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A New Program Application must be submitted and approved prior to the initiation, enrollment, or advertising of any new program. A new program is: 1. one that has never been offered by the institution; 2. one that has never been offered at the campus where it is to be initiated; or 3. an existing program that has been revised: a) to award a higher academic credential than previously approved by ACICS (e.g., diploma to degree); (Program Application Part III - TRANSITION PLAN TO ADD A HIGHER CREDENTIAL) b) to change 25% or more of the previously approved contact hours, credits, curriculum content (courses offered), or program length of a previously approved program; c) to reflect a change in academic measurement from clock hours to credit hours or vice versa, or a change from quarter to trimester or semester credits or vice versa; or d) to reflect any additions or deletions of courses offered that may change the overall objective of a currently approved program.
All submissions must use the most current version of the application. Previous versions of the new program application will not be accepted.
Please be sure to include contact information for all parties involved in the program application.
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Please note that all outstanding invoices must be paid before purchasing an application. To view outstanding orders, institutions should login to the ACICS member website and go to MY ACCOUNTS/MYORDERS.
For a complete list of fees, view the Schedule of Fees. For payment by check follow the steps outlined in the instructions for Submitting Payment via Check.
STEP 1 - Download and complete all required documents:
Download templates and prepare the following documents for submission in Step 3:
STEP 2 - Purchase the New Program application
See Instructions for Purchasing an Application Submission of identical programs to multiple locations: (see fee schedule): If an identical new program is submitted for multiple locations at the same time, see the schedule of fees. A complete application must be submitted for each location using their unique. ACICS ID. ACICS staff will verify uniformity of identical programs submitted. All duplicate applications must be submitted within three (3) business days.
STEP 3 - Upload and submit documents listed in Step 1
See Instructions for Uploading DocumentsIMPORTANT: Completed applications should be submitted to the Council office at least 45 business days before the institution plans to advertise recruit, enroll, or start classes in the program. The program must be approved before any of these activities can occur.
STEP 4 - Review
Staff will review documentation and determine when the program will be reviewed on-site. All applications for a new program offered at a higher credential than currently awarded at the campus in question require a Readiness Visit to the institution before Council approval for the program is granted. (See Step 3) Please note that an application for a new program delivered either partially or 100% through a non-traditional format requires the submission of a response to Appendix H of the Accreditation Criteria. (See Narrative)
STEP 5 - Notification
Institutions will receive a Letter of Approval from Council Staff via e-mail. Programs that are considered to be in scope will be reviewed during the next regularly scheduled new grant visit. Programs that are considered to be out of scope will be scheduled for a new program visit approximately a year following the visit start date. (Step 6- are applicable) Programs being initiated at a higher credential level will be scheduled for a readiness visit approximately 6 months following the visit start date (Step 6 - are applicable)
STEP 6 - Schedule Visit
Institutions will be contacted by Council staff approximately two months prior to the first month of the visit cycle stated in your Letter of Approval (Step 5).
STEP 7 - New Program Visit or Readiness Visit
Visits will include Council Staff and a qualified program specialist for each program identified in the Letter of Approval.
STEP 8 - Submit Payment for Visit
Institutions will receive a manual invoice sent via U.S. Postal service. In addition, institutions view any outstanding invoices via their ACICS login - MYORDERS and pay via credit card.
Step 9 - Visit Report
A copy of the team visit report including detailed response instructions will be sent by Council Staff to the institution via email approximately two weeks following the visit. Team visit reports will include a cover letter notifying institutions of the response due date.
STEP 10 - Visit Response
Institutional responses must address each area of non-compliance identified in the team visit report. Team visit response instructions
STEP 11 - Council Decision
Notification of Council decision will be sent via e-mail within a month following Council meeting. Notifications will be sent via U.S. Postal mail for U.S. domestic institutions.
Effective July 1, 2010 institution's with programs that fit the U. S. Department of Education definition of clock-hour program, who use the clock to credit hour conversion for Title IV, HEA funding and who plan to increase a program's total clock hours by adjusting the total instructional hours, MUST submit a Letter of Justification. The letter must provide a detailed and comprehensive written justification for the increase in hours to demonstrate that the new program length is necessary for students to fulfill all the program and course objectives and to achieve specific knowledge, skills, and competencies required for employment. This letter of justification must be addressed to the ACICS Director of Campus Development and submitted with a new program or non-substantive program modification application.


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Mises Daily
New articles appear every day.
All Authors | List View | Album View
New articles appear every day.
All Authors | List View | Album ViewAllen McDaniels is a practicing physician in San Pedro, California who developed an interest in revisionist history under the tutelage of Professor James J. Martin at Robert LeFevre's Freedom School in Colorado. Dr. McDaniels also teaches medical acupuncture to physicians at UCLA, Stanford, and the US military; and he is a past director of the American Academy of Medical Acupuncture. Send him mail.
Title | Author | Date(sorted descending) | |
Keynes Was No Liberal | Allen McDaniels | 11/08/2011 |

subset: commoncrawl


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Mark Hyman, MD is a pioneer in functional medicine, which fixes the underlying causes of obesity, diabetes, inflammatory, digestive, mood and memory disorders


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Journal Sentinel TV and film critic Duane Dudek looks at life on the small and big screen, and some of the cool stuff on both.
Is Charlie Sykes being positioned to be next Glenn Beck?
According to the liberal website Media Matters, the Journal Broadcast Group is positioning WTMJ-AM (620) talk show host Charlie Sykes to be a national conservative voice similar to that of Glenn Beck.
A story by investigative reporter Joe Strupp describes "a new marketing project aimed at spreading (Sykes') hard conservative talk brand ... to web, video, social media and perhaps other media outlets owned by parent company Journal Communications."
"....Sykes' burgeoning network of platforms resembles nothing other than a smaller-scale version of the former Fox News host's (Beck) sprawling web-base," according to Strupp.
His observations are based on an online ad for something called the Conservative Politics Digital Project and the website RightWisconsin.com, which Strupp writes "seeks to take his outspoken conservative approach and expand it to many platforms, including podcasts, web columns, videos, and on-location events."
The ad, quoted in the article, "for a managing editor of the Conservative Politics Digital Project indicates it will be 'a new suite of digital products related to Charlie Sykes and targeted at Conservatives in Wisconsin.' "
On his blog Sykes wrote "RightWisconsin will be a digital community, a rallying point, a one-stop source for conservatives on the front lines here."
"It will be "more than simply another conservative website; it will have a full-time staff and multiple platforms -- mobile, tablet, internet, social media applications."
And Strupp reports that Journal Communications will help spread his influence:
"We can do all of this because we have the resources of a major media company behind us, including the state's biggest radio station and top-rated television station. In other words, we have built-in platforms for promotion as well as the infrastructure to make RightWisconsin multi-media."
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I am a conservative but I don't listen to Charlie....never been much of a Beck fan either. What interests me here is the same ol' hypocrite liberals whining about both of them. Any of you idiots complaining about either of these guys spewing hatred should first look in the damn mirror!!...Then look at your own dishonest biggoted party. You people say the same crap about anyone that dares voice a contrary view to your own....Of course when pressed, none of you can come up with any concrete examples...what a pathetic crowd you have become!!!
Wow. Sounds like you have anger management issues. Your comments are extremely negative and accusing. How is that any different from the "hypocrite liberals" that you're railing against? And how many negative words did you use.... hypocrite, idiots, damn, bigoted, crap, pathetic. Yeah, that's the way to get your point across. NOT.
pubic, have you been stupid asll your life, or just since the repubnutz told you to
ditto to for your "pathetic crowd."
ditto as well.
Would have preferred that they kept James T and got rid of this twit.
attc44 - Today at 10:58 AM - Report Abuse
If you think it's that simple, you should start a liberal talk radio show.
He didn't say he thought it was that simple. He simply gave his impression of what takes place on his shows. It's very accurate. -
i try not to listen to sykes as much as possible. when he is for something most of the time i am not for it and when he is not for it i am for it.
Sykes should just leave the state, he is a complete jerk and a lowlife scumbag
It all boils down to one thing Da Left HATES scrutiny.
Sykes sucks. That says it all.
1) Thanks to Duane for labeling Media Matters what it is; a liberal website. It's not often we see these sort of organizations described by their political leanings unless they are conservative.
2) As for Sykes becoming the next Glen Beck; all Charlie needs is more talent, knowledge, wit, personality and charisma. -
Why are there no liberal hate talk shows outside of the Republic of Madison?
Sounds like sour grapes Mr Dudek. The funniest part of the Media Matters article was this:
"Several newspaper staffers point to Sykes' partisan approach as undermining the paper's image as the source for fair, unbiased news."
The second funniest was YOUR quote: "I don't put it past Sykes to be able to do this," Dudek said. "If he had a national platform, he'd have a national audience. I am sure he is part of a movement. He's a pot-stirrer and Journal Broadcasting has a good record of creating these formula programs."
A pot stirrer. Sharight. And I am sure YOU are part of a movement as well!
Hows that circulation workin' for ya??-
Isn't Media Matters a George Soros creation? Talk about a lack of credibility.


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Staten Island LivingKids & families, health & fitness, cooking & food, lifestyles and pets
Featured Story
Birth announcements
By Staten Island Advance
October 23, 2012, 11:23AM
STATEN ISLAND UNIVERSITY HOSPITAL SOTO — a son, Christian Alexander, to Kristine Bungarz and Jorge Soto of Huguenot, July 20. OLIVIERI — a daughter, Giada Marie, to Kristen and Richard Olivieri of Annadale, Oct. 5. RICHMOND UNIVERSITY MEDICAL CENTER ALOI — twins, a son, Justin, and a son, Jeffrey Jr.,... Full story »
State by state, moms lobby for legalization of marijuana to treat their children with seizure disorders
By Washington Post
March 10, 2014, 2:20PM
The drug the mothers are seeking is an extract that contains only trace amounts of the part of the plant responsible for the euphoric effect of the drug Full story »
It was heel, toe; heel, toe at the hoedown, errr Staten Island Slim Down (photos)
By Kathryn Carse/Staten Island Advance
March 10, 2014, 1:48PM
Peter Burdack returned to get everyone dancing at Week 7's Fitness Surprise at the College of Staten Island. Full story »
Staten Island's State Sen. Savino leads the charge in N.Y.'s pending medical marijuana bill
By Kathryn Carse/Staten Island Advance
March 10, 2014, 1:29PM
New York is one of 15 states considering legislation; 20 states have legalized using marijuana as medicine Full story »
'Jumping Jacks' Kennedy
By Washington Post
March 10, 2014, 12:00PM
With Presidents' Day coinciding with the Olympics in Sochi, GQ magazine's blog paused in its coverage of style, sex and sports to post a vintage physical fitness promotional film featuring President John F. Kennedy. Full story »
It's the 8th week, so what, don't let that stop you from getting in on the Staten Island Slim Down (video)
By Kathryn Carse/Staten Island Advance
March 09, 2014, 10:55PM
if you are thinking, Maybe I should try this next year, don't wait. Or if you signed up, but never came or came once or twice, there is no reason not to come again. Full story »
Staten Islanders who lost 100-plus pounds will tell their stories at a free Weight Watchers meeting
By Kathryn Carse/Staten Island Advance
March 07, 2014, 3:35PM
The event is held to celebrate the accomplishment of members and to inspire those who might undertake the challenge Full story »
Staten Island Pet Calendar:Free rabies vaccinations Sunday 3/9
By Staten Island Advance
March 07, 2014, 8:00AM
Health Department hosting program for dogs, cats in Blue Heron Park Saturday Dog and cat adoptions: Meet dogs and cats in the care of Pet Lovers United Together as One (P.L.U.T.O.) Rescue of Richmond County, at PETCO in Charleston Shopping Center, 2752 Veterans Rd. West, noon to 3 p.m. View the animals at www.plutorescue.petfinder.org. Kitten, cat and dog adoptions:... Full story »
March health events on Staten Island: Free breast exams, Affordable Care Act info, 'chemo brain' teleconference
By Kathryn Carse/Staten Island Advance
March 06, 2014, 10:30AM
Events are free and open to the public Full story »
Take care: Attend a Colorectal Cancer Awareness Fair and make time for a screening
By Richmond County Medical Society
March 04, 2014, 7:00PM
A number of alternatives exist for early detection, which makes a crucial difference in treatment Full story »
Michelle Gonzalez and Derek Brown are engaged
By Staten Island Advance
March 04, 2014, 3:59PM
STATEN ISLAND, N.Y. -- Michelle Gonzalez of Richmond and Derek Brown of Port Richmond have announced their engagement. They are planning a September 2015 wedding. The future bride is the daughter of Karen Gonzalez. The future bridegroom is the son of Debra and Robert Brown. Miss Gonzalez is a graduate of St. Joseph by-the-Sea High School, Huguenot, and earned... Full story »
Cara Liander and John Gordon are engaged
By Staten Island Advance
March 04, 2014, 3:52PM
STATEN ISLAND, N.Y. -- Cara S. Liander of Dongan Hills and John M. Gordon of West Brighton have announced their engagement. The future bride is the daughter of Sharon and Robert Liander. The prospective bridegroom is the son of Anne and Jack Gordon. Miss Liander is a graduate of Notre Dame Academy, Grymes Hill. She earned a bachelor of... Full story »
It's all about you, Mother
By Carolyn Hax/Tell me about it
March 04, 2014, 3:32PM
New grandma creates drama after the birth of daughter's first child Full story »
Inappropriate post? Alert us.
Issue punishments that fit the crime
By James Windell/Coping with Kids
March 04, 2014, 3:23PM
Columnist has five rules of thumb to follow when figuring out the best way to discipline your teen Full story »
Inappropriate post? Alert us.
Projects for passing on memories
By Associated Press
March 04, 2014, 3:19PM
Baby boomers wishing to portray their personal histories have many options these days Full story »
Heartmelting proposals: Staten Islanders find creative ways to pop the question (with photos)
By Elise G. McIntosh/Staten Island Advance
March 04, 2014, 3:19PM
These Staten Islanders pulled out all the stops when popping the question Full story »
- Talk in the living forums
Pray for Peace... by ggooh 1:04 AM What is a Christian! by newnature23 3:10 PM POTUS to give SOTU address tonight... by ggooh 6:27 PM Civility by 1943ranger 11:25 AM Suz, here is nostalgia we all understand: by fitzwilly 7:28 PM Staten Island Memories by johnls 3:45 PM Funny clips for Relaxing Mind. by SarahTucker 2:19 AM Offer on family Nanny services by SarahTucker 5:03 AM Full or Part Time babysitter service by SarahTucker 1:04 AM


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In their red hats and suits, their dark shirts and glasses they caught the mood of the moment, chanting: "We are watching you. You know what to do, pay the climate debt."
This was a reminder how many activist here blame the developed world for the climate crisis, for their carbon emissions as industrialisation built their fortunes while stealing their futures.
There had been a feeling of momentum, a sense that all 192 countries were moving in the one direction, heading for a deal.
But on Day 3, that had been replaced with an air of suspicion.
'Danish text'
The problem, the so-called "Danish text", a set of proposals drawn up by the Danish, the British and the Americans which, among others, proposed radical ideas which were instantly rejected by many of the world's poorer countries.
The basis of the document proposed that both industrialised and emerging countries cut carbon emissions to limit global warming and that the UN is sidelined in future talks about climate change.
The conference tried to get back to work, but in the small meeting halls and coffee shops that dot this huge sprawling venue, it was the topic that continued to dominate.
Near one I found Kumi Naidoo, the new charismatic head of the environmental group Greenpeace.
He told me the text showed that the rich, powerful countries were reluctant to hand over power in the negotiations.
"The Danish text is dead in the water. Now we have to go back to the hard work that's been done since the Bali summit two years ago.
"Let's not ignore what the negotiators have done but we should keep our eye on the prize which is to deliver to our children and grandchildren a fair, ambitious and binding treaty which secures their future".
Work to be done
One of the groups most at risk from the continuing rise in global temperatures is the Association of Small Island states.
Every morning they meet to discuss their plan for the day.
Every night they gather to discuss what they've achieved, and the tactics to use the next day.
Their chairperson is the impressive Dessima Williams, Grenada's ambassador to the United Nations.
She understands why people are upset by the leaked document, but believes people should now get back to work.
In between her never ending round of meetings in Copenhagen, she told me: '"We don't see this as something which will disrupt the meeting. In fact, as far as I know, this paper was floated and withdrawn some time ago, so it hasn't disturbed us at all."
This smart and savvy diplomat has been at enough of these gatherings to know how things work.
Most of the discussions here, the most important climate talks in history, are held behind closed doors.
There's no access for the media, none for environmentalists who may have a case to present.
Somehow, in all these discussions, over the course of the next few days, various drafts will be floated.
Some will anger the rich nations; some will send the developing countries into a tirade.
But in the flurry of proposals and ideas, one will form the basis of a deal, if there is one.
The world leaders will arrive in Copenhagen next week to sign a deal which they will claim will change the world.
It appears a few attitudes may have to change first.
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This Patriotic Poolside Babe Has a Super-Famous Little Sister! Who Is She?
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See that girl? The one on the right in every picture? She's part of a mega-famous family, but like most of her siblings, she's had her own share of the spotlight.


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In what might be a Pierce County precedent, a judge Thursday ordered police to give a Tacoma man back marijuana seized from him during a traffic stop last year.
Municipal Court Judge Jack Emery agreed with Joseph L. Robertson's arguments that police had no right to seize the less than 40 grams of pot because he is a designated provider of medical marijuana.
Robertson's attorney, Jay Berneburg, said outside court that it might be the first such ruling in Pierce County history. Almost a year ago, two owners of a medical-marijuana dispensary lost a bid in Pierce County Superior Court to get back pot police seized from them during a case later thrown out of court.
"As far as that goes, it's a big deal," said Berneburg, who is active in medical marijuana issues.
Robertson hoped to retrieve his marijuana from the police property room within the week.
"I feel great," he said outside court. "You've got to stand up for people's rights sometimes."
Police seized the pot in May 2012 after pulling Robertson over for speeding. The officer who made the stop reported smelling marijuana inside Robertson's car and later found a small amount, court records show.
Robertson was cited for driving without a valid license and misdemeanor marijuana possession and released.
City prosecutors in December dismissed the possession charge after the state's vote to legalize the possession of small amounts of marijuana. Robertson then asked for his pot back. The city refused, which set up Thursday's hearing before Emery.
City prosecutor Charles Lee stood by the city's opposition.
"Had this gone to trial it would have been an issue of fact as to whether or not the marijuana Mr. Robertson was possessing on that day was for personal consumption or for (a patient)," Lee said.
Lee also argued it hadn't been proven that Robertson is in fact a valid medical-marijuana provider or that the person he intended to supply is a qualified patient.
Berneburg countered that the law is clear when it comes to medical marijuana.
A qualifying patient is a person with a debilitating or terminal condition diagnosed by a medical professional who then prescribes marijuana as medicine, he said. A designated provider is someone over 18 who a qualifying patient has contracted with, in writing, to provide the pot, the attorney argued.
A designated provider can have up to 24 ounces (680 grams) of usable marijuana and 15 plants at any given time.
Berneburg provided as evidence copies of his client's contract to provide marijuana to a specific person and that person's "documentation of physical authorization to engage in the medical use of cannabis in Washington State."
It is not up to the state to determine whether someone is a qualifying patient, he said outside court. That decision is between a person and his or her doctor, he said.
"The law is very simple, and it is very boring," Berneburg told Emery. "If he is a lawfully appointed designated provider, he's lawfully in possession of that marijuana. Being lawfully in possession of that marijuana, he can not be forced to forfeit that, and the state, the government, the city can not seize it."
Emery agreed and ordered the city to relinquish Robertson's marijuana.
Lee told Emery the city had no plans to appeal.
adam.lynn@ thenewstribune.com blog.thenewstribune.com/crime @TNTadam


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Welcome Spring!!!
by Rick
posted Mar 17 2010 10:08AM
By now you've no doubt seen the signs of Spring, they're every where!! The daffodils are shooting up, the birds are returning to the feeders and the Rockies are in Tucson getting ready for opening day. Yep, Spring is here and the calendar will officially say so on Saturday. My favorite season has always been Fall, but Spring runs a close second. My issue with Spring is Spring cleaning. We get a beautiful season of new growth, warmer days, fresh air and we ruin it by cleaning the garage!! I say we have a one week period in late February we call Cleaning Season and do all the scrubbing and painting and washing then. It's dark and dreary in February so it's the perfect time to do dark and dreary chores. Then in March, we enjoy Spring. If we can get the greeting card company's behind Cleaning Season it just may work. Happy Spring!!!
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Posts Tagged 'Pioneer DJ'
New Colors for Pioneer DJ Pro Audio
Profile: Beach Fossils
Whether or not you've been listening, there are some trends worth noting in today's music scene. Lo-fi, beachy music, much like the Beach Boys reinvented for 2011 is everywhere. Best Coas buy propecia online t, Beach House, and others have shaped this sound almost into its own genre. This week we're going to look at […]
Summer Sounds For Professional Audio Equipment
This week, the lo-fi residues of new sounds are starting to sound like summer to us, even though we still have a few more weeks of slogging through slushy puddles and being careful not to fall on ice. If you're preparing your
Motown's Influence on Today's Professional Audio Equipment
Motown was a period of music that laid the ground for hip-hop. It began in Detroit in 1960 and over the next 10 years, Stevie Wonder, Marvin Gaye, The Jackson 5, and The Supremes all led the label to Top 10 hits. This period began at a time when audiences were segregated, and helped to […]
3 Songs for Your Pioneer DJ Pro Audio
Part of being a DJ is exposing yourself to new sounds. This is so you can incorporate the best of what is being, and what has been produced, into your music with a professional audio mixer a Cialis best place to buy nd Pioneer DJ pro audio. That said, here are three cool songs we […]


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New Track: Tortured Soul – "Dirty"
December 11th, 2012
Soulful electro-dance band Tortured Soul has just released their new single, "Dirty," which they tout to be "all about showing your inner freak." The original track and its live version are both available for free stream and download below.
Also released today are remixes by DJ Spinna, DJ Pepsi, Makoto, and Sir Piers. Transporting "Dirty" to new dimensions, these remixes make sure you experience this song to the fullest degree. The remixes can also be streamed and are available for purchase below.


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Select () or exclude () categories to narrow your recipe search.
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Find exactly what you're looking for with the web's most powerful recipe filtering tool.
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"I am sharing this classic recipe for those who have got caught up in the "hot breakfast" fad or those who need a change from the fast food drive through lines.
This recipe is so easy, even a 6 year old can make it.
*You may substitute bagged cereal for boxed cereal"
Ingredients: cereal, milk...
Prep Time: 2 mins
Total Time: 4 mins


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Hi everyone,
what does this mean "make every word tell"? I don't get it.
Thanks a lot
Don't use a word unless it adds something. Eschew obfuscation.
"Make every word tell" is BrE in my opinion. In AmE we would say "make every word count." To employ another AmE idiom, it means don't waste a single word, i.e. even one word. Each and every one of your words should carry its own impact.
Context is important. Please provide enough for us to be able to deal effectively with your question.
Your thread title should include all or part of the word/phrase being discussed.
If you just want to know the meaning of a word, try OneLook Dictionary Search first.
Thank you
Yes, it's a bit of an odd collocation. 'Make every word/bullet/second...' usually, in my experience, ends '...count'. Perhaps 'tell' is an unlikely choice in either Br Eng or Am Eng, and it found itself in the forefront of the writer's mind because of the pun. I've seen some psychology texts about this sort of pre-loading of possibly appropriate words.... No reference, I'm afraid, but perhaps someone else can help


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Home Delivery & Route ServiceAvailable throughout most of the Twin Cities Metro area, we offer environmentally friendly home delivery and route service. |
About Non-Toxic Dry CleaningWhat's in it for you? Find out why utilizing a non-toxic dry cleaner is not only better for your clothes and garments, but better for the environment. |


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Emily Conyngham's Reviews
The little girl had the making of a poet in her who, being told to be sure of her meaning before she spoke, said, 'How can I know what I think till I see what I say?"
—Graham Wallas
About Emily
I've coached, written and edited for others, helping them say what they mean. Now, I hope to see what I mean.
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Copyright © 2013 Elsevier Inc. All rights reserved.
Cell Stem Cell, Volume 12, Issue 2, 147-148, 7 February 2013
Add/View Comments (0)The NIH Stem Cell Registry: An Absence of Gamete Donor Consent
Amy Wilkerson1, , , Kathaliya Wongsatittham1 and Josephine Johnston2, 3
1 Research Support, The Rockefeller University, New York, NY 10065, USA
2 The Hastings Center, Garrison, NY 10524, USA
3 Tri-Institutional Stem Cell Initiative Embryonic Stem Cell Committee
Main Text
Information on the provenance of human embryonic stem cells (hESCs) is critical for both scientific and ethical reasons. The genetic origin is important for selecting appropriate hESC lines for proposed research, and the consent terms may determine whether they can be used in subsequent studies, clinical trials, or development of therapeutics. From an ethics perspective, requiring informed consent is one crucial way to show respect for persons who may not support hESC research. Further, information about how the embryos were created and who consented to their use in research is essential to the reviews and approvals that many institutions, funders, and regulators require prior to initiation of what is still controversial research. As such, it is surprising that not all providers of hESC lines, including lines listed on the National Institutes of Health (NIH) Registry, ensure that full provenance information is readily and publicly available.
In 2009, the NIH issued guidelines (http://stemcells.nih.gov/policy/2009guidelines) for federal funding of hESC research that require that the cells be derived from embryos originally created by in vitro fertilization (IVF) for reproductive purposes that are no longer needed for that purpose. The individual(s) who sought reproductive treatment must give informed consent for the embryos to be used to derive hESCs for research purposes. The NIH Guidelines make no mention of the possibility that some embryos will have been created using donor gametes and do not require consent from the gamete donor to use the resulting embryos in research, a problematic omission that was noted when the draft Guidelines were released (Majumder and Cohen, 2009).
On this issue, the NIH Guidelines conflict with national and international guidelines that most hESC researchers in the US have been following for 7 years. Guidelines from both the National Academies of Science (National Research Council and Institute of Medicine, 2005) and the International Society for Stem Cell Research (International Society for Stem Cell Research, 2006) require the informed consent of gamete donors before embryos can be used in hESC research. Some state funding agencies do the same. The NAS Guidelines, amended in 2007, 2008, and 2010 (National Research Council and Institute of Medicine, 2007, National Research Council and Institute of Medicine, 2008, National Research Council and Institute of Medicine, 2010), have been particularly influential. The 2010 Amendments call for written consent specifically to the generation of hESCs when gametes are donated for research purposes, but allow that, when gametes were donated for reproductive purposes, written agreement for subsequent "embryo research" is sufficient (National Research Council and Institute of Medicine, 2010).
In response to these recommendations, many institutions have formed Embryonic Stem Cell Research Oversight (ESCRO) committees to review hESC research. Insofar as they are adhering to the NAS Guidelines, ESCRO committees approve research only if consent to use of the embryo in hESC research was obtained from the embryo donors and if a minimum of generic consent for research use was obtained from any oocyte or sperm donors. Unfortunately, determining whether these consents were obtained can be difficult.
The Tri-Institutional Stem Cell Initiative (Tri-SCI) ESCRO Committee, which oversees hESC research at Memorial Sloan Kettering Cancer Center, The Rockefeller University, and Weill Cornell Medical College, established procedures in 2006 for review of hESC research that are very closely aligned with the NAS and, since 2009, NIH Guidelines. Because these two sets of guidelines do not agree on the issue of gamete donor consent, the Committee continues to apply the stricter NAS standard.
For the first few years of the Tri-SCI ESCRO's operation, it assumed that hESC lines listed on the 2001 NIH Registry were obtained with the informed consent of embryo and gamete donors. This assumption was strengthened when the 2007 Amendments to the NAS Guidelines deemed these lines acceptable for use (National Research Council and Institute of Medicine, 2007). However, when a 2008 study reported problems with some of the consent forms used for donation of embryos from which 2001 NIH Registry hESC lines were derived (Streiffer, 2008), the Tri-SCI ESCRO prohibited use of four particular lines.
Last year, the Tri-SCI ESCRO was moved to request an examination of the provenance of the current NIH Registry lines when another study reported that just 30% of oocyte donor consent forms in surveyed US IVF clinics mention the possibility that resultant embryos might be donated to research, and only 8% mention donation to hESC research specifically (Schaefer et al., 2012).
As a first step, we reviewed the NIH Registry website and the line providers' websites and found gamete donor provenance information for 48 of the 198 current lines. For the remaining 150 lines, we made direct requests to the providers and obtained provenance information for an additional 131 lines. We therefore have information for 179 of the 198 lines.
From the information we received, we determined that for 104 lines, the embryo donors were the gamete providers. For eight additional lines, donor gametes were definitely used and in six of these cases, we were able to determine that the gamete donors gave generic consent for research purposes. It is unclear whether donated gametes were used for the other 67 lines, but we obtained assurances from the providers of 33 of these that, if third party gametes were involved, the consent form for gamete donation would have included reference to possible donation of resultant embryos for derivation of hESCs. For an additional four lines, the providers told us that generic consent for research would have been obtained from any gamete donors.
This leaves 30 lines for which the providers say they do not know whether gamete donors were involved and whether they provided consent for research (generic or specific to hESC research). In total, we are satisfied that 137 of the 198 lines currently listed in the NIH Registry meet our requirement that all individuals whose gametes were used provided written consent specifically for hESC research. For an additional ten lines, we are satisfied that gamete donors provided a general consent to research use.
Given the steady pace at which new lines are added to the NIH Registry, these numbers will soon be out of date. Yet, our general findings will likely remain. (1) Some NIH Registry lines were derived from embryos created using donor gametes. (2) Not all of these gamete donors provided specific consent for derivation of hESCs from resultant embryos. (3) Obtaining information about gamete donor consent is difficult.
With such rapid advances occurring in stem cell research, it is critical that consent forms for donation of gametes to IVF refer not just to the possibility of future research use, but also to derivation of hESCs specifically. Also, information about the provenance of the hESC lines should be public and readily available. The hESC research community will be best served if their essential research materials—gametes and embryos —are donated by individuals who knowingly and willingly agree to the use of those materials in hESC research.
Web Resources
The URL for data presented herein is as follows:
International Society for Stem Cell Research, 2006 (2006). Guidelines for the Conduct of Human Embryonic Stem Cell Research, Version 1: December 21, 2006. (Northbrook, Illinois: ISSCR). PubMed
Majumder and Cohen, 2009 (2009). Science 324, 1648–1649. CrossRef | PubMed
National Research Council and Institute of Medicine, 2005 (2005). Guidelines for Human Embryonic Stem Cell Research. (Washington, DC: The National Academies Press). PubMed
National Research Council and Institute of Medicine, 2007 (2007). 2007 Amendments to the National Academics' Guidelines for Human Embryonic Stem Cell Research. (Washington, DC: The National Academies Press). PubMed
National Research Council and Institute of Medicine, 2008 (2008). 2008 Amendments to the National Academics' Guidelines for Human Embryonic Stem Cell Research. (Washington, DC: The National Academies Press). PubMed
National Research Council and Institute of Medicine, 2010 (2010). Final Report of the National Academies' Human Embryonic Stem Cell Research Advisory Committee and 2010 Amendments to the National Academies' Guidelines for Human Embryonic Stem Cell Research. (Washington, DC: The National Academies Press). PubMed
Schaefer et al., 2012 (2012). Fertil. Steril. 97, 427–433. CrossRef | PubMed
Streiffer, 2008 (2008). Hastings Cent. Rep. 38, 40–47. PubMed


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I guess 3D is the next big thing. I'd like to see Beauty in 3D.
Once again, on this cool blog I found: My Disney Mania
he discusses a new deal for 3D movies that Disney has made. One movie that is going to be brought back to theaters is Beauty and the Beast! Not only is it going back to theaters, but they are making it into a 3D movie!!!
What do you think?
WDW Marathon '12
WDW Goofy '13
I guess 3D is the next big thing. I'd like to see Beauty in 3D.
When you wish upon a star.....
Adults are only kids grown up, anyway. WD
...That's the real trouble with the world. Too many people grow up. WD
"For those who get it, no explanation is necessary. For those who don't, no explanation will do."
I have to say, the recent 3D movies I've seen have been a huge improvement over what they used to be. I say bring 'em on.
Founder of TestSherpa LSAT Test Preparation
The LSAT is not as fun as the Haunted Mansion, but just as scary.
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Home & Garden
Tear-Shaped Memorial Ornament
"Those we love don't go away they walk beside us every day. Unseen, unheard, but always near. Still loved, still missed, and forever dear." Commemorate a loved one with this elegantly crafted pewter-finished ornament.
Includes a card of the verse, and you can have the back engraved to create a meaningful memento.
Crystal accents and hanging ribbon; comes gift boxed.
2"x 2-3/4"$22.953.8/5 (17) -
Home & Garden
Get ready for the holidays with holiday decor, or create an outdoor oasis with garden and patio furniture and fashions that are fun and functional.
It Came To Me... Wood Sign
For all the dogs you've loved, and for all the furry family members you have yet to meet. A heartwarming ode, great as a gift for anyone who strives to be as generous and loving as our four-legged friends.
Crafted of solid knotty pine with a distressed painted finish.
9" x 18"$29.954.5/5 (21) -
Home & Garden
Get ready for the holidays with holiday decor, or create an outdoor oasis with garden and patio furniture and fashions that are fun and functional.
Love You to the Moon Framed Art
It's like delivering a love letter, every time that special someone lays eyes on it. Rich color and quirky artwork accompany "I love you to the moon and back" a natural in a nursery, but also delightful in a guest room or by the kitchen table.
Burled metallic finish on poly frame with glass.
Made in USA.
15" x 15"$39.954.2/5 (6) -
Forest Owl Pillow
Perky owls and folk-art flowers decorate this charming pillow that will brighten your indoor and outdoor spaces. Made of moisture- and fade-resistant fabric to ensure fresh color and a bit of whimsy.
100% polyester with polyfill; color-coordinated matching back.
24" x 18"
Jennifer Brinley, Licensed by Ruth Levison Designs$29.955.0/5 (1) -
50 in. x 60 in. Throw
RugStudio presents the Throw by Rizzy. Size: 50 inch x 60 inch. Maretial: 100% Acrylic Yarn. Loom Woven with Fringe. Tight Weave. Plaid Threads. Machine Wash on Gentle Cycle with Mild Detergent. Lay Flat to Dry.
Select color from drop down box.$74.00 - $90.00 -
Attack Wave Pest Repeller
*Produces strong sound pressure in the air, attacking the auditory and nervous systems of rodents causing them to abandon their food sources and shelters
*Ultrasonic sounds continuously penetrate up to 5,000 unobstructed sq ft
*Uses automatic wave variation, minimizing chance that pests become immune to sound
*Inaudible and harmless to humans and common pets (do not use in presence of gerbils, hamsters, Guinea pigs and other rodent pets)
*Operates totally chemical and battery free$19.95 -
Four Things Wood Sign
In the real world, there's no "undo" option. Wisely worded and beautifully lettered, this sign reminds us to live each day with kindness, compassion, and a mindful presence.
Distressed finish on beveled-edge solid knotty pine.
7-1/4" x 18"$27.95 -
Solar Powered LED Garden Light - Dragonfly Mushroom
Powered by a small solar collector that cleverly adjusts to capture your best sun angle, our vibrantly colored glass mushroom with a whimsical dragonfly accent artfully illuminates a patio pot or flowerbed. Wonderfully brilliant at night.
Made of painted glass with long-lasting LED light and a copper-finished metal stake.
6-1/2" dia x 18-1/2"H$29.95 -
Kill-A-Watt Electricity Usage Monitor
- Large LCD counts consumption by the kilowatt hour
- Connects to household appliance and it will assess its efficiency
- Calculates electrical expenses by the day, week, month or year
- Checks the quality of power by monitoring voltage, line frequency and power factor
- 5.13"H x 2.38"W x 1.63"D
- UL listed
$19.99 -
Kill-A-Watt EZ
- Large LCD
- Shows the operating costs of household appliances
- Accurate with in 0.2%
- Calculates cost and forecasts by week, month and year
- Checks the quality of power by monitoring voltage, line frequency and power factor
- Built-in battery backup
- Displays 8 critical units of measure
- Dimensions: 5.13"H x 2.5"W x 1.5"D
- UL listed


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Roy and Janice Myers celebrated their 40th wedding anniversary recently at a family dinner held at Prioetti's Restaurant and later at their daughter's home in Webster. They were married on June 24, 1972 at St. Anthony's Church in Fredonia, with the Rev. Thomas Carlesimo officiating.
Janice is the daughter of the late Anthony and Catherine Leone. Roy is the son of the late Carrie and Robert Myers.
Bridal attendants included Marilyn Gehner, Patricia Szczerbacki, Kathi Anderson and Robin Muscato. Groomsman were Robert Myers, Joseph Stehn, Richard Laughner and William Westin. Frank Leone and John Myers served as ushers.
Article Photos
Mr. and Mrs. Roy Myers
Mr. Myers is a project specialist at the Nestle Purina Petcare Company in Dunkirk. Mrs. Myers is retired from the Fredonia Central School District and is a wedding and special event consultant and coordinator.
The couple have two children, Lisa Mathewson and Cheryl Rauls, both residents of Webster. They have two grandchildren, Brendan and Katie Mathewson.


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Reviews of Latest Camcorders
Your Selections
CNET UK > Reviews > Cameras and Camcorders > Camcorders
Panasonic SDR-S10 review
Panasonic's SDR-S10 all-weather flash-based camcorder is waterproof, dustproof and drop-proof, making it great for a beach holiday, a music festival or some hardcore snow action. Thankfully it's both light in weight and light on the pocket, too Read more
7 June 2007 by Mark Harris
CNET UK > Reviews > Cameras and Camcorders > Camcorders
Panasonic SDR-H250 review
Panasonic brings a 3CCD hard drive camcorder to the table with the SDR-H250. It helpfully provides an option to record to a memory card and it offers many useful scene modes, but it will struggle to keep up with hi-def models Read more
6 March 2007 by Mark Harris


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3-Piece Set: Cotton Sateen Duvet Cover & Shams
$44.00 Our Price
$129.00 Retail
Go to bed in luxury with this super-sweet super-luxurious 3-Piece Cotton Duvet Cover Sets. These 315 thread count Cotton Sateen Duvet Sets are a perfect way to protect your comforter from excessive wear and tear while adding style and comfort. The sateen finish adds an element of shine and luxury to any bedroom space. This bedding set will most certainly be nice to come home to--just try and stop yourself from jumping in between these sheets before bedtime! Want to know more? • Made of 100% cotton sateen fabric • 315 thread count • Button closure • Machine washable • Set includes: 1 duvet cover and 2 standard size pillow shams • Twin size: 62" x 86" • Full / queen size: 86" x 86" • King size: 102" x 86'•
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- Sacred Destinations
- Switzerland
- Geneva
- Archaeological Site
Archaeological Site, Geneva
Excavations beneath Geneva's cathedral have revealed Roman mosaics, several Early Christian churches and a medieval crypt. A catwalk leads visitors through the ancient ruins.
What to See
The Site Archéologique (Archaeological Site) in Geneva was discovered underneath the Cathédrale St-Pierre when its foundations needed reinforcement in 1976. So far, excavations beneath the cathedral have uncovered:
The ruins encompass so many different eras that they can be confusing, but there are audio guides in English and excellent signs (with diagrams and drawings) in French and English to help.
The foundations are not terribly exciting (being piles of stone), but the in-situ mosaics and artifacts are quite interesting. The self-guided walking tour is well laid-out, with good lighting and sturdy catwalks leading visitors around an underground maze of ancient history.
Quick Facts on Archaeological Site
Site Information | |
Names: | Cathedral Archaeological Site; Cathedral Archaeological Site, Geneva; Geneva Cathedral Archaeological Site ; Site archéologique |
City: | Geneva |
State: | Canton Geneva |
Country: | Switzerland |
Categories: | Churches |
Faiths: | Ancient Roman; Christianity |
Feat: | Roman Mosaics |
Styles: | Roman; Paleochristian |
Status: | ruins |
Visitor and Contact Information | |
Location: | Geneva, Switzerland |
Coordinates: | 46.201140° N, 6.148025° E (view on Google Maps) |
Lodging: | View hotels near this location |
Map of Archaeological Site
Below is a location map and aerial view of Archaeological Site. Using the buttons on the left (or the wheel on your mouse), you can zoom in for a closer look, or zoom out to get your bearings. To move around, click and drag the map with your mouse.
- Personal visit (December 23, 2006).
- Fodor's Switzerland 2005.
More Information
- Archaeological Site, Geneva - Go Historic
- Photos of Archaeological Site - here on Sacred Destinations
Article Info
Title: | Archaeological Site, Geneva |
Author: | Holly Hayes |
Last updated: | 10/08/2009 |
Permalink: | www.sacred-destinations.com/switzerland/geneva-archaeological-site |
Link code: | Archaeological Site, Geneva |


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"Arrested Development" creator Mitch Hurwitz announced today that the show will be coming back to television -- five years after it was cancelled.
Hurwitz said the show will do a "limited" season which will show us what the characters have been up to since the show last aired ... which will then lead right into the planned movie.
There is no official deal in place yet for where or when the show will air.
Have a frozen banana and celebrate!
This is AMAZING. I just had the most stressful weekend of my entire life, but hearing this news makes me feel all better!
This is the first time I've ever seen news on TMZ that didn't make me want to regurgitate!
Never saw the show but for some reason am happy for the cast esp. Bateman. Will make it a point to watch if it does come back.
YES!!! I Hope crazy ass Carl Weathers comes back.
Whoa, whoa, whoa. There's still plenty of meat on that bone. Now you take this home, throw it in a pot, add some broth, a potato. Baby, you've got a stew going.
I really don't think a movie will do that well. I have watched every episode about 5 times and every time I see something new it seems. To have the show as a 1 season deal will be expensive seeing how some of the folks on the show have better careers now.
My hope would be that they come back for a season and do really well and a network pays them well enough to keep the show going.


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Welcome to the Muppet Central Forum!
You are viewing our forum as a guest. Join our free community to post topics and start private conversations. Please contact us if you need help with registration or your account login. -
"Muppets Most Wanted" Official Trailer
The official trailer for the new movie "Muppets Most Wanted" is now on-line! Watch it now and let us know your thoughts.
Your Thoughts: It's Hard Out Here for a Shrimp
Discussion in 'Muppet Merchandise' started by Phillip, Oct 20, 2008.
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Follow FEMA:
News Releases
Main Content
July 18, 2013
During the April 2011 tornadoes, Prattville, Ala. resident Ty Story took cover in a closet with his wife Becky and their three daughters using a mattress for extra protection."We were about a mile...
Region IV, Alabama
March 5, 2013
The Alabama Emergency Management Agency (AEMA) and Federal Emergency Management Agency (FEMA) are teaming up to promote National Severe Weather Preparedness Week March 3-9. Sponsored by FEMA and the...
Alabama, Region IV
February 5, 2013
ATLANTA – In two days, more than 2.5 million people are expected to participate in the Great Central U.S. ShakeOut earthquake drill.
The ShakeOut will be held Thursday, February 7 at 10:15 a.m. local...
Region IV, Alabama
December 28, 2012
Resolve to be Ready in Alabama, Commit to Emergency Preparedness in 2013! ATLANTA — This year was characterized by extremely active and devastating weather events across the country; flooding in the...
Region IV, Alabama
October 4, 2012
CLANTON, Ala. – Governor Robert Bentley's request for five counties to be added to the President's major disaster declaration for damage caused by Hurricane Isaac was granted Wednesday, Oct. 3, 2012...
September 21, 2012
WASHINGTON -- The U.S. Department of Homeland Security's Federal Emergency Management Agency (FEMA) announced that federal aid has been made available for the state of Alabama to supplement state and...
Alabama, Region IV
September 21, 2012
Following is a summary of key federal disaster aid programs that can be made available as needed and warranted under President Obama's major disaster declaration issued for Alabama.
Assistance for...
Alabama, Region IV
July 24, 2012
ATLANTA – The Federal Emergency Management Agency (FEMA) announced that a grant of nearly $2.7 million will be awarded to the Alabama Office of Water Resources in support of its floodplain mapping...
Region IV, Alabama
July 11, 2012
Birmingham, Ala. earns Discount on Flood Insurance PremiumsATLANTA, Ga. -- On July 10, 2012, Birmingham, Ala. was recognized at its city council meeting for its active participation in the National...
Region IV, Alabama
March 29, 2012
ATLANTA, Ga. -- Alabamians who sustained damage from the January 22-23 storms have less than a week left to register for assistance through the Federal Emergency Management Agency.
The deadline is...


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A Scottsboro High football player will play Friday night despite a three quarter suspension.
On behalf of track and football player Madison Estes, a judge has issued a temporary restraining order.
School officials ordered Estes be suspended three days from school and a quarter of the first football game for a September 5 altercation.
Ten days later, they said he needed to be out a full game.
The family sued, saying college sports scholarships are at stake.
A hearing is set for next week.
Copyright 2012 WAFF. All rights reserved.


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Skip to content
and found 3 items
1151cc, 105bhp, 130mph, Insurance group 13
Modifications to Moto Guzzi's 2011 Stelvio, now called the 'Stelvio 1200 8V' have brought it closer to its closest rival: BMW's R1200GS, than ever before. It's fast, fun, excellent handling and comes with a massive 32-litre fuel tank, giving it a fuel range of around 270-miles between fill-ups. There's also a new NTX 'adventure' version, which costs £1200 extra and ...
1151cc, 105bhp, 125mph, Insurance group 13
The Moto Guzzi Stelvio is well built, sounds great, stylish, easy to handle, comfortable, practical and comes with that historic Moto Guzzi badge on the tank. It's not as focussed as the BMW R1200GS Adventure on road and nowhere as accomplished off-road, but it doesn't take itself as seriously either, it's easy to ride and it comes with an air ...
1151cc, 95bhp, 126mph, Insurance group 13
There are few bikes as comfortable as Moto Guzzi's Norge. Soft suspension and a relaxed riding position lets you take full advantage of its 200-mile plus tank range with no aches or pains, while the loud mechanical Italian exhaust note reminds you that you're riding something with huge character and charm.
Save money by comparing quotes. It's quick and easy
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Getting Started with F# and Mono on OSX
My doctor told me to take it easy over my winter break after a recent injury. I'm utterly incapable of taking it "easy." He did expressly forbid me from working on my home improvement projects for a month. However, he did not say anything about giving my brain a good workout, even though that's the part I physically injured. So I thought it might be fun to learn another language and to do some of the cross-platform game development that I've been thinking about for the past couple of years…
F# looks interesting. It's a strongly typed functional language that is also focused on object-orientation and the asynchronous (threaded) programming tools are being backported to C# in C# 5.0. It seems like it'd make a lot of the (hopefully) asynchronous AI and world generation programming that an infinite-world RTS requires somewhat simple. Since there's GTK# bindings available to make basic UI chores easier, I'm wondering if it's possible to do some moderately complicated game development in it. Initial research indicates that this is definitely the case, and there are some people working on it.
I've seen a few other tutorials, but they don't seem to be using the most recent version of MonoDevelop. Getting started with F# is now insanely easy on OSX as of MonoDevelop 3.x.
Note: This will install F# 2.0 — apparently F# 3.0 is available if you instead install the Mono Project 3.x+; since I had MonoDevelop install it and was running the 2.x (stable) branch of Mono Project, I got F# 2.0.
- Install the Mono Framework From the Mono Project website and install it.
- Download MonoDevelop (I used 3.0.5) from the MonoDevelop download site
- Install the app and run it.
- Click MonoDevelop->Add-In Manager
- Click Gallery, and expand Language Bindings
- Click F# and Install
After the install runs (it took about thirty seconds), you can select F# projects from the new project tool, and the fsi, fsc, and other command-line tools are available and work well.
Hardware Vendors Suck AGAIN
In the past, I've talked about how we've had problems getting hardware from major vendors to live up to it's specifications and intended use, and to get the vendors to support and fix problems with the hardware that they ship us.
It's just bitten us in the ass again.
HP's current generation of DL580 and DL980s will not boot with a bad DIMM or DIMM slot. Period. Even with RAM mirroring enabled. There is no option in the UEFI menu to bypass it, and there is no option to boot anyway, even if you have RAM "Pairing" enabled. There is, in fact, no way to boot at all if you have a bad DIMM in a slot, even if the DIMM is good and the slot is bad.
HP support, after two days of phone calls (aka "wasted time") insists it works. They finally dispatched a technician, who proved it didn't work and there was no way to make it work. Ball in HP's court. We don't expect to see the ball back any time soon.
Our $30,000 HP boxes won't boot (and we've had a DIMM failure in the same slot in two machines now), but the $4,000 Supermicro ones will still boot. Guess which ones we'll be buying more of?
The wife of a person who I wish I could count as a close friend has passed away, leaving Kris the single father of three young children who will grow up without their mother. I'm not even sure that words can describe how I feel at this point — I'm part of a small family that is not used to bereavement.
A bit of unwritten PHP/Symfony history: I hired Kris in late 2004 to be a part of the contracting company I was running at the time. It was immediately obvious he was a better programmer (and better person) than I was; it was also immediately obvious that I was a better programmer than I was a business owner — that is to say, I sucked at both roles. The company quickly folded, and I had to lay off Kris. The mayfly of a company was the first exposure that Kris had to the kind of mess that in-house developed PHP frameworks could be.
After I'd had to fold the company, Franya still invited me into the home she, Kris, and Sadie (at the time, a newborn) shared. They stored some of my furniture in their basement for a year until my family could come pick it up. I was too ashamed of myself to pick up my own possessions.
Tonight is my own personal wake for Franya. I remember the times that she tolerated the nickel poker games that Kris invited people over for, I remember her cheering on her father-in-law's bottom-ranked indoor soccer league team as if it was the next incarnation of the Timbers. There were holes in the floor of the bathroom where the toilet was supposed to be in their home, but there was never a tattered heart in Kris and Franya's home until tonight.
Rest well, Franya, we will remember you.
SATA/SAS RAID Cards Don't Perform
We've got a little project running to build out our new cloud environment. More on that later. The first problem is the hardware, which is left over from another project. Except that project never bought RAID cards for the hardware, even though they did buy disks.
The enclosures are 2u SuperMicro machines that support 12 3.5″ disks, but require low profile expansio cards. The disks are 1TB Western Digital WD1001FALS. We have this new policy of testing hardware before we put it into production to make sure that something isn't seriously wrong with it, so we started out by benchmarking single drive performance on the crummy onboard IC10H SATA controller.
Our testing methodology is basic. We're using fio 1.58 and running a mixed read/write across 1GB of files, in order to exceed any cache. 8 of the drives will be in a RAID0 (yes, I know, but we're basically doing RAIM — Redundant Array of Independent Machines and it doesn't matter if we lose a drive…) and the remaining 4 drives will be used for various system tasks. As a result, we evaluated 16, 12, and 8 port cards — we can have the 4 drives used for various cloud system tasks on the onboard, and the bulk storage on the 8 port card, and tried to evaluate one from each major manufacturer where we could.
We used this FIO configuration file for the testing.
Many thanks, by the way, to Joe of Scalable Informatics fame, who helped me with the mostly undocumented fio configuration and interpreting the results. The intent was to really load down the system, as we'll occasionally see performance at it's worst while we're rebalancing GlusterFS nodes.
All drives as tested were formatted with XFS, and XFS was given the proper parameters to match the RAID stripe size, block size, and RAID member count. Stripe size did not affect performance, and misconfiguring XFS only knocked a few MB/S off of the performance. The systems being tested were based on Debian Squeeze or Wheezy.
The bare drive performance was … barely acceptable. These drives are just not fast. We have several hundred of them sitting around unused at this point, but they're just not fast. I'm aware of this, and aware that if I wanted faster drives, I would need to … buy faster drives. That doesn't change that the results of the single drive on the on-board IC10H were faster than a hardware RAID0 array, independent of card manufacturer. As expected, a RAID0 of four drives on the motherboard did perform better than the single drive.
The number to pay attention to here is the "aggrb" number, which is the Aggregate Bandwidth (I'm assuming average?) of the Read and Write performance.
Single Drive
Run status group 0 (all jobs):
READ: io=3899.1MB, aggrb=43205KB/s, minb=5389KB/s, maxb=6518KB/s, mint=79407msec, maxt=92432msec
WRITE: io=3854.2MB, aggrb=42698KB/s, minb=5411KB/s, maxb=6329KB/s, mint=79407msec, maxt=92432msecDisk stats (read/write):
sdb: ios=11269/116, merge=0/4, ticks=990700/7375576, in_queue=11339444, util=99.99%
four-drive md RAID0 on motherboard
READ: io=3865.4MB, aggrb=58034KB/s, minb=7693KB/s, maxb=8684KB/s, mint=56725msec, maxt=68203msec
WRITE: io=3888.4MB, aggrb=58379KB/s, minb=7188KB/s, maxb=9407KB/s, mint=56725msec, maxt=68203msec
Disk stats (read/write):
md3: ios=14434/6379, merge=0/0, ticks=0/0, in_queue=0, util=0.00%, aggrios=3608/1532, aggrmerge=0/18, aggrticks=174913/2779239, aggrin_queue=3007156, aggrutil=98.52%
sdb: ios=3610/1599, merge=0/15, ticks=162252/1948784, in_queue=2111332, util=91.81%
sdd: ios=3622/1615, merge=0/19, ticks=158384/1409576, in_queue=1568244, util=88.70%
sde: ios=3621/1452, merge=0/23, ticks=210640/4865588, in_queue=5220932, util=98.52%
sdf: ios=3581/1465, merge=0/18, ticks=168376/2893008, in_queue=3128116, util=96.82%
Now, on to the hardware cards.
HighPoint RocketRaid 2740
RAID0, 64kb stripe
Run status group 0 (all jobs):
READ: io=3837.8MB, aggrb=29420KB/s, minb=3727KB/s, maxb=4083KB/s, mint=122403msec, maxt=133571msec
WRITE: io=3903.0MB, aggrb=29921KB/s, minb=3672KB/s, maxb=4227KB/s, mint=122403msec, maxt=133571msecDisk stats (read/write):
sdb: ios=61319/953, merge=0/6219, ticks=7324792/16807752, in_queue=24753304, util=100.00%
Wow! Just to be on the safe side, I put the card in JBOD mode and ran a test against a single disk.
Run status group 0 (all jobs):
READ: io=3928.8MB, aggrb=41145KB/s, minb=5176KB/s, maxb=6050KB/s, mint=85203msec, maxt=97775msec
WRITE: io=3822.0MB, aggrb=40027KB/s, minb=5062KB/s, maxb=5900KB/s, mint=85203msec, maxt=97775msecDisk stats (read/write):
sdc: ios=62770/523, merge=0/3073, ticks=5474732/8123704, in_queue=15781220, util=99.99%
That's a bit slower, but pretty much rules out the cable or drive being tested — it must be the logic of the card or the driver that's causing the slowdown.
LSI / SuperMicro AOC-USAS2LP-H8iR
While this card was fastest, we couldn't get a solid result from FIO no matter how dumbed down the configuration we gave it. The test would run overnight before it finished with an error, after one of the 8 threads was consistently writing to/from disk. I'm not sure if this was a bug in FIO or a bug in the LSI/SuperMicro card, but SuperMicro's support was so stellar in pointing fingers at LSI that we never resolved the problem. LSI, in turn, referred us to SuperMicro, saying they held no responsibility for cards purchased through the third party. It's interesting to note that we could reproduce similar results by using LVM striping across 4 drives on any other card. We had so many problems with this card's BIOS (which has a Windows 3.1-like shell as a configuration tool and doesn't support USB mice) and drivers (wouldn't support Debian Wheezy or Linux 3.0) that we just gave up on it.
Areca 1880ixl
Run status group 0 (all jobs):
READ: io=32206MB, aggrb=36641KB/s, minb=4585KB/s, maxb=4788KB/s, mint=900006msec, maxt=900035msec
WRITE: io=31983MB, aggrb=36387KB/s, minb=4534KB/s, maxb=4796KB/s, mint=900006msec, maxt=900035msecDisk stats (read/write):
sdd: ios=108411/106883, merge=0/515, ticks=9122710/8694050, in_queue=17816860, util=100.00%
Out of all of the cards, I liked Areca's drivers and management interfaces the best.
Adaptec 6805
Run status group 0 (all jobs):
READ: io=3906.8MB, aggrb=41960KB/s, minb=5380KB/s, maxb=5783KB/s, mint=89043msec, maxt=95339msec
WRITE: io=3847.9MB, aggrb=41328KB/s, minb=5085KB/s, maxb=5782KB/s, mint=89043msec, maxt=95339msecDisk stats (read/write):
sdd: ios=19236/19941, merge=0/965090, ticks=1565890/1470100, in_queue=3035980, util=99.96%
Since this card came closest to the single drive performance, we ended up choosing it.
My methodology here is lacking. The few variables that I could control for were different machines/motherboards of the same model, two different cards from the same manufacturer, different 1TB drives, and multiple runs of tests. We ran tests in RAID5 as well. I didn't publish the RAID5 results here as they were superfluous; just knock 10mb/s or so off of the RAID0 time and you've got the RAID5 time. We tried different stripe sizes and different filesystem configurations; with explicitly aligned partitions and without. Nothing seemed to make a difference.
I would expect that any RAID0 array would be faster than a single disk. I would further expect that any cache would improve the performance, even in a heavily loaded random read/write environment. These expectations were proven false. I'm not sure why this is, unless no one else has truly measured performance in a random read/write environment, and people mostly rely on benchmarking tools like bonnie++ that aren't as brutal about keeping queues flooded and randomizing I/O.
If I were working in a real hardware testing lab, I would move on to test these cards with different motherboards, backplanes, and drives. Unfortunately, I'm not — and this article is the result of 3 months of testing, ordering another card, testing again, tinkering with settings, reading obscure mailing lists, tinkering further with settings, and finally ordering another card in exasperation. I'd welcome someone else's reproduction or refutation of these results with their own hardware, drives, and cards, a critique of my fio configuration and methodology, and suggestions on optimizing the other variables for improved performance.
Stephen Foskett is running a series about server blades — and as usual for someone who gets a lot of trial equipment to review, he's pretty bullish on them.
After a few years with blades at my current company, I'm not. Unless you need the density that they offer, they're probably not worth your time and money — and if you can afford them, you can probably afford to lease another rack or a larger cage.
While Stephen does an excellent job of covering the high points of blades, he skips or glosses over the downsides. The downside is that you re-introduce several single points of failure in the form of the backplane and modules that are plugged into the chassis, and extra management overhead of switches attached to the backplane, and add risk of heat because of the miniaturized and densely packed nature of the components.
Think this is doom-and-gloom? We've got a bunch of hardware sitting in a pile that says it isn't. One of our IBM BladeCenter chassis has only one slot that will work in it — the rest of the slots give you strange PCI bus errors, KVM won't work, or the management module will fail to connect to the hardware that's installed properly. Since the blade's backplane and management modules are a part of the chassis, IBM declined to replace it under our parts-and-labor warranty agreement — they said that we'd have to replace the entire chassis at our cost since the chassis is not a Field Replaceable Unit.
Troubleshooting problems with parts or upgrading parts on individual blades is a chore. Again, many of the parts aren't technically Field Replaceable Units (and this includes parts like on-blade flash disks), so you'll need to get out your oddball collection of Torx heads. It's like laptop repair, with fine ribbons and cooling ducts stitching together byzantine layers of circuit boards. And let's add another negative in — even if you cool the systems appropriately and your cooling systems aren't overloaded and don't ever overload, you still face heat death problems after the term of a normal warranty. Many higher ed institutions are starting to buy on a five year lifespan instead of the traditional three year lifespan, so high density systems like blades or thumpers are not an advisable solution there.
Many blade chassis are limited on expansion module space. Depending on your I/O configuration, you need at least six expansion slots to have some semblance of redundancy — two management modules, two I/O bus (Fiber Channel, Infiniband, 10gbE, SAS, etc.) modules, and two switch (ethernet) modules. The IBM BladeCenter S and E chassis options only support four modules. The higher end newer options, H and HT, support four high-speed and four legacy — keep that in mind when you're thinking about expanding. Most of the modules only support six ports, which means that you'd need three modules (high speed slots only, of which you have four!) to support a single full-bandwidth fiber channel connection to a server in each of the 14 bays in an BladeCenter H-series — with no redundancy, and no way to expand further. For environments that need both Fiber and Infiniband, you're pretty much out of luck.
Let's not forget that each of the modules usually has a management interface of it's own. The fiber channel modules have a console that you need to manage separately from any other fiber channel interfaces you might have. The switches have a cisco IOS-like interface to them, unless you buy actual Cisco modules for your blade center. Why's that a hassle? Keep in mind that you need to manage VLAN and trunking assignments and limits on both your core switch and your blade center's switch.
So: High-bandwidth environments need not apply, since shared connections are the rule instead of the exception. Environments where an addition or switch to a new technology might be managed by adding three or four PCI cards to the affected servers need not apply — your chassis won't have room for it.
For all of those "Features", you gain the ability to save some floor space … and you pay a lot more.
Let me introduce to you a new technology called the "40 blade server" — you take a 42U rack, set up appropriate power modules on it, and then plug 40 1U servers and a pair of switches in at the top. Sure, there's a bit more wire, but that's easily managed. The 1u servers are individually less expensive than server blades and have a host of nice features — such as independent KVM and individual expansion card slots — that you won't find in any blade server.
Admittedly, one place we have been very happy with "Bladed" components is our Cisco routers. The ability to hot swap modules and fail between modules is nice — but it's something that we could manage without; it's simply a better way to do things in the Cisco world since the price differential isn't that high and the equipment lifespan is closer to ten years than to three.
But for compute? Heck with that. I see very few environments where blade centers are a good solution compared to a rack of 1u servers.
Dad and I are both hobbyist renovators. Dad has been doing it for about thirty years longer than I have, though, and is a LOT better at it than I am. When I bought my house, he sent me a list of products and notes on them. I'm re-posting here, with some of the discussion edited out, for posterity, reference, and linking purposes. I actually keep a text copy of the entire thing on my phone for reference when I'm away from the internets…
We have a saying in my family — "Ask me how I know!" — which usually means that we've screwed something up, bought the cheaper tool or the cheaper product, and ended up regretting it. Each and every one of the below points can be followed with "Ask me how I know!" from personal experience, because I don't always believe good ol' Dad either. The below is in completely random order.
- Spackle: MH Ready Patch – Spackle is used for small repairs to drywall, such as picture holes or where you've pulled out a molly/plug. MH will stick to lots of things and will harden up well without sagging. It's solvent based, so it won't cause problems with oil finishes and can be used on both wood and drywall.
- Caulk: Two products. Polyseamsealis available at Lowe's and Home Depot and many other places. Unfortunately, Loctite recently bought the parent company, Henkel (also makers of the much beloved PL Premium), so the tub/tile stuff is no longer available in matte and they may have changed the formulation. Outside, we use Sashco Big Stretch Caulk & Seal, 10.5-Ounce, which is pretty amazing stuff. It's the most elastic caulk I've ever seen, but you really have to fill a crack in it — and larger cracks fill better unless you can sort of 'glue' the two pieces together. I especially like to use it on Hardi Board/Panel, which shifts a lot in the Texas heat. Once it dries, though, it can only be removed with lacquer thinner, if that.
- Paint: Benjamin Moore. Super Spec is contractor crud, I use a LOT of Regal Aquavelvet, and Aura is amazing with dark or highly pigmented colors. We use Satin Impervo (oil) on trim. I have recently had decent experience with the HGTV and Duration lines of paint from Sherwin, but anything except their top of the line has performed poorly for me both in application and over time.
- Wire Nuts: Use only wire nuts with springs in them, like the tan Ideal ones available at Home Depot. Don't buy the cheaper mixed bag of Buchanan ones with the different sizes/colors… you'll spend more time dropping them or having them fall off in the j-box than you will actually screwing them on to wires.
- Screws: Don't use drywall screws for construction, fencing… or really, anything but hanging drywall. For construction, I put everything together with screws because it makes it WAY easier to take apart later. I've done several structural changes to my house and used SPAX screws to hold interior framing together. (I typically use 2 inch or 3 inch screws.) For fences or decks, use fencing or decking screws.
- Paint Brushes: We tend to use Purdy brushes. Remember that you use different brushes for latex and oil; I don't trust the "all purpose" ones to leave a clean line. My personal favorite brush is a Purdy Cub XL 2″ brush. Wooster brushes are also OK, but I don't like them anywhere near as much as I like Purdy brushes. Clean them well and they'll last you a long time.
- Drop Cloths: We put a 3-4 mil plastic drop cloth down with a canvas drop cloth over it. Why? Because without the plastic, the canvas will let the paint soak through. And without the canvas, when you spill or dribble some paint, you will step in it and then track it all over the rest of the house. Ask us how we know…
- Extension cords: Don't get the cheap 14 or 16 gauge ones. Spend the money for a decent 12 gauge one. You can't pull enough amps down a 14 gauge one in most cases for the tool to perform properly, and most power tools worth the name are going to pull 10-15 amps under load, not to mention any spikes or high draws.
- Sand Paper: Don't bother buying Gator. They're garbage, even the "higher grade" black stuff… the grit doesn't last long enough and the paper loads up far too easily with dust and other leavings. I have had really, really bad luck with Norton discs leaving horrible dual action orbiter marks because of the "universal" five hole/eight hole design. The Dad-approved product is Mirka sandpaper.
More blog posts along this line coming down the pipe…
RHEL 5 supports XFS out of box
I was trying to figure out how to get XFS working on a RHEL box at work so that we could store more than 16TB on a filesystem, and found Gianpolo Del Matto's excellent XFS on RHEL tutorial.
And then I found out that most of that mucking around in the kernel build process isn't necessary.
RHEL5 u6 (at least my copies — note that I have the -xen kernel packages installed, which might affect things) actually has the XFS kernel module in /lib/modules/kernel/fs/xfs — it just doesn't have the xfsprogs package, and the xfsprogs package is not available via any supported means. I downloaded the xfsprogs srpm from the XFS project page and used rpmbuild to build and install it myself.
Does anyone else in this day and age find it ridiculous that Redhat does not support filesystems larger than 16TB without some form of hackery? I can buy that much disk storage at my local Office Depot.
Note that I'm pretty sure that the mount option 'inode64′ is required if you're over 16TB, and that 32-bit NFS clients do not like the inode64 option one tiny bit.
The Economist has had a bunch of articles recently about legal reform and how necessary, but unlikely, it is.
One of the things I love most about science fiction is it's ability to take an idea like "legal reform" and extrapolate it into a meaningful, personal story to illustrate the need for changes. How would you explain to your ten year old daughter why someone is suing her for the things her ancestors did? Or why she can't sing along out loud without permission? How would you like it if your baby was sued before he or she was born? If the lawyers get their way, that's our future.
1 1/2 years as a homeowner and…
So far, in one and one half years as a homeowner, I'll have spent $25,000 (about 1/5 of my home's purchase price) on repairs and maintenance.
That only includes receipts that I've kept; I have no clue how much I've actually spent. Triple the figure if I'd had to include labor costs.
It makes me sick to think that people who bought in stupidly at a peak and don't have steady employment are getting breaks. Shouldn't people who work hard successfully get rewarded?
(This post brought to you by NeatDesk, which has managed to collate and report on an unbearable number of receipts in the past few weeks.)
Lesson to all the kids in the audience: Homeownership isn't for everyone. If you're not willing to lift a hammer and you have no savings, it's a trap you'll never get out of.


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This title in other editionsThe Sartorialist: Closerby Scott Schuman
Synopses & ReviewsPublisher Comments:After the enormous success of The Sartorialist, Scott Schuman is back with a completely new collection of beautiful images of the men and women who have caught his attention. His much-loved blog, thesartorialist.com, remains one of the most-read in the fashion world and continues to grow in popularity as Scott travels further and more widely. This book emcompasses the diverse style and visual attitude of people as far afield as Japan, Korea, London, Milan, New York, Paris, and beyond. In The Sartorialist: Closer, Scott Schuman looks deeper and with great breadth at human style, and the way it is expressed across the world. Always reacting to an inspirational moment, the images in his new book continue to reflect Scott's unique sensibility and vision. Available with two different covers: one featuring a woman, the other a man. About the AuthorScott Schuman started The Sartorialist simply to share photos of people on the street that he thought looked great. The blog now receives more than 14 million page views per month. His work resides in the permanent collections of the Victoria & Albert Museum and the Tokyo Metropolitan Museum of Photography and has been featured in GQ, Vogue Italia, Vogue Paris, and Interview. He lives in New York City with fellow style blogger Garance Doré, with whom he was awarded the CFDA Media Award in 2012. What Our Readers Are SayingBe the first to add a comment for a chance to win!Product Details
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Mini Easter Baskets Recipe
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1 pkg | refridgerated sugar cookie dough |
1 bottle | colored sugar crystals |
1 pkg | fresh coconut |
1 bottle | green food coloring |
1 pkg | speckled jelly beans |
2 small | mini muffin pans |
1 pkg | pipe cleaners |
The Cook
Nettie's notes for this recipe:
I made these for the kids but the adults took them over...They are so cute and very yummy
Make it Your Way...
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Spray mini muffin pan with Pam throughly. Roll each cookie dough in colored sugar and place each one in the mini pan. Bake at 350 for about 15 mins. when they puff in the middle touch the middle with a spoon and it will fall . That makes the well you will need. Don't overbake..Bake just until you see the edges turning brown and the center doesn't look done.
Take out of oven and let them cool for a couple of minutes..Leave them in the pan while finishing the other steps. Bend the pipe cleaners and carefully put in each cookie while warm. (when they cool pipe cleaners will stay put)
In the meantime put some coconut in a plastic bag and add the food coloring. Shake until the coconut is covered with the coloring.
Take pinches of the coconut and put in each cookie dough basket and then put in 3-4 speckled jelly beans in each one.
Just move the cookie around a bit and it comes right out. These make an adorable Easter Basket
About this Recipe
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Karen Patricia Leary
Mar 29, 2011
Love this! I am also going to make these for Easter. Somehow, we all become kids again when something like this is brought to the table. It reminds me of many years ago, when my mom would make the crystal sugar eggs and her home made Easter Baskets...
Tina Baker
Mar 29, 2011
Can sugar cookie mix be used instead if sugar cookie dough in a roll?


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top ten fights u DON'T want to see, have at it... |
top ten fights u DON'T want to see, have at it... |
Sep 20 2012, 08:48 PM
Cruiserweight Group: Members Posts: 5,773 Joined: 20-May 11 From: killa kali Member No.: 12,336 |
pac/jmm donaire/nishioka canelo/mayorga...or any other past it or underweight/overmatched opponent to be continued.... (IMG:style_emoticons/default/laugh.gif) This post has been edited by daprofessor: Sep 20 2012, 08:50 PM |
Sep 21 2012, 03:42 PM
Super Middleweight Group: Members Posts: 3,210 Joined: 18-August 11 From: Golden State of Mind Member No.: 13,079 |
Any klitschko fight unless it's against each other. By the way I have a quick question for everyone that said they don't want to see Martinez vs mayweather. I know all your reasons were because of the weight difference. So is it that Martinez will be just to big and end up just beating the shit out of Floyd easily? If yes then I can understand why you don't want. But I see it being competitive and a good fight reguardless of weight. Floyds a master and would make it competitive. And for that I'd love to see that fight. Do y'all ever want to see Floyd test himself mentally and physically in a situation where the outcome isn't obvious and he has a huge chance at losing? I think it remains to be seen if martinez can make the weight effectively at this point in his career. I think the reasoning behind most people not wanting to see martinez vs floyd at 154 is that it has the potential to turnout to be like dawson vs ward or josesito vs canelo ( either drained or too big). Doubt that people just dont want to see floyd tested mentally. You could argue that he was tested mentally against cotto and maybe thats why hes in no rush to come back boxing. I like franchize statement about there being plenty of competition at 147 that could potentially test floyd, because im not at all sold on alvarez until he fights someone who is actually his size and ranked in the top ten. IF alexander wins im certain were gonna hear pac/floyd come out of his mouth This post has been edited by checkleft: Sep 21 2012, 03:43 PM |
Lo-Fi Version | Time is now: 12th March 2014 - 11:12 AM |


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Wednesday, 22 February 2012
brightening the blues
Matalan dress, Betsey Johnson tights, Clarks shoes c/o Sarenza
I always think blue makes an apt outfit for a Monday, and the one just gone proved to live up to it's reputation with general chaos and all round confusion at work! I love these tights but forgot just how much attention they attract until I was walking by a main road on route to work and a couple of cars slowed down as they passed.
I hope everyone enjoyed pancake day! I went, sadly, without due to lack of planning and general laziness! What was the best topping you tried? I'm wondering which reader set a new record of number of pancakes eaten?! And now we're on the countdown to Easter (bring on the mini eggs and malteaser bunnies!) what have you given up for Lent, if anything?
39 comments:
Loving the dress, gorgeous shape and colour.
n didn't get pancakes either, because I was at uni until 2100, but because we're heathens and don't observe lent, Dad promised to make me some tonight. My favourite all time topping- cherry pie filling (from the tin, naturally) and possible a drizzle of chocolate sauce or a tiny amount of vanilla ice cream.... or, orange marmalade is great, or y'know... good old lemon and sugarI adore your tights! I would definitely stop and look at you too! x
Ella @ Belle Vintage
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Observation Status Costly for Hospitals
And while the Centers for Medicare & Medicaid Services has proposed a rule change in which the hospital could submit claims for inpatient care for those patients who justifiably spend at least two midnights in the hospital, many worry that it won't be enough to resolve concerns. That proposal would take effect in October.
A patient rights organization, the Center for Medicare Advocacy, has filed a lawsuit against the federal government seeking an end to observation status altogether.
The dollars lost to hospital revenue isn't the only downside.
Observation status creates tension and sours relationships between hospitals and their patients, who are surprised to learn that because they weren't considered inpatients, they aren't covered under Medicare Part A, and instead must absorb a 20% share of costs for their care under Medicare Part B.
Patients also aren't eligible for Medicare coverage for expensive skilled nursing facility care they may need after discharge unless they meet Medicare's inpatient criteria for at least a three-day stay, although a bipartisan bill seeks to fix that problem as well.
"We still have a lot of patients who are being financially hurt by this rule," Sheehy says. "Patients come in and have a much larger out-of-pocket bill, because Medicare Part B doesn't cover them, and they're not eligible for nursing home coverage, even though they're in the hospital for at least three days.
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A Concerned Compliance Professional (7/12/2013 at 3:20 PM)
Dear Ms. Clark, I am certainly thankful that someone is paying attention to this crisis in America's hospitals and the inequality it has [INVALID]d with Medicare Fee Schedules and reimbursement patterns. There is an aspect of observation status that is often overlooked. The idea that a patient in observation should cost less, is a CMS derived fantasy. To a nurse caring for a patient in observation status, there is no difference in the care, treatment, resources or costs to the hospital provider. The patient is admitted to the same bed regardless of their admission status of inpatient or observation. Most bedside nurses and care providers know that the patients status is observation but they don't know what that means. To an organization, as stated above, the patient is still "admitted" though it may be "observation", the patient still receives care from any and all providers that are necessary to improve the patient's condition; including expensive diagnostic radiology procedures, medications, respiratory therapy procedures, physical or occupational therapy etc. The observation status patient receives the same compassionate care and respect of any other patient. The rubber meets the road as you mentioned when it comes to CMS reimbursement. But what was not mentioned is that while the patient is admitted to "inpatient observation" hospital providers must also spend thousands of dollars to hire and train staffs to "carve-out" the number of minutes or hours that the patient may be away from his or her bed to receive the expensive tests and procedures mentioned above. Not to mention that hospitals are not permitted to count inpatient observation patients in the daily census. This [INVALID]s another "ding" when the cost reports, average daily census, case mix index and other financial data is reported. In addition, CMS has been trying to "fix" this "short-stay" debacle for a number (many) of years. I remember in the 90's as an ER nurse, transcribing telephone orders from a physician. The physicians were frustrated then because they continued to be confused with the rule's revisions. CMS's many changes to the rule has [INVALID]d physician admitting orders to be defied because the physician did not write the order "precisely". Meaning, the rule changed and the "new" admission order had to change. Observation has been called such things as admit for 24 hours, 24 hour admission (even though the patient may stay up to two days), observation and admit to observation. CMS obviously recognized that observation status, may not actually mean twenty-four hours or less. It is noted in your report that patients may actually stay for two or more days. I propose to aks every Medicare beneficiary or their loved ones; caught in the "observation status"-hospital stay, if their care was any different than a previous "real" inpatient admission. How do you tell a 90 year-old widowed patient that their overnight hospital stay for uncontrolled high blood pressure did not qualify him or her and therefore they are now responsible for 20% of the charges and 100% of the self-administered drugs. As you can see, Ms. Clark, the issue of observation reaches much farther and into every crevice of our infrastructure. Thank you very kindly for reporting on this subject.
Tyco Brahe (7/12/2013 at 11:54 AM)
Observer status is a way for hospitals to skirt the rules on readmissions so their numbers looks better than they really are and the hospitals don't incur penalties. Patients get angry because they have to pay a large part of the bill (using Medicare Part B) instead of Medicare Part A.
Mary P. Malone (7/12/2013 at 11:21 AM)
I am wondering if placing recently discharged patients in observation status helps keep "readmission rates" lower?
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