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The nationalists feared that friction between the Condo minium powers might eventually result in the attachment of Northern Sudan to cholesterol elevated discount 300 mg gemfibrozil with amex Egypt and of Southern Sudan to jogging cholesterol levels generic 300 mg gemfibrozil visa Uganda and Kenya cholesterol juice fasting buy generic gemfibrozil canada. Nationalists and religious leaders disagreed about whether Sudan should seek independence or union with Egypt. Coalitions supported by each of these leaders formed rival wings of the national ist movement. The moderates favored Sudanese independence in cooperation with Brit ain and, together with the Ansar, established the Umma Party. The governor-general rejected these demands but agreed to a government-supervised transformation of indirect rule into a modernized system of local government. In 1948, over Egyptian objections, Britain authorized the partially elected Legislative Assembly, representing both regions, to supersede the advisory executive council. In 1952 leaders of the Umma-dominated legislature negotiated the SelfDetermination Agreement with Britain. The legislators adopted a con stitution that provided for a prime minister and council of ministers 28 Historical Setting responsible to a bicameral parliament. The Egyp tians, demanding recognition of their sovereignty over Sudan, repudi ated the Condominium agreement and declared their reigning monarch, Faruq, king of Sudan (see fig. After seizing power in Egypt and overthrowing the Faruq monarchy in late 1952, Colonel Muhammad Naguib resolved the problem of Egyp tian sovereignty over Sudan. In February 1953, London and Cairo signed the Anglo-Egyptian Agreement, which allowed for a three-year transition period from Condominium rule to self-government. During the transition phase, British and Egyptian troops would withdraw from Sudan. British officials also had become more sensitive to Arab criti cism of the policy in the South. In 1946 the Sudan Administrative Con ference determined that Sudan should be administered as one country. Conference delegates also agreed to readmit Northern administrators to posts in the South, abolish the trade restrictions imposed under the Closed Districts Ordinances, and allow Southerners to work in the North. Additionally, Khartoum nullified the prohibition against Muslim proselytizing in the South and introduced Arabic in the South as the official administration language. Some British officials in the South accused Northerners of unduly influencing the conferees and of refusing to examine reasons for retaining the separate-development policy. These officers argued that Northern domination of the South would result in a Southern rebel lion. Khartoum convened a conference at Juba to resolve these issues and to assure Southerners that a postindependence government would safeguard Southern political and cultural rights. Despite these promises, many Southerners expressed concern that Northerners would overwhelm them. After the government replaced several hundred colonial officials with Sudanese, only four of whom were Southerners, the Southern elite abandoned hope of a peaceful, unified, independent Sudan. The rebellious troops killed several hundred Northerners, including government offi cials, army officers, and merchants. But this harsh reac tion failed to pacify the South, as some mutineers escaped to remote areas and organized resistance to the Arab-dominated government. Independent Sudan the al-Azhari government, hoping to promote unity with Egypt, set aside the agenda for self-determination proposed by the Condominium powers. In August 1955, he called for the speedy withdrawal of foreign troops and requested that the Condominium pow ers sponsor a plebiscite in advance of the scheduled date. Independence was achieved, however, by a simple declaration adopted unanimously by the Sudanese parliament on December 19, 1955. The Politics of Independence Sudan gained independence without a permanent constitution. Instead, the Constituent Assembly adopted a document known as the Transitional Constitution that replaced the governor-general as head of state with a five-member Supreme Commission elected by a par liament composed of an indirectly elected Senate and a popularly elected House of Representatives. The Transitional Constitution also allocated executive power to the prime minister, who was nominated by the House of Representatives and confirmed in office by the Supreme Commission. Although it achieved independence without conflict, Sudan inherited many problems from the Condominium.

The Islamist movement started in universities and high schools as early as the 1940s under the influence of the Egyptian Muslim Brotherhood low cholesterol food indian purchase cheapest gemfibrozil and gemfibrozil. The Islamic Liberation Movement cholesterol levels of seafood discount gemfibrozil 300mg amex, a precursor of the Sudanese Muslim Brotherhood cholesterol levels vegetarian diet safe gemfibrozil 300 mg, began in 1949. Al-Turabi then took control of it under the name of the Sudanese Muslim Brotherhood. Al-Numayri put him back in prison in 1985; the new military government released him later the same year. Al-Turabi played a major role in the government, including his election as speaker of the National Assembly in 1996, until his falling 254 Ali Uthman Muhammad Taha Courtesy Embassy of the Republic of the Sudan, Press and Information Section out with al-Bashir in 1999, when al-Turabi again began to spend time in jail or under house arrest. Among other things, the memorandum noted that self-determi nation is a legitimate right of the people of South Sudan. After three months in prison, the government released al-Turabi from prison and put him under house arrest. Released from detention, al-Turabi was rearrested in March 2003 on charges of masterminding a coup attempt. Al-Turabi managed, however, to have a significant impact on political developments in Sudan from jail or house arrest and eventually was released. Al-Turabi by 2011 had been the leader of Islamists in Sudan for the last half century. Al-Turabi sup ported sharia and the concept of an Islamic state, but his vision was not Wahhabi (see Glossary) or Salafi (see Glossary). He appreciated that the majority of Sudanese followed Sufi Islam, which he set out to change with new ideas. He did not extend legitimacy to Sufis, Mahdists, and cler ics, whom he saw as incapable of addressing the challenges of modern life. Although the political base for his ideas was probably relatively small, he had an important influence on Sudanese politics and religion. Young Sudanese, who provided much of his following, saw his ideas as modern and not a return to the past. Al-Turabi had his greatest success in recruiting supporters from the educated and pro fessional classes in urban areas. He attached fundamental importance to the concept of shura (consultation) and ibtila, his view of modernity, which he believed should lead to a more profound worship of God. Its goal was to mobilize progressive Islamic move ments against the West and to promote Islamic revolution within reac tionary Muslim states. Al-Turabi failed to achieve his goals in Sudan because it was ethnically, culturally, and religiously diverse and probably not subject to unification by any form of Islamism. Umma Established in 1945 with the goal of achieving independence from Britain and Egypt, the Umma Party obtained most of its support from the Ansar (see Glossary) Sufi order. Although the Ansar were found throughout Sudan, most lived in rural areas of western Darfur and Kord ofan. Sadiq al-Mahdi, a direct descendent of the Mahdi, became head of Umma and spiritual leader of the Ansar in 1970. Constantly in conflict with the military government, he was imprisoned by al-Numayri in 1983 because of his opposition to government policies, including the September Laws that institutionalized sharia. Umma was, however, an Islamic party dedicated to achieving its own political agenda for Sudan. Sadiq al-Mahdi did not object to sharia becoming the law of the land but rather to the "un-Islamic" method al-Numayri used to implement it. Released early in 1991, he eventually went into exile and actively supported the Northern opposition coalition, the National Democratic Alliance. The government, believing that it had successfully split the political opposition, invited the Umma Party leadership back to Sudan. Sadiq al-Mahdi went back late in the year, hoping to find al-Bashir more willing to permit truly democratic elections. The government temporarily banned Umma from all political activity in the spring of 2005, claiming it had not been properly registered.

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This vaccination program led to cholesterol levels keto generic gemfibrozil 300 mg on line a major decrease in incidence compared with that in the prevaccine era cholesterol ketogenesis 300 mg gemfibrozil visa. Unfortunately high cholesterol foods healthy discount gemfibrozil 300mg amex, pertussis continues to be a major problem in developing countries, where it is estimated to cause 200,000 deaths each year (534). Clear nationwide increases have more recently been noted since around the year 2005, especially among children 6 years of age. In the past 5 years, major outbreaks have taken place in Washington State, with 2,500 cases reported in January through June 2012 (538), as well as in California, initially in 2010 and again in 2014, with nearly 9,900 cases and 3 deaths reported through January 2015 (539, 540). This is best exemplified by a large outbreak in Germany during the period of April through June 2005 (5). In that outbreak, a total of 75 cases were identified, 39 (52%) of which involved children aged 5 to 14 years and another 25 (33%) of which occurred among adolescents and young adults. For all individuals, complete ageappropriate immunization with a pertussis-containing vaccine was documented. Most of these cases have involved children 16 years of age, with large clusters involving 12 or more cases noted to occur at seven military installations, predominantly in the West Coast (541). Subsequent analysis for the period of January 2012 through June 2014 revealed continued pertussis activity in the military, with 39 confirmed and 124 probable cases among military personnel (542; A. Additionally, increased risks and outbreaks have been documented for Israeli Defense Forces recruits (544) and French military boarding school students (545), who are not routinely immunized upon arrival at training sites. These illnesses in young adults, although generally mild (546), have been quite incapacitating. The incubation period for pertussis is usually 9 to 10 days, with a wide range of 6 to 20 days (42). In otherwise healthy adults, pertussis usually presents with a gradual onset of a paroxysmal, nonproductive, unrelenting, hacking cough. The cough can result in cyanosis or posttussive emesis, which in adults is highly suggestive of pertussis (547). Some complications of pertussis may include pneumonia, otitis media, rib fractures, urinary incontinence, and syncope (547, 548). Specimens should be collected in a patient care area that is separate from where vaccination occurs in order to avoid cross-contamination. Testing is not recommended for asymptomatic persons, given the high false-positive rate. However, testing after 5 or more days of antimicrobial therapy may result in a false-negative test result (549). Treatment should be started prior to the return of any test results if the clinical history is strongly suggestive of, or if the patient is at risk for, severe or complicated disease. Trimethoprim-sulfamethoxazole is an alternative agent for patients 2 months of age or older. The choice of agent should be based on tolerability, drug-drug interactions, cost, and ease of adherence. For many years, whole-cell pertussis vaccines were recommended for children under the age of 7 years. Initial acellular vaccines approved for use in 1997 were associated with reduced rates of rare severe side effects seen with whole-cell vaccines (552). Unfortunately, these vaccines were also associated with waning immunity and pertussis resurgence, as mentioned above (553). The impact that these acellular vaccines and associated immunization policies will have on the control of this disease in civilian communities or among military service members and the potential increase in the number of breakthrough cases due to reduced immunogenicity are not known at this time. Mycobacterium tuberculosis Background historical information, epidemiology, and transmission. Once inhaled, the infection is established with or without a visible primary lung lesion, and lymphatic and hematogenous spread usually follows 3 weeks following infection.

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Section 2002-Expiration of Authorizations and Amounts Required to cholesterol count foods purchase gemfibrozil overnight delivery Be Specified by Law cholesterol chart for males purchase gemfibrozil 300mg on-line. Section 2104-Modification of Authority to cholesterol test where to go buy gemfibrozil 300 mg online Carry Out Certain Fiscal Year 2019 Projects. Section 2205-Modification of Authority to Carry Out Certain Fiscal Year 2017 Project. Section 2305-Modification of Authorities to Carry Out Phased Joint Intelligence Analysis Complex Consolidation. Section 2306-Modification of Authority to Carry Out Certain Fiscal Year 2016 Project. Section 2307-Modification of Authority to Carry Out Certain Fiscal Year 2017 Project. Section 2308-Modification of Authority to Carry Out Certain Fiscal Year 2018 Projects. Section 2309-Modification of Authority to Carry Out Certain Fiscal Year 2019 Projects. Section 2401-Authorized Defense Agencies Construction and Land Acquisition Projects. Section 2601-Authorized Army National Guard Construction and Land Acquisition Projects. Section 2603-Authorized Navy Reserve and Marine Corps Reserve Construction and Land Acquisition Projects. Section 2604-Authorized Air National Guard Construction and Land Acquisition Projects. Section 2605-Authorized Air Force Reserve Construction and Land Acquisition Projects. Section 2701-Authorization of Appropriations for Base Realignment and Closure Activities Funded through Department of Defense Base Closure Account. Child Play Areas at Exceptional Family Member Program Installations Defense Access Road Projects. Feasibility of Transitioning from 100-Year Floodplain to Sea-Level Rise Modeling at Coastal Installations as a Planning Assumption for Military Construction Projects. Report on Integration of Information Regarding Environmental Health Hazards into Defense Occupational and Environmental Health Readiness System. Section 2801-Prohibition on Use of Military Construction Funds for Construction of a Wall, Fence, or Other Physical Barrier along the Southern Border of the United States. Section 2802-Modification and Clarification of Construction Authority in the Event of a Declaration of War or National Emergency. Section 2803-Inclusion of Information regarding Military Installation Resilience in Master Plans for Major Military Installations. Section 2804-Improved Consultation with Tribal Governments when Proposed Military Construction Projects Potentially Impact Indian Tribes. Section 2805-Amendment of Unified Facilities Criteria to Promote Military Installation Resilience, Energy Resilience, Energy and Climate Resiliency, and Cyber Resilience. Section 2806-Modification to Department of Defense Form 1391 regarding Consideration of Potential Long-Term Adverse Environmental Effects. Section 2811-Enhanced Protections for Members of the Armed Forces and Their Dependents Residing in Privatized Military Housing Units. Section 2812-Prohibition on Use of Nondisclosure Agreements in Connection with Leases of Military Housing Constructed or Acquired Using Alternative Authority for Acquisition and Improvement of Military Housing. Section 2813-Authority to Furnish Certain Services in Connection with Use of Alternative Authority for Acquisition and Improvement of Military Housing. Section 2814-Modification to Requirements for Window Fall Prevention Devices in Military Family Housing Units. Section 2816-Development of Process to Identify and Address Environmental Health Hazards in Department of Defense Housing. Section 2817-Report on Civilian Personnel Shortages for Appropriate Oversight of Management of Military Housing Constructed or Acquired Using Alternative Authority for Acquisition and Improvement of Military Housing. Section 2818- Inspector General Review of Department of Defense Oversight of Privatized Military Housing. Section 2819-Department of Defense Inspection Authority regarding Privatized Military Housing. Section 2832-Access to Department of Defense Facilities for Credentialed Transportation Workers.

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