 In the FY2000 VA-HUD-Independent Agencies appropriation (P.L. 106-74) conference report, Congress directed
EPA to contract with RFF to analyze the projected federal costs of the Superfund program for the period FY2000-
FY2009.
10 Katherine Probst, et al., 2001, Superfund’s Future: What Will It Cost?, Resources for the Future, Washington, DC,
2001, p. 31.
11 The process has been called “more art than science.” Probst, Katherine, 2005, “Superfund at 25 - What Remains To
(continued...)
other than the HRS score, influence whether a site is proposed for listing—for example, state 121314
support, community concerns, and Superfund budgetary issues. EPA has stated that
The NPL is only of limited significance, however, as it does not assign liability to any party
or to the owner of any specific property. Neither does placing a site on the NPL mean that 15
any remedial or removal action necessarily need be taken.
There are two categories of response activity in the Superfund program: (1) short-term removal
action and (2) long-term remedial action. The trust fund can support removal action at NPL or
non-NPL sites. However, trust fund monies can be used for remedial activity only if the site is on 16
the NPL.
The removal program grew out of the recognition that certain hazardous substance releases would
necessitate a quick response. Removal action seeks to stabilize a site, and in some cases this
minimizes the need for further cleanup. Removal action can be undertaken at sites regardless of 17
their NPL status, and historically, most removal actions occur at non-NPL sites. CERCLA limits 18
removal action to a one-year effort and expenditures of not more than $2 million. This limit
applies only to efforts led by EPA and funded by trust fund dollars, not at sites where the
responsible party is performing cleanup.
Not all actions under the removal program are considered equally urgent. EPA groups removal
actions into the following three categories:
(1) Classic emergencies. Those actions where the release requires that on-site activities be
initiated within minutes or hours of the determination that a removal action is appropriate.
(2) Time-Critical Actions. Those actions where, based on an evaluation of the site, EPA
determines that less than six months is available before site activities must be initiated.
(...continued)
Be Done?” Resources, Fall 2005, p. 20.
12 P.L. 104-19 (an FY1995 appropriations bill) directed EPA to obtain a letter of concurrence from the governor of a
state prior to listing a site in that state on the National Priorities List. P.L. 104-134 (an FY1996 appropriations bill)
provided similar direction. EPA, as a matter of policy to further enhance the role of states in the Superfund program,
continues to request a governor’s letter of concurrence prior to NPL listing.
13 An NPL designation generally carries a stigma, and local communities often worry about the effects an NPL site will
have on nearby property values.
14 For example, EPA might be hesitant to list “mega sites” on the NPL, unless the parties responsible for the site have
been identified. RFF Report, p. 89.
15 See, for example, U.S. EPA, “National Priorities List for Uncontrolled Hazardous Waste Sites,” 70 Federal Register
54329, September 14, 2005.
16 40 CFR § 300.425(b)(1).
17 From FY1992-FY1999, approximately 76% of removal actions occurred at non-NPL sites. RFF report, p. 16.
18 CERCLA § 104(c)(1). These limits can be exceeded if a waiver is obtained. EPA estimated that as of January 2001,
about 8% of the removal actions conducted by EPA have exceeded $2 million. RFF report, p.16, citing EPA analysis.
(3) Non-Time-Critical Actions. Those actions where, based on an evaluation of the site, EPA 19
determines that more than six months is available before on-site activities must begin.
Removal actions may include, but are not limited to:
• repairing a hazardous waste storage unit (e.g., landfill cover),
• transporting leaking drums to an appropriate disposal facility, and
• erecting a security fence to reduce opportunity of exposure.
In recent years, the removal program has consistently received about one-third of the amount
appropriated to the remedial program (see Figure 1).
Figure 1. Removal and Remedial Program Annual Appropriations Compared With
Total Superfund Annual Appropriation, FY2003-FY2007
Sources: Prepared by the Congressional Research Service from the following: (1) Removal and Remedial data:
FY2003 and FY2004 amounts are EPA estimates provided by the Office of Congressional Affairs; FY2005
amounts are from the conference report on the Interior, Environment, and Related Agencies Appropriations Act
for FY2006 (H.R. 2361, H.Rept. 109-188, p. 154); FY2006 and FY2007 amounts are from EPA’s FY2007 and
FY2008 budget justifications, Appendix, Program Projects Table, p. 82 and p. 78, respectively; (2) Total
Appropriations data: FY2003-FY2005 are from prior year funding comparisons in committee reports on annual
appropriations bills from FY2004-FY2006; FY2006 and FY2007 are from EPA’s FY2007 and FY2008 budget
justifications. FY2005 and FY2006 amounts include rescissions.
The remedial program is the core of the Superfund program. In contrast to removal actions,
remedial actions, in general, take more time, cost more money, and represent a more permanent
19 See EPA’s Response Program description at http://www.epa.gov/superfund/programs/er/hazsubs/ralts.htm.
solution. Congress consistently apportions about half of the annual Superfund appropriation to the 20
remedial program (see Figure 1).
The remedial program consists of multiple process steps, each with its own term of art. Although
the remedial process does not typically follow a linear, step-by-step progression, a simplified
version of events is discussed below, highlighting the main milestones.
The remedial program first involves a comprehensive investigation of the site and analysis of
cleanup alternatives or remedies. This examination process (the Remedial 21
Investigation/Feasibility Study, or RI/FS) can take months, or even years.
Following completion of the RI/FS, EPA selects a remedy to address the site’s contamination.
EPA must solicit public comment when determining the remedy for the site, and states typically
play an active role in the remedy selection process. CERCLA directs EPA to select a permanent
remedy or treatment whenever possible. The less-preferred option is to leave the waste in place
and reduce human exposure (e.g., soil cover or security fence). If the method chosen is not
permanent, EPA must review the site every five years to ensure remedy protection.
After EPA decides the site-specific cleanup remedy and issues a formal Record of Decision
(ROD), the remedial design (RD) phase commences. The RD is the engineering plan used to
implement the remedy chosen by EPA. Development of the RD takes, on average, approximately 22
two years. After the RD is complete, the actual cleanup process (Remedial Action) begins. For
sites where cleanup has been completed, the total process, from start (a proposed listing on the 23
NPL) to finish (cleanup goals achieved), takes between 8 and 11 years, on average.
CERCLA directs EPA to assure that Superfund site cleanups protect human health and the 24
environment. CERCLA specifically requires cleanups to meet “any standard, requirement, 25
criteria, or limitation” under any federal or state environmental law. EPA may waive this
requirement if, for example, meeting the standard will not provide a balance between (1) the need
for protection of health and the environment at the site and (2) the availability of monies in the 26
trust fund for other locations.
20 Other substantial accounts in the total appropriation include the removal program ($194 million), enforcement ($180
million), and operations and administration ($122 million). Amounts reflect FY2006 enacted appropriation.
21 The RFF report (p. 48) cites EPA data from FY1993-FY1999, which indicates the average duration is 2.6 years.
22 The RFF report cites EPA’s estimate at 1.7 years, but the report authors calculated an average RD duration of 2.25
years. RFF report at p. 210.
23 EPA estimates the average duration is eight years, but the RFF report finds this calculation to be inaccurate because
only completed actions are included. If incomplete actions are also included, as demonstrated in the RFF report, the
average duration increases to 11 years ( pp. 48-52).
24 CERCLA § 121(d).
26 CERCLA provides five other conditions that allow EPA to waive the requirements. CERCLA § 121(d)(4).
CERCLA contains a liability scheme that is, by any measure, stringent. If a hazardous substance
is released, or threatened to be released, from a facility, CERCLA liability may attach to a wide
variety of persons. A potentially responsible party (PRP) is any individual or company that may
have contributed to contamination at a Superfund site.
PRPs may include
• current or former owners of a facility or vessel,
• current or former operators of a facility or vessel,
• generators who sent hazardous substances to the site, and
• transporters who brought hazardous substances to the site.27
CERCLA liability is considered to be strict, joint and several, and retroactive:28
• Strict liability means that a party can be held responsible regardless of
negligence. Moreover, under CERCLA, proof of causation is not necessary.
• Joint and several liability means that any liable party can be held responsible for
the full cost of cleanup, regardless of the degree of involvement.
• Retroactive liability means that parties can be held responsible for actions that
caused contamination prior to the passage of CERCLA.
CERCLA’s liability scheme provides EPA with strong enforcement authority to require PRPs to
address site contamination. The joint and several component creates an incentive for one PRP
(already identified by EPA) to locate other PRPs, so that the cleanup costs can be shared.
The statute does provide several defenses, exemptions, and mechanisms for eliminating or 29
reducing a party’s CERCLA liability. This report does not discuss these devices. For
information regarding several of them, see CRS Report RL31911, “Innocent Landowners” and
“Prospective Purchasers” Under the Superfund Act, by Robert Meltz.
In addition to cleanup costs, CERCLA requires PRPs to address the environmental harm they
caused by restoring or replacing any injured natural resources. PRPs must also pay for the lost use
of a publicly owned resource and the associated damage assessment. CERCLA designates federal,
state, and tribal authorities to serve as natural resource trustees within their jurisdiction. Only the
27 CERCLA § 107(a).
28 The CERCLA statute does not include the text “strict, joint and several, and retroactive.” These features of CERCLA
liability derive from legislative history, case law, and the CERCLA instruction that its liability standard is the same as
that in Clean Water Act § 311. See CERCLA § 101(32).
29 See, for example, CERCLA §§ 107(b), 107(d), 107(n), 107(o), 107(p), 107(q), 107(r).
30 For more background on this issue, see CRS Report RS20772, Superfund and Natural Resource Damages, by Mark
Reisch.
trustees can make a natural resource damages claim under CERCLA.31 In some respects, liability
for natural resource damages is more narrow than the liability for cleanup costs. For example,
natural resource injuries occurring wholly before the enactment of CERCLA (1980) are 32
excluded. Also, a claim must be brought within three years of its discovery and connection to a
particular release.
With the passage of SARA in 1986, federal facilities became subject to CERCLA in the same 33
fashion as non-governmental entities. Before SARA was enacted, no federal facilities were
placed on the National Priorities List (NPL). Since 1986, EPA has placed 172 federal facilities on 34
the final NPL. Almost all federal facilities on the NPL are defense sites, including military
facilities administered by the Department of Defense (DOD) and former nuclear weapons
production sites administered by the Department of Energy (DOE). These sites are among the
most contaminated of those on the entire NPL.
The Superfund Trust Fund cannot be used to pay for cleanup at federal facilities. The agency
responsible for the contamination is responsible for cleanup, and funding for removal or remedial
action must come from that agency’s budget. However, the trust fund may be used to provide
alternative water supplies if groundwater contamination migrates beyond the facility boundaries
and other PRPs are involved at the site.
At federal sites on the NPL, EPA oversees remedy selection and remedial action. Federal sites
that do not qualify for the NPL are subject to state laws concerning removal, remedial action, and
enforcement. At these sites, states oversee cleanup activity. There are almost 800 sites nationwide 35
that fall into this category.
SARA encourages state involvement at Superfund sites, and outlines minimum requirements for
state participation at virtually every phase of decision-making, from site assessment to
enforcement and actively managing the site cleanup. CERCLA § 104(c) requires states to pay
10% of the remedial cleanup costs, and 100% of the operation and maintenance costs beginning
10 years after construction of the remedy has been completed. However, if the facility was
operated by the state (or a political subdivision thereof) at the time of disposal, the state must
share 50% of the removal or remedial cleanup costs.
31 “Although private parties do not have a statutory cause of action for natural resource damages, they may assert
similar claims under common law theories, such as negligence and strict liability.” Bradley M. Marten and Cestjon L.
McFarland, “Litigating CERCLA Natural Resource Damage Claims,” Environment Reporter, July 19, 1991, p. 671.
32 CERCLA § 107(f).
33 CERCLA § 120.
34 http://www.epa.gov/superfund/sites/query/queryhtm/npltotal.htm visited May 24, 2007.
35 A CERCLIS search (January 18, 2007) identifies 787 federal sites not on the NPL, of which 15 were deleted from
the NPL and 6 are proposed to be on the NPL.
This cost-sharing component may play a role in whether sites are listed on the NPL. Although not
currently required by law, EPA typically does not propose new sites to the NPL without a state’s 36
agreement. For budgetary reasons, states may be hesitant to add Fund-led sites to the NPL.
Most Superfund sites are not on the NPL. Of the roughly 10,000 sites currently in the CERCLIS
database, about 90% are not on the NPL. At these non-NPL sites, the federal role may include
cleanup assessment or removal activity, or the federal government may have no presence at all.
State cleanup programs have the authority to assess and clean up non-NPL sites and to identify
other potential hazardous sites. The majority of the state cleanup programs have authorities 37
similar to the federal Superfund program.
This section of the report discusses four Superfund issues that have received interest in recent
years. The first two issues concern program funding, including who should fund the program
(industry or general taxpayers) and how much funding is needed to meet the program’s
obligations. The second two issues concern CERCLA interaction at specific site types: abandoned
hardrock mines and animal feeding operations.
In February 2002, controversy erupted over the Bush Administration’s proposal not to request 39
renewal of the Superfund taxes in its FY2003 budget submission—a decision repeated in its
submissions for FY2004 through FY2008. Congress has concurred with the Administration’s
position and chosen not to renew the Superfund taxes.
The tax authority expired in 1995, but the fund’s balance remained positive until FY2003.
Without dedicated taxes, and with a relatively small balance in the trust fund, Congress has been
using general revenues for a larger percentage of cleanup funds. Although several Members of
Congress have introduced bills to reinstate the taxes during these years, such efforts have lacked
the necessary support.
CERCLA established the Superfund program and its trust fund in 1980. Although General 40
Treasury revenues have provided some support for the program since its inception, the trust
fund traditionally provided most of the funding for the Superfund program. Congress raised trust
fund revenues primarily through excise taxes on the petroleum and chemical industries, and a
37 Environmental Law Institute, 2002, An Analysis of State Superfund Programs: 50-State Study, 2001 Update, p. 13.
38 For a more comprehensive discussion, see CRS Report RL31410, Superfund Taxes or General Revenues: Future
Funding Issues for the Superfund Program, by Jonathan L. Ramseur, Mark Reisch, and James E. McCarthy.
39 The Administration had not requested renewal of the taxes in its FY2002 budget submission either, but the issue did
not become particularly contentious, in part, perhaps, because the fund had a larger balance at the time.
40 From FY1991-FY1995—the five year period prior to the expiration of the Superfund taxes—General Treasury
revenues contributed approximately 17% of the total revenues supporting the Superfund Trust Fund.
corporate environmental income tax. These dedicated taxes sustained the trust fund until the
taxing authority expired December 31, 1995. Since 1995, efforts to reinstate the taxes have not
At the end of FY1996, the trust fund reached a peak balance of $3.8 billion (see Figure 2).
Without a consistent source of funding, the balance dwindled essentially to zero by the end of 41
FY2003. The annual budgets have compensated for the lack of dedicated tax revenue by
increasing the contribution from the general fund of the U.S. Treasury. In fiscal years 2004-2007,
virtually the entire Superfund program was funded through General Treasury revenues
appropriated by Congress. The FY2008 budget request followed this course, proposing to fund
the vast majority of the $1.24 billion requested appropriation from General Treasury revenues.
Figure 2. Superfund Trust Fund, Beginning Year Balance, FY1994-FY2007
Source: Prepared by the Congressional Research Service, with information provided by OMB Budget of the
United States Government, Appendix, Fiscal Years 1996-2008.
In a majority of cases, Superfund cleanups are paid for by potentially responsible parties
(PRPs)—usually current or previous owners and/or operators of the site. According to EPA, PRPs 42
conduct cleanup at more than 70% of the sites on the NPL. At approximately 30% of the NPL
sites, either EPA cannot locate PRPs for these properties or the PRPs located do not have the
necessary financial resources to assist with cleanup. It is primarily for this group of NPL sites
41 The trust fund received (and continues to receive) income from interest earned, cost recoveries, and fines and
penalties, but these sources are minor compared with the previous tax revenues.
42 At many sites, EPA cannot immediately locate a financially viable PRP, or there are disputes among the PRPs
concerning their degree of responsibility. In such cases, the statute permits EPA to proceed with cleanup using the trust
fund’s resources, to locate PRPs after or during cleanup, and to recover the cleanup costs from PRPs at a later date.
(often called “orphan” sites) that EPA uses funds from the trust fund to conduct cleanup activities.
In general, the current Superfund funding debate (i.e., whether a dedicated tax or General 43
Treasury revenues should support the trust fund) applies to this subset of NPL sites.
Proponents of reinstating the Superfund taxes argue that the cleanup of orphan sites should rely
on taxes paid by the chemical and petroleum industries and companies that use CERCLA
hazardous substances, not ordinary taxpayers. They refer to this as the “polluter pays” principle.
When Bush Administration spokespersons indicate support for the “polluter pays” concept, they
generally mean that cleanup should be funded by the parties directly involved (i.e., PRPs) rather
than by industrial sectors or corporations that did not directly contribute to a specific site’s
contamination. Opponents of reinstating the tax argue, for example, that the tax is overreaching
and unfair, as it applies to all industry sectors and to both compliant and noncompliant
companies. Superfund tax proponents contend that in the context of federal budget deficits, it may
be difficult to maintain spending at needed levels without dedicated taxes.
Amendments to CERCLA have addressed some of the claims of unfairness. The Asset
Conservation, Lender Liability, and Deposit Insurance Protection Act of 1996 (P.L. 104-208)
limited banks’ and other lenders’ exposure to Superfund liability at a contaminated site to the
amount of their loans. Businesses engaged in recycling were absolved of liability if they met
certain criteria showing that their activities were genuine recycling, and not shams to disguise
illegal disposal of hazardous substances (Superfund Recycling Equity Act, P.L. 106-113).
Additional limits on CERCLA liability were provided in the Small Business Liability Relief and
Brownfields Revitalization Act (P.L. 107-118), which made contributors of small amounts of
hazardous substances at an NPL site exempt from liability if the wastes were disposed prior to
April 1, 2001. Also exempted were residential property owners, small businesses, and small
nonprofit organizations that sent only municipal solid waste to NPL sites, as well as property
owners whose land abuts a Superfund site, prospective purchasers of contaminated property, and
innocent landowners.
Since the 107th Congress, legislation has been introduced that would reinstate the Superfund th
taxes, but these efforts have failed. In the 110 Congress, several members, including Senate
Environment and Public Works Committee Chairman Barbara Boxer and Subcommittee on
Superfund and Environmental Health Chair Hillary Clinton, have spoken in favor of restoring the
taxes. Representative Maurice Hinchey (H.R. 1887) and Senator Robert Casey (S. 1179)
introduced companion bills that would reinstate the taxes, and for the first five years would
increase them by 50% to fund a response at “megasites” (where cleanup costs exceed $50
million) and at sites that present high health risks. Representatives Earl Blumenauer and Frank
Pallone introduced H.R. 3636, which would reimpose the taxes beginning with the date of
enactment until January 1, 2018. Representative Pallone’s H.R. 3962 would restore the taxes at
their previous rates through the end of 2015.
43 Although 70% of the NPL cleanups are performed by PRPs, the RFF report (chapter 5) finds there may be many
orphan sites eligible for the NPL (i.e., have a high enough HRS score) that remain unlisted for various reasons
(discussed in the NPL subsection above). Thus, one might argue that the 70%-30% ratio understates the universe of
orphan sites that need federal funding for cleanup.
Related to the Superfund program funding debate is the concern that the Superfund program is
not receiving enough funding to match its annual obligations. Recent evidence indicates that
appropriations from the past several years have fallen short of program needs. If Congress
decides to increase annual appropriations without reinstating the Superfund taxes, General
Treasury revenues contribution to the program will increase, possibly conflicting with deficit
reduction goals.
As noted above, in July 2001, Resources for the Future (RFF) released a comprehensive study, 44
mandated by Congress, that estimated future program needs for fiscal years 2000-2009. RFF
calculated that the base case program needs for FY2008 would be $1.7 billion. The report also
estimated a high and low case: $1.5 billion and $1.8 billion per year, respectively. RFF concluded
that funding needs would remain above $1.6 billion annually through FY2009 (using RFF’s base
case). As Figure 3 indicates, annual Superfund appropriations in recent years have consistently
been several hundred million dollars less than the funding needs projected by RFF.
Several factors contributed to RFF’s projections for increased funding needs. First, RFF
anticipated that numerous “mega sites” would move beyond the analysis and design phases and 45
into the actual construction and cleanup phases. In the RFF analysis, the cost of remedial action
at mega sites was projected to remain above historic levels through FY2007, and the cost of the
Superfund program as a whole was projected to remain above FY2001 levels through at least 46
FY2009 (the final year in the analysis).
Second, EPA’s Office of Inspector General (IG) highlighted the concern that hardrock mining
sites may have a significant financial impact on the trust fund. The IG identified “156 hardrock
mining sites nationwide that have the potential to cost between $7 billion and $24 billion to clean
up.” Although the IG points out uncertainty regarding the risks to human health and the 47
environment at these sites, there is also uncertainty concerning PRPs and their ability to pay for 48
44 In the FY2000 VA-HUD-Independent Agencies appropriation (P.L. 106-74) conference report, Congress directed
45 “Mega sites” are sites at which the projected cleanup cost is $50 million or more. The average cost at mega sites is
projected to be $140 million. RFF Report, p. 87.
46 RFF Report, pp. 127, 266.
47 This factor is important because sites must be on the NPL to qualify for long-term cleanup (remedial) assistance from
the trust fund.
48 EPA Office of Inspector General, Annual Superfund Report to Congress for Fiscal Year 2004, EPA-350-R-05-001,
August 2005, p. 3.
Versus Resources for the Future Projections of Funding Needs
(amounts in millions prior to transfers)
Sources: Prepared by the Congressional Research Service using the following sources: FY2001-FY2005 enacted
amounts are from prior year funding comparisons in committee reports on annual appropriations bills from
FY2002-FY2006; FY2006 and FY2007 enacted (FY2007 is from continuing resolutions), and FY2008 requested
amounts are from EPA’s FY2007 and FY2008 budget justifications; projected funding levels are from the
Resources for the Future report, Superfund’s Future: What Will It Cost?
There is evidence that funding shortfalls have occurred in recent years. According to an EPA IG
report, in FY2002, the EPA regional offices received no funds for seven of the sites at which the
regions requested construction funding. At five different sites, the Regions received less than half 49
of the total funds requested. In FY2003, the IG identified an additional 11 sites that could not
begin construction because of a funding shortfall, and at least 5 other sites that did not receive 50
their full funding request in that year. Although the IG did not report on the subject in FY2004,
a survey of EPA staff by the House Energy and Commerce Committee Democratic staff found a 51
reported shortfall of $263.1 million. EPA challenged some of the committee data but confirmed
49 Letter of October 25, 2002, from Nikki L. Tinsley, EPA Inspector General, to Senator James Jeffords, Chairman,
Committee on Environment and Public Works, and Senator Barbara Boxer, Chair, Superfund, Toxics, Risk, and Waste
Management Subcommittee, pp. 1-3.
50 U.S. EPA, Office of Inspector General, Congressional Request on Funding Needs for Non-Federal Superfund Sites,
Report 2004-P-00001, January 7, 2004, pp. 4, 8-9.
51 Letter from Representative John Dingell, Ranking Member of the House Committee on Energy and Commerce, to
Mike Leavitt, EPA Administrator, August 13, 2004.
in letters to House and Senate Democrats that, due to lack of funding, it did not start construction 52
at 19 sites that were ready for construction in FY2004.
Congress could increase appropriation levels to meet the increased funding needs. The
Administration notes that it requested increases in funding in both its FY2004 request for $1.39
billion and its FY2005 request for $1.38 billion, which Congress did not provide. Congress cut
the FY2004 and FY2005 requests by $132 million and $134 million, respectively. Although the
Administration’s request in FY2006 ($1.28 billion) was lower compared with previous years,
Congress cut the proposal by $40 million, enacting $1.24 billion. The Administration requested
$1.26 billion for FY2007, a $20 million decrease from its previous request, but $20 million above th
the amount enacted by Congress in FY2006 (See Figure 4). The 109 Congress adjourned
without finalizing FY2007 appropriations for EPA, but it enacted a continuing resolution (P.L.
109-383, H.J.Res. 102) to provide funding through February 15, 2007. Pursuant to the formula
provided in the continuing resolution, the Superfund program will continue to receive funding 53
consistent with the FY2006 enacted appropriation. For FY2008 the Administration has
requested $1.24 billion.
Given RFF’s projected funding needs for the Superfund program and the relatively minimal
amounts available to the fund from sources other than general revenues, Congress will face
competing interests if it attempts to appropriate all of Superfund’s needs. RFF estimates that
General Treasury revenue contributions as high as $1.5 billion per year would be needed to
finance Superfund through the rest of the decade in the continued absence of Superfund taxes.
This could prove difficult in light of current federal deficits and other funding priorities.
52 See Letter from Mike Leavitt, EPA Administrator to Representative John Dingell, Ranking Member of the House
Committee on Energy and Commerce, October 14, 2004. See also “FY04 Cleanup Delays Renew Democrats’ Criticism
of Superfund Budget,”Inside EPA Superfund Report, October 25, 2004. The data in the article were confirmed by EPA
in a personal communication March 3, 2005.
53 The funding formula sets continuing appropriations for programs and activities generally at either the current
(FY2006) level, the level in the pertinent House-passed bill, or the level in the Senate-passed bill, whichever is lowest.
On May 18, 2006, the House passed the FY2007 Interior, Environment, and Related Agencies appropriations bill (H.R.
5386, H.Rept. 109-465) providing a total of $1.26 billion for EPA’s Superfund account (prior to transfers to other
accounts). This is $14.8 million more than the FY2006 enacted amount. The Senate did not pass a bill, thus under the
continuing resolution, funding will continue at FY2006 levels.
FY2004-FY2008
Sources: Prepared by the Congressional Research Service using data from the following sources: FY2004-
FY2005 enacted amounts and FY2004-FY2006 requested amounts are from prior year funding comparisons in
committee reports on annual appropriations bills from FY2004-FY2006; FY2006 enacted amount and FY2007
and FY2008 amounts are from EPA’s FY2007 and FY2008 budget justifications.
Although CERCLA liability is a powerful tool for EPA to drive cleanup of contaminated sites, the
threat of CERCLA liability may act as a cleanup disincentive at abandoned hardrock mines.
There are thousands of inactive or abandoned hardrock mines in the United States. As discussed
previously, the number of hardrock mining sites listed on the NPL in future years, particularly
those without identifiable PRPs, could play an important role in the Superfund funding debate.
This section examines the interaction between CERCLA and contaminated hardrock mines.
Hardrock mining involves the extraction of metals found in the earth’s hard formations.54
Although the raw materials generated are essential to the U.S. economy, the hardrock mining 55
process creates vast quantities of waste materials. EPA’s Toxic Release Inventory (TRI) data
54 Hardrock mining includes gold, silver, copper, and other metals, but not coal.
55 For example, in 1992, gold and copper mining in the United States generated 1.2 billion metric tons of waste
materials. In contrast, approximately 200 million metric tons of municipal solid waste are produced annually. U.S.
EPA, 1997, National Hardrock Mining Framework, Appendix A, at A-1, at http://www.epa.gov/superfund/programs/
aml/policy/hardrock.pdf.
show that the metal mining industry consistently leads other industry sectors in total annual 56
releases of TRI chemicals.
Hardrock mining played a central role in the development of the American West. However, as
mining sites became uneconomical, mines were closed or the owners simply walked away. The 57
precise number of inactive or abandoned mines is unknown. Though arguably a conservative 58
estimate, EPA states that there are 200,000 inactive or abandoned mines throughout the 59
country. The actual number of sites that pose a threat is also unknown. Estimates vary, and they
seem to depend on how a threat is classified. For example, the Western Governors Association 60
estimated that approximately 20% of abandoned mine lands (AMLs) may present a “concern” to 61
water quality, public safety, or both. In its 1997 report, EPA found that only a small percentage
of AMLs “contribute significantly” to threats to human health or the environment, but the
aggregate impact is substantial, with many localized areas suffering serious environmental
impacts. In 2002, an EPA team found that 5%-10% of the abandoned mines across the country
may pose a “real environmental and health risk.”
CERCLA provides EPA with the authority to address environmental contamination (e.g., acid 62
mine drainage) at AMLs. Pursuant to CERCLA authority, EPA has completed or overseen 63
removal actions at 74 hardrock mining sites. EPA has listed at least 88 hardrock mining sites on 64
the NPL. At least 17 of these mines are considered mega sites, with cleanup costs over $50
million at each site.
Considering the large universe of AMLs, one might question why such a small percentage of the
sites are listed on the NPL. There are several factors, particular to the mining industry, that may
explain this. First, AML ownership often goes back more than 100 years and involves numerous
private and public entities. Thus, the identification of PRPs is especially complex at mining
56 See TRI Public Data Releases at http://www.epa.gov/tri/tridata/index.htm.
57 For more information on inventory efforts, see, for example., GAO, 1996, Federal Land Management: Information
on Efforts to Inventory Abandoned Hardrock Mines, GAO/RCED-96-30, available at http://www.gao.gov/archive/
1996/rc96030.pdf.
58 The Mineral Policy Center places the number at approximately 500,000 (see http://www.mineralpolicy.org/
AbandonedMineLegacy.cfm). Though it is often quoted, the 1996 GAO report and others find fault with the Mineral
Policy Center’s estimate.
59 U.S. EPA, 1997, National Hardrock Mining Framework, p. 2, at http://www.epa.gov/superfund/programs/aml/
policy/hardrock.pdf; U.S. EPA Office of Inspector General, 2004, Nationwide Identification of Hardrock Mining Sites,
Report No. 2004-P-00005, p. 4.
60 Most groups use the phrase “abandoned mine lands” (AMLs), but several sources describe the sites as “inactive or
abandoned mines” (IAMs). In general, these terms seem to be interchangeable, though AMLs include land that is
contiguous to the mine proper.
61 Western Governors Association, 1998, Cleaning Up Abandoned Mines: A Western Partnership, p. 5, available at
http://www.westgov.org/wga/publicat/miningre.pdf.
62 CERCLA § 104 (Response Authorities).
63 See EPA’s abandoned mine lands CERCLIS inventory at http://www.epa.gov/superfund/programs/aml/amlsite/
removal.htm.
64 For EPA’s list of AMLs on the NPL (as of April 2005), see http://www.epa.gov/superfund/programs/aml/amlsite/
npl.htm.
sites.65 Second, the average cleanup cost—about $22 million—at a non-mega mining site is more
than double the average cost of non-mega sites in other industries. Cleanup activities at mega
mining sites can cost hundreds of millions of dollars. Third, states may provide some resistance to
Fund-led (i.e., sites without PRPs) cleanup at mining sites, because the Superfund statute requires 66
the state to pay 10% of the remedial costs and 100% of operation and maintenance costs. At 67
mining sites, these costs could be significant and last for an indefinite period of time.
On the other hand, several factors may lead EPA and the states to increase the number of AMLs
on the NPL. For instance, growing populations in the West, due either to business development or
purchases of second homes, may bolster the pressure to remove contamination from local water
sources. Moreover, CWA requirements may provide further pressure to address the pollution from
AMLs. Section 303(d) of the Clean Water Act requires states to identify pollutant-impaired water
segments and develop “total maximum daily loads” (TMDLs) that set the maximum amount of 68
pollution that a water body can receive without violating water quality standards.
As with the total number of inactive or abandoned mines, the precise number of these mines on 69
federal lands is unknown. The federal government owns a substantial percentage of the land in 70
the western states, and many of the AMLs are on federal land. CERCLA prohibits the use of 71
trust fund dollars at federally owned facilities. Federal land managers may need to clean up the
site with funds from their own budget, if the federal government is considered the owner of the
abandoned mine.
The term “good samaritan” refers to parties (e.g., government agencies, nonprofits, and
corporations) that attempt to clean up abandoned mines for which the parties have no legal
responsibility. In most cases, these parties have a vested interest in cleaning up the contaminated
mines and are not acting purely for altruistic reasons, as the term “good samaritan” might imply. 72
Some stakeholders believe that the threat of CERCLA liability serves as a disincentive to good
65 At the start of EPA’s enforcement-first policy in FY1991 through FY1998, only 33% of remedial action at mining
sites was performed by PRPs. In contrast, the same measurement at other site types (chemical manufacturing, oil
refining, etc.) was generally doubled, ranging from 56% to 89%. Probst, p. 216.
66 CERCLA § 104(c)(3).
67 RFF Report, p. 92.
68 For more information on the TMDL program, see CRS Report 97-831, Clean Water Act and Total Maximum Daily
Loads (TMDLs) of Pollutants, by Claudia Copeland.
69 For various agency efforts on this calculation, see GAO, 1996, Federal Land Management: Information on Efforts to
Inventory Abandoned Hardrock Mines, GAO/RCED-96-30.
70 The Bureau of Land Management and the Forest Service own almost 40% of the land in the 12 western states.
National Research Council, 1999, Hardrock Mining on Federal Lands, p. 19.
71 CERCLA § 111(e)(3).
72 CWA liability is also a concern for Good samaritans. For more information regarding the CWA, see CRS Report
RL30030, Clean Water Act: A Summary of the Law, by Claudia Copeland. For a discussion regarding CWA liability at
abandoned mines, see, for example, McAllister, Sean, 2003, “Unnecessarily Hesitant Good Samaritans: Conducting
Voluntary Cleanups of Inactive and Abandoned Mines Without Incurring Liability,” 33 Environmental Law Reporter
10245, at http://www.restorationtrust.org/goodsam.pdf (hereafter “McAllister, 2003”).
samaritan groups who might offer cleanup assistance. Under CERCLA’s joint and several
liability, EPA can hold one PRP responsible for the entire site cleanup. Under the statute’s broad
liability structure, good samaritans could potentially become liable as site owners, operators, or as 73
persons who arrange for the disposal of a hazardous substance. For example, good samaritans
who conduct remediation activities, such as the treatment of acid mine drainage, might be 74
considered a site operator. Many groups argue that the threat of CERCLA liability creates a
chilling effect, discouraging volunteer cleanup at abandoned mining sites. These parties have
called for federal legislation that would provide good samaritans with protection from
Superfund’s liability scheme.
In general, most parties support the concept of encouraging good samaritan assistance at AMLs.
However, some environmental groups are concerned about providing exemptions from
CERCLA’s liability, pointing out that the strong liability provisions often drive cleanup at mining 7576
sites. Furthermore, some argue that the Superfund statute already provides liability protection 77
for good samaritans. CERCLA § 107(d) (often referred to as the “good samaritan provision”)
might allow good samaritans to provide cleanup assistance at the direction of EPA, without the
threat of liability.
The Small Business Liability Relief and Brownfields Revitalization Act of 2002 (P.L. 107-118),
which amended portions of Superfund, added the “bona fide prospective purchaser” (BFPP) 78
exemption. This provision allows parties to purchase contaminated property without accepting
the liability for historical contamination, notwithstanding that they knew of the contamination 79
when they purchased. The BFPP exemption is conditional. For example, BFPPs must take
“reasonable steps” to (1) stop continuing releases, (2) prevent threatened future releases, and (3)
prevent or limit human, environmental, or natural resource exposure to earlier hazardous 80
substance releases. Thus, BFPPs may need to address the releases related to the actions of
former owner/operators. Regarding this issue, EPA stated:
Congress did not intend to create, as a general matter, the same types of response obligations
that exist for a CERCLA liable party (e.g., removal of contaminated soil, extraction and
treatment of contaminated groundwater).... Nevertheless, it seems clear that Congress also
did not intend to allow a landowner to ignore the potential dangers associated with hazardous 81
substances on its property. [Emphasis in original.]
73 CERCLA § 107(a). See also Testimony of Assistant Administrator for Water, U.S. EPA, Benjamin Grumbles, in
U.S. Congress, House Subcommittee on Water Resources and the Environment, 109th Cong., 2nd sess., March 30, 2006.
74 See, for example, Testimony of Administrator of Colorado Water Quality Control Commission, Paul Frohardt, in
75 See, for example., Testimony of Velma Smith, Senior Policy Associate with the National Environmental Trust, in
76 See, for example, McAllister, 2003, 10245; Kodish, Jeffrey, 2002, Addendum: Restoring Inactive and Abandoned
Mine Sites: A Guide to Managing Environmental Liabilities, at http://www.restorationtrust.org/legalguides.htm.
77 See, for example, Kodish, Jeffrey, 2002, Restoring Inactive and Abandoned Mine Sites: A Guide to Managing
Environmental Liabilities, p. 115, at http://www.restorationtrust.org/legalguides.htm., and McAllister, 2003, p. 10256.
78 CERCLA §§ 101(40), 107(r).
79 For a more legal analysis of the BFPP provision and other liability defenses, see CRS Report RL31911, “Innocent
Landowners” and “Prospective Purchasers” Under the Superfund Act, by Robert Meltz.
80 CERCLA § 101(40)(D).
81 Memorandum from Susan Bromm, Director of EPA’s Office of Site Remediation and Enforcement, to Regional
Directors, “Interim Guidance Regarding Criteria Landowners Must Meet in Order to Qualify for Bona Fide Prospective
Regardless of the opportunities for avoiding liability, interested parties argue that the threat of
Superfund liability remains. In a general sense, good samaritans may be uncertain how EPA 82
would apply the BFPP provisions at a particular mining site. This uncertainty is perhaps
amplified due to the possibility of citizen suits, which may occur if environmental or community 83
groups disagree with an agency’s interpretation or application of the law.
Four good samaritan bills were introduced in the 109th Congress. None of the bills received
committee action, although the House Transportation and Infrastructure, Water Resources and
Environment Subcommittee held an oversight hearing on hardrock mine cleanup and good th
samaritans on March 30, 2006. No bills have been introduced in the 110 Congress. For more
information, see CRS Report RL33575, Cleanup at Abandoned Hardrock Mines: Issues Raised th
by “Good Samaritan” Legislation in the 109 Congress, by Claudia Copeland and Robert Meltz.
In the United States, there are approximately 238,000 animal feeding operations (AFO)—
agriculture enterprises where animals are kept and raised in confinement. Animal waste from
these operations generates several chemicals (e.g., ammonia, hydrogen sulfide, and phosphorous)
that are listed as CERCLA hazardous substances. CERCLA requires facilities to report hazardous
substance releases into the environment, including ambient air, that are above reportable 85
quantities (RQ). The RQ for hydrogen sulfide and ammonia is 100 pounds per day; the RQ for 86
phosphorous is 1 pound per day.
In recent years, there have been questions as to how CERCLA applies to animal feeding
operations. For example, are AFOs required to report ammonia air emissions as releases under
CERCLA, and if so, how should the releases be counted in regards to the RQ? Several federal 87
courts have addressed this particular issue by examining the CERCLA definition of “facility.”
Instead of counting each barn, lagoon, or land application area as separate facilities, these courts
have ruled that the entire site should be considered a facility for purposes of CERCLA. Under this
interpretation, large AFOs (referred to as concentrated animal feeding operations, or CAFOs)
will be more likely to breach the reportable quantity levels because multiple release locations at a
given site will be aggregated.
Purchaser, Contiguous Property, or Innocent Landowner Limitations on CERCLA Liability (“Comment Elements”),”
March 6, 2003, p. 9.
82 For example, what are “reasonable steps” under the BFPP exemption?
84 For further discussion, see CRS Report RL33691, Animal Waste and Hazardous Substances: Current Laws and
Legislative Issues, by Claudia Copeland.
85 The Emergency Planning and Community Right to Know Act (EPCRA, P.L. 99-499, USC §§ 11001-11050) also
contains reporting provisions. Facilities must report to state and local officials any releases greater than the reportable
quantity of a CERCLA hazardous substance or an “extremely hazardous substance” under EPCRA.
86 40 CFR § 302.4.
87 See Sierra Club v. Seaboard Farms, 387 F.3d 1167 (10th Cir. 2004); Sierra Club v. Tyson Foods, 299 F. Supp. 2d
693, (W.D. Ky. 2003).
At a hearing before the House Appropriations Subcommittee on Interior, Environment, and
Related Agencies on February 28, 2007, EPA Administrator Stephen Johnson testified that the
Agency was developing a regulation to exempt CAFOs from Superfund mandates to report air 88
emissions. He said this would be a “very narrow regulation.”
Another question concerns CERCLA liability for manure that reaches water bodies (via erosion 89
or leaching into groundwater). Manure is often applied to the land as fertilizer, but CERCLA 90
excludes the “normal application of fertilizer” from the definition of release. Interested parties
have argued that some AFOs are taking advantage of this exclusion by applying more manure to
the land than is necessary. In the past three years, two federal district courts have looked into this
matter, but both cases were settled. The terms of the settlements were not made public, and the
settlements effectively ended the court proceedings without a formal ruling on the CERCLA 9192
applicability issues. However, a third case involving this issue is currently in the federal
This court activity has increased concern in the agricultural community that other legal actions
will follow, and that the courts will continue to apply CERCLA to AFOs. This concern has led to th
recent congressional interest. Members in the 109 Congress made several attempts to exempt
manure from the requirements of CERCLA. Although one of these legislative proposals (H.R.
4341) gained considerable support (191 co-sponsors), the proposals also generated opposition
from environmental groups and state and local governments. None of the bills were enacted. In th
the 110 Congress, H.R. 1398 and S. 807 follow a similar approach. There has been no action on
either bill. Senator Blanche Lincoln submitted Senate Amendment 1556 to the energy bill, H.R. 6,
on June 13, 2007; it would have added an exemption for manure from the definitions of
“hazardous substance” and “pollutant or contaminant,” and would have provided exceptions from
other provisions of CERCLA. However, during debate the amendment was not offered. H.R. 6
passed the Senate on June 21, 2007.
Superfund issues, such as the four described above, continue to generate debate and interest. The
selected topics discussed in this report are not mutually exclusive; activity in one of the issues
may influence policy in another. For example, if more abandoned hardrock mining sites are added
to the NPL, Congress may consider increasing annual appropriations to the Superfund program.
This action could affect the argument concerning who should pay for the program. Similarly,
CERCLA’s level of application to animal feeding operations could affect the use of agency
88 “EPA Plans Exemption for CAFO Emissions from Superfund Reporting,” Inside EPA.com, February 28, 2007. As of
October 21, 2007, the regulation had not been proposed.
89 Data collected for the EPA’s 2000 National Water Quality Inventory identify agriculture as the leading contributor to
water quality impairments in rivers and lakes and the fifth leading contributor to impairments in the nation’s estuaries.
Animal feeding operations are only a subset of the agriculture category, but 29 states specifically identified animal
feeding operations as contributing to water quality impairment.
90 CERCLA § 101(22).
91 See City of Waco v. Schouten, W.D. Tex., No. W-04-CA-118 (settled January 17, 2006); City of Tulsa v. Tyson
Foods, Inc., N.D. Okla., No. 01-CV-0900-EA (settled July 16, 2003).
92 Oklahoma v. Tyson Foods, Inc., N.D. Okla., 4:05-CV-329 (filed June 13, 2005). The case is expected to come to trial
in 2009, according to the Oklahoma Attorney General’s office. “Oklahoma AG’s Vow Fails to Limit Industry Fears
Over CAFO Waste Suit,” Water Policy Report, September 17, 2007, viewed at InsideEPA.com, October 22, 2007.
resources in the future. If more sites fall under the CERCLA umbrella, finite agency resources
may be strained, thus further fueling a debate over Superfund taxes and funding levels.
Mark Reisch Jonathan L. Ramseur
Analyst in Environmental Policy
jramseur@crs.loc.gov, 7-7919
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BATTLE ON, JOHN
OUR thoughts are with John Hartson and his family after it was confirmed that the former Hammers striker is battling testicular cancer that has spread to his brain.
Hartson was diagnosed with the illness after he went to Singleton Hospital in Swansea suffering from severe headaches.
The 34-year-old ex-Wales striker and father of three is said to have begun a course of radiotherapy and chemotherapy treatment yesterday.
Hartson moved to Glasgow in 2001 after being signed by then Celtic manager Martin O'Neill for £6m and spent five years at Parkhead, scoring 89 goals.
He was voted player-of-the-year by his fellow professionals and the Scottish Football Writers' Association.
During his international career, he scored 14 goals before stepping down in February 2006 to concentrate on his club football.
Hartson made his Wales debut in March 1995 in an away match against Bulgaria, often leading the line as a lone striker, until his last game in November 2005 against Cyprus.
He began his senior career at Luton in 1992 as a 17-year-old and the player's bustling style soon caught the eye of bigger clubs.
Arsenal paid £2.5m for Hartson in January 1995.
A £3.3m move to Upton Park followed two years later, although that stay was marred by an altercation with team-mate Eyal Berkovic.
In 1999 Wimbledon paid a whopping £7.5m for Hartson, while spells at Coventry, Celtic, West Bromwich Albion and Norwich - on loan - followed before he announced his retirement as a player in February 2008.
When the 6ft 1in target man retired he said his biggest regret was not having played for his beloved Swansea City, the local club he had supported since a boy.
Since his retirement as a player, Hartson has proved himself an articulate and knowledgeable football commentator for media outlets, including the BBC and Setanta, since hanging up his boots last year.
Hartson seemed destined to move into football management and has been linked with vacant posts at the likes of Falkirk, Swansea and East Stirlingshire.
Big John will always be remembered by West Ham fans for the major role he played in helping Hammers to avoid relegation at the end of the 1996-97 season. Signed in February from Arsenal at the same time fellow new signing Paul Kitson arrived from Newcastle, they scored the goals that saw Harry Redknapp's side preserve their Premier League status against all the odds.
Now we wish John all the best in the biggest battle of his life.
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/ Music
/ “The Legendary Fist of Takinawa” by Jeremy Rice
Music News Reviews
“The Legendary Fist of Takinawa” by Jeremy Rice
Sebastian Cole 4 November 2019
Strings as soft as silk form a delicate, colorful harmony as “The Legendary Fist of Takinawa,” one of nine songs found of Jeremy Rice’s Jeremy Rice and the Legendary Fist of Takinawa, takes shape before us, but there’s a cloud of hesitation that follows its reverberating warmth. The fragile landscape is quickly shattered with the appearance of a chugging riff and a lumbering bassline in the background, and we soon discover an energetic surge of electricity in the lead vocal from Rice that can be found in every track he appears on in this debut LP (which, as you would guess, is all nine of them).
URL: https://www.jeremyrice.net/
“Nme,” “Beleev” and the sterling singles “Arriianne” and “Somebody Like You” are really well-mixed pop songs with reliably crisp finishes and a strong focus on Rice’s singing abilities. There’s an interesting mix of standard, vocal-centric tunes and abrasive, almost punky pop/rock numbers of Jeremy Rice and the Legendary Fist of Takinawa, and though some might feel a little overwhelmed by all of the variety that the disc has to offer, I think that this is essentially what a good virgin outing should consist of – it’s the many layers of its artist’s personality on display all at once.
I would have stuck “The Legendary List of Takinawa” at the start of the album and put the combo of “Johnny Rogers” and “Arriianne” a bit closer to the end, but only to make this LP flow just a little better than it already does. In this current arrangement of the songs, it feels rather sprawling and difficult to process in a single sitting, but aside from that the content here is beefy, and even slightly over the top in a few instances (“Dream Tonight,” in particular, sparkles just a touch more than it really needs to).
The guitar parts in “Underneath the Ground” and “Arriianne” are a lot more rugged than they are anywhere else on the record, but it doesn’t disrupt the mood of the music at all – if anything, I actually think that it adds a touch of contrast where there would have otherwise been none. The only real problem Rice has in this album is recycling a familiar hook from one track to the next; if he can spread out the melodies a little more than he has in songs like “Somebody Like You,” he’s going to maximize his appeal to serious and occasional pop fans alike.
CD BABY: https://store.cdbaby.com/cd/jeremyrice4
It’s nowhere even close to being a perfect debut, but Jeremy Rice and the Legendary Fist of Takinawa is a likeable LP with a strong pop center and a lead singer in the aforementioned Jeremy Rice who can really belt it out when it counts the most. There are a few growing pains that he can clearly get past between now and the next time he hits the recording studio, but by and large I would have to say that Rice has a lot to look forward to at this juncture of his career – provided he can keep making harmonies as powerful as the best ones we hear on this album, of course.
Sebastian Cole
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Encyclopedia > 1982 Lebanon War
Lebanon War
Redirected from 1982 Lebanon War
The history of Lebanon contained many periods of prosperity separated by chaos and wars between the different minorities.
Beginning of the Civil War--1975-81 Fullscale civil war broke out in Lebanon in April 1975. After shots were fired at a church, gunmen in Christian East Beirut ambushed a busload of Palestinians. Palestinian forces joined predominantly leftist-Muslim factions as the fighting persisted, eventually spreading to most parts of the country and precipitating the President's call for support from Syrian troops in June 1976. In fall of 1976, Arab summits in Riyadh and Cairo set out a plan to end the war. The resulting Arab Deterrent Force, which included Syrian troops already present, moved in to help separate combatants. As an uneasy quiet settled over Beirut, security conditions in the south began to deteriorate.
After a PLO attack on a bus in northern Israel and the Israeli retaliation caused heavy casualties, Israel invaded Lebanon in March 1978, occupying most of the area south of the Litani River. In response, the UN Security Council passed Resolution 425 calling for the immediate withdrawal of Israeli forces and creating the UN Interim Force in Lebanon (UNIFIL), charged with maintaining peace. Israeli forces withdrew later in 1978, turning over positions inside Lebanon along the border to a Lebanese ally, the South Lebanon Army (SLA) under the leadership of Maj. Saad Haddad, thus informally setting up a 12-mile wide "security zone" to protect Israeli territory from crossborder attack.
In 1981 heavily armed forces of the Palestine Liberation Organization (PLO) occupied large areas of southern Lebanon. Terrorism against the State of Israel increased; The PLO's armed forces used Lebanon as a base to attack Israel with rockets and artillery. PLo soldiers fought with Lebanese forces, and killed many thousands of Lebanese citizens. Due to continued civil war since 1975, Lebanon had no effective central government at the time.
Israel launched an attack against its Northern neighbor Lebanon in 1982. While Israel claimed it needed to defend its Northern border, many independent observers pointed to Lebanon's water resources and arable land.
The 1982 attack was the result of a slow escalation. In the years following the 1948 war, Israel's border with Lebanon was quiet compared to its borders with other neighbors. However, in March 1978, after a series of clashes between Israeli forces in Lebanon, Israeli forces crossed into Lebanon. After passage of Security Council Resolution 425, calling for Israeli withdrawal and the creation of the UN Interim Force in Lebanon[?] peace-keeping force (UNIFIL), Israel eventually withdrew its troops. In July 1981, after additional fighting, President Ronald Reagan's special envoy, Philip C. Habib[?], helped secure a cease-fire between the parties.
In June 1982, Israel invaded the southern half of Lebanon. While a few pro-Israeli Lebanese did at first welcome the Israelis, almost all Lebanese came to resent Israeli occupation. Heavy Israeli casualities and a lack of clear goals led to increasing disquiet among Israelis at the war as well. Within six months after the war began, Israel withdrew from most of the Lebanese territory it occupied but continued to occupy a ten mile wide area of Lebanese territory along the Israeli-Lebanese border; it referred to this area as its "security zone". Israel finally withdrew from the "security zone" in 2000, during the Prime Ministership of Ehud Barak. Israel continues to occupy a small area called "Sheeba Farms", which Lebanon claims to be Lebanese territory but Israel insists is Syrian, not Lebanese, territory.
In August 1982, the PLO withdrew its forces from Lebanon. With U.S. assistance, Israel and Lebanon reached an accord in May 1983 that set the stage to withdraw Israeli forces from Lebanon. The instruments of ratification were never exchanged, however, and in March 1984, under pressure from Syria, Lebanon canceled the agreement. In June 1985, Israel withdrew most of its troops from Lebanon, leaving a small residual Israeli force and an Israeli-supported militia in southern Lebanon in a "security zone," which Israel considered a necessary buffer against attacks on its northern territory.
British Mandate of Palestine
Balfour Declaration 1917
1922 Text: League of Nations Palestine Mandate
1947 UN Partition Plan
Declaration of the Establishment of the State of Israel, May 14, 1948
1948 Arab-Israeli War
1949 Armistice Agreement
1956 Suez War
1967 Six Day War
1970 War of Attrition
1973 Yom Kippur War
1978 Camp David Peace Accords between Egypt and Israel
1990/1 Gulf War
1993 Oslo Peace Accords between Palestinians and Israel
Camp David 2000 Summit between Palestinians and Israel
Proposals for a Palestinian state
2003 invasion of Iraq
Middle East conflict
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Encyclopedia > Battle of Puebla
Battle of Puebla
The Battle of Puebla took place on May 5, 1862 near the city of Puebla, Mexico during the French invasion of Mexico. It was a major Mexican victory, and is commemorated in the Mexican holiday the Cinco de Mayo.
2 The Combatants
Background In late 1861 Napoleon III of France sent his troops to Mexico, supposedly to collect debts owed by a previous Mexican government which Mexican President Benito Juarez had agreed to pay, but only in installments over time. Napoleon III's troops took the port city of Veracruz on December 8, 1861. It soon became apparent, however, that their actual goal was not collection of debts, but rather the control of Mexico.
The Combatants French General Conde de Lorencez[?] commanded 6,000 to 6,500 well trained troops.
Mexican General Ignacio Zaragoza commanded some 2,000 to 4,000 forces. Less than 1,000 were regular Mexican army; these were suplimented with local militias, hastily conscripted men of Puebla, and untrained volunteers.
The pass leading to Puebla was protected by Fort Loreto and and Fort Guadalupe. Zaragoza had defensive trenches dug across the road and linking the forts.
The Mexicans were aided by the weather, as the rain made the ground muddy slowing the movement of French artillery.
General Lorencez was at first contemptuous of the Mexican troops, assuming they would quickly flee from heavy fighting. He therefore directed his first charge directly at the Mexican center. The Mexicans held their ground and drove the French back.
The French regrouped and launched two more charges, both of which were similarly defeated.
The Mexicans then counter-attacked, including a force of Zapotec Indians, many armed only with machetes but who none the less succeded in overrunning part of the French lines. Porfirio Diaz (later to be President of Mexico) led a well disiplined company of Mexican cavalry which flanked the French.
The French then pulled back some distance as dark fell. General Lorencez waited two days for a Mexican counter-offensive, but Zaragoza did not wish to attack the French in open country where he would lose his defensive advantage. Unwilling to risk another attack on the Mexican position, Lorencez then withdrew his forces back to Orizaba[?].
Aftermath On May 9, 1862, President Juarez declared that the anniversary of the Battle of Puebla would be a national holiday, the Cinco de Mayo.
The French realized their forces were inadiquate to their intended task, and were eventually reinforced with an additional 30,000 troops. In 1863 the French again marched towards Mexico City -- this time bypassing Puebla on their route-- and succeeded in taking the capital and installing the puppet regime of Emperor Maximilian.
While the Battle of Puebla did not stop the French takeover of Mexico, it was an important victory for the Mexicans none the less. It greatly raised Mexican morale and strenghtened determination to resist the invasion. It gave the Juarez government more time to prepare, and while they were forced to abandon Mexico City and retreat to the north of the country, they continued to maintain a working government which was recognized as the legitmate government of Mexico by many foreign nations, and eventually succeeded in defeating Maximilian and his allies in 1867.
The Mexican victory surprised much of the international community, demonstrating the Mexican resolve not to be governed by a foreign monarch and that the Mexicans could defeat one of Europe's best armies.
The Battle of Puebla was also of historic importance in that it quashed Napoleon III's hopes of a quick take over of Mexico, which he could then use as a base to aid the Confederates in the American Civil War.
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Timeline: Egypt’s efforts to combat climate change
Sama Osama, Tuesday 24 Sep 2019
The fertile arc-shaped basin is home to nearly half the country’s population AFP
UN plans vast urban forests to fight climate change
Youth leaders at UN demand bold climate change action
Egypt plays key role in climate change negotiations: Environment minister
Egypt took part in the UN Climate Action Summit in New York on Monday; it was organised by UN Secretary General Antonio Guterres in order to follow up progress made by states in fulfilling their commitments to limiting global warming.
Egypt is co-chairing a joint coalition on climate adaptation and resilience with the UK, with the goal of raising funds for implementing resilience and adaptation strategies that address the impacts of climate change.
This coalition was announced in June by Egyptian Minister of Environment Yasmine Fouad, its goal is to raise funds for implementing the resilience and adaptation strategies that address the impacts of climate change.
According to the UNDP, Egypt is extremely vulnerable to climate change due to its large population. Its Mediterranean coast and low-lying Nile Delta are also threatened by the rises in sea level expected to result from climate change.
Other predicted effects include a decrease in country’s water supply, which could have serious implications given Egypt’s rapid population growth and existing status as a country already in “water poverty,” according to international measurements.
The timeline below features some of the major measures Egypt has taken in order to combat climate change, whether on its own or under the umbrella of the international community.
Climate Action Summit
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