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Now, here's an online business model that has unfortunately become the butt of far too many jokes. This is because a certain segment of society (that's you, hipster!) went around loudly telling anyone willing to listen that they were full-time bloggers. The net result of all this misplaced enthusiasm is that if you tell any of your friends or family you're going to start a blogging business, they'll wrinkle their collective noses at you, while coughing politely.
Overall, the Internet itself is overflowing with one money making opportunity after another. While making money online for most people isn't their primary source of income, it can net a very solid supplement stream of incoming dollars each month. There are some online entrepreneurs, however, that are managing to mine gold due to all the effort, persistence, and time they've invested in order to make that dream come true. Can one of these online money making options work for you?
If I have a blog that is getting 100,000 page views a month that means that I'm probably getting at least 50,000 people to the site (most blogs will do between 1.2 to 1.4 pages per session). That means I have to try and get some small percentage of those people to buy something from me if I really want to do well. If I can't get them to buy something then (in some cases) I have ads running on the site that will make me money anyways.
Fiverr is one of the biggest providers in the gig economy on the web and you can sell a wide variety of services and products through this medium. Do the research and find out what you can offer. However, keep in mind that like any other money-making task, it takes time to succeed here. And stellar reviews will help you generate more and more income over time.
Yes, you can research on people's problems and needs; then all you have to do is to come up with a solution, package it in an eBook, video or audio format and you are in business. In fact, the over head startup cost for this business is so low that anybody can do it. To have an idea on hottest selling information products, I will recommend you visit Clickbank.com
If you're willing to take on some risk and have the heart of a true hustler, you can make extra money online doing commission-only sales for startups and other businesses. While you won't be getting a regular salary, with the right sales strategies and skills as an inside sales rep, you can make decent money for each sale you bring in. And because you'll most likely be working with startups, if you can negotiate a little equity you could profit big time if you're pitching a solid product and the startup succeeds.
If you have a knack for organization, you can make money online as a virtual assistant helping people to keep their days in order. A virtual assistant will do everyinthing from bookkeeping to research, database entry, booking travel, and managing email. It can also be an awesome way to rub shoulders with some very important people, build up your professional network, and of course grow another stream of income. You can find great gigs on UpWork, Fiverr, Indeed, and Remote.co.
YouTube Partner Program. The YouTube Partner program empowers YouTube channel operators to monetize certain types of videos. Finding paying advertisers is hard work, and you need a sizable following before you can find companies willing to pay for direct or indirect promotion. Plus, your videos must meet YouTube's monetization criteria, which ban explicit or copied content. Pay potential is directly proportional to the size of your channel following and, to a lesser extent, audience demographics.
Hi Nick! I was researching online successful businesses and came across your article. For the last couple months I have been thinking about starting my own online business that is geared towards online health/fitness coaching. Then I think maybe freelance writing or perhaps starting my own blog. Do you any suggestions on how to start these businesses? Where I could even begin? I have been a nurse since 2010, love fitness. However, starting a blog would be interesting as well.
If you want to help shape digital products in their early stages, joining an online focus group or answering survey questions is a great way to make extra money online. They don't pay as much as some of the other options we're highlighting in this list, but you can join groups on sites like Survey Junkie, User Interviews and InboxDollars that pay out through PayPal, check or even Amazon gift cards. You'll be asked to provide a bit of information about your personal demographics (age, location, etc…), but after that you can get going making money online through completing surveys.
In 2017, there were almost 90 million pet dogs in the US. Which has opened up a huge opportunity to make money online as a dog watcher or sitter. Specialized sites like Rover or Care.com connect pet owners with pet walkers, sitters, and boarding houses to help look after their best friends when they're at work or on a trip. If you're an animal lover, you can make extra money and get to spend some quality time with a furry friend.
As the craze for social media content increases; so also does the competition for social media attention by big company increases, thereby increasing the need for social media marketers. Do you know how to make a content go viral on social media? Can you build a strong brand presence on social media? Have you mastered the intricacies of social networking? Then become a social media consultant and you are in for cool cash.
Clothing: thredUp makes it easy to sell clothes online. To sell your items, order a free "Clean Out Bag" on thredUP's website. Then send in your shoes via FedEx or USPS. Once they arrive, thredUp will inspect your items before listing. Their site says they accept less than 40% of items in the average Clean Out Bag. Make sure your items are clean, name-brand, less than five years old, and in excellent condition to increase your chances. Depending on the popularity of the clothing items you send in, you will be paid either after processing or once your items sell.
There are many ways to get people onto your list. Lead magnets are one such resource. For example, you can build ebooks, checklists and cheat sheets. But you can also do content upgrades, such as PDF versions of an article with added resources in them, four-part video training series, and more. Think about your audience and what you can offer them to better serve them, then treat them with some respect and you'll eventually reap the rewards.
Secondly, I want you to know that you can start an online business from anywhere in the world; provided you have an internet connection. So whether you are in Philippines, Nigeria, USA, UK, Canada, India, etc; you will still find this information useful. Without wasting your time, below are the top 40+ online business ideas and opportunities to start from home.
Don't sacrifice morals for a quick buck — At the outset, you'll want to do all sorts of things to make money online, but don't sacrifice your morals for a quick buck. Not only will you put people off, but you'll lose Google's trust. You also shouldn't concern yourself with things like Adsense or other ads on a blog before you have around 100,000 visitors per day. Yes, per day.
There are different ways to market an ebook. One of the most common is through Amazon's Kindle program. They can help you with all the steps to both publish and market your ebook through their incredibly popular platform. There are some specialized sets of writing software that will help with not only writing your ebook but also formatting it correctly for the Amazon market as well Barnes & Noble and iTunes
Large corporations and business firms can easily hire a full-time staff coordinator or corresponding agency to run their Twitter, Facebook, and Instagram accounts, but smaller businesses frequently have to manage their own marketing for social media. But, because they have a great number of other responsibilities, many times business owners are too overwhelmed or busy to spend a lot of time on developing their social media approach.
28. Subscription – If you think of something valuable (newsletter, online magazine, etc.) that you can consistently offer on a certain basis (weekly, monthly, etc.), you may want to offer a subscription service. This could be a fee charged each time your product is sent out or on a monthly basis. Either way, this has to be something that your customers can only get by subscribing to your website.
Take advantage of the growing delivery trend and sign up for a service like Instacart, UberEats, Postmates or Amazon Flex. You get paid per delivery, in most cases, and can even earn tips. A car isn't always required — Postmates lets you use a bike, scooter or your own two feet to make deliveries — but a background check almost always is part of the deal. Learn more about how to get started with Amazon Flex, UberEats and Instacart.
Hello! I am 26 and just hit a huge life crisis wall! I had a great job and was let go out of the blue, with little to no money left for bills and other needed expenses. I was scheduled to drive home from Florida to Michigan tomorrow with my boyfriend and he has no idea I have only $400 to my name. I have no idea what to do or how to get enough money to get me through this trip. I already have found a new job but I don't start until we are back in 10 days! I feel like I am so underwater!
Secondly, I want you to know that you can start an online business from anywhere in the world; provided you have an internet connection. So whether you are in Philippines, Nigeria, USA, UK, Canada, India, etc; you will still find this information useful. Without wasting your time, below are the top 40+ online business ideas and opportunities to start from home.
Getting used to software, meeting deadlines, and making yourself popular online are the keys to launching a desktop publication home businesses. While some desktop publishers would like to meet clients in person and serve their local neighborhood market, a desktop publisher who renders services through the internet will have a much broader market to work on.
Secondly, I want you to know that you can start an online business from anywhere in the world; provided you have an internet connection. So whether you are in Philippines, Nigeria, USA, UK, Canada, India, etc; you will still find this information useful. Without wasting your time, below are the top 40+ online business ideas and opportunities to start from home.
Here's a good example of how lead sales can work in real life: My second website, Life Insurance by Jeff, brings in a ton of traffic from people who are searching the web to find answers to life insurance questions. While I used to have the website set up so I could sell these people life insurance myself, it was a lot of work to process all the different requests and clients. As a result, I started selling the leads I gathered instead.
As internet-based businesses go, affiliate marketing has huge income potential. And as mentioned earlier, once it's set up properly the income from it can be almost 100% passive. In fact, this is how I quit my job originally. I built lots of little niche sites that eventually were bringing in income of over $10,000 a month! So, I say "Adios!" to my day job and I've never looked back.
If you're ready to enter the ecommerce fray, you could sell your own stuff. Of course, along with selling your own stuff on your own website comes a whole slew of both responsibilities and technical configuration and requirements. For starters, you'll need a website and a hosting account. You'll also need a merchant account like ones offered by Stripe or PayPal. Then you'll need to design that site, build a sales funnel, create a lead magnet and do some email marketing.
Manuscript Editor. Looking for a longer-term engagement? The self-publishing boom has created an unprecedented demand for manuscript editors – specialists who help writers organize and sharpen book-length works before publication. Depending on your clients' budgets, manuscript editing can be lucrative, though it'll likely take time to build your reputation to the point that you're working with accomplished writers. Entry-level opportunities abound on reputable freelance platforms and with niche publishing houses.


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Psalm 44:13
New International Version
Psalm 44:13
New International Version
Read full chapter
13 You have made us a reproach(A) to our neighbors,(B)
13 You have made us a reproach(A) to our neighbors,(B)
the scorn(C) and derision(D) of those around us.
Hosea 7:16
New International Version
Hosea 7:16
New International Version
16 They do not turn to the Most High;(A)
they are like a faulty bow.(B)
Their leaders will fall by the sword
because of their insolent(C) words.
For this they will be ridiculed(D)
in the land of Egypt.(E)
New International Version (NIV)
Holy Bible, New International Version®, NIV® Copyright ©1973, 1978, 1984, 2011 by Biblica, Inc.® Used by permission. All rights reserved worldwide.
NIV Reverse Interlinear Bible: English to Hebrew and English to Greek. Copyright © 2019 by Zondervan.
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subset: commoncrawl


text:
Music Box & Modulin - 2 new music instruments ("All Was Well" by Wintergatan),Music,wintergatan,music box,musicbox,modulin,instrument,instrumental,doepfer,a-100,gears,martin,molin,marble,machine,marblemachine,vintergatan,all was well,We filmed this one-take video to demonstrate the newly built Music Box and the Modulin, Enjoy! Get the audio version on Bandcamp: https://wintergatan.bandcamp.com/track/all-was-well-music-box-modulin-version See how the Music Box was built: https://youtu.be/Lf5Qw1kTbzY Video Made by Martin Molin & Hannes Trainerds Knutsson If you want to support: The fact that you are watching the videos and care about the music and future of Wintergatan is the best support anyone can have, I want to thank everyone who is here for that kind of support, it is really the fuel for the Wintergatan Engine. If you apart from that further want to support the projects, we have these different options set up: YOUTUBE SPONSOR ►Sponsor the Wintergatan Youtube Channel by clicking the blue sponsor button next to subscribe PATREON ►www.patreon.com/wintergatan PAYPAL ME ►www.paypal.me/wintergatan Why do we accept support in this way? I, Martin, can already sustain myself 100% doing what I love to do. If you want to support artists/organisations who have not yet reached that privileged position, please consider supporting other artists/organisations who need the support more. With that said, I have too many ideas and too little time and with your support I can get more help from people around me to execute the ideas better and bring them out in the world faster. Read a longer statement on this here: ►http://www.wintergatan.net/#/post/105/Supporting-Wintergatan DIGITAL MUSIC DOWNLOADS ►https://wintergatan.bandcamp.com WINTERGATAN RECORDS ►http://www.wintergatan.net/#/shop SPOTIFY ►http://bit.ly/2oKxXWd ITUNES ►http://apple.co/2ntWNsZ SUBSCRIBE ON YOUTUBE ►https://www.youtube.com/user/wintergatan INSTAGRAM ►https://www.instagram.com/wintergatan2000 REDDIT ►https://www.reddit.com/r/MarbleMachineX/ DISCORD ►https://discord.gg/QdNwA5Y Thanks to www.CNCRouterparts.com and www.Matterhackers.com for providing the CNC Machine and the 3D Printer for the Marble Machine X Project! All income will be used to build the Marble Machine 2.0, a full sized but transportable Marble Machine that we can tour with! I am going to build it in seven modular horcrux parts, every part has its own case. When we are playing we will arrive the day before the show to assemble it. And we should bring the Music Box as well and synch the two machines up in a plywood duet... just have to succeed with the MM2.0 build first... wish us luck and take care, all the best// Martin & Wintergatan Ps. I have named this instrument "The Modulin" because i see it as a mix of a MODular syntheseiser and a vioLIN - MODULIN. We will film more videos to explain how it works. I am also building a version 2.0 of this Modulin for stability, it is very cobbled together at this stage and it has broken down on us on stage several times...
Wintergatan,музыка,music video,видео,video,All Was Well,песочница
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Software Listing of Author : "Desktoolssoft"
- DriverFinder
- License: Shareware
- Price: 29.95
DriverFinder finds device drivers for your PC in minutes. It offers fast driver downloads and even helps install drivers for you. Our non-stop growing driver database ensures that you find the drivers your PC needs in minutes. It\'s easy-to-use, and 100% safe & effective. DriverFinder Features: unlimited driver downloads; precision PC scanning technology; huge driver database; accurate driver update recommendations; super-fast driver downloads; driver installation support; driver backup & restore; self-updating; premium customer service. DriverFinder Benefits: saves you the manual labor (and countless hours) of trying to find the right driver for your device; saves you the trouble of installing drivers manually; protects your PC by backing up old drivers; enables you to copy drivers and move it to another system; facilitates...
- Publisher: DeskToolsSoft
- Date Released: 15-05-2014
- Download Size: 244 KB
- Download
- Platform: Win7 x32, Win7 x64, Windows 8, Windows Vista, WinOther, WinVista, WinVista x64
- QuickPCOptimizer
- License: Shareware
- Price: 29.95
QuickPCOptimizer (qPCo) is an advanced PC analyzer, cleaner and optimizer. Its highly efficient scanning technology digs deep down to detect redundant and damaged entries in the registry that slows down your PC and inhibits system performance. By using qPCo, your system is maintained in tip-top shape, enabling you to keep your PC running like it did the first day you bought it.
- Publisher: DeskToolsSoft
- Date Released: 03-09-2012
- Download Size: 5847 KB
- Download
- Platform: WinOther
- QuickSYS Informer
- License: Freeware
- Price: 0.00
The QuickSYS Informer is a handy freeware utility that enables you to know more about your local system resources at a glance. The user interface is professionally designed and is very intuitive so it's a breeze to use. The QuickSYS Informer monitors the following system resources. - CPU usage; - Hard disk usage (track up to two drives); - Memory usage; - Network usage (track up to two network adapters); and - Battery life (for laptops). The QuickSYS Informer enables you to make the following setting changes. - Refrest rate - specify the rate at which QuickSYS Informer shows you changes in your system resources. - Hard Disk - specify which hard disks you want to monitor (if you have more than one). - Network - specify which network adapters you want to monitor (if you have more than one). The QuickSYS Informer also gives a summary of...
- Publisher: DeskToolsSoft
- Date Released: 22-10-2012
- Download Size: 1423 KB
- Download
- Platform: WinOther
- SecureUninstaller
- License: Shareware
- Price: 29.95
SecureUninstaller - Completely removes any unwanted software from your PC, including applications that the standard Add/Remove feature cannot remove. It applies a heuristic approach to tracking down traces, entries and remnants of hard-to-remove software on your PC.
Features: Advanced heuristic uninstall technology, tough on stubborn applications, safe program backup and restore, convenient Windows registry backp and restore.
- Publisher: DeskToolsSoft
- Date Released:
- Download Size: 5406 KB
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- Platform: Win2000, Win7 x64, Windows 7, WinOther, WinVista, WinVista x64


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- Home
- Edinburgh Playhouse Parking
- Parking on Dublin Street, EH1
Parking on Dublin Street, EH1, Edinburgh
- Space Details
- Reviews
- Street View
Space Description
One allocated space located on Dublin Street in Edinburgh. The space is suitable for vehicles up to the size of a Large - (4x4). At this location there is Allocated Space.
The space is available 6AM-8:30PM on all days.
Off street private car park. 5 minutes walk to Waverly Station, 2 minutes to Bus station 2 minutes to St Andrews Square. Allocated spaces with sign.
Important notice: The full address of the parking space/garage/car park will be provided following a successful booking
Access Hours
Kenneth M.
9th March 2020
Currently difficult to access due to building work blocking road. Otherwise it would be handy to let customers know that the entrance is via a narrow & low passageway that requires extreme care and excellent driving skills. General condition of entrance and parking area very rough and uneven. Otherwise no problem of use and very handy to town centre
Giles S.
24th February 2020
Easy peasy! All just as advertised, so just great
Nicola K.
17th February 2020
Excellent parking space in central location. Would definitely use again.
Emylee S.
11th February 2020
Spot seemed very safe, it was in a courtyard car park in front of some apartments so I was happy to leave my car there. Arrived a little bit early due to no traffic but thankfully didn't seem to be a problem when I let the owner know. Worth the money.
Yvonne S.
7th February 2020
Wee bit awkward to find due to Construction vans blocking the entrance however once located it's the ideal city centre location.
Tom M.
27th January 2020
This customer rated the space 5 stars but chose not to leave a comment.
Heather S.
22nd January 2020
Easy to find 5 mins from Edinburgh Playhouse which was ideal.
Nadine B.
9th January 2020
Real easy to get too, 2mins walk to the playhouse, fantastic value, will definitely use again, thank you
Nicola C.
7th January 2020
Brilliant, easy to find using directions and really close to the bus station. I would definitely recommend
Scott C.
6th January 2020
Very handy spot 5 minutes walk from playhouse
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text:
Memphis Grizzles Visa Athletic Center, Orlando 4 PM • Sacramento Kings vs.
Kawhi Leonard 6.
Holmes grabbed five rebounds and added an assist, tallying a plus-minus of +6 in his 21 of playing time.
Partnership and Community Activation.
Cristiano Ronaldo 4.
NBA Return To Play Opening Weekend Schedule ESPN Wide World Of Sports Complex July 30 • Utah Jazz vs.
Brooklyn Nets HP Field House 2 PM • Memphis Grizzlies vs.
NBA Return To Play Opening Weekend Schedule ESPN Wide World Of Sports Complex July 30 • Utah Jazz vs.
Houston Rockets The Arena, Orlando ABC 8 PM • Dallas Mavericks vs.
are projected to spend more than $6 billion on food for the Fourth of July this year.
15: Stanley Cup 125th Anniversary Celebrations June 2017: NHL Awards June 23: NHL Draft Nov.
Kobe Bryant 7.
We are happy to be partnering with such a wonderful organization and hope to create together many moments that will further our common interest and passion in advancing the goals of college student athletes.
Concurrently, Topps Bunt brings baseball cards to life via an app where people can download virtual cards to their devices, then collect and trade them.
Naomi Osaka 4.
Stephen Curry $74 million $30 million $44 million NBA 7.
We're looking for someone who can capture the essence of the NFL International Series and present it back to customize your own football jersey U.S.
Wal-Mart said that support would be anchored by a veteran's appreciation campaign to promote awareness of the event and encourage every American to share a message of thanks to the over 25 million active duty and veterans who serve our country.
Keisuke Honda 10.
Keisuke Honda 10.
We're excited to offer Visa card holders with a once-in-a-lifetime opportunity that truly lasts a lifetime and speaks directly to their passion.
Of those, between six and 13 states are tipped to pass legislation, while other states are expected to move forward this year under the terms of laws already on the statute books.
features the iconic household cleaner, Mr.
According to the Hockey Hall of Fame, there are more than 2 names engraved on bands that are then clamped around the Cup, most recently 52 players from the 2015 Stanley Cup champion Pittsburgh Penguins.
Arbo adds, Try as I might, I can't simulate Arrowhead's 70+ screaming Chiefs fans!
According to Michael Finley, who was on that tour and became one of the first Jordan Brand athletes during his 17-year NBA career, Jordan never lost his competitive nature.
Geguri finds a seat in the front row, where she stares at the screen, her mouth set in a grim line as she watches the competition, relegated to sitting alongside the other female fans.
Cristiano Ronaldo $105 million $60 million $45 million Soccer 3.
From D-League Dec 31 1 PM The Phoenix Suns have recalled forward Derrick Jones Jr.
Serena Williams 3.
In having the Giants, having the players come up with us to Binghamton and to Ithaca, we wanted them to see the courts and the jail, we wanted them to hear from community members who have been directly impacted by the justice system.
Ronda Rousey 9.
In addition, nine of the 10 season-ending races in the Chase for the Nascar Sprint Cup will be on ESPN.
In an e-mail to UCLA constituents, athletic director Dan Guerrero wrote We are exploring all of our options to resist Under Armour's actions.
7 CBS • Super Bowl LVI SoFi Stadium Los Angeles Feb.
• : Lululemon is buying Mirror, the buzzy home fitness startup that sells a $1 wall-mounted product for streaming workout classes.
Memphis Grizzles Visa Athletic Center, Orlando 4 PM • Sacramento Kings vs.
Global spending on motorsports sanctioning bodies, teams and tracks hit $5 billion in 2017, https://www.fiitgshop.com/collections/football-best-seller 3% from $5 billion in 2016, according to research and consulting firm ESP Properties, Chicago.
Brooklyn Nets HP Field House 2 PM • Memphis Grizzlies vs.
So, hold onto the good and get rid of the bad and I think we're fine.
co-founder Bill Polian, head of football operations JK McKay; board of directors member Dick Ebersol; and a Player Engagement Board of Advisors led by such former NFL players as Jared Allen, Troy Polamalu and Hines Ward.
And also as per Super Bowl tradition, these previews will amp-up the intensity when it comes to action, adventure and sometimes outlandish story lines.
His leadership would help the team in high-pressured game situations.
Samsung has a history of creating unique campaigns that connect people around common passions and I'm looking forward to having the fans join us on this incredible journey.
Kawhi Leonard 6.
Milwaukee Bucks HP Field House, Orlando ESPN 6PM • Sacramento Kings vs.
At its core, the entire campaign is built in the essence of the brand.


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Our Hope
To make disciples of Jesus Christ by sharing His good news with all people, especially with those of Chinese descent, and helping them grow as followers of Christ, so that together we will bear witness of His glory in Austin, in the surrounding areas, and to the ends of the earth.
COVID-19 Update & Church Re-Opening Survey
Dear ACC Family,
Thank you all who participated in the survey by the 7/8 deadline. Our church's COVID-19 Response Team has completed the analysis of the survey results. Based on the results, as well as the most up-to-date decisions made at all levels of government, organizations and school districts, the COVID-19 Response Team believes no time-definite plan for reopening on-campus ministries should be provided at this time, although some on-campus ministries may resume at some point this year upon cautious and diligent consideration. Furthermore, the team recommends that all ministries plan for an online version where practical for the fall term, that continues through the end of 2020. For more details see acc.church/acc-reopen-status. The report from the Covid-19 Reopening Survey is available here acc.church/survey-results. The Covid-19 Response Team thanks all for their valuable input, patience, and prayers.
By His grace,
ACC's Covid-19 Response Team
Latest Sermon
Affected to be Effective
1 John 4: 7-21
The words "perfect" and "love" are used several times in this passage. John seems to say that God desires to perfect our love for Him and others by what His perfect love does in, and through, us. "Affected" is a verb, while "effected" is a noun. What is the effect in us when God's love affects us? What is going on, and what is God's end game?
Announcements & Events
We welcome all 3-year old children to incoming 5th graders to join AWANA starting on September 11th, every Friday at 7:30 PM. The format will be virtual online gatherings, and will include praise, Bible messages, Bible verse memorization, sharing and prayer. Please check out https://acc.church/awana-20-21 for more details.
First Time Visitors
Dear Visitors,
Due to temporary suspension of onsite service, we would like to stay in touch online if you are visiting our church for the first time. Please complete the short Contact Information form at: www.acc.church/visitor. We are glad you came to worship with us today!
Discovery Group
Interested in Discovery Groups?The Discovery Group ministry aims to provide excellent, engaging, Scripture-based teaching so that together we will grow in our knowledge, understanding, and application of God's Word. Summer Discovery Groups have begun and are meeting from 11:00 AM - 12:15 PM via zoom. It's not too late to join so please register at acc.church/dgsignup. After registering you will receive class login information. Anyone college-age and above is welcome!
The Big Story: Exploring God's Global Purpose
How do the different books of the Bible connect to each other? Is there a grand theme through all of Scripture? Join us as we discover the global thread interwoven throughout the Old and New Testaments. We will peer through different lenses to see God's global purpose and the role we can play in His story.
Emotionally Healthy Spirituality
What role does emotional health play in spiritual maturity? How should we understand ourselves as emotional beings, created in the image of a God who has emotions? We picture the ideal Christian having a peaceful spirit, godly confidence, and loving relationships, but we ourselves may experience anxiety, sadness, insecurity, and anger. In this class we will examine biblical principles and truths that can guide us into lasting, beneath-the surface transformation.
Into the Promised Land
We will continue our journey through the Scriptures, specifically the books of Numbers, Deuteronomy, Joshua, Judges, and Ruth. We will learn how God guides His people, gives them a home, and delivers them. Let's explore together some exciting Biblical narratives, marvel at God's faithfulness to His promises, and respond to His Word in faith and obedience.


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UPLB bags regional feasib and quiz tilts
Both the Inter-University Quiz Contest and Feasibility Study teams of UPLB DIE bagged their respective first place titles in the recently-concluded PIIE-Calabarzon Regional Student Congress held last 27 January 2019 in Sta Rosa Auditorium, Sta Rosa, Laguna.
The members of the UPLB IE Quiz Team include Jude Vincent G. Guliman, Joshua Patrick O. Jamison, Ven-Rem Bill A. Pasion, Jason Ryan A. Ramos, and Jaydon Marley C. Ramos. The UPLB Quiz Team was coached by Asst. Prof. Angelo C. Ani.[Read More]
Academic Calendar for SY 2019-2020
The Office of the University Registrar (OUR) released the schedule for the Academic Year 2019-2020.
Please download the attached file to view the complete schedule.
UPLB dominates 2018 CIE Exam
UPLB IE graduates delivered an impressive performance in the recent Certificate in Industrial Engineering (CIE) exam simultaneously held last November 25, 2018 held in UP Diliman, Quezon City, and University of San Jose Recoletos, Magallanes Street, Cebu City.
Engr. Marc Edelbert S. Villanueva, who completed the BS IE program in 4 ½ years, scored 87.34% to lead the list of CIE passers. This secures a back-to-back Top 1 finish for UPLB in two consecutive years.[Read More]
Kyushu University Accepts IED Faculty Member
Engr. Lizbeth A. Mariano, Instructor 7, has been accepted as one of the six graduate school participants of the 2015 Human Science Summer School at Kyushu University, Fukuoka, Japan with full scholarship from the said university. The summer program will start August 24 and end September 3, 2015 where Engr. Mariano will attend a series of lectures and laboratory sessions on ergonomics and human science.[Read More]
The Department of Industrial Engineering of UPLB consists of experienced Industrial Engineers with passion for teaching and service.


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Glatfelter to Report Earnings on October 29th
YORK, Pa., Oct. 10, 2019 (GLOBE NEWSWIRE) -- Glatfelter (NYSE: GLT) announced today that it expects to issue its 2019 third-quarter results on Tuesday, October 29, 2019. Management will hold a conference call at 11:00 AM (EDT) that morning to discuss the Company's results. Glatfelter's earnings release and an accompanying financial supplement, which includes significant financial information to be discussed on the conference call, will be available on its Investor Relations website at http://www.glatfelter.com/about_us/investor_relations/default.aspx.
|Glatfelter's 3rd Quarter 2019 Earnings Release Conference Call
|Tuesday, October 29, 2019, 11:00 a.m. (EDT)
|US dial (888) 335-5539
|International dial (973) 582-2857
|Conference ID:
|Rebroadcast Dates:
|October 29, 2019, 2:00 p.m. through November 12, 2019, 11:59 p.m.
|Rebroadcast Number:
|Within US dial (855) 859-2056
International dial (404) 537-3406
|Conference ID:
About Glatfelter
Glatfelter is a leading global supplier of engineered materials. The Company's high-quality, innovative and customizable solutions are found in tea and single-serve coffee filtration, personal hygiene and packaging products as well as home improvement and industrial applications. Headquartered in York, PA, the Company's annualized net sales approximate $910 million with customers in over 100 countries and approximately 2,600 employees worldwide. Operations include eleven manufacturing facilities located in the United States, Canada, Germany, France, the United Kingdom and the Philippines. Additional information about Glatfelter may be found at www.glatfelter.com.
|Samuel L. Hillard
|Eileen L. Beck
|(717) 225-2743
|(717) 225-2793
P. H. Glatfelter NewsMORE
|Glatfelter Reports Second Quarter 2020 Results GlobeNewswire 4d
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|P. H. Glatfelter Co. hosts conference call for investorsMarkets Insider Automation 5d
|Glatfelter to Present at the Jefferies Virtual Industrials Conference on August 6th GlobeNewswire 15d
|Glatfelter to Report Earnings on August 4th GlobeNewswire 31d
|Glatfelter Increases Dividend by 3.8% to $0.135 per Common Share GlobeNewswire 92d
|P. H. Glatfelter Company declares $0.135 dividend Seeking Alpha 92d
|Glatfelter Reports First Quarter 2020 Results GlobeNewswire 95d
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Heat Alert and Response Systems to Protect Health - University
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Heat Alert and Response Systems to Protect Health: Best Practices Guidebook Prepared by: Water, Air and Climate Change Bureau Healthy Environments and Consumer Safety Branch
Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health. We assess the safety of drugs and many consumer products, help improve the safety of food, and provide information to Canadians to help them make healthy decisions. We provide health services to First Nations people and to Inuit communities. We work with the provinces to ensure our health care system serves the needs of Canadians. Published by authority of the Minister of Health. Heat Alert and Response Systems to Protect Health: Best Practices Guidebook is available on Internet at the following address: www.healthcanada.gc.ca Également disponible en français sous le titre : Élaboration de systèmes d'avertissement et d'intervention en cas de chaleur This publication can be made available on request in a variety of alternative formats. For further information or to obtain additional copies, please contact: Publications Health Canada Ottawa, Ontario K1A 0K9 Tel.: 613-954-5995 Fax: 613-941-5366 Email: firstname.lastname@example.com © Her Majesty the Queen in Right of Canada, represented by the Minister of Health, 2012 This publication may be reproduced without permission provided the source is fully acknowledged. HC Pub.: 110209 Cat.: H129-9/2011E ISBN: 978-1-100-19671-8
ACKNOWLEDGEMENTS Health Canada recognizes the contributions from: › Davidge, Andrew (GHK International [Canada] Ltd.) › Dobilas, Geoff (GHK International [Canada] Ltd.) › Ebi, Kristie L. (Stanford University and Carnegie Institution) › Fedos, Peter (Surrey Extreme Weather Response Coordinator) › Hamel, Stephan (New Brunswick Public Health) › Hersi, Hibak (City of Vancouver) › King, Norman (Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal) › Lefebvre, Luc (Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal) › Luber, George (United States Centers for Disease Control and Prevention) › McInnes, Judith (Department of Epidemiology and Preventive Medicine, Monash University) › Morris-Oswald, Toni (Manitoba Health and Healthy Living) › Pacheco, Elaine (Toronto Public Health) › Paszkowski, Dawn E. (University of British Columbia) › Pratt, James (James Pratt Consulting) › Price, Karine (Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal) › Richters, Karina (City of Windsor) › Robinson, Martha (Ottawa Public Health) › Roy, Lucie-Andrée (Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal) › Ruf, Fred (Outsourcing Services Inc.) › Sénécal, Ghyslaine (Agence de la santé et des services sociaux de Montréal) › Shapiro, Howard (Toronto Public Health) › Smargiassi, Audrey (Air pollution, climatic changes and health research chair, University of Montréal) › Sullivan, Sue (Canadian Public Health Association) To receive more information about climate change and health activities at Health Canada, please contact: email@example.com Heat Alert and Response Systems to Protect Health: Best Practices Guidebook i
Table of Contents Table of Contents Foreword 1 1 Introduction 2 1.1 Overview of Heat Alert and Response Systems 2 1.2 How the Guidebook was Developed 4 2 Risks to Canadians from Extreme Heat 5 2.1 Relationship Between Heat and Health 5 2.2 Impacts of Air Pollution and Extreme Heat on Health 9 3 Preparing for the Health Impacts of Extreme Heat 11 3.1 Heat Alert and Response Systems to Protect Health 12 3.2 Assessing Vulnerability to the Health Impacts of Extreme Heat 16 3.3 Tips for Getting Started 18 3.3.1 Developing a Heat Alert and Response System 18 3.3.2 Engaging Stakeholders 19 Case Study 1: How Fredericton Developed a Heat Alert and Response System from the Ground Up 22 3.4 Developing an Alert Protocol 23 3.4.1 Identifying an Alert Trigger 23 3.4.2 Calling Alerts 28 Case Study 2: How Winnipeg Chose its Heat Alert and Response System Alert Triggers 30 3.5 Developing a Response Plan 32 3.5.1 Cooling Facilities 36 Case Study 3: Community Response to Extreme Heat Events in the City of Ottawa 37 Case Study 4: How a Rural Community in Manitoba Reduces Impacts on Health from Extreme Heat 39 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook iii
Table of Contents 3.6 Supporting a Heat Alert and Response System with Communication Activities 41 3.6.1 Before the Heat Season 44 3.6.2 During the Heat Season 45 3.6.3 During an Extreme Heat Event 46 Case Study 5: How Windsor-Essex Communicates Heat-Health Risks to the Public 48 3.7 Improving Heat Alert and Response Systems Through Evaluation 50 3.7.1 Evaluation Design 50 3.7.2 Process Evaluation 52 3.7.3 Outcome Evaluation 52 3.7.4 Evaluation Results 54 Case Study 6: Evaluation of the Montréal Heat Plan Communication Program 55 3.8 Preventative Action: Reducing Urban Heat 56 3.8.1 The Urban Heat Island 56 3.8.2 Reducing the Urban Heat Island 57 Appendices 61 Appendix A—Questionnaires 63 Sample Partner Questionnaire for Assessing Heat-Health Vulnerability 63 Sample Target Population Questionnaire 65 Sample Partner Survey: End-of-Season Heat Alert and Response System Evaluation 67 Appendix B—Integration of Extreme Heat into the Assiniboine Regional Health Authority Disaster and Emergency Response Plan 70 Appendix C— Information Resources for Developing a Heat Alert and Response System Plan 71 Appendix D—Examples of Alert Triggers Used by Canadian Communities 74 References 76 iv Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
Foreword Extreme heat poses growing risks to the health # guidance on developing a HARS that addresses of Canadians. Public health and emergency heat-health vulnerabilities at population and community levels communities are developing interventions to reduce # a framework for evaluating the effectiveness Foreword heat-health risks and to prepare for the expected of HARS increase in the frequency, duration and severity of extreme heat events due to climate change. To # examples of preventative measures to reduce ambient temperatures in urban help Canadians protect themselves and their families, environments health authorities are seeking information about the most effective public health interventions to # examples and case studies of interventions assist those at risk. A range of actions to safeguard drawn from communities across Canada and health are being taken, but many remain untested. internationally In support of these efforts, Health Canada is taking The information in this document was developed action to help Canadians and their communities with support from a range of governmental and become more resilient in the face of a changing non-governmental partners, including experts and climate. As more communities in Canada begin stakeholders responsible for providing assistance to develop systems to reduce risks to health from to vulnerable Canadians during heat emergencies. extreme heat, they will require effective strategies Lessons learned, as well as best practices for to protect health. organizing community HARS, are provided to help A key adaptation step to protect people from extreme " heat events is the development and implementation in partnership with non-government community of Heat Alert and Response System(s) (HARS) by organizations, protect the health of Canadians from extreme heat. Heat Alert and Response Systems to Protect Health: Best Practices Guidebook provides an overview of health risks from extreme heat and offers evidence-based strategies for alerting health authorities and the public when hazardous conditions arise. It is intended for use by policymakers, planners and service providers involved in protecting citizens from extreme heat events. The Guidebook is designed to help develop interventions tailored ! " the Guidebook provides: # information on extreme heat events and the potential health risks to Canadians, including those most vulnerable to the impacts # guidance on assessing heat-health vulnerabilities and adaptation options for a community or a region Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 1
1. Introduction As a result of climate change, in the past century, not as well documented.15 As a result, these events global temperatures increased by 0.8ºC/1.4ºF. The have the potential to stress existing health and best estimates provided by the Intergovernmental social services, thereby impacting the provision Panel on Climate Change (IPCC) suggest future of these services to the public. Extreme heat events warming to be between 1.8°C/3.2ºF and 4.0°C/7.2ºF also result in high economic costs to society. It by 2100.1 European summer temperatures as high is estimated that the 2003 European extreme heat as those observed in 2003, which resulted in over event cost the affected countries 10 billion euros 70,000 deaths,2,3 are projected to become a common due to the combined effects of drought, heat stress occurrence by the middle of the century.4 In 2010, " " * another catastrophic extreme heat event struck Russia and forestry.16 1. Introduction and resulted in an estimated 55,000 deaths.5 1.1 Overview of Heat Alert "Heat is an environmental and and Response Systems occupational hazard. The prevention of The effects of heat on the health of Canadians deaths in the community caused by will depend upon actions taken by public extreme high temperatures (heat waves) " is now an issue of public health concern." community health and social service providers, and by individuals to prepare for and respond – R.S. Kovats and S. Hajat, 2008, p. 416 to the impacts. Research suggests that the health effects of extreme heat are a function of 6: ! $ # the duration and severity of an extreme event. The European research project EuroHEAT heat event % & % $ apparent temperature and minimum temperature are # when an extreme heat event occurs in the season over the 90th percentile of the monthly distribution # the sensitivity of the population for at least two days."7 Environment Canada's # the ability of a community to respond during % & % extreme heat events three consecutive days of maximum temperatures # * " at or above 32ºC [90ºF]." 8 A more physiologically particularly the most vulnerable, to manage $ % the risks the "threshold and duration that are observed to be associated with an increased morbidity and mortality To prepare for extreme heat events, some ' 9 communities in Canada and internationally have developed Heat Alert and Response System(s) Even though heat-related deaths are preventable, (HARS).17 These systems have the following core extreme heat eventsa have been associated with elements described in detail in Section 3: sudden, short-term increases in mortality, especially among older adults, those who are chronically ill Community Mobilization and Engagement— and socially disadvantaged people.6,9–12 Increases in Requires a coordinating agency to prepare the morbidity are also observed13,14; however, they are community for the upcoming heat season by a The term "extreme heat event" rather than "heat wave" is used in this document. 2 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
identifying community needs, recruiting stakeholders Communication Plan—Raises awareness about and developing plans to implement a HARS. the impacts that heat may have on health, and provides advice through media releases, interviews Alert Protocol+
There is a wide disparity across Canada in the The objective was to document the types of measures measures being used to protect the health of citizens. available to communities to protect citizens through Measures range from disseminating health protection HARS and through preventative actions. The review advice through websites during extreme heat events drew its analysis from original data sources, to full community outreach and response efforts to published and grey literature, and included both assist heat-vulnerable populations.18,19 To adapt to % extreme heat events, communities need a systematic of technical and government reports. Information application of best practices in the development, was obtained from both domestic and international implementation and evaluation of HARS. sources; however, international literature was included only when it had a Canadian component 1. Introduction or when it provided a theoretical or methodological 1.2 How the Guidebook basis for the analysis that was applicable to the Was Developed Canadian context. Few formal evaluations of HARS in Canada Expert input was collected from a HARS Advisory and internationally have been completed. Committee, established to guide a Health Canada Consequently, the advice and best practices initiative to develop heat-resilient individuals and provided in this Guidebook draw from a communities in Canada. The committee consisted of variety of sources. A literature review was experts with knowledge and professional experience conducted of studies related to: in the development and implementation of HARS, # climate change and health adaptation climate change and health adaptation, public health and emergency management, the needs of heat- # development and implementation of HARS vulnerable populations and occupational health. The # urban heat island mitigation Guidebook was reviewed by issue experts and # communication of heat-health risks to the public in Canada. # evaluation of public health programs The Guidebook also draws from the experiences of Health Canada's four Canadian communities that piloted the development of a HARS from the ground up (Winnipeg, Manitoba; a rural region in Manitoba, within the Assiniboine Regional Health Authority [ARHA]; Windsor, Ontario; Fredericton, New Brunswick).b These communities used the $ vulnerability assessments to inform their HARS. The Guidebook is supplemented with information $ select Canadian communities that currently have a HARS (e.g. Hamilton, Sudbury, Toronto, Ottawa, Kingston, Frontenac, Lennox & Addington in Ontario, and Montréal in Quebec). b Between 2008 and 2011, Health Canada engaged four communities to pilot development of a HARS and address heat-health * > " ?XYZ " community outreach activities, and implemented communication plans and products. These communities undertook a participatory approach and engaged in community consultations with local partners and stakeholders to develop their HARS. 4 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
2 Risks to Canadians from Extreme Heat 2.1 Relationship Between Heat and Health The human body tries to maintain a normal core temperature of about 37°C/99°F by constantly regulating the balance of heat gain with heat loss.20 Excessive atmospheric temperature in combination with high humidity, radiant solar load and/or metabolic workload (especially without moderate air movement) can overwhelm the body's capacity to thermoregulate and cool itself.21 Over-exposure to extreme heat and/or over-exertion for a person's age and/or physical condition in such environments can lead to excessive stress on the body that may result in moderate heat illnesses, such as 2. Risks from Extreme Heat heat rash, edema, loss of consciousness, cramps and exhaustion. This exposure can also lead to life- threatening heat stroke that may result in severe and long-lasting consequences.21–23 During periods of extreme heat, people may also succumb to underlying health conditions (e.g. respiratory, cardiovascular) that are heat sensitive. Analysis of morbidity and mortality data from # certain occupational groups (e.g. farmers, previous extreme heat events reveals that the construction workers, miners, tree planters)30–32 following population groups are more vulnerable # those who are physically active13,33 due to underlying risk factors: Early summer extreme heat events generally result # older adults11 in higher health impacts than those occurring later # infants and young children24 in the summer.34 Most people who are regularly # people with chronic illnesses (e.g. psychiatric exposed to high temperatures become acclimatized illnesses) or who are physically impaired10 to hot environments.34,35 However, the body's ability # people taking certain medications that affect heat to acclimatize may be limited for some people, sensitivity by interfering with the body's such as those with heart disease,36,37 older adults37 cooling functions or water/salt retention (e.g. and young children.37 Acclimatization is due to antihypertensives,25 antidepressants, 26 physiological adaptation in both cardiovascular and antipsychotics,26,27 anti-Parkinson's agents 27) sweating systems.38! \ lessen as a person's exposure to high temperatures # socially disadvantaged individuals (e.g. low- decreases.39 income earners,23 homeless people,28 people living alone10) Health risks from extreme heat are well documented. # newcomers to Canada and transient populations Many international and Canadian studies show (e.g. tourists)29 that daily mortality rates increase when temperatures rise above certain levels.40,41 Recent analysis of Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 5
the 2009 extreme heat event in British Columbia, To further understand the relationship between heat an eight-day period where temperatures reached as and health in Canada, temperature-mortality curves high as 34.4ºC/93.9ºF (measured at the Vancouver were developed for Winnipeg, Windsor, Hamilton, International Airport), suggests that it contributed Toronto and Fredericton (Figure 2). The curves to 156 excess deaths in the province's lower show that temperature is a health risk in all cities mainland area.42 examined and that the temperature-mortality relationship varies among them. For example, in A historical analysis of annual average mortality Hamilton relative mortality above 100% (average associated with extreme heat from 1954 to 2000 mortality for June, July and August of each year) found that Montréal, Toronto, Ottawa and Windsor was observed at a daily maximum temperature experienced an annual average of 121, 120, 41 of 26ºC/79ºF, while in Windsor it was detected and 37 excess deaths, respectively, over this time at 30ºC/86ºF. The rate at which deaths occur as frame.43 In addition, some studies also show a temperatures increase is also variable. In Fredericton, correlation between elevated temperatures and the increase in relative mortality was greater increases in morbidity.13 Smaller communities as temperatures increased when compared with (e.g. rural) also face heat-health impacts.44–46 These Windsor (demonstrated by the slope of the curve 2. Risks from Extreme Heat impacts are harder to measure due to lower in Figure 2). Similar results have been shown population densities in the communities and for 8 regions in Quebec40 and for 15 cities in Europe.7 consequently fewer deaths.45 These differences are frequently attributed to local adaptive capacity, differences in vulnerable populations and local climate.7! are consistent with published reports that also demonstrate variability between regions, cities and within neighbourhoods.7,47 Heat impacts on health are worse if high temperatures persist over several days and throughout the night. Elevated nighttime temperatures prevent relief from daytime heat and contribute to additional heat stress.51–54 Some regions in urban areas, known as urban heat islands (Section 3.8), trap daytime heat and cool down slower than outside temperatures. The type (e.g. design) and location of a building _ ` exposure. For example, indoor temperatures can be higher in taller buildings.55–57 Figure 3 illustrates how indoor temperatures in a duplex can remain high even though outdoor temperatures decrease at night. 6 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
Figure 2: Relationship between daily maximum temperatures in June, July and August, and all non-traumatic deaths for selected Canadian cities, 1986–2005 Daily maximum temperatures during June, July and August from 1986 to 2005 were correlated with all non-traumatic deaths using the Generalized Additive Statistical Model.48,49,c,d 140 Winnipeg Windsor Hamilton Relative mortality (%) from 1986 to 2005 130 Toronto Fredericton 120 2. Risks from Extreme Heat 110 100 90 5 10 15 20 25 30 35 40 Daily maximum temperature (in degrees Celsius) Source: Adapted from B. Casati and A. Yagouti, in press.50 c For each community, meteorological data from Environment Canada's National Climate Archive were selected based on the meteorological station's proximity to Statistics Canada's census divisions and subdivisions where deaths occurred. Relative mortality was then calculated by standardizing daily total non-traumatic deaths using an annual reference value. An average mortality for June, July and August of each year for 1986 to 2005 was { |& '! " % dividing each daily total deaths by their correspondent reference value. This standardization was performed to account for interannual trends due to changes (e.g. demographics, urban landscape) over the time period analyzed. d For a more detailed description of the methodology used to develop these mortality curves, see Curriero et al., 2002 and Kim et al., 2006.48,49 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 7
Figure 3: Comparison between temperatures in a Montréal duplex and in the ambient environment, July 7-9, 2010 Concordia University (Montréal) conducted a study on the indoor thermal conditions in 55 Montréal dwellings to better understand the impact of the urban heat island on indoor conditions during extreme heat. Indoor temperatures (green solid line) measured on the second floor of a two-storey building located on Montréal Island, from July 7 to 9, 2010, are graphed along with outdoor temperatures measured at Montréal's Pierre Elliott Trudeau Airport (orange dashed line). The graph demonstrates that on both days the indoor temperatures reached levels above 34ºC/93ºF. In addition, the lack of cooling at night was detected (shaded areas). The indoor temperature stayed above 31ºC/88ºF while the outdoor temperature was much cooler (about 24ºC/75ºF). 36 Indoor Temperature Outdoor Temperature 34 Ambient Temperature (in Degree Celsius) 32 2. Risks from Extreme Heat 30 28 26 24 07JUL: 00:00 07JUL: 12:00 08JUL: 00:00 08JUL: 12:00 09JUL: 00:00 Date and Time Source: Adapted from K. Park, et al., 2011.58 An analysis of temperature trends by Environment are expected to more than triple between 2071 and Canada revealed that between 1971 and 2000, 2100. The projected increase in warm nights will 29 southern Ontario communities experienced also limit nighttime relief from the heat. 10 to 15 days annually with temperatures }~}X The increased number of extreme heat events between 15 to 25 days annually with temperatures resulting from climate change will impact the over 30°C/86°F.59 Some years had more hot days; health of Canadians unless more adaptation for example, in 2005, temperatures over 30°C/86°F efforts are made. For example, without further were recorded in Windsor and Toronto for 47 and actions to manage the risks, projections suggest 35 days, respectively. Temperature projections that there will be an increase of 150 excess deaths (Figure 4) indicate that the number of days with annually by 2020 in Quebec, 550 excess deaths by temperatures above 30°C/86°F in Toronto, 2050 and 1,400 by 2080.60 The actual number of Winnipeg and Fredericton are expected to almost deaths may be even higher due to population aging double between 2041 and 2070. In Windsor, they and a general increase in heat vulnerability.61 8 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
Figure 4: Historical and projected number of hot days and warm nights for selected cities in Canadae 1961–2000 2011–2040 2041–2070 2071–2100 2. Risks from Extreme Heat Source: B. Casati and A. Yagouti, in press.50 2.2 Impacts of Air Pollution and Extreme Heat on Health The health effects of exposure to both air pollution synergistic impacts on health.63 Air pollution and extreme heat are of concern to public and extreme heat could combine to impact health authorities. There are complex relationships health in three main ways: between high atmospheric temperatures, air pollution levels, types of air pollutants, individual Environmentally—High ambient temperatures behaviours and measures to protect the public. increase the formation of air pollutants, such According to the Canadian Medical Association, as ground-level ozone.63,64 Air quality can also be in 2008 there were 21,000 deaths in Canada "% associated with the effects of air pollution alone.62 in warmer and dryer climatic conditions.65,66 People Limited evidence suggests that combined exposures $ * to air pollution and extreme heat result in experience eye irritation and respiratory irritation, leading to bronchitis.63,67 e Temperature projections were obtained from the Canadian Regional Climate Model (CRCM) developed by the Ouranos Consortium on Regional Climatology and Adaptation to Climate Change, which used the Special Report Emission Scenario A2.1 The A2 scenario describes "a very heterogeneous world with high population growth, slow economic development and slow technological change."1 The number of hot days and warm nights for each city is based on the observed temperature data between 1961 and 2000, and projected for 2011–2040, 2041–2070 and 2071–2100. Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 9
Physiologically—Reduced pulmonary function or heart rate variability due to ozone or particulate Source: B.C. Ministry of Forests and Range matter pollution may lead to inadequate tissue oxygenation, especially under increased cardio- vascular stress associated with an increase in thermoregulatory demands.68,69 Compromised respiratory function due to air pollution may also interfere with cardiovascular function during heat stress.63 Behaviourally—Individual behaviour during extreme heat events may put people at higher risk to air pollution. People are likely to spend more time outside or leave their windows open, resulting !!" in higher exposure to outdoor pollutants. Properly designed measures to protect people from 2. Risks from Extreme Heat air pollution and extreme heat can result in greater levels of physical activity if they include more walking and biking paths as alternative transportation example, reducing ambient temperatures by routes. This can contribute to reduced air pollution developing parks to provide shade and dissipate heat and active Canadians, both of which are associated through evaporation and transpiration can lead to with positive health outcomes.70,71 10 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
3 Preparing for the Health Impacts of Extreme Heat ! ` \ " # providing response measures that reduce an aging population, and a projected increase in heat-health risks and meet the needs of those the exposure of Canadians to hotter temperatures most vulnerable to heat due to climate change will likely be associated # choosing communication strategies that increase with negative impacts on population health in the awareness and change behaviours absence of further adaptations.72 Currently, many communities in Canada and the United States are # monitoring HARS activities and evaluating them at the end of the heat season unprepared to deal with such events.53,73-76 Many people who are most vulnerable to heat-health risks # implementing long-term preventative actions do not take protective actions during extreme heat. that reduce heat exposure and negative health They may not believe their health is at risk or not outcomes know about the measures that should be taken.29,77,78 The following sections of the Guidebook provide information on core elements of HARS and their effective implementation. Given that Canadian Health Canada recommends the communities are diverse (e.g. demographic makeup, development and implementation population density, unique capacities to issue alerts of HARS to prevent, prepare and mobilize a response), the Guidebook offers for and respond to health risks multiple approaches that can be adapted to address from extreme heat. heat-health risks. Relevant examples of actions to protect health from the experiences of communities in Canada and elsewhere are highlighted to offer HARS reduce heat-related morbidity and mortality useful approaches and tools for public health and 3. Preparing for the Health Impacts during extreme heat by alerting the public about the risks, directing the community response to help vulnerable populations, and providing individuals with information and other resources to help them take protective actions before and during an extreme heat event.73,79–81 The health risks associated with extreme heat events are most effectively reduced by: # identifying target population groups and areas by conducting vulnerability assessments # ensuring that a HARS plan is designed to address local needs and priorities # engaging stakeholders who are best positioned to add value to a HARS # % that is developed based on relationships between heat and health Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 11
3.1 Heat Alert and Response plans and limited coordination between social Systems to Protect Health services and health organizations were likely major contributing factors to negative health outcomes.6 Alert systems that warn of impending dangerous conditions can be used to mobilize community HARS require coordinated actions by government resources to assist people in need. Well-targeted authorities at regional and local levels. Involvement messages and outreach strategies can be effective of private sector participants and community groups in raising awareness of heat-health risks and result is also crucial for reaching out to vulnerable groups.73 in behavioural change.82 Evaluations of existing The core HARS elements include: HARS, though few in number, demonstrate that # community mobilization and engagement these systems help protect people from illness # an alert protocol and death associated with extreme heat events.79–81 Analyses of past extreme heat events that resulted in # a community response plan the loss of life suggest that the lack of intervention # a communication plan # an evaluation plan Table 1 presents the core elements and preventative HARS plans and guidance documents. Core elements of HARS are implemented at different times. Some activities take place over the whole year (e.g. delivery of preventative actions, 3. Preparing for the Health Impacts stakeholder education and awareness) while others * education and awareness, weather surveillance and analysis, evaluation) (Figure 5). The start and end dates for the heat season are determined by the local climate and the possibility of an extreme heat event occurring based on historical climate data and trends. Weather forecasts are monitored daily during the months when extreme heat may pose a health risk. 12 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
$ " Continued analysis of weather forecasts determines when weather conditions no longer pose a threat triggers have been reached and whether risks to to health. The alert is deactivated through internal health warrant activation of the HARS. If an alert $ "% " $ debrief and evaluation. The weather monitoring through pre-set communication activities, the public continues until extreme heat is forecasted again and is informed of heat-health risks, and community the HARS is reactivated, or until extreme heat response measures to assist heat-vulnerable people events are unlikely to occur. are often put into place. Figure 5: Timeline for implementation of core HARS elements and preventative actions S ON HE S EA AT Monitor AT SE weather HE Confirm AS forecasts E- stakeholder ON PR involvement and HARS Analyze forecast 3. Preparing for the Health Impacts response to activate/ measures deactivate HARS Educate and raise public awareness Evaluate Educate and raise HARS stakeholder awareness ON Deliver preventative OF AS actions (e.g. reduce urban F- SE heat island effect) SE AS ON E AT -H ST PO Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 13
Table 1: Core elements of HARS and preventative actionsf Canadian WHO EuroHEAT U.S. EPA Australia England Communities Community mobilization and engagement—Requires a coordinating agency to prepare the community for the upcoming heat season by identifying community needs, recruiting stakeholders and developing plans to implement a HARS. Identify a principal coordinating X X X X X X agency Engage broad X X X X X X stakeholders Organize and develop X X X X X X HARS Mobilize X X X X X X community Lead pre-heat season X X X X X X preparations Alert protocol—
Canadian WHO EuroHEAT U.S. EPA Australia England Communities Community response plan—Facilitates actions by individuals to protect themselves during periods of extreme heat by directing public health interventions aimed at reaching vulnerable individuals who require assistance. Establish formal community response X X X X X X plan Include measures tailored to the needs of X X X X X X vulnerable populations Stakeholder driven X X X X X X Communication plan—Raises awareness about the impacts that heat may have on health and provides advice through media releases, interviews and websites on how to reduce health risks. Establish formal X X X X X X communication plan Develop pre-season education and X X X X X X awareness campaign Identify and plan to address contradictory X X X X X 3. Preparing for the Health Impacts messages < heat-health messages and X X X X X outreach strategies Evaluation plan—Assesses HARS activities and facilitates improvements. Aims to evaluate the extent to which implemented measures are timely, relevant, effective and meet local priorities and contribute to the reduction of health impacts. Establish formal X X X X X X evaluation plan Implement real-time X X X X health surveillance Hold end-of-season X X X X X evaluation Preventative action: reducing the urban heat island—Addresses heat-health risks through measures designed to reduce urban heat. Investigate the urban X X X X heat island effect Plan long-term (e.g. implement urban X X X X X heat island mitigation measures) Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 15
3.2 Assessing Vulnerability # Social isolation—limited access to heat-health to the Health Impacts of information and services Extreme Heat # Low income—utility bill arrears, concerns with costs associated with running an air The vulnerability of individuals and communities to conditioner and accessing other cooling options, the health impacts of extreme heat varies according living in older housing that may gain heat to the physiological sensitivity of the population, and retain it even when outdoor temperatures rates of exposure to these events, and the availability decrease of programs and activities that directly or indirectly # Dangerous behaviours during extreme heat lower heat-health risks. events—strenuous physical activity, inadequate
To help communities assess vulnerability to * extreme heat events, Health Canada developed vulnerable to extreme heat. They can also help a guidance document, ; ) identify effective adaption measures to safeguard Heat Events: Guidelines for Assessing Health health, and strategies to overcome barriers to Vulnerability.90 Examples of the proposed methods and key tasks relating to six assessment groups may face. A sample partner questionnaire steps are provided in Figure 6. Throughout the for assessing heat-health vulnerability that assessment, stakeholders should be engaged to Health Canada developed for its pilot communities provide neighbourhood-level information about is provided in Appendix A. Figure 6: Steps for conducting an extreme heat and health vulnerability assessment t Descr ss men ibe Cu s se r re th eA 2 nt Vu te Characterize heat ln tia Identify assessment exposure & heat & air pollution exposure er scope, objectives, & i In ab develop work plan Characterize community vulnerability ilit Identify & organize 1 Characterize individual y stakeholders vulnerability Inventory programs & activities to address heat-health risks s col Evaluate the effectiveness RS STAK DE of existing programs & 3 Per formance Proto O L EH activities 3. Preparing for the Health Impacts Asses EH Develop protocols OL for evaluating Methods for K adaptation options D ER Describe trends expected S STA Assessment to influence heat-related s Future Risks Develop protocols for monitoring the burden health outcomes Literature review S STA of heat-sensitive health Describe projected outcomes Inventory of data Surveys & interviews increase in temperature D ER & extreme heat events Geographic information systems Public health mapping Describe possible Climate modelling K additional health L elop O EH outcomes due to OL projected increases EH 6 D ER in temperature v K S STA D e Assess how changes in Ex other sectors may influence heat-health risks Inventory possible adaptation options 4 am Prioritize adaptation options ns ine M Assess barriers to adaptation io ea options & how they can be t su overcome Op res n tio in Oth er S 5 Ada pt a ectors tif y Iden Source: Reprinted from Health Canada, Adapting to Extreme Heat Events: Guidelines for Assessing Health Vulnerability, 2011.90 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 17
3.3 Tips for Getting Started # geographic region of coverage # lead organization To develop a HARS, it is important to identify an organization that will be responsible for leading the # vulnerable populations and stakeholders initiative. The lead organization coordinates overall # " development of the plan, engages partners and response measures) assumes the role of, or picks a local champion. The # mechanisms for coordinating activities and disseminating information among the lead participants. The stakeholders should understand organization, internal partners, community their respective roles and responsibilities and be partners and the public engaged in all stages of plan development. HARS # back-up response plans for extreme heat and plans will often differ among municipalities as other emergencies (e.g. electricity shut-offs, * water shortages) # steps for phased HARS implementation characteristics (e.g. regional climate, heat-vulnerable populations, budgetary allocations, organization of # evaluation plans with data requirements and " methodologies and environments affecting community heat # processes and responsibilities for maintaining exposure). They are also often integrated into, and and updating the HARS plan complement, existing public health and emergency Challenges may arise during the initial stages of plans (Appendix B). HARS development (Box 1). To help communities, a wide range of resources is available including 3.3.1 Developing a Heat Alert and guidance for conducting vulnerability assessments, 3. Preparing for the Health Impacts Response System information for health care practitioners on Communities should develop a formal HARS plan diagnosing and treating heat illnesses, tools for that provides implementation guidance for alert, developing HARS communication strategies, response, communication and evaluation components with information on72: and health data (Appendix C). # ultimate goals and intermediate objectives # timelines for HARS activities Box 1: Examples of anticipated challenges during HARS development # # ` # data accessibility and limitations (e.g. heat-related morbidity and mortality, accessibility to meteorological forecasts) # engaging stakeholders and maintaining their interest in heat-health activities # stakeholder information needs (e.g. data on temperature-mortality relationships, cost-effectiveness of interventions, tailored heat-health messaging products) # obtaining senior management support for development and approval of a HARS # coordinating stakeholders, municipal departments and levels of government # * " providers 18 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
3.3.2 Engaging Stakeholders services, poverty and literacy agencies, homeless services, tourism centres, and active living and HARS efforts are most effective when local health faith-based organizations are needed to ensure that " " the HARS plan includes partners that are integral % to heat-health protection efforts in the community planning stages.6,74,91 For example, representatives (Figure 7). from emergency planning organizations, home care Figure 7: Examples of government and community partners participating in the Toronto Hot Weather Response Plan Medical Officer of Health Toronto Public Health City Partners Community Partners › Healthy Environments › Toronto Shelter › Canadian Red Cross, Support and Housing Toronto Region › Emergency Planning Administration and Preparedness › Findhelp Information › Toronto Emergency Services › Healthy Living Medical Services 3. Preparing for the Health Impacts › Office of the Chief › Healthy Families › Toronto Public Library Coroner, Toronto › Communication and Region › Toronto Parks, Forestry Public Relations and Recreation › Street Health › Communicable › Toronto Police Services › Community Care Disease Control › Toronto Community Access Centres Housing Corporation › Ontario Community › Toronto Office Support Association of Emergency › Community Health Management Centres › Toronto Homes for › Environment Canada the Aged › Kent State University › Toronto Animal › Innovators' Council Services Source: Toronto Public Health, 2009.92 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 19
A stakeholder engagement plan should be developed and followed early in the process (Figure 8). The interest and engagement of stakeholders should be maintained and their contributions acknowledged by keeping them informed of important developments at each stage of the project. This can be achieved through face-to-face meetings, e-mail updates, the provision of detailed notes, and/or involvement in the decision-making process. Pre-season discussions with key stakeholders offer an opportunity to gather input to validate or modify existing HARS protocols. To facilitate engagement, partners should be provided with information about the nature and magnitude of risks to health from extreme orientation and education support. Questions heat, the potential impacts of climate change, and about HARS development that can be expected examples of adaptations that other jurisdictions from stakeholders include: have used successfully. Many non-professionals # Why develop a HARS now, and why take action may not be familiar with professional jargon or on heat over other natural hazards? wording and may require an audience-appropriate # What is the risk to health in our community from extreme heat events (past data: number 3. Preparing for the Health Impacts of hot days, humidex values)? # What are the projections for extreme heat events in the future for our community? # What trigger should be used to issue heat alerts? # What public messages should be used? # Who are most vulnerable to the heat-health impacts in our community and where are they located? # How can vulnerable groups be reached? # What role could my organization play in responding to or preparing the community for extreme heat events? # How will the HARS be maintained over the long term? It is important to recognize information gaps and provide material in a timely manner that will help address important questions so the HARS can be improved and the credibility of the process maintained. 20 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
Figure 8: HARS stakeholder engagement approach Step 1 Step 2 Step 3 Step 4 List the Analyze the Develop the Update the Stakeholders Stakeholders Engagement Plan Engagement Plan List stakeholders Analyze the list and Develop the plan Throughout the that could be engaged identify: according to the level project, update in development and of desired engagement, the stakeholder › the existing level implementation of the stakeholder concerns engagement plan of interest from HARS. They should and interests, and to ensure all relevant each stakeholder have one or more of operational requirements groups are engaged. in the HARS these characteristics: to complete the project. › level of expected › address an existing influence of The plan identifies need stakeholders in stakeholders that › can bring to the table helping achieve the should be: required networks project's objectives › active partners › able to contribute › the level of (e.g. shared valuable experiences involvement and responsibility for and expertise to partnering appropriate planning) enhance the function for each stakeholder › kept involved of the HARS (e.g. representatives › can liase between on project boards) the project and their › consulted 3. Preparing for the Health Impacts parent organization (e.g. briefings › cater to heat-vulnerable and workshops) groups › regularly informed of › have existing plans progress (e.g. e-mail and protocols or bulletins) have the capacity to develop them › can increase capacity of HARS › provide an opportunity for resource leveraging Source: Adapted from Ebi, K. L. et al., 2011.93 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 21
Case Study 1 How Fredericton Developed a Heat Alert and Response System from the Ground Up The City of Fredericton, New Brunswick (N.B.), is one of four Health Canada pilot communities that introduced a HARS in 2009. The specific HARS objectives were to: Actions to beat the heat Source: City of Fredericton and Government of New Brunswick ! develop partnerships with local stakeholders to support their engagement this summer ! develop heat alert and response protocols Pay attention this summer to the Weather Network channel, the radio ! increase public awareness of heat-health risks and change behaviours and the web for heat alerts. ! increase community support to at-risk populations during heat episodes ! identify best practices for communication and share information among agencies to reduce heat-health risks among the public Early in the development stages, a lead organization (N.B. Department of Health, Health Protection Branch) was identified and a project coordinator was assigned to supervise and roll out the HARS. A core group of stakeholders was recruited, including the District Medical Officer of Health, Canadian Red Cross, the N.B. Emergency Measures Organization, Environment Canada, Meals on Wheels, and the N.B. Home Support Association. To gain their interest on heat-health issues and HARS development, stakeholders were provided with health and environment data, including: ! Environment Canada data demonstrating that Fredericton has historically experienced a higher number of days (along with the central portion of the province) with humidex values above 35 compared with other regions in the Maritimes 3. Preparing for the Health Impacts ! mortality curves demonstrating strong relationships between non-traumatic deaths, temperature and humidex ! temperature projections showing that by 2041 the number of days in Fredericton with temperatures above 30°C/86°F is expected to double ! experiences of other communities (e.g. Europe in 2003 and Chicago in 1995) demonstrating potentially severe detrimental heat-health outcomes The lead agency established a HARS Advisory Committee to provide guidance on how to develop the HARS, including a public education program to reduce morbidity and mortality during extreme heat events. Regular committee meetings, e-mail updates, telephone discussions and personal contact with the individuals representing organizations were necessary to keep everyone engaged and focused. Information provided by community partners on the needs of the target audiences, availability of data and information resources, identification of community-specific risk factors and educational opportunities helped shape development of the HARS. Partners gave one-on-one training to their clients about heat-health risks and the HARS. They also distributed material directly to heat-vulnerable people, including older adults, homeless people, and people living alone with mental illnesses or physical limitations. The City of Fredericton also played a key role in the awareness campaign by including heat-health information on their website and in water utility bills mailed in the spring to 16,000 households in the city. In addition, a direct link to heat-health resources is displayed on the City of Fredericton homepage during the summer months. When an alert is issued a message is disseminated for its duration and a press release is sent to news agencies. For more information on the Fredericton HARS, visit www.fredericton.ca/heatalert. 22 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
3.4 Developing an Alert Protocol An alert trigger approach that is transferable to all communities and is most effective in accurately Weather alert systems have proven effective in identifying different levels of health risk has not reducing morbidity and mortality from a range 41,95,h Few of weather hazards.94 In many Canadian and communities in Canada and elsewhere have international jurisdictions, public health and systematically examined the association between emergency management decision-makers use rapid the trigger they are using and resultant health communication systems to alert the public, as outcomes, or other measures of effectiveness.41 well as health and social services agencies, of To help communities identify an alert trigger impending hazardous weather conditions so that approach for their unique needs, some strengths actions can be taken to protect health.29 and weaknesses of select triggers used in Canada and internationally are highlighted in Table 2. 3.4.1 Identifying an Alert Trigger Communities should choose a trigger approach for their HARS that is best able to contribute to a Alert triggers protect human health reduction in heat-health impacts. Whatever approach " % when they are based on knowledge of to activate outreach and response plans as well % as advise stakeholders and the public of an conditions that result in increased extreme heat event at least one or two days before heat-related morbidity and mortality. it occurs.96–98< " ` community needs, response capacities, existing – S. Hajat, et al., 2010; S. Hajat and T. Kosatsky, 2009 41,95 " 3. Preparing for the Health Impacts vulnerabilities (e.g. cities with cooler average An alert trigger should be based on a physiological temperatures, less air conditioning and higher $ + % population density99,100), and changing population the intensity and duration of the event is associated demographics and needs. This will ensure that the % trigger is effective and guards against the development population.9 The alert trigger is usually a community- of public apathy associated with activating an alert too often.81,95 more meteorological parameters (e.g. temperature, humidity) that are forecasted to last for one or more days.96 It is determined by: # extreme heat event timing, intensity and duration # forecasted maximum and/or minimum temperature and/or humidex # synergistic risks to health from other meteorological conditions (e.g. air quality) # contributing factors (e.g. power outages, water shortages) h For a good evaluation of HARS alert trigger, see L.-A. Roy, K. Price, M. Pâquet ?&!@!DJ ? Developed by the Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, 2011.179 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook 23
Table 2: Examples of triggers used in Canada and internationally to issue a heat alerti Strengths Weaknesses Trigger: Temperature—In Canada, air temperatures are measured at Environment Canada's meteorological stations and reported in degrees Celsius. › Widely used. › Often measured at airports and therefore may › Minimum and maximum thresholds account not represent community conditions where most for day- and nighttime risk.96 vulnerable populations reside. › Easy to communicate. › Does not account for other environmental parameters (e.g. humidity, radiant load, wind › A well-understood measure of thermal comfort. speed) or for air pollution. › Forecasted by Environment Canada across Canada with relatively high accuracy.95 Trigger: Humidex—> $& $ opposed to something measured) devised to describe how hot or humid weather feels to the average ! $ ` perceived temperature."101,102,j › Environment Canada issues Humidex › Humidex is not forecasted by Environment Advisories for many Canadian communities Canada; however, the Weather Network to alert the public and authorities of potential humidex forecast may be monitored and used heat-health risks. for issuing an alert. › Easy to communicate and widely understood. › Accuracy of humidex forecasts is lower than › Has been reported by Environment Canada temperature forecasts.96 since 1965.103 › Humidex Advisories issued by Environment 3. Preparing for the Health Impacts _ ` and vulnerabilities. › Does not account for other environmental parameters (e.g. radiant load, wind speed) or for air pollution. Trigger: Temperature and/or humidex in combination with daily morbidity and/or mortality— Hospital admissions and coronary reports are factored into the decision-making process to trigger an alert or upgrade to a higher alert level. › Directly linked to heat-health outcomes and › Requires use of real-time syndromic surveillance may be more protective of health.104 system for heat. › X% › Requires real-time monitoring for heat. vulnerabilities. › Challenges in data analysis and integration. › X% › Mortality may not peak until a few days after resources for community heat response. the onset of extreme heat.83 Continue to next page i This is not a complete list of alert triggers. This list aims to provide the reader with the most common triggers used in Canada and some communities in United States that border Canada. j To calculate humidex, visit the Environment Canada website www.ec.gc.ca/meteo-weather/default.asp?lang=En&n=86C0425B-1. 24 Heat Alert and Response Systems to Protect Health: Best Practices Guidebook
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