text:
Focus Area:Prevention
- HIV Prevention Knowledge Base
- See All Topics
- Topics by Alphabetical Order
- See All Topics
- Combination Approaches
- Biomedical Interventions
- Behavioral Interventions
- Structural Interventions
- Multimedia Resources
- Podcast: Reaching Transgender and MSM Populations through Social Media
- Video on Voluntary Medical Male Circumcision (VMMC)
- Prevention Update
- HIV Prevention Update: Latest Must-Read Literature
- Subscribe to the Prevention Update
- Resources
- Case Studies
- Promising Practices (G3Ps)
- Reports
- Spotlight on Prevention
- Structural Approaches to HIV Prevention Position Paper Series & Resource Tool
- Technical Briefs
- Technical Consultation Materials
- National Guidance
- National HIV/AIDS Strategic Plans
Subscribe to AIDSTAR-One!
Sign up to receive current HIV technical resources delivered to your inbox. Customize your updates based on your areas of interest.
What can AIDSTAR-One do for you?
From short-term technical assistance to long-term program implementation support and more, AIDSTAR-One provides rapid, evidence-based services to PEPFAR country teams in generalized, mixed and concentrated HIV epidemic settings.
Combination Approaches: An Overview of Combination Prevention
I. Definition of the Prevention Area
In 2009, The U.S. President's Emergency Plan for AIDS Relief (PEPFAR): Five Year Strategy defined combination prevention as its major approach to HIV prevention, stating that:
"Successful prevention programs require a combination of evidence-based, mutually reinforcing biomedical, behavioral, and structural interventions."
This definition was expanded upon in a 2009 meeting of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Prevention Reference Group and published in the 2010 UNAIDS Discussion Paper on combination prevention, in which combination programming was defined as:
"...rights-based, evidence-informed, and community-owned programmes that use a mix of biomedical, behavioural, and structural interventions, prioritized to meet the current HIV prevention needs of particular individuals and communities, so as to have the greatest sustained impact on reducing new infections."
II. Epidemiological Justification for the Prevention Area
The goal of combination prevention is to reduce the transmission of HIV by implementing a combination of behavioral, biological, and structural interventions that are carefully selected to meet the needs of a population. Also, because individuals' HIV prevention needs change over a lifetime, combination approaches help ensure that people have access to the types of interventions that best suit their needs at different times. Practitioners and researchers currently believe that combination approaches result in synergies in which the total effect of a set of carefully chosen interventions is greater than the sum of its parts, with a greater impact on reducing the transmission of HIV. This hypothesis, however, remains to be proven.
Prevention programmers have used various models to attempt to identify the drivers of the epidemic, provide a guide on which mix of interventions would have the greatest impact, and give strategic choices on combination prevention approaches.
Others caution against the use of models in making strategic prevention decisions, since models may provide outputs that fail to identify the key behaviors that drive an epidemic and are difficult to fit to local epidemics that are heterogeneous across different locations. Therefore, models are a tool that should always be used in conjunction with other data sources to make programmatic decisions.
The evidence base for combination prevention programming is in its infancy. However, a number of evaluations are currently being conducted to help determine the effectiveness of different combination prevention approaches. The National Institutes of Health are supporting HIV combination prevention studies in Botswana, Estonia, Lesotho, Malawi, Uganda, and in North and South America with a range of populations (e.g., men who have sex with men, people who inject drugs, serodiscordant heterosexual couples, and people of reproductive age). PEPFAR is supporting three studies, over four years, to evaluate combination prevention approaches—one in Zambia and South Africa, another in Botswana, and the last in Tanzania.
III. Core Programmatic Components
In August 2011, PEPFAR issued Guidance for the Prevention of Sexually Transmitted HIV Infections, and recommends a combination approach to prevention that includes three types of mutually reinforcing interventions:
- 1. Biomedical interventions are those that directly influence the biological systems through which the virus infects a new host, such as blocking infection (e.g., male and female condoms), decreasing infectiousness (e.g., ART as prevention), or reducing acquisition/infection risk (e.g., voluntary medical male circumcision).
- 2. Behavioral interventions include a range of sexual behavior change communication programs that use various communication channels (e.g., mass media, community-level, and interpersonal) to disseminate behavioral messages designed to encourage people to reduce behaviors that increase risk of HIV and increase protective behaviors (e.g., risks of having multiple partners and benefits of using a condom correctly and consistently). Behavior interventions also are aimed to increase the acceptability and demand for biomedical interventions.
- 3. Structural interventions address the critical social, legal, political, and environmental enablers that contribute to the spread of HIV. PEPFAR uses five categories to describe structural interventions: legal and policy reform, reducing stigma and discrimination against people living with HIV and marginalized groups, gender inequality and gender-based violence, economic empowerment and other multi-sectoral approaches, and education.
The PEPFAR guidance goes into further detail on which core interventions (i.e., prevention of mother-to-child transmission, voluntary medical male circumcision programs, condom programs, and programs for most-at-risk populations and people living with HIV) should be prioritized and implemented based on UNAIDS' "Four Knows." The Four Knows bases selection and scale of interventions on epidemiological evidence, country context, knowledge of other donor programs, and national strategies. Additionally, prevention strategies should be assessed through impact evaluations.
To achieve this, programmers should perform a gap analysis in their countries to determine which key drivers, geographical locations, and range of interventions are lacking and then include those in their prevention portfolio to try and create synergy among them. In order to implement the interventions that would be most effective in the country's context, the questions to ask when making prevention portfolio decisions are, "How much, when, and where?"
IV. Current Status of Implementation Experience
Although the term "combination prevention" is relatively new, the concept itself is not. Countries experiencing HIV epidemics routinely implement complex packages of prevention interventions; yet the scale, intensity, and quality of these interventions is often insufficient. Furthermore, only a minority of programs include interventions designed to address structural drivers of the epidemic. Complex and successful programs have existed for some time in concentrated epidemics where service packages include biomedical, behavioral, and structural interventions; however, these approaches remain under-implemented and under-evaluated. Often, prevention portfolios are not adequately focused on the populations and the behaviors that actually drive the epidemic, nor are they sufficiently well implemented in the locations where the risk behaviors are most likely to occur. Interventions need to be chosen based on the complexity of behaviors within populations as well as how social and cultural norms influence sexual and health-seeking behaviors. However, current combination prevention programs are building on lessons learned and improving strategies to increase their impact on the epidemic.
A number of countries are implementing combination prevention packages such as South Africa, Botswana, India, Namibia, Uganda, and the Ukraine. Combination prevention is a portfolio approach for a given geographic area—whether at the national, state, district, or community level. It is not an individual implementing a partner-level approach, but involves a number of partners who contribute towards a combination prevention approach. For example, in South Africa, several studies have demonstrated a reduction in HIV incidence mostly due to increased condom use among youth and a slight reduction due to antiretroviral treatment. The decline in incidence also seems to coincide with the increase of prevention interventions in the country such as increased distribution and availability of condoms, school-based HIV life skills programs, and a large mass media serial program that depicted how positive and negative behaviors can affect health outcomes.
HIV Prevention Transformed: The New Prevention Research Agenda
Padian, N. S., McCoy, S. I., Abdool Karim, S. S., et al. The Lancet (2011), Vol. 378 No. 9787, pp. 269–278.
This paper reviews developments over the last three years in HIV prevention since the 2008 Lancet series. The authors searched topics in behavioral, biomedical, and structural interventions, which together make up combination prevention, using Medline and PubMed search engines, HIV conference literature, as well as publications from international (e.g., UNAIDS) and nongovernmental organizations. The paper focuses on the most salient and current issues in the field, such as the state of the search for a vaccine, ART for prevention and its challenges, the scale up of proven prevention interventions (e.g., voluntary medical male circumcision), and an update on behavioral and structural interventions. The paper concludes and discusses the following: that the separation between biomedical and behavioral approaches is counterproductive since both rely on the other, the benefits of having more women-controlled prevention possibilities, implementation challenges to ART as prevention programs, and increasing research in implementation sciences and impact evaluations of proven interventions.
Combination Prevention: A Deeper Understanding of Effective HIV Prevention
Hankins, C. A., & de Zalduondo, B. O. AIDS (2010), Vol. 24 (suppl 4), pp. S70–S80.
This paper provides an overview of what combination prevention programs are and how to design and implement them to match each country's unique social and epidemiological context. It emphasizes how HIV prevention is vital in keeping the epidemic at bay and has been a mainstay of the response since the beginning. A historical perspective to HIV prevention is provided, and how the field evolved into its current focus on combination prevention programs. UNAIDS "know your epidemic, know your response" is the starting point for planning combination prevention programs. It recommends that prevention programmers "know their epidemic" by asking where the next 1,000 infections will come from instead of focusing on past prevalence rates. "Know your response" focuses on prevention programmers designing strategies based on the current activities being implemented, compared to where the next infections will be coming from, to perform a gap analysis. The results of the gap analysis can help programmers develop a tailored approach unique to the social, cultural, and epidemiological context of a country, region, district, and/or community. The paper states that the evidence base for combination prevention programs is weak and investing in impact research as well as implementation science is vital for the continual refinement and improvement of programs. The paper concludes by stating that focusing on long-term strategies that are tailored to the immediate causes of vulnerability and underlying risk of populations is necessary to curb the rate of the epidemic.
A Decline in New HIV Infections in South Africa: Estimating HIV Incidence from Three National HIV Surveys in 2002, 2005 and 2008
Rehle, T., Hallett, T., Shisana, O., et al. PLoS ONE (2009), Vol. 5 No. 6, e11094. doi:10.1371/journal.pone.0011094.
South Africa conducted three nationally representative household-based surveys in 2002, 2005, and 2008. The study uses the HIV prevalence data from all three surveys to estimate incidence from 2002 to 2005 and from 2005 to 2008. The 2008 survey tested samples to detect the presence of ART drugs in the blood to determine its affect on prevalence due to longer survival. The study also measured behavioral changes in the three surveys among young women between the ages of 15 and 24. It was found that HIV prevalence in 2008 was 16.9%, and that the "excess" (increase in prevalence due to longer survival from ART) prevalence was 1.7%; therefore, HIV prevalence without the affect of ART on survival would be 15.2%. Incidence levels decreased from 2002 to 2005 and 2005 to 2008 for men and women aged 15-49 years (2.0 per 100 person-years at risk verses 1.3 per 100 person-years at risk), but were not statistically significant. The incident decrease was statistically significant for women between the ages of 15 and 24. It went from 5.5 per 100 person-years at risk from 2002 to 2005, to 2.2 per 100 person-years at risk from 2005 to 2008. Because the incident decline was mostly among young women, behavioral trends were analyzed. It was found that significant changes were found in condom use at last sex and being tested for HIV. The changes in incidence and behavior among young women were encouraging, but it should not equate to program complacency. Incident levels still need to be halved in order to meet the goals in the 2011 National Strategic Plan.
Combination HIV Prevention: Tailoring and Coordinating Biomedical, Behavioural and Structural Strategies to Reduce New HIV Infections, A UNAIDS Discussion Paper
Joint United Nations Programme on HIV/AIDS (UNAIDS). (2010).
This discussion paper outlines the advantages of implementing a combination prevention approach by using the synergies of behavioral, biomedical, and structural interventions. While there have been notable declines in prevalence and incidence linked to behavioral changes in the population, greater and more effective prevention programs must be supported to continue and improve upon these trends. The paper provides a definition of combination prevention and outlines the necessary steps in planning and implementing a coherent, evidence-based, and rights-based approach. For planning, the paper highlights issues such as having an inclusive, transparent, and evidence-informed process; identifying modes of transmission, geographic patterns, and populations; as well as developing a national plan for combination prevention. For implementation, understanding and addressing political and capacity barriers and simutaneously working on coordination, quality, and efficiency issues are essential. Lastly, in order to plan and implement effective and evidence-based interventions, investments in monitoring and evaluation must be made. Combination prevention is an attempt to address not just the individual causes of vulnerability but to target the underlying social, cultural, legal, and structural causes of vulnerability as well. Local solutions must be found and responses must be coordinated, synergistic, evidence-based, strategic, and sustained to reach the zero new infections goal found in many national HIV/AIDS strategic plans.
South African National HIV Prevalence, Incidence, Behavior and Communication Survey, 2008, A Turning Tide Among Teenagers?
Shisana, O., Rehle, T., Simbayi, L. C., et al. (2009).
This is a report on the 2008 population-based household survey (two others were conducted in 2002 and 2005). The survey examined the prevalence, incidence, behavioral, and communication differences over time. A multi-stage stratified sample was taken and about 23,000 individuals participated in the survey. A structured questionnaire was utilized to capture demographic information as well as social and behavioral information. Blood samples were drawn to determine HIV prevalence and HIV incidence. Overall, prevalence has remained stable from 2002 to 2008, and is around 11%. However, large differences were found among age groups, gender, and geographic regions. Some positive findings included a decrease in prevalence among young people who were between 15 and 24 years old (10.3% in 2005 compared to 8.6% in 2008) and, using mathematical models, incidence has decreased among young people between 15 and 20 years old. Substantial increases in condom use were observed with people between 15 and 49; 31% reported condom use at last sex in 2002 compared to about 65% in 2008. There was also an increase in youths between 15 and 24 years old being reached with communication messages. Despite these positive trends, women are still infected by HIV more than men, with the highest levels being in the 25 to 29 age group where 1 of every 3 women is infected. Intergenerational sex also increased among young women from 18.5% in 2005 to 27.6% in 2008. Therefore, while South Africa has made numerous advances to combat the epidemic, programs must continue to be strengthened and expanded.
Financing the Response to HIV in Low-Income and Middle-Income Countries
Izazola-Licea, J.A., Wiegelmann, J., Aran, C., et al. Journal of Acquired Immune Deficiency Syndromes (2009), Vol. 52, No. Suppl. 2, pp. S119-S126.
Most countries are not using their funds for HIV treatment and prevention efficiently. According to this study of 50 low- and middle-income countries, funds for prevention constituted 21 percent of all AIDS expenditures. According to UNAIDS, about 45 percent of funding should be invested in prevention. Spending on most-at-risk populations accounted for less than 1 percent in countries with generalized epidemics and 7 percent in countries with concentrated epidemics. The mismatch in the burden of risk and funding was most acute in Latin America, where 60 percent of the people living with HIV are men who have sex with men, but only 0.5 percent of funds were directed toward this group. Among the 17 low-income countries, 87 percent of their funding came from international donors.
Making HIV Prevention Programmes Work
Bertozzi, S.M., Laga, M., Bautista-Arredondo, S., et al. The Lancet (2008), Vol. 372 No. 9641, pp. 831-844.
HIV prevention programs will underperform when any of the following four issues is not appropriately addressed: targeting of risk groups; selection of programs to match the needs of risk groups; delivery and implementation of programs; and funding. Inadequate surveillance or failure to monitor and evaluate interventions can lead to programs that are mismatched for the needs of the region or country. Since quantity is often easier to measure than quality, incentive schemes have favored the former over the latter. This has resulted in situations such as the recent implementation of antiretroviral therapy in which the number of people treated was emphasized over changes in patients' life expectancy.
Behavioural Strategies to Reduce HIV Transmission: How to Make Them Work Better
Coates, T.J., Richter, L., & Caceres, C. The Lancet (2008), Vol. 372 No. 9641, pp. 669-684.
Behavioral strategies, such as programs to encourage condom use or to reduce or eliminate sex with non-primary partners, can be difficult to sustain and should be combined with other strategies (biomedical and structural) to effect population-level changes. Promoting behavioral change in the absence of structural change can be particularly difficult, for example, when drugs or alcohol are central to a country's economy. Monitoring and evaluation (M&E) of programs should be integrated into local programs; current M&E projects are often conducted largely in high-income countries with uncertain relevance to lower-income countries. Four key steps to achieving behavioral change are described.
Structural Approaches to HIV Prevention
Gupta, G., Parkhurst, J.O., Ogden, J.A., et al. The Lancet (2008), Vol. 372 No. 9640, pp. 764-775.
Structural factors (economic, social, political, environmental) can affect HIV risk. For example, gender inequality is linked to unprotected sex. That could be due to male control of finances or due to male physical violence, causing some women to submit to unprotected sex out of fear of physical violence or fear of losing financial support. Although the outcome is the same in either case, the necessary interventions differ. Financial problems could be addressed by micro-loans and changes in inheritance laws that treat men and women unequally. Male violence might be addressed by programs exploring concepts of masculinity. Monitoring and evaluation of structural approaches can be difficult since such programs don't readily lend themselves to experimental design; the authors give recommendations for program assessment.
The History and Challenge of HIV Prevention
Merson, M.H., O'Malley, J., Serwadda, D., & Apisuk, C. The Lancet (2008), Vol. 372 No. 9637, pp. 475-488.
The history of HIV is traced from June 5, 1981, when the disease was first announced by the U.S. Centers for Disease Control and Prevention, to the present. Biomedical, epidemiologic, political, and activist history provides insights into an era of tremendous discovery; obstacles; and social and political ferment. Although the disease was first recognized in men, women now constitute 61 percent of adults living with HIV in sub-Saharan Africa. Projections about the course of the disease were often wrong. The most successful early prevention efforts didn't come from the medical or public health communities, but from people living with HIV and from combination programs that addressed structural, biomedical, and behavioral issues simultaneously.
Biomedical Interventions to Prevent HIV Infection: Evidence, Challenge, the Way Forward
Padian, N.S., Buvé, A., Balkus, J. et al. The Lancet (2008), Vol. 372 No. 9641, pp. 585-599.
Several biomedical interventions have proven efficacy; the benefits of other medical interventions are less clear. According to a Cochrane review, male condoms are 85 percent effective in preventing transmission of HIV. However, long term compliance, especially with primary partners, tends to wane. Disinhibition – or an increase in risky behaviors associated with a sense of being protected – is a problem with this and several other interventions. Male circumcision is estimated to be 58 percent effective, and has the benefit of being a one-off commitment. However, circumcised men also reported increased numbers of sexual partners. The benefits and limitations of female condoms, cervical barriers, treatment of sexually transmitted infections, vaccines, topical and oral antiretroviral prophylaxis, and microbicides are discussed.
Coming to Terms with Complexity: A Call to Action for HIV Prevention
Piot, P., Bartos, M., Larson, H., et al. The Lancet (2008), Vol. 372 No. 9641, pp. 845–859.
Despite widespread knowledge about the transmission of HIV, approximately 7,000 people are newly infected each day. The impact of combination programs is complex and can cause unexpected consequences. For example, HIV infection in men who have sex with men in Bangkok, Thailand, paradoxically increased in 2005 as sex venues were closed – driving men into illegal settings for sex. There is no single "magic bullet" intervention, and combination prevention approaches are as necessary as combination treatment of HIV. Globally, about 85 percent of HIV transmission is sexual. The promise and limitations of current combination interventions for youth, high-risk groups, and women are discussed.
Reassessing HIV Prevention
Potts, M., Halperin, D.T., Kirby, D., et al. The Lancet (2008), Vol. 372 No. 9641, pp. 845–859.
Nine countries in southern African—where more than 12 percent of adults are infected with HIV—account for two-thirds of infections globally. In these generalized epidemic settings, emphasis has been placed on condom promotion and distribution, voluntary counseling and testing (VCT), and treatment of other sexually transmitted infections (STIs). The authors review the evidence and find that the assumptions driving this choice of HIV prevention strategies are largely unsupported, concluding that the largest donor investments are being made in interventions that will fail to deliver large-scale impact. Greater focus on two promising interventions, male circumcision and reducing multiple sexual partnerships, is suggested.
Expert Think Tank Meeting on HIV Prevention in High-prevalence Countries in Southern Africa Report
Southern African Development Community (2006) Maseru, Lesotho.
Southern Africa is home to 40 percent of all people living with HIV globally. The Southern African Development Community, with support from UNAIDS, USAID, WHO and other organizations, convened a meeting of 38 participants to analyze the drivers of the epidemic and to make recommendations for stepped-up prevention. Key drivers identified included multiple and concurrent partnerships; low levels of circumcision; and sexual violence. Factors underlying the drivers were identified, such as wealth disparities and high population mobility. The report includes recommendations to address the drivers of HIV and their causes; key priorities and processes; and monitoring and utilizing resources.
Evaluation of Large-Scale Combination HIV Prevention Programs: Essential Issues
Paden, N., McCoy, S., Manian, S., et al. Journal of Acquired Immune Deficiency Syndromes (2011), Vol. 58 No. 2, pp. e23-e28.
This commentary provides guidance on how to plan and implement evaluations to determine the impact of combination prevention interventions. The authors note the numerous challenges in conducting evaluations for combination prevention programs, but stress the importance in surpassing these to design a solid study. Challenges that are described include the need to have large population sizes and long time lengths if HIV incidence is the outcome of interest; absence of a naïve control group and ethical considerations with having a control group; and poor outcome surrogates (i.e., measures on self-reported behaviors, sexually transmitted infections, and pregnancy) cannot replace outcomes such as HIV incidence, prevalence, and infections averted. Large-scale evaluations should consider the following: defining the evaluable package, deciding if the evaluation is to study each individual intervention verses the entire package, choosing a "control" or "comparison" group in the study design, finding a reliable assay to measure HIV incidence when one is currently lacking, deciding on various methods in one study, and providing shorter-term outcomes on longer-term goals. In conclusion, a strong evidence base is crucial for combination prevention programs. The HIV community is open to the challenge and is supporting it through current evaluations.
The Future of HIV Prevention
Padian, N.S., Isbell, M.T., Russell, E.S., et al. Journal of Acquired Immune Deficiency Syndromes (August 2012), Vol. 60 Suppl. 2, pp. S22-S26.
According to the authors, prevention strategies have historically been categorized as either behavioral or biomedical. Behavioral interventions have included strategies for condom promotion, partner reduction, and cash transfers to keep young women in school or choose partners close to their own age. Biomedical prevention strategies include the use of antiretrovirals and vaccines (when they become available) to reduce or eliminate infectiousness, and to prevent mother-to-child transmission. The authors note that strategies considered strictly biomedical often include behavioral elements, such as retention in care and adherence to prescribed regimens. They highlight the recent success of using antiretrovirals to prevent new infections and describe some of the challenges that remain in implementing this methodology with population-level effectiveness, including acute and early infections, drug-resistant variants of HIV, and concerns about adherence and long-term use of antiretroviral regimens. The authors encourage further implementation research on how best to increase demand and retention, improve adherence, and prevent behavioral disinhibition. The authors endorse combination prevention, where biomedical, behavioral, and structural interventions are implemented concurrently. They stress the need for assessing large, complex, heterogeneous prevention programs to identify cost-effective, efficient, and effective strategies that improve health outcomes. At the broader systemic level, they endorse the use of implementation science on cost-effectiveness to guide decision makers with limited resources.
HIV Epidemic Appraisals for Assisting in the Design of Effective Prevention Programmes: Shifting the Paradigm Back to Basics
Mishra, S., Sgaier, S. K., Thompson, L. H., et al. PLoS ONE (2012), Vol. 7 No. 3: e32324. doi:10.1371/journal.pone.0032324.
HIV prevention resources are limited, and countries must make strategic decisions on how to allocate funds to result in the highest impact. Two approaches have often been utlized in aiding program planners in making these strategic decisions—the numerical proxy method and the modes of transmission approach. The study examined both approaches in terms of strengths and weaknesses by applying them to diverse epidemics. The study's authors then took the results of each approach to see how it would affect national and district level HIV/AIDS policies. The study used data from six countries and six districts in India to apply in both approaches. The research team also proposed and tested an alternative qualitative approach to addressing HIV prevention goals called the "transmission dynamics epidemic classification." Using data for the six countries, it was found that the two methods (numerical proxy and modes of transmission) generated different results that would affect HIV prevention policies. All three methods were applied to the district level epidemic data. When the numerical proxy and modes of transmission approaches were used, similar results were found in terms of them making different conclusions on what populations were the key drivers of the epidemic. When the transmission dynamics epidemic classification was utilized, it found that all of the districts were defined as concentrated epidemics. The study highlights the limitations of the two predominant approaches that are utilized to help program planners strategize their HIV prevention portfolios. To plan in the long-term, strategies should be based on the local dynamics of an epidemic and its trajectory.
Combination HIV Prevention: Significance, Challenges, and Opportunities
Kurth, A. E., Celum, C., Baeten, J. M. et al. Current HIV/AIDS Reports (2011), Vol. 8 No. 1, pp. 62-72.
This discussion paper highlights the advantages of combination prevention programs by focusing on specific populations, behavioral drivers, and geographical areas that are sustaining the HIV epidemic. Evidence-based interventions should be chosen for inclusion in combination prevention approaches, and in 2009 the National Institutes of Health initiated the Methods of Prevention Package Program (MP3) to fund research on combination prevention approaches. A second round of grants was provided for studies that focused on different populations than were represented in the first round, and those started in 2011. The intent of the MP3 program was to better understand the risk patterns at the population level in a particular country, district, or community to enable programmers to design and implement the most effective prevention strategy. The design of combination prevention packages should focus on interventions with shown efficacy in reducing transmission or acquisition. The choice of interventions would depend on the target population, the stage of the epidemic, and behavioral drivers. Interventions that have demonstrated success in reducing transmission or acquisition or have shown promise based on single randomized-controlled trails, preliminary data, observation data, or phase-1 or animal studies include prevention of mother-to-child transmission, voluntary medical male circumcision, male condoms, opioid substitution therapy for people who inject drugs, pre-exposure prophylaxis, and needle exchange. Additional strategies such as microbicides, HIV vaccines, and conditional cash transfers are also possibilities. Structural interventions are key to creating an enabling environment by supporting gender equitable laws, supporting risk-reduction polices, and reducing stigma and discrimination. Combination prevention is the next generation for HIV prevention science.
Namibia's Prevention Planning Process: Successful Collaboration for a National Combination HIV Prevention Strategy
Clark, S., & Stash, S. AIDSTAR-One (2011)
Namibia's experience demonstrates the necessity and importance of having an articulated planning approach to design a national combination prevention strategy. This case study describes how Namibia formulated is strategy through a long-term planning and advocacy process. It provides background information on how Namibia decided to invest human resources and finances for the planning process as well as for its technical approach, how the planning process started, and how roles and responsibilities were determined. Successes included increasing national commitment to reorienting the prevention strategy to address the key drivers of the epidemic, performing a situational analysis to determine the epidemiological and contextual factors, initiating and maintaining a participatory process, and having several key documents guide the strategy's development. Several objectives had not been achieved at the time of the case study's completion, such as mapping the ongoing prevention programs to increase regional participation and having a budgeted national prevention action plan. The case study outlines what worked well in the planning process as well as the challenges, future programming, and recommendations.
The Avahan-India AIDS Initiative: Promising Approaches to Combination HIV Prevention Programming in Concentrated Epidemics
Rau, B. AIDSTAR-One (2011).
The Avahan-India AIDS Initiative has successfully offered a combination prevention program to many of the regions' most-at-risk-populations (MARPs) including sex workers, men who have sex with men, transgender individuals, migrant populations, and people who inject drugs. At the start of the program in 2003, it covered six regions and provided the traditional mix of activities to MARPs such as peer educators and outreach workers implementing behavior change programs, condom promotion and distribution, and sexually transmitted infection (STI) treatment. The program also added structural elements to prevent harassment and violence from police, and worked to expand national HIV prevention policies to support behavior change and health seeking behavior. The program evolved into a combination prevention program targeted to MARPs by implementing risk-reduction strategies founded on the latest data and evidence. The combination prevention elements included peer outreach to support behavior change, STI treatment, condom promotion and distribution, distribution of clean needles and syringes, community mobilization, and advocacy to reduce structural barriers. The program was highly reliant on peer educators and they were key in the program's success and scale-up. The program's focus on data collection and use was another key achievement. The high reach and effectiveness of the program (e.g., a goal of 80% of MARPs reached with prevention services) has lead to the government agreeing to fully support it financially by 2014.
Prevention of HIV Infection for People Who Inject Drugs: Why Individual, Structural, and Combination Approaches are Needed
Degenhardt L., Mathers, B., Vickerman, P., et al. The Lancet (2010), Vol. 376 No. 9737, pp. 285-301.
This review examines HIV prevention interventions among the population of people who inject drugs (PWID). Articles for inclusion were found through sources such as the Cochrane Library, Evidence-Based Medicine Reviews, and drug and global health interventions that prevented HIV among PWID. For structural interventions, searches were conducted in PubMed, Medline, the Cochrane Review Library, and Embase. Reference lists of selected articles were also reviewed. The paper summarizes current findings on needle and syringe programs, opioid substitution treatment, and antiretroviral treatment for HIV-positive PWID. These programs were found to achieve the greatest positive affect on preventing HIV among PWID. These three interventions were also modeled in various combinations, and degrees of coverage, to explore their effects on HIV incidence. It was concluded that no single intervention addressed all of the risk factors of PWID, which suggests that a combination prevention approach is necessary.
Contact with HIV Prevention Services Highest in Gay and Bisexual Men at Greatest Risk: Cross-Sectional Survey in Scotland
McDaid, L. M., & Hart, G. J. BMC Public Health (2010), Vol. 10, pp. 798.
The paper explored contact of men who have sex with men with HIV prevention interventions and factors that affected that contact. 1,514 men participated in the anonymous 2008 MRC Gay Men's Survey and provided oral fluid samples. Men were recruited from gay bars and saunas in Glasgow and Edinburgh. The survey questions collected information on demographics, HIV testing history, sexual risk behaviors in the last year, and exposure to HIV prevention activities such as obtaining condoms, picking up sexual health leaflets, and interacting with an outreach worker. It was found that the majority of men had at least one contact with an HIV prevention activity (82.5%), and the predominant activity was obtaining free condoms from a gay venue or over the Internet (73.1%). Other activities included picking up a sexual health leaflet or looking up information on the Internet (51%), talking to an outreach worker (13.5%), and participating in a counseling session (8%). Only 3.6% had exposure to all four activities. Factors that were associated with contact with all four prevention activities included men who frequented the gay establishments most often, received a sexually transmitted infection (STI)/HIV test in the last 12 months, had 10 or more partners in the last year, and had an STI in the last 12 months. It was found that contact with any of the HIV prevention activities was higher among men with more sexual partners and any risky sexual behaviors. The authors conclude that a combination prevention strategy is required to curb the HIV epidemic among men who have sex with men in the United Kingdom.
The Alliance-Ukraine: Promising Approaches to Combi¬nation HIV Prevention Programming in Concentrated Epidemics
Bergmann, H., & Stash, S. AIDSTAR-One (2010).
The International HIV/AIDS Alliance in Ukraine (Alliance-Ukraine) has provided services to most-at-risk-populations (MARPs) since 2004. It is the largest AIDS organization in Ukraine and implements a combination prevention program for people who inject drugs (PWID), sex workers, men who have sex with men, and prisoners. Alliance-Ukraine partners with a number of local nongovernmental organizations and smaller informal groups with growing potential to scale up their activities as well as meet varying regional needs. The program includes a data-driven approach that allows it to change and adapt to local needs, ensures that the affected communities play a central role in the program, provides strong linkages to other governmental and nongovernmental services, and conducts advocacy for supportive policies and regulations. Alliance-Ukraine is able to reach groups of MARPs through innovative and simultaneous approaches including drop-in centers, mobile clinics, partnering with pharmacies, and having a peer-drive response. The program reached an estimated 33% of PWID with harm reduction services and a total of 66% of PWID have had some type of contact with the program since its inception. Challenges remain for the program including the continual work to reduce structural barriers, and coordinating all of the activities of its implementing partners and providing technical support. Recommendations include basing the selection of combination prevention approaches on evidence and the evolving needs of MARPs, and striving to reach all MARPs with quality services. The program has become a technical hub in the region and is offering technical assistance to other countries/programs based on its successful model.
What Mathematical Models Can Tell Us About Prevention Packages
Hallett, T. Imperial College London.
Tim Hallett reviewed how models could aid in the design of HIV prevention portfolios in his presentation during a two-day U.S. President's Emergency Plan for AIDS Relief (PEPFAR) meeting from November 8 to 9, 2010. The goal of the meeting was to inform the development of a revised PEPFAR HIV prevention guidance document. Hallett's presentation outlined how models can aid programmers in making strategic choices in their prevention portfolios and provided examples of the limitations of the models.
The U.S. President's Emergency Plan for AIDS Relief: Five-Year Strategy
The Office of the U.S. Global AIDS Coordinator (2009).
This is the guiding document through 2015 for PEPFAR, the largest international HIV/AIDS program of the United States government. The four separate documents consist of the plan and three annexes: Prevention, Care, and Treatment; Global Context of HIV; and PEPFAR's Contributions to the Global Health Initiative. A "new direction" cited as a goal is to transition from emergency responses to "sustainable country programs" that are "country-owned and country-driven." The plan calls for addressing HIV within a broader health and development context; linking HIV to women and children's health; and expanding programs to relieve hunger.
The U.S. President's Emergency Plan for AIDS Relief Five-Year Strategy: Annex: PEPFAR and Prevention, Care, and Treatment
The Office of the U.S. Global AIDS Coordinator (2009).
This annex identifies obstacles to successful prevention, care, and treatment programs as well as goals and processes to overcome each obstacle. Special emphasis is placed on combination interventions. A wide range of topics are addressed. These include: blood and injection safety; innovation in prevention; helping governments to support alternatives to prostitution; youth; mobile populations; involvement of people living with HIV; palliative care programs; care of orphans and vulnerable children; targeting treatment; antiretroviral prophylaxis for pregnant women; and expanding efforts to treat people co-infected with tuberculosis and HIV. Links to nine key articles and documents are provided.
Evaluating HIV Prevention Effectiveness: The Perfect as the Enemy of the Good
Laga, M., Rugg, D., Peersman, G., & Ainsworth, M. AIDS (February 2012), e-publication ahead of print.
"Magic bullet thinking" (prioritizing only the well-defined and measurable biomedical interventions) may inhibit understanding of "what works" by leaving out the less measurable social and contextual approaches, as well as the program coverage, uptake, and quality needed for efficacy of all interventions. According to the authors, measuring the impact of combination prevention—the mix of biomedical, behavioral, and structural interventions—remains an elusive goal for the HIV prevention community due to the methodological challenges of applying the "gold standard" of randomized controlled trials (RCTs) for prevention programming. The authors contend that the use of costly randomized designs with the community as unit of intervention (c-RCT) may not produce valid data due to a number of challenges in measuring change in HIV incidence, including a lack of reliable, easy-to-use tools to measure HIV incidence at a population level, the use of unrealistically large sample sizes, and the unreliability of such intermediate indicators as reported behavior change or sexually transmitted infection rates. The authors suggest that plausibility designs—which do not include randomly selected control groups but instead use triangulation of data sources—may provide important data on impact and help explain why a program may have been effective or ineffective. The authors encourage the use of a program impact pathway, which is a clear description of program components and their potential causal pathways, intermediate outputs, and outcomes leading to HIV incidence reduction. They also encourage the use of mixed methods and modeling as an alternative to probability evidence. They acknowledge that there is a clear need to develop incidence assays; until then, they encourage the use of modeling to produce proxy incidence estimates.
Guidance for the Prevention of Sexually Transmitted Infections
U.S. President's Emergency Plan for AIDS Relief (PEPFAR). (2011).
The August 2011 guidance from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) on the prevention of sexually transmitted infections aims to support PEPFAR country teams to identify the best combination of HIV prevention strategies, based on country-specific epidemiology. It describes the overarching principles for prevention programs and then summarizes the evidence base and implementation guidelines for specific interventions. Biomedical interventions included in the guidance are male and female condoms, voluntary medical male circumcision, HIV testing and counseling, diagnosis and treatment of sexually transmitted infections, and antiretroviral drug-based prevention. Behavioral interventions that are listed include the different channels of communication (e.g., mass media, community-level, interpersonal) and types of messages (e.g., addressing multiple partners, intergenerational and transactional sex, and alcohol use). Creating the demand for biomedical services is also detailed. Among the structural interventions described are legal and policy reforms, reducing stigma and discrimination against people living with HIV and marginalized groups, gender inequality and gender-based violence, education, and economic empowerment and other multi-sectoral approaches. Comprehensive packages for most-at-risk populations; positive health, dignity and prevention for people living with HIV; and prevention interventions for young people are included as well.
Technical Guidance on Combination HIV Prevention, Men Who Have Sex with Men
U.S. President's Emergency Plan for AIDS Relief (PEPFAR). (2011).
This guidance was developed in response to the U.S. President's Emergency Plan for AIDS Relief's (PEPFAR's) second five-year strategy, which outlines priorities and plans for countries that implement HIV programs. The guidance is one component in an effort to support comprehensive combination prevention programs. It was found in a review that men who have sex with men (MSM) are 19 times more likely to have HIV compared to the general population. PEPFAR is working to ensure that most-at-risk populations, including MSM, are a prevention priority in epidemics where MSM are shown to be a key driver of transmission. The guidance reviewed the evidence base for HIV prevention programs with MSM, and supports five key elements of a comprehensive response. The elements include community-based outreach; distribution of condoms and condom-compatible lubricants; HIV testing and counseling; active linkages to health care and antiretroviral treatment; targeted information, education, and communication; and sexually transmitted infection prevention, screening, and treatment. Discussion on how to support effective HIV prevention for MSM, and key points on how to optimize prevention programs are described. PEPFAR budgets will support implementation, training, collection, and use of strategic information, research, monitoring and evaluation, and commodity procurement of/for MSM programs. Additional resources are listed at the end of the document to provide PEPFAR country teams with information that may be needed in strategizing their MSM combination prevention portfolios.
Comprehensive HIV Prevention for People Who Inject Drugs, Revised Guidance
U.S. President's Emergency Plan for AIDS Relief (PEPFAR). (2010).
The guidance was updated in response to the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008 that was signed into law in July of that year. PEPFAR supports three core elements in comprehensive HIV prevention programming targeted to people who inject drugs (PWID). These are: community-based outreach programs, sterile needle and syringe programs, and drug dependence treatment, including medication-assisted treatment with methadone or buprenorphine and/or other effective medications. These elements are globally recognized as best practices with populations of PWID and are endorsed by organizations and agencies such as the World Health Organization, Joint United Nations Programme on HIV/AIDS, and the U.S. Centers for Disease Control and Prevention. It is estimated that there are about 5 million PWID in the 13 countries in which PEPFAR is supporting HIV prevention programs, mostly in Eastern Europe and East and Southern Africa. The sexual partners of PWID are also at risk of acquiring HIV and act as a bridge population to groups that conduct less-risky behaviors, which can fuel the epidemic. Therefore, the evidence base for programs for PWID supports a comprehensive HIV prevention program that includes behavioral, biomedical, and structural interventions as a means to reduce HIV transmission. There are 10 core interventions that PEPFAR adopted from the WHO, UNODC, UNAIDS Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. A combination of the ten interventions should be chosen based on the epidemiological, social, legal, and cultural environment of the country and region and implemented with a human rights approach.
Identifying Appropriate Livelihood Options for Adolescent Girls: A Program Design Tool
Caro, D. (2009).
Limited data are available on the effectiveness of economic strengthening interventions among adolescent girls and the impact—if any—on HIV prevention. As such, a series of tools was developed, including this livelihoods tool. It is designed to help program managers conduct more in-depth design, monitoring, and evaluation of activities reducing adolescent girls' economic vulnerability. The user is guided through a series of diagnostic steps to identify how such girls are at risk of HIV resulting from their lack of control over their immediate environment. Once the program manager identifies constraints and opportunities these youths are living in, they are guided to livelihood interventions that are most appropriate in those situations.
AIDS Indicator Survey (AIS)
MEASURE Demographic and Health Surveys (2009).
The AIS provides survey protocols that meet the reporting requirements of the President's Emergency Plan For AIDS Relief (PEPFAR), the United Nations General Assembly Special Session on HIV/AIDS (UNGASS), and most other funding agencies. This website provides links to standardized questionnaires, instruction manuals, survey data, and other information that can assist with the effective monitoring of national HIV programs and allow for comparison of data over time and between countries. Webpage tabs provide links to an overview of the AIS; its methodology; and to household and individual questionnaires and manuals that can be downloaded. Guidance on survey instruments, sampling design, data tabulation, and a timeline for implementing the surveys are provided. Other links provide access to survey results and databases that can be queried to provide information on a national basis. Data can be organized by various topics and individual countries.
HIV Triangulation Resource Guide: Synthesis of Results from Multiple Data Sources for Evaluation and Decision-Making
The World Health Organization (2009).
This 12-step guide provides detailed information on how to conduct data triangulation analysis, a dynamic and iterative process, in which each step informs and shapes subsequent and earlier steps as new data become available. Examples of how to conduct the analysis are drawn from experiences with HIV. Case reports and exercise questions and answers provide practical insights into the process of HIV triangulation.
Epidemiological Software and Tools
This UNAIDS website provides the most up-to-date guidance and versions of free software to estimate and project adult HIV prevalence and incidence from surveillance data. Components include:
- Estimation and Projection Package (EPP) software and manuals on generalized and concentrated epidemics
- Workbook Method spreadsheet and manual – useful when there is a lack of HIV prevalence data from consistent sites over time
- Spectrum software suite of tools
- Modes of Transmission spreadsheets (Excel) and manuals
Behavioral Surveillance Surveys: Guidelines for Repeated Behavioral Surveys in Populations at Risk of HIV
Family Health International (2003).
This comprehensive, 358-page collection of surveys allows programs to track risk behavior over time as part of an integrated surveillance system for HIV. These tools are helpful in understanding the behaviors of high-risk and hard-to-reach populations such as sex workers and their clients, men who have sex with men, and injecting drug users.
PEPFAR Announces Largest Study of Combination Prevention
U.S. President's Emergency Plan for AIDS Relief (PEPFAR). (2011).
This media note provides details on three PEPFAR-supported evaluations on combination prevention in Zambia and South Africa, Botswana, and Tanzania. A total of $45 million dollars over a four-year period was awarded to leading research organizations and universities to conduct the research. Critical research questions on combination prevention programs will be answered through these evaluations. Additional links are provided to the websites for the U.S. President's Emergency Plan for AIDS Relief, U.S. Agency for International Development, U.S. Centers for Disease Control and Prevention, and National Institutes of Health.
Practical Guidelines for Intensifying HIV Prevention
These guidelines provide a "synthesis of essential prevention measures required for countries to 'tailor your prevention plans' in relation to the epidemic scenarios." Topics include Prevention; Leadership; Know Your Epidemic; Match Your Response to the Epidemic; Prioritizing According to Epidemiological Scenario; Set Ambitious, Realistic, and Measurable Prevention Targets; Tailor Youth Prevention Plans; and Use Strategic Information to Stay on Course. Fifty-four references are provided and links to 21 Tools for HIV Prevention Planning are offered.
View Guidelines (PDF, 387 MB)


text:
Cash Mob ASHE will descend on Lansing tomorrow morning, bringing an influx of customers and cash to local businesses, and demonstrating the power of the community to organize in support of the local economy.
Nancy Shannon, organizer of the mob, said the idea came to her after she participated in a cash mob in Boone in November, which was covered by Carolina Country Magazine in their January edition.
"Boone is only one of many North Carolina towns where stores and restaurants have been 'mobbed' this year. Others include Cary, Thomasville, Pineville, Mount Holly, Franklin, Wake Forest and High Point," according to Carolina Country's article, "Mobbing Stores in Broad Daylight."
Shannon, a resident of Fleetwood, was inspired by the effectiveness of the Boone cash mob, and decided to quickly organize one in Ashe County. "If we let too much time go by, we'd lose momentum," she said.
Like flash mobs, cash mobs form through social media, using Facebook and Twitter to coordinate mob activity. Mobs arrive en masse at selected retailers and restaurants at an appointed hour, and give those business a shot in the arm.
"It's all about infusing local businesses with cash," she said.
Shannon's effort is organizing as a Facebook group: "Cash Mob" ASHE. To go to the site click http://www.facebook.com/groups/516875038333066/. She chose Lansing because the town is struggling, and because businesses there support local farmers.
Cash Mob ASHE will hit Lansing at 11:30 a.m. tomorrow at Lansing Foods, which recently began stocking meat and produce from local farms, enabling residents to support local farmers by supporting their local grocery.
From Lansing Foods, the mob will move to Pie on the Mountain, Lansing's pizza, salad and sandwich cafe, which uses locally-grown ingredients, and serves coffee from local microroasteries.
"We want to encourage stores and restaurants to source as much local food as possible," Shannon said.
After giving Pie on the Mountain the business, the mob will move to Phoenix Mountain Arts. The mountain art and craft gallery opened last summer, and features work by local artists and artisans, as well as furniture, antiques and curios.
"It's a passion," Shannon said of her avid support of homegrown economy. "I've never set foot in the Walmart."

subset: commoncrawl


text:
|Your Gear Show your Gear - Pictures - Descriptions
|Thread Tools
Vintage Premier restoration-ish
Sorry in advance that my writing is pretty crap but I thought I would give this a go.
A couple of years ago I was give a vintage premier kit by a guy who owns a rehearsal studio. It was quite a nice sounding kit, but was in dire need of new heads. I used it for a while but couldn't get used to the huge 14" tom i was using as my rack tom.
So luckily one day I was rummaging around the spare stuff at the studio and found a matching 10" tom. I asked if i could swap it with him for the 16" tom and sure enough he agreed. Now I was really happy with the set. As I like to have quite a tight set up, the small 10" and 14" toms worked perfect.
After a while of using it I decide I wanted to make it look a bit better, which is what I am still doing at the moment. First thing I did was to give it a new paint job. I removed the old scratched and worn wrap and found a lovely black stain underneath. Unfortunately though the ridiculously sticky wrap pulled a lot of it off so this was unusable. At this point I also noticed that the bass drum used to be a 10 lug and had been changed to a 8 lug. Who ever owned this kit before me really butchered it. Once I sanded it down I decided to spray it matte black. The result looked like this.
This is what I have at the moment, and to be fair, I am happy with how it looks. Also, now it has been completely re-skined, It sounds really nice. However I wanna do some more, so I mocked an image up quickly in Photoshop to see how it would look with some new details.
As you can see, I am planning to add new bass drum spurs, the logo, maybe a holz, some premier badge decals and the floor tom needs a new bracket. Other things I wanna do is buy some more lugs and claws and turn the bass drum back into a 10 lug. I may also buy some gauger mounts, for the toms. I think this would greatly improve the sound as the brackets are currently attached straight to the shell which is chocking the sound of the drums.
So let me know what you think, any ideas/ opinions on what I could do improve the kit.
Re: Vintage Premier restoration-ish
i dont know what to improve, but the kit looks awesome :) any sooundclips?
Re: Vintage Premier restoration-ish
Nice job - it looks good.
I played a set with 13 and 14" toms that were about that deep (like in the first pic), mounted on the bass drum - LOL. So I fell your pain and joy. I'm very pleased with the smaller sizes I've got now.
I think the bass drum spur idea is great. Your mock-up looks a lot better to me. I just like straight spurs though.
I'm not sure going back to 10 lugs would be worth the effort though, unless you'd be doing it just because you like the look better. 8 lugs is plenty to hold a tuning.
Last edited by wildbill; 04-26-2013 at 12:43 AM.
Re: Vintage Premier restoration-ish
Personally I would make the port hole perimeter black. I think that would look much sharper. I highly recommend those Gauger RIMS suspension mounts for both toms - just make sure everything will fit. I tried to use an imitation mount (Gibraltar I think) on one of my vintage Premier toms, and the side plate did not fit my Premier tom bracket, and the band itself did not realy fit my drum. Adam, I think his name is, at Gauger, is extremely helpful and will make sure any of your questions are answered.
Re: Vintage Premier restoration-ish
I think the 10 lugs will look better. But mainly because that's what it was originally. All the holes are there so it would just be a case of buying some more lugs and filling in the newer holes. I dunno what the guy who had it before me was thinking when he messed with this kit. I also believe that it was originally a resonator and that the inner shell was taken out. I'm not too sure on that but it's the only kit I can find with the same lugs.
As for the black hole, I alread brought the chrome one. I bloody love chrome :P
I was going to get Guager mounts as they are the only place that I could find that do a 5 lug 10" mount. I will definitely get in touch before I buy them but as far as I am aware they are quite adjustable?
Re: Vintage Premier restoration-ish
Ya - that seems a little strange. But if the holes are already there, might as well go for it.
Re: Vintage Premier restoration-ish
Here is some Pics of what I did the weekend:
New Spurs, logo and Bass drum O.
New badges
Also, if any one is interested, I got a new Evans level 360 G1 head for my snare. Haven't had a chance to properly try it out yet but there was definitely a noticeable improvement in sound and tuning range when I was tuning it up. Ill post some set up pics next weekend after band practice.
Re: Vintage Premier restoration-ish
Here's some more pics of what I did over the weekend.
New bracket, air vents and badges:
Overall kit:
I think its looking good now. Next thing to do is turn it back to a 10 lug bass drum. Got the extra lugs, just waiting to get some money for some extra claws. I'm gonna tidy up some of the filler work I did too and give the bass drum a fresh spray of paint.
Last edited by drummyjosh; 04-30-2013 at 05:43 PM.
Re: Vintage Premier restoration-ish
Josh, just for info: One of your posts was moderated by the Drummerworld system (automatically), displaying that post as possible spam. So I had to approve that post to have it being displayed in the thread. That's for the confusion why your post didn't come up at first when you submitted it...
Re: Vintage Premier restoration-ish
Some pics from my visit to Aberystwyth the other day:
And one from the gig I played with my band there:
Gonna be doing some more work on the drums and buy some new things over the coming weeks. If any one is actually interested I will keep posting in this.
|Thread Tools


text:
Jump to main content.
EPA Science Advisory Board (SAB)
Recent Additions
Contact Us
You are here:
EPA Home
EPA Science Advisory Board (SAB)
Current and Complete Activities by Name
Current and Complete Activities by Name
This site provides access to information about advisory activities since 2003.
SAB advisory reports
provide information about SAB science advice before 2003. Please contact the
SAB Staff Office
for other information.
<-- Clicking on these images below will collapse (hide) detailed information.
<-- Clicking on these images below will expand (show) detailed information.
Acrylamide IRIS Assessment
Aging Drinking Water and Wastewater Infrastructure Research Initiative
Air Monitoring Plan Related to Hurricane Katrina
Aircraft Drinking Water Rule
All Ages Lead Biokinetic Model
Animal Feeding Operations Air Emission Estimation Methodologies
Anthrax Technical Assistance Document Update
Aquatic Life Criteria Guidelines Revision Strategy
Aquatic Life Protection Mode of Action Methodology for Deriving Water Quality Criteria
Arsenic Health Effects Assessment
Ballast Water Advisory
Calculating Violators' Economic Savings from Violating the Law-- Determining the Benefit Derived from an Illegal Competitive Advantage (ICA)
Cancer Risk Estimation from Exposure to Ionizing Radiation - Revised Blue Book
Carbon Dioxide Accounting for Emissions from Biogenic Sources
Conceptual Model and Revised Indicator Criteria for EPA's Report on the Environment
Concern about the Future of the Science to Achieve Results (STAR) Fellowship Program
Connectivity of Streams and Wetlands to Downstream Waters: A Review and Synthesis of the Scientific Evidence.
Contaminated Sites and RCRA Multi-Year Plans
Critical Ecosystems Assessment Model
Demolition and Disposal of Hurricane Debris
Dioxin Reassessment - Response to the National Academies of Science
Drinking Water Contaminant Candidate List Draft Revisions
Drinking Water Research Strategy and Multi-Year Plan
Ecological Assessment Action Plan
Ecological Benefits Strategic Plan
Ecological Research Program Strategy and Multi-year Plan
Ecological Risk Assessment Approach
Economic Analysis Guidelines Update
Economic Research Strategy
Ecosystem Services Research Program
Emergency Response Quality Assurance Sampling Plan for Hurricane Katrina Response
EPA Risk Assessments - Use of Computational Toxicology
Estimating the Value of Water to the U.S. Economy
Estimation Programs Interface (EPI) Suite
Ethylene Oxide Carcinogenicity Assessment
Ex Ante Regulatory Cost Estimates - Exploratory Analysis
Expert Elicitation White Paper Review
Exposure Assessment Guidelines Update Plans
Geographic Information System Screening Tool for Ecological Assessments
Great Lakes Restoration Initiative Action Plan FY2010 - FY2014 and Implementation Strategy
Human Health Research Strategy
Hydraulic Fracturing Potential Impacts on Drinking Water Resources - 2012 Progress Report
Hydraulic Fracturing Research Plan
Hydraulic Fracturing Study Plan
Hypoxia in the Northern Gulf of Mexico: Scientific Assessment of Causes and Options for Mitigation
Implementation of ORD's New Strategic Directions
Improving EPA Leach Testing of Waste
Inorganic Arsenic - Toxicological Review for IRIS
Inorganic Metals Risk Assessment Framework
Interim Water Quality Advisory Methodology for Estimating Conductivity
Ionizing Radiation: Updated Methodology for Estimating Cancer Risks
IRIS Assessment for Libby Amphibole Asbestos
IRIS Assessment for Trichloroethylene
IRIS Technical Document for Polycyclic Aromatic Hydrocarbon (PAH) Mixtures - Relative Potency Factor (RPF) Approach
Lake Erie Eutrophication Indicators - Ensemble Modeling Approach
Lead Paint Hazard Standards for Residential Buildings, Public and Commercial Buildings, and Renovations of Exteriors of Public and Commercial Buildings
Mercury Risk Assessment
Microbial Risk Assessment Framework for Biothreat Agents
Microbiological Risk Assessment Protocol in Water Media
Model Assessment Guidance from the Council for Regulatory Environmental Modeling (CREM)
Mortality Risk Measurement and Valuation for Policy Analysis
Mortality Risk Valuation for Policy Analysis
Mountaintop Mining – Valley-Fill Ecological Assessment
Multi-Agency Radiation Survey & Site Investigation Manual (MARSSIM) Supplement: Multi-Agency Radiation Survey and Assessment of Materials and Equipment (MARSAME)
Multimedia, Multipathway, and Multireceptor Risk Assessment (3MRA) Model
New ORD Research Program Strategic Directions
Nutrient Criteria for Florida's Estuarine and Coastal Waters, and Southern Canals - Methods and Approaches for Deriving Numeric Approaches
Nutrient Criteria for Water Quality - Guidance for Numeric Approaches
Oil Spill Research Strategy
OSWER Interim Method to Assess Asbestos-Related Carcinogenic Risk
Partial Lead Service Line Replacement Effectiveness
Particulate Matter Research Centers Program Review
PCBs Released from the ex-Oriskany Following Deployment as an Artificial Reef: Approach for Assessment of Human Health and Environmental Risks
Perchlorate - Approaches for Deriving Maximum Contaminant Level Goals for Drinking Water
Perfluorooctanoic Acid Human Health Risk Assessment
Pollution Prevention (P2) Programs - Performance Measurement
Preparedness for Manmade and Natural Environmental Disasters
President's Requested Fiscal Year 2012 Science and Research Budget Review
President's Requested Fiscal Year 2013 Science and Research Budget Review
Radiation Survey Manual (Multi-Agency Radiation Survey and Site Investigation Manual) Revisions
RadNet Environmental Radiation Tracking System
Reactive Nitrogen: An Integrated Approach
Regional Vulnerability Assessment (ReVA) Integration Tool and Underlying Methods for Multi-Scale Decision Making
Report on the Environment 2003
Report on the Environment 2007
Report on the Environment (ROE) 2014
Research Budget Review - Fiscal Year 2011
Residual Risk Rulemaking-Consolidated Rulemaking for Hazardous Air Pollutants (HAPs)
Residue Sampling Plan Related to Hurricane Katrina
Review of Agency's Interim Guidance on Children's Cancer Risk
Review of Nominations for the EPA's 2006 Scientific and Technological Achievement Awards (STAA)
Review Prototype of the Emergency Consequence Assessment Tool (ECAT)
Risk and Technology Review Assessments for Phase II Source Categories
Risk Assessment Principles and Practices and Preliminary Briefings
Risk Assessment Principles & Practices Staff Paper: Priorities
SAB Discussions about EPA Planned Actions in the Fall 2012 Unified (Regulatory) Agenda and their Supporting Science
SAB Discussions about EPA Planned Actions in the Fall 2013 Unified Agenda and their Supporting Science
SAB Discussions about EPA Planned Actions in the Fall 2014 Unified Agenda
SAB Discussions about EPA Planned Actions in the Spring 2013 Unified Agenda and their Supporting Science
SAB Discussions about EPA Planned Actions in the Spring 2014 Unified Agenda and their Supporting Science
SAB Workgroup on Coastal Mississippi Water Quality Assurance Plan
Science Advice and EPA Priority Topics
Science and Technology Budget Review – Fiscal Year 2009
Science Budget Review Fiscal Year 2010
Science Integration for Decision Making
Science Needs for EPA
Science Program Investments Advisory-2008
Science Program Investments Advisory - 2007
Science Research Vision
Scientific and Technological Achievement Awards (STAA) - 2002/2003
Scientific and Technological Achievement Awards (STAA) 2004
Scientific and Technological Achievement Awards (STAA) 2007
Scientific and Technological Achievement Awards (STAA) 2008
Scientific and Technological Achievement Awards (STAA) 2009
Scientific and Technological Achievement Awards (STAA) 2010
Scientific and Technological Achievement Awards (STAA) 2011
Scientific and Technological Achievement Awards (STAA) 2012
Second Generation Model
Soil and Sediment Sampling Plan Related to Flooding from Hurricane Katrina
Standardized Analytical Methods for Use During Homeland Security Events
Strategic Research Directions for EPA's Office of Research and Development (ORD) 2016-2019
Strategic Research Directions for EPA's Office of Research and Development (ORD)
Superfund Benefits Analysis
Sustainability Research Strategy
Technical Guidance for Assessing Environmental Justice in Regulatory Analysis
The WaterSentinel Contamination Warning System for Public Water Systems
Total Coliform Rule Revisions: Risk Assessment and Occurrence Analysis
Uranium In-Situ Leach Recovery - Post-closure Stability Monitoring
Valuation of Mortality Risk Reduction
Valuing the Protection of Ecological Systems and Services
Waterborne Diseases - Measures To Link Drinking Water Programs To Public Health Outcomes
"Definition of 'Waters of the United States' Under the Clean Water Act" - Advice and comment on science supporting the EPA's proposed rule
Local Navigation
SAB Home
Basic Information
Committees, Panels, and Membership
Advisory Activities
Advisory Reports
Federal Register
EPA SAB Staff
Public Involvement in Advisory Activities
Nomination of Experts
Ethics Requirements for Advisors
Clean Air Scientific Advisory Committee
Advisory Council on Clean Air Compliance Analysis
EPA Home
Privacy and Security Notice
Contact Us
Jump to main content.


text:
Hunt and Fish Since the dawn of brokind.
There are no products in this section
Current Promotions
Summer Sock Sale: Spend $60+ on socks and save 10% off of your order (coupon: HOT10) or spend $30+ on socks and save 5% off of your order (coupon: HOT5). Excludes brands running other current promotions.
Smartwool Sale: 20% or more off all Smartwool socks (code: TREAT).


text:
Zach Weston
Lecturer (CAS), Kinesiology & Physical Education
Contact InformationEmail: firstname.lastname@example.com | firstname.lastname@example.com
Other Phone: 519-616-0927
Office Location: AIM INST of Sports & Lifestyle Medicine
Languages Spoken
Academic Background
BSc Honours Kinesiology (CO-OP) University of Waterloo
MSc Exercise Physiology/Kinesiology University of Waterloo
MBA Entrepreneurship and Marketing Wilfrid Laurier University
Zach is the Director of Exercise Physiology and Metabolism at the AIM Institute of Sports and Lifestyle Medicine and since 2003 a faculty member in the department of Kinesiology and Physical Education at WLU. As a Kinesiologist and Exercise Physiologist he has worked with athletes in the CIS, OHL, NHL (including Stanley Cup Champions), CFL, NFL, CSL, CUFLA, Boston Marathon, Ironman, Triathlon World Championships, World Police and Fire Games, Olympics, Paralympics and Namibia Ultramarathon. As a faculty member he teaches Advanced Exercise Assessment, Advanced Exercise Training Methods and Nutrition for Health and Human Performance. He is driven to enable athletes to achieve personal best performances and regularly coaches age group athletes in various disciplines across Ontario. He also works with patients in a team oriented environment focusing on chronic disease management and prevention with a particular interest in diabetes and cardiovascular disease.
As a father of two active boys, Zach is typically coaching hockey or soccer if he is not in the game himself. At home, the neighbourhood kids claim he makes the best backyard rink with better ice than some of the local arenas - even with the "lucky loonie" faceoff dot!
In the Newshttp://www.thestar.com/life/health_wellness/diseases_cures/2010/11/03/exercise_keeps_him_at_the_top_of_his_game.html
Additional Information
Through the Accelerator Centre and Communitech Hub, Zach has served as an advisor to numerous local startup companies including BlackTree Health Technologies, PumpUP Inc, Nicoya Lifesciences and NeuroVasc Clinical.
Member of the Exam Development Committee for the College of Kinesiologists of Ontario
2011 Vice President of Strategic Partnerships for the Ontario Kinesiology Association (Board and Executive member of the Ontario Kinesiology Association from 2007-2011)
SC 200 - Entrepreneurship in Science
KP 324 - Advanced Exercise Testing and Prescription (Since 2004)
KP 424 - Advanced Exercise Training Methods (Since 2009)
KP 332 - Human Nutrition in Exercise and Health (2006, 2011)
KP 223 - Functional Human Anatomy (2003)
Ontario Society for Health and Fitness Annual Meeting, Toronto 2013
Canadian Society for Exercise Physiology Annual Meeting, Toronto 2013
Ontario Kinesiology Association Annual Meeting, London 2013
Run for the Toad Medical Practitioners Keynote Presenter, Paris 2012
New Brunswick Kinesiology Association Annual Meeting, Moncton 2009
Ontario Family Health Team FHT Forum, Cambridge 2008
St. Mary's General Hospital Acute Care Cardiology Conference, Waterloo 2001, 2004, 2006, 2007, 2008
Dearborn Health Multisport Symposium, Waterloo 2007
Canadian Cardiovascular Congress Annual Meeting, Halifax, 2001
American College of Sports Medicine Annual Meeting, Indianapolis, 2000


text:
La Maison du Chocolat Dark Chocolate Truffles
- Exclusive
- Online Only
- Summary
La Maison du Chocolat, founded by Robert Linxe in 1977, is world renowned for its superlative creations prepared using special house-blended chocolate that starts with carefully selected and roasted cacao beans from around the world. Hand made at the chocolatier's Paris workshop, these exquisite chocolate truffles contain dark chocolate truffle mousse covered with a thin layer of dark chocolate. Each hand-shaped truffle is lightly dusted with cocoa powder. The box is handsomely packaged and ready for giving.
- 6.7. oz.
- Approx. 23 pieces.
- Dimensions & More Info
- Made in France and shipped fresh weekly to the U.S.
- Use & Care
Receiving Instructions
- Keep the chocolates in a cool place at room temperature or refrigerate sealed in an airtight container. Chocolates will keep up to 4 weeks, unopened. Do not freeze the chocolates.
- Ingredients
- Dark chocolate (cocoa paste, sugar, cocoa butter, emulsifier (soy lecithin), vanilla natural flavoring), cream, cognac fine champagne 40° proof (4,5%), butter, cocoa powder, glucose syrup, sweetener (sorbitol), invert sugar
- Shipping
Shipping Information
To ensure freshness, perishable items are shipped via 2-day delivery from the supplier and are not eligible for rush shipping. Please allow one to two weeks for delivery.
Shipping Rates
The shipping rate varies depending on your order total and shipping destination.
Return Policy
At Williams-Sonoma, we take great pride in the quality and craftsmanship of our products. Attention to design, materials, safety and construction are our priority. Upon receipt, please inspect your purchase and notify us of any damage; we will arrange for a prompt replacement.
We cannot accept returns on monogrammed, personalized, special-order items, custom upholstery, food, items shipped direct from the vendor, or on items damaged through normal wear and tear. Final sale items ending in .97 or .99 cannot be returned. View Full Return Policy.


text:
What is New in Autodesk Building Design Suite Premium 2014
A webinar on October 31st, 2013 from 12:00-1:00PM
Many of the BUGI members have been asking for a presentation on what is new in Autodesk's 2014 Revit. This webcast will give attendees an overview of Revit 2014. However we decided to expand the presentation just a bit and touch on Building Design Suite Premium as a whole. Why? Because it is really at the heart of the "What's new in 2014" question. BDSP is the most common building design tool in use today. The ever increasing interoperability that Autodesk is including between the various products puts BDSP at the heart of "what's new". We will spend a good amount of time on the new Revit tools specifically – from both the Architecture, a little structure and the MEP side as well.
Presented by Brian Juge RA, AIA and Tony Crawford ME
Title: What is New in Autodesk Building Design Suite Premium
Date: Thursday, October 31, 2013
Time: 12:00PM – 1:00PM MDT
After registering, you will receive a confirmation email containing information about joining the webinar.
To register: Click the register link in the webinar invite email you received. If you did not receive a webinar email invite, please subscribe to our newsletter (click the "Subscribe" button in the upper left on this page), or email us at firstname.lastname@example.com


text:
Dentistry is a practice that basically depends on the number of patients in order to grow and prosper. Patients are the life and blood of dentistry. Hence, dentists should know how to come up with
precise marketing in order to convert inquiry call to actual patients. In any forms of business, you could have the best marketing plan, but if you don't know how to implement it, then you could end up losing potential clients and potential income.
The Scheduling Institute by Jay Geier helps dentists reach out to as many patients as possible; especially potential new patients. By increasing new patient conversion, dentist and the dental staff as a whole will be able to increase both their monthly and annual patient percentage and profit. Jay Geier is the founder of Scheduling Institute (SI). He used his decades of experience in building his very own company; the Scheduling Institute.
The Scheduling Institute has different components, but only one ultimate goal and that is to promote career and business growth. From its humble beginning, today it is one of the most powerful and biggest companies in the world. It now has numerous training centers in different parts of America. There is a Scheduling Institute Atlanta Georgia, Phoenix Arizona, and the rest of the United States.
The components of Scheduling Institute
- Telephone training
- Establishing systems
- Coaching
- Consultation
- Providing incentives
- Responsibility and accountability
The Scheduling institute members will enjoy the following:
- Full time support team
- Personal coaching conducted by highly knowledgeable coaches
- On-site trainers and on-site training
The Scheduling Institute is truly a life saver of every dentist. This private company founded by Jay Geier practice what it preaches. This company does not only teach the dentists and their staff the basic elements of growing their dental practice, but as well as provide care and teach the fundamental qualities of dental business. The on-site training, coaching, and support team only goes to show that the Scheduling Institute is serious with its goal and that is to help dentists and their team in growing their career and business.
If you are not a Scheduling Institute member yet, then now is the time to become one. If you have been in the dental industry for many years now and you are frustrated with the current number of your patients, then seek professional help. Become a Scheduling Institute member and see improvement in the number of patients and the dental practice as a whole in just a short period of time.
Related Articles: DentalEconomics.com on Scheduling Institute


text:
The charge to the Committee is to assess the academic state of NYU's global network (the 11 global sites plus portal campuses in Abu Dhabi and Shanghai) and make recommendations to the President and Provost for improvements, including recommendations for how best to integrate the global centers with schools and programs in New York and one another.
Deans were asked to choose representatives from their schools to serve on this Committee. Additionally, leadership of other university-wide groups (Faculty Senators Council, Undergraduate Academic Affairs, Academic Priorities) were asked for representatives.


text:
You are a fan of dnevnici relax ? Come to discover the best forums dnevnici relax on the internet and share your experience with a community fan of dnevnici relax . You can also build a forum dnevnici relax and create your online discussion.
A gaming community for those that are looking to relax, have fun, and meet some new people
botc, headquarters, gaming, community, those, that, looking, #relax, have, meet, some, people
An RP forum for mature RPers willing to relax and have fun. A refuge for a friendly community. Specialized in anime-style Roleplays, though we try to experiment iwth new ideas.
newts, suits, roleplays, forum, mature, rpers, willing, #relax, have, refuge, friendly, community, specialized, anime-style, though, experiment, iwth, ideas


text:
Online Learning
Kent State University at Ashtabula provides many different opportunities for lifelong learning. For our customers that are interested in learning via computer, we have negotiated a discount from some providers for our customers. Please click on the link below to see a full listing of available on-line learning classes.


text:
My name is Raymond Mihaere The reason for this site is to allow all the immediate family to have access to the information about our ancestors and to share the knowledge of them that we have. If you have any comments or feedback about this site, please click here to contact me.Our family tree is posted online on this site! There are 5331 names in our family site.The site was last updated on Aug 3 2015, and it currently has 80 registered member(s). If you wish to become a member too, please click here. Enjoy!
All of the people on this tree are from my investigations and are as correct as possible. There will always be errors as I have noted that the information that was automatically transferred recorded all those who have children as being married when they may not be, so I have tried to correct those but may have missed some.
The more input everyone has the more the fuller the picture of those who did their best to give us every opportuntiy to have a rich heritage to inherit.
Owen Gould, Tiana Mihaere & Julia Fauth
Oamaru's rowing contingent have performed well at the New Zealand Schools' Maadi Cup Regatta at Lake Karapiro picking up a respectable medal haul. The change in format where more crews are taken through to the quarter-finals, rather than the repechage system, has been a plus with six crews from the three local schools progressing to the quarter-final stage. St Kevin's College's Julia Fauth continued to impress taking gold in her Girls Under-16 A final with a time of 8:20.91, shaving almost seven seconds from her second place semi-final finish. Fauth and Tiana Mihaere then went on to take a silver medal in the Girls Under-16 2X.
Ngāti Rakai Paaka, Ngāti Kahungunu (? – 1875)
It is not known when Ihaka Whaanga was born, but he died on December 14 at Mahia in 1875 and is buried at the southern tip of the Mahia Peninsula, marked by a memorial stone.
Whaanga was the youngest child of Te Ratau and Kainga and the only survivor of a raid that claimed the lives of his parents and five brothers. Married three times to Kahungunu women from influential families, he lived the origins of his ancestor Te Huki's saying Te Kupenga a Te Huki (the net of Te Huki) which means to maintain unity and peace by marrying within the tribe.
In the 1820s, Whaanga had met his first Pākehā trader touting muskets and powder for dressed flax. They arrived at Mahia in the vessel Fanny and were regular visitors during the 1820s. Ihaka is the Māorified name for Issac, a name presumably taken after converting to Christianity. It is not known when he converted to the Mormon faith, but Ihaka did take a sea-voyage to Utah in 1894 travelling aboard the San Francisco steamer.1 Since, the Whaanga name is synonymous with rise of Mormonism in Hawkes Bay. By 1898, the church claimed they have 4,000 members, most of whom were Māori.2
From http://www.lindaueronline.co.nz/maori-portraits/ihaka-whanga
2012 TrustPower Youth Community Spirit AwardWinner: Hannah Mihaere from St Kevin's CollegeHannah is so passionate about serving her school that this year she was made Cultural House Captain and a Special Character Prefect at St Kevin's College. Her leadership and guidance skills are also widely recognised by peers and staff across her school.At St Kevin's Hannah is the student leader of the Kapa Haka Group, a member of the Justice Awareness group, she represents St Kevin's on the Youth and Students against Drink Driving Councils and she is a strong sportsperson too.Outside of School Hannah represents the under 17 & 18 Maori Netball Otago squad, and she is also the secretary of SADD.Hannah was also fortunate to be selected to travel to India with the Edmond Rice India Immersion Experience where she was able to volunteer in one of the Mother Teresa Houses and experience firsthand some of the poverty that exists there.Hannah is a very talented young lady who according to her Assistant Principal is always prepared to use her talents for the good of others. Hannah aspires to complete either a Law degree or Medical Science degree and we wish her all the best for the future. As part of her prize money Hannah donated $250 to SADD (Students Against Drink Driving).
Photo above: from left to right; Waitaki District Mayor Alex Familton, TrustPower Oamaru Youth Community Spirit Winner Hannah Mihere and TrustPower Chief Executive Vince Hawksworth.
Elder Matthew Cowley (Who Davis knew well because he often recieved scowling looks when he tried to jitterbug at green and gold balls as jitter bugging and rock n roll was frowned upon) tells of a great convention held in 1881 that represented all of the native tribes of New Zealand. They were gathered at a native village near Mastertown, near Wellington. Many who attended that conference were old enough to have seen the first Christian missionaries arrive in New Zealand, and all who attended belonged to a Christian church. They were Catholics, Methodists, or Presbyterians. One of the dominant topics considered was why the Maoris were no longer religiously unified as they had been before Christianity came to them. If Christianity was the higher light—the true religion—why were they divided into many churches? So they began asking themselves which of these Christian churches was the right one for the Maori race and which one they should all belong to so that there would be only one church among them. Not knowing the answer and not being able to decide in their debate, they turned to their wisest sage, Paora Potangaroa, and asked him which church they should all join. He said he would have to think on it and then went to his own residence which was nearby. After three days of fasting and prayer, asking Jehovah which was the right church for the Maori people, he returned to his people and said: "My friends, the church for the Maori people has not yet come among us. You will recognize it when it comes. Its missionaries will travel in pairs. They will come from the rising sun. They will visit with us in our homes. They will learn our language and teach us the gospel in our own tongue. When they pray they will raise their right hands" (Cowley 200–01).
Paora Potangaroa then asked Ranginui Kingi to write down what he was going to say and his words were proclaimed to his people at the "eight-years house" on the 16th day of March 1881. Several things were said of interest to us: First, the year 1881 is the "day of fulness"; that is the year that the missionaries first taught the fulness of the gospel to the Maori people. It is also the year W. M. Bromley arrived to preside over the mission. He was told before leaving Utah "that the time had come to take the gospel to the Maori people." Potangaroa said the next year, 1882, would be the year of the "sealing." It was in 1882 when they were first taught about the sealing ordinances performed in the temple. He said the third year, 1883, would be the year of "the honoring," when they would pay "tribute to whom tribute was due, custom to whom custom . . . honor to whom honor" (See Romans 13:7). Elder Cowley interpreted that as the year when Maoris joined the Church in great numbers and gave "tribute to whom tribute was due [and] custom to whom custom" was due as they began worshiping the Lord (203–04).
The prophecy went on to say that they were the lost sheep of the house of Israel. They would learn of the scepter of Judah, and of "Shiloh, the king of peace." They would also learn of "the sacred church with a large wall surrounding it." There would be an "increase of the[ir] race" and of their faith, love, and peace (203). That was at a time when the Maoris were beginning to be exterminated, much as the American Indian was in the United States. There was a great deal of apprehension among them, a fear they would disappear as a people.
This covenant was written down on a piece of paper, and at the top of the piece of paper they drew an "all-seeing eye." This prophecy was then placed in a cement monument in the eight-years house where the convention was held. It remained there from 1881 until 1929, when a Maori sect known as the Ratana Church, in groping for substantiation that they were the true church of the Maoris as foretold by Potangaroa, broke open the cement monument to get at his prophecy, hoping to find something in it that would establish their claim to be the right church for the Maori (203–04).
Unfortunately, the storage chamber which contained the prophecy had not been hermetically sealed and the paper had been so damaged by moisture that nothing was legible on it.
That was 1929. In 1944, Matthew Cowley was the New Zealand mission president. He was there during the war years, and the only American missionaries he had were himself, his wife, and their daughter. They held a convention for the Maoris in the same area where Paora Potangaroa gave his prophecy in 1881. Present at the 1944 convention was Eriata Nopera, another great Maori chief. When he rose to speak, he told his people that he had been a little boy there when Paora Potangaroa gave his prophecy and repeated what he remembered of the prophecy. At the end of that day's convention, one of the women attending the convention had her husband go fetch parcel wrapped in brown paper from a trunk in their house. When he brought her the parcel, she called President Cowley and Eriata Nopera into an adjoining room and gave it to them. They opened the parcel and found a photograph of Potangaroa's written prophecy wrapped up in it (205).
What had happened was that in 1881, when the prophecy was written down by Ranginui, a photographer in Wellington had heard that a Maori had made a prophecy. He traveled out to that village and asked for permission to photograph it. This was granted and he photographed the prophecy before it was sealed in the cement monument. This woman's family got a copy of that photograph and had kept it since. She then gave it to Brother Nopera, who in turn gave it to President Matthew Cowley (205). That is the way we know what was in Paora Potangaroa's prophecy.
Many prominent Maori from all over Aotearoa have made the point that we have connections to Israel. As maori we can connect ourselves back to the 7 Waka on which our ancestors arrived and then it starts to get a bit vague. Being a member of the Church of Jesus Christ of Latter Day Saints, through the patriarchal blessings that we recieve, we already have that belief. It is through Joseph the son of Jacob who was sold as a slave into Egypt and became second olny to Pharoah and his son Mannasseh that we are predominantly from. So what evidence do we have? Here are a list of customs that we have that coincide with biblical customs.
So I believe that we as Maori lived a law similar to the law of Moses. We had Whare Waananga which were houses of learning about God and that our Tohunga were the spiritual directors of our world like the priests or sons of Aaron of the Tribe of Levi were for Ancient Israel.
You can call allot of this coincidence but I think it is more than just coincidence. I know that we are connected to The Indian tribes of North America and Peru. This links us up to Lehi and Mulek who settled in the Americas from the middle east. It is the from the origins of the Indigenous Americans that we link back to Israel.
That is what I believe.
Our Tangoio Connections.
Davis Mihaere's Grandfather originally named Mihaere son of Ihakara TeTuku and Maata Pouaru changed his name to TeTihi Mihaere when he arrived in Tangoio from Otorohanga. He got Te Tihi from Maatas Father who was of Kahungunu Descent and that is how the Mihaere surname was born and that is perhaps why he ened back in the Kahungunu rohe. Mihaere's Brother, Rapana also ends back in Kahungunu and Marries a McRoberts from Wairoa. From there he has a son Named Ihakara TeTuku Rapana or Ike Robin and that is how the Rapana name for this side of the Whanau is born.
Charlene married Kaaran Toatoa whangai to the Spooner (Puna) family from Tangoio
Mere Whaanga's sister Molly or Mako who is still alive lived in Tangoio and it is here that she lived with her Taunoa cousins as there is a Taunoa Connection here as well.
Tangoio is just north of Napier heading toward Wairoa here is the website link where you can register. http://www.tangoio.maori.nz/
We connect to Iwitea through Koro Tihi Whaanga, Mere's Grandfather who was the first of Epanaias sons who moved to Iwitea from Nuhaka. Here is the website http://www.naumaiplace.com/site/iwitea-marae/home/welcome/ and this a picture of the Wharenui
We get our Rangitane connections through Davis's Grandmother Emaraina Paewai. Through this connection we connect to the Hapu Ngati Mutuahi and our Pepeha I have recorded on one of my pages on this site.
Just got to the Rangitane Tamaki nui a rua website and register your families there if you haven't already. http://rangitane.co.nz/
Interestingly the Name Rangitane is short for Rangitane nui a rangi the name for the son of the Sky Father. If you were to marry this name up biblically it is another name for Jesus Christ. A Kuia from Takapau gave a friend the rangitane waiata to him and all of the words to all of the waiata were about God and praise to God. These waiata predated the arrival of the pakeha indicating that Maori already had an understanding of their being a saviour.


text:
*image shown is 5 x 8 or larger rug
*smaller sizes will not show complete pattern, will be scaled down to fit.
Rating: 4.50
Read 2 Reviews >>
Name: #U32208
Manufacturer: Safavieh Rugs
Material: Polypropylene
Construction: Machine Made
Colors: Ivory/Beige , Reds/Burgundy
Origin: China
Ships in 1-2 weeks
Description: This collection offers the beauty and painstaking detail of traditional Persian and European styles with the ease of polypropylene. With a symphony of florals, vines and latticework detailing, these beautiful rugs bring warmth and life to any room of your choice. (#U32208)
Other Related Patterns You Will


text:
GOSHEN — Churubusco's football team held Prairie Heights to seven yards of rushing, and the Eagles shut out their conference foe 34-0 Friday night.
On defense, 'Busco only gave up 54 yards, with a squad led by Teegan Brumbaugh, who tallied several tackles for losses.
"Our defense played great," Churubusco Head Coach Paul Sade said.
The Eagle defense forced seven turnovers — four fumble recoveries and three interceptions by Beau Barkley, Hayden Kilgore and Dakota Labenz.
To read the rest of this story, see the September 7-8 issue of The Post and Mail. Don't have a subscription? Call (260) 244-5153 or subscribe to our e-edition [3]. For breaking news, sports updates and additional coverage, bookmark the homepage [3] and find us on facebook [3] and twitter [4].
[1] http://thepostandmail.com/sites/default/files/Brumbaughpursuit.JPG
[2] mailto:email@example.com
[3] http://thepostandmail.com/http
[4] http://thepostandmail.com/https


text:
Khabib's striking has given me pause in having him pushed directly to a number one contender's bout, I don't feel as though he's developed to that level yet.
I'd book Gil/Grant if TJ has been cleared of those concussion problems for the new year and book RDA vs. Bendo or Khabib as a second rung of contenders bout. I think RDA or Khabib may actually end up drawing Gray next if Nate is setting on going to his reunion lol, and for me, I think Myles Jury may be sneaking up in rankings in a fight or two, so he may get a nice matchup next as well.