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Young's Literal Translation (YLT) | New International Version (NIV) |
11 Who [is] like Thee among the gods, O Jehovah? Who [is] like Thee -- honourable in holiness -- Fearful in praises -- doing wonders? | 11 "Who among the gods is like you, O LORD? Who is like you--majestic in holiness, awesome in glory, working wonders? |
Young's Literal Translation is in the public domain. (Young's Literal Translation - The Bible Online) | Scripture quoted by permission. Quotations designated (NIV) are from THE HOLY BIBLE: NEW INTERNATIONAL VERSION®. NIV®. Copyright © 1973, 1978, 1984 by Biblica. All rights reserved worldwide. (New International Version Bible Online) |


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Hey All!
First off, I realize that the Uncle Mike's Open Top Holsters may not be the best holsters on the market, but I have had good experience with them for other firearms for OWB carry. My question is, does anyone know if a full-size (4") SA XD-40 with CT laser grips and fiber optic sights (taller than standard) will fit in that holster? It's a tough question and I don't have one locally I can look at, so I am hoping someone on here has done this before and can tell me what the clearance looks like.
Thanks a lot!

subset: commoncrawl


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The Webster Bible (WBT) | New International Version (NIV) |
16 And that he might reconcile both to God in one body by the cross, having by it slain the enmity: | 16 and in this one body to reconcile both of them to God through the cross, by which he put to death their hostility. |
The Webster Bible is in the public domain. (The Webster Bible Online) | Scripture quoted by permission. Quotations designated (NIV) are from THE HOLY BIBLE: NEW INTERNATIONAL VERSION®. NIV®. Copyright © 1973, 1978, 1984 by Biblica. All rights reserved worldwide. (New International Version Bible Online) |


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menu servings:4
T his saucy supper gets a double dose of fennel flavor from ground seeds and a sliced bulb of fresh fennel.
Splurge on the tomato sauce to make this dinner a standout. A better brand may cost a few extra dollars but it will make all the difference.
back to Dinner Rush: Week of April 7
28 reasons why doughnuts (and doughnut holes)baked or fried, glazed or dustedare perfect morning, noon, and night
plus: everything you need to know about making doughnuts at home ›
Get the inside dish on 10 restaurants Parisians don't want you to know about
plus: Over 1,300 recipes à la Française to cook at home ›


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Arizona schools chief Tom Horne has reignited a bitter, decade-old debate over how much school choice should cost the state's taxpayers by stumping for charter schools to get millions extra from the Legislature.
Newly re-elected, Horne announced last week that next year he will push state lawmakers to grant charter schools 15 percent more funding, totaling $78.5 million. The additional cash flow is needed to bring funding for the privately run public charters in-line with traditional public school districts, Horne said.
The proposal has drawn complaints from school choice advocates, who contend charters are supposed to offer a better education for less money than the districts do.
"It was never really, in my mind, understood that (charters) would necessarily have equal funding in every capacity because that wasn't what they were asking for at the time," said Rep. Mark Anderson, RMesa, of the argument behind allowing charters to begin operating in 1995.
Despite his reservations, Anderson agreed to sponsor the legislation at Horne's request. School districts' supporters have criticized Horne over the state Department of Education study used to justify the proposed increase.
The study was to provide an "apples-to-apples" comparison of taxpayer dollars given to districts and charters, said Lyle Friesen, school finance director for the education department.
However, Friesen acknowledged that many of the numbers used are purely theoretical, calculated to try and bridge the gap between two hugely different funding formulas.
The study indicates the state pays out more per student to charters than it does to districts. A disparity slighting charters emerges only when districts' voter-approved capital bonds and federal dollars are included in the calculation.
"It's very misleading, what they've put together there," said Chuck Essigs, lobbyist for the Arizona Association of School Business Officials.
Horne defended his proposal and the study, arguing the state is responsible to ensure all schools receive funds equally, regardless of where the tax dollars come from.
"My job is to maximize the educational benefit for the students," he said.
In the 11 years since a change in state law opened the door for charters, Arizona has become a national model for the good and bad that school choice brings. Almost 500 charters now operate here, educating roughly 90,000 students — 10 percent of all public school students.
The charters are a mix of nonprofit and for-profit companies, with curriculums ranging from back-to-basics to performing arts.
Charters annually boast some of the top scores on Arizona's Instrument to Measure Standards.
There have also been highly publicized failures, particularly in the first years when those opening charters enjoyed little oversight.
Some charters went bankrupt or folded due to gross mismanagement and fraud. The state Auditor General just two years ago condemned the Arizona State Board for Charter Schools for faulty oversight.
Now, Arizona's laws better protect against misconduct and, overall, outside analysts and state officials say school choice has been successful.
A Tribune review of this year's AIMS math and reading scores found that, on average, charters score marginally better than district schools.
Success has brought charters growth, but not enough funding to build facilities to meet their needs, said Tom Dorn, a lobbyist for the Arizona Charter School Association.
Districts can ask their taxpayers to approve bonds and budget overrides to pay for new buildings and renovations. Charter operators must rely on their yearly allotment from the state or take on debt.
"(Parents) don't have choice if you don't have adequate funding and quality in public charter schools," Dorn said.
School choice proponents said they agree with that sentiment, but added that governments are supposed to see their costs drop when private businesses take over.
Part of charters' appeal was their inability to levy property taxes to cover hundreds of millions of dollars in construction on top of regular education spending, said Kevin McCarthy, president of the Arizona Tax Research Association. That is lost if the state hands the charters millions every year to make up the difference.
"We should adequately fund charters, but I do think there should be some recognition of the fact that when charters were created, part of the incentive was they were gonna save taxpayer money and be a better deal," McCarthy said.
The local real estate market makes that unrealistic, Dorn said.
In 2005, Valley property values jumped as much as 50 percent, pricing out many first-time home buyers and small business owners.
The charters are entitled to millions more in funding to secure facilities and equipment that will allow them to compete with districts, Dorn said.
At the Tempe Preparatory Academy, Headmaster Ronald Bergez said his liberal arts high school's facilities require some renovation.
But if the extra funding comes through, Bergez said he would have to put it into teacher salaries to keep his employees from moving to other schools with better pay.
The solution to charter schools' funding woes, Bergez said, is for the state to allow the businesses to band together and seek voter approval to sell bonds. "It'd probably take a raft of attorneys to get it done," he said.
Horne and Dorn argue the additional charter cash should come from the state's General Fund, not a new tax.
Dorn characterizes it as a civil rights issue, with some public school students receiving less because they did not remain in district schools.
However, a number of poor and rural school districts have been unable to win voter-approval to sell bonds and therefore receive fewer dollars per student than charters.
While Dorn said that disparity is significant, correcting it is not his focus.
"That's not my issue," he said. "I don't represent districts."


text: Why are there miles and miles of "unused" DNA within each of our bodies? Why should a bee give up its own chance to reproduce to help raise her sisters and brothers? With a prophet's clarity, Dawkins told us the answers from the perspective of molecules competing for limited space and resources to produce more of their own kind. Drawing fascinating examples from every field of biology, he paved the way for a serious re-evaluation of evolution. He also introduced the concept of self-reproducing ideas, or memes, which (seemingly) use humans exclusively for their propagation. If we are puppets, he says, at least we can try to understand our strings. --Rob Lightner


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Goodbye, Mr. Ruby Tuesday.
That's NOT ka-blamo.
And he's left to do… a sitcom on BBC3? K. I mean, sure, it could be dynamite, but BBC3 is the British equivalent of [a really terrible channel, idk if you have those in the US].
It's kind of confusing bc SNL has never been remotely near a thing here so Sandberg will be like [a really obscure person] appearing opposite the dad from 'The Inbetweeners'.
Feels like Mike Myers being on the Timmy Mallet show only not.
I don't think we have any terrible channels here. If we do, it's Fox News to me!
More breaking SNL news:Kenan Thompson refuses to leave. WHAT'S UP WITH THAT?
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text: We visited Le Bonheur after a trip to the Belgian seaside and were nicely surprised by the fresh Filet de Sole that was cooked to perfection and accompanied by crisp potatoes baked in butter and herbs. The interior is cool but understated and complemented by being situated in the lovely center of a beautiful place. Well worth the detour from... More


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The U.S. Department of Health and Human Services' Metropolitan Medical Response (MMRS) program has evolved from an idea originally developed in the Washington, D.C., area in 1995. Using the combined personnel and equipment resources from Washington, D.C., Arlington County in Virginia, and Montgomery and Prince Georges Counties in Maryland, the Metropolitan Medical Strike Team (MMST) received training, equipment, and supplies specifically designed to facilitate an effective response to a mass-casualty terrorism incident with a weapon of mass destruction (WMD). The first of its kind in the civilian environment, the MMST was intended to be capable of providing initial, on-site emergency health, medical, and mental health services after a terrorist incident involving chemical, biological, or radiological (CBR) materials. The team's mission includes CBR agent detection and identification, patient decontamination, triage and medical treatment, emergency transportation of patients to local hospitals, coordination of movement of patients to more distant hospitals via the National Disaster Medical System (NDMS), and planning for the disposition of nonsurvivors. Building from the initial efforts of the Washington, D.C., Metropolitan Area MMST, OEP provided funding for the development of a similar team in the city of Atlanta in preparation for the 1996 Summer Olympic Games. The U.S. Congress has subsequently authorized and provided funding for additional contracts with the 120 most populous U.S. cities.
Although the first two MMSTs were essentially enhanced hazardous materials (hazmat) teams, with plans, training, and equipment centered around dealing with chemical agents, some of the other early MMRS cities changed the MMST concept by integrating on duty existing fire, emergency medical services, and police personnel into a "MMST response." In addition, their plans incorporated local public health officials, non-governmental organizations, state agencies, including the National Guard, federal military and non-military officials, and private healthcare organizations. OEP soon amended the initial contracts to focus more attention on coping with a covert release of a biological agent and changed the name of the program to the Metropolitan Medical Response System. The new name emphasizes that the program is intended to enhance the capabilities of existing systems that involve not just hazmat personnel, law enforcement, emergency medical service, public hospitals, and the American Red Cross, but also public health agencies and laboratories, private hospitals, clinics, independent physicians, and other private sector organizations. This emphasis on enhancing existing systems rather than building new, and perhaps competing, CBR-specific systems was strongly recommended by a previous Institute of Medicine (IOM) committee as a first principle in efforts to prepare for CBR terrorism.1
It was in this spirit of system improvement and enhancement that OEP approached IOM about OEP's ongoing need to systematically assess and evaluate the preparedness of the MMRS cities ("MMRS city" is used throughout this report to mean the metropolitan area encompassed by a given MMRS program contract, which might involve several cities and counties) and understand the effectiveness of the overall program approach. Continuing improvement, as in any program, is
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Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report
The U.S. Department of Health and Human Services' Metropolitan Medical Response (MMRS) program has evolved from an idea originally developed in the Washington, D.C., area in 1995. Using the combined personnel and equipment resources from Washington, D.C., Arlington County in Virginia, and Montgomery and Prince Georges Counties in Maryland, the Metropolitan Medical Strike Team (MMST) received training, equipment, and supplies specifically designed to facilitate an effective response to a mass-casualty terrorism incident with a weapon of mass destruction (WMD). The first of its kind in the civilian environment, the MMST was intended to be capable of providing initial, on-site emergency health, medical, and mental health services after a terrorist incident involving chemical, biological, or radiological (CBR) materials. The team's mission includes CBR agent detection and identification, patient decontamination, triage and medical treatment, emergency transportation of patients to local hospitals, coordination of movement of patients to more distant hospitals via the National Disaster Medical System (NDMS), and planning for the disposition of nonsurvivors. Building from the initial efforts of the Washington, D.C., Metropolitan Area MMST, OEP provided funding for the development of a similar team in the city of Atlanta in preparation for the 1996 Summer Olympic Games. The U.S. Congress has subsequently authorized and provided funding for additional contracts with the 120 most populous U.S. cities.
Although the first two MMSTs were essentially enhanced hazardous materials (hazmat) teams, with plans, training, and equipment centered around dealing with chemical agents, some of the other early MMRS cities changed the MMST concept by integrating on duty existing fire, emergency medical services, and police personnel into a "MMST response." In addition, their plans incorporated local public health officials, non-governmental organizations, state agencies, including the National Guard, federal military and non-military officials, and private healthcare organizations. OEP soon amended the initial contracts to focus more attention on coping with a covert release of a biological agent and changed the name of the program to the Metropolitan Medical Response System. The new name emphasizes that the program is intended to enhance the capabilities of existing systems that involve not just hazmat personnel, law enforcement, emergency medical service, public hospitals, and the American Red Cross, but also public health agencies and laboratories, private hospitals, clinics, independent physicians, and other private sector organizations. This emphasis on enhancing existing systems rather than building new, and perhaps competing, CBR-specific systems was strongly recommended by a previous Institute of Medicine (IOM) committee as a first principle in efforts to prepare for CBR terrorism.1
It was in this spirit of system improvement and enhancement that OEP approached IOM about OEP's ongoing need to systematically assess and evaluate the preparedness of the MMRS cities ("MMRS city" is used throughout this report to mean the metropolitan area encompassed by a given MMRS program contract, which might involve several cities and counties) and understand the effectiveness of the overall program approach. Continuing improvement, as in any program, is
Institute of Medicine. 1999. Chemical and Biological Terrorism: Research and Development to Improve Civilian Medical Response. Washington, DC: National Academy Press.
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Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report
critically dependent on regular evaluation of successes and shortcomings, a task rendered more difficult in this case by the low rate of actual CBR terrorism incidents.
IOM shall identify and develop performance measures and systems to assess the effectiveness of, and to identify barriers related to, the MMRS development process. Additionally, IOM shall establish appropriate evaluation methods, tools, and processes, based upon the performance measures, to assess the MMRS development process. The products of this work will assist OEP in determining appropriate mechanisms to assess the effectiveness of, and identify barriers related to, the MMRS development process.
In Phase I, an expert committee shall identify, recommend, and develop performance measures and systems to assess the effectiveness of, and identify barriers related to, the MMRS development process at the site, jurisdictional, and governmental levels. [OEP posed 11 more specific questions relevant to this task. The questions, and the committee's answers, are provided below in a separate section].
In Phase II, the committee shall use the performance measures developed from Phase I to recommend and then develop appropriate evaluation methods, tools, and processes to assess the MMRS development process.
The evaluation system(s) developed should be geared toward the timely assessment of each deliverable or phase of the development process with emphasis placed on identifying barriers, identifying solutions, and sharing successes of both the technical and administrative components of the MMRS program.
In the fall of 2000, IOM assembled a committee whose members provided expertise from the fields of emergency medicine, emergency and disaster management, medical toxicology, urban planning, epidemiology, public safety, public health, hospital administration, infectious diseases, mental health services, and program evaluation. This was accomplished in accordance with the established procedures of the National Academies, including an examination of possible biases and conflicts of interest and provision of an opportunity for public comment.
A wide variety of sources were used to assemble the data and the information necessary to respond to the charge. A comprehensive list of individuals who assisted the committee in this effort will be provided in the final report. An initial organizational and data-gathering meeting of the committee in December 2000 provided an overview of the MMRS program from the viewpoints of both OEP and several of the initial MMRS cities. Other speakers provided an overview of program evaluation principles and practices and some insights into two Federal Emergency Management Agency (FEMA) programs focused on assessing state and local readiness for a variety of potential disasters.
At a subsequent meeting, in February 2001, the committee heard about the legislative and executive origins of the MMRS program and other federal counterterrorism programs.
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Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report
Representatives from the U.S. Department of Justice (DOJ) and the Centers for Disease Control and Prevention (CDC) described their current programs aimed at enhancing state and local capabilities, and a Public Health Service (PHS) project officer described the different approaches used and the levels of success achieved by the 16 MMRS cities in his geographic area. That meeting also featured briefings on the assessment techniques and procedures used by medical organizations evaluating residency training programs, poison control centers, and individual physician specialists and by FEMA's National Urban Search and Rescue Team program. Follow-up with the speakers provided more detailed information and points of contact for additional questions.
The sponsors' project officers shared copies of completed plans from six MMRS cities from their files and put committee members in touch with offices that had relevant data. The committee members themselves contributed both personal contacts and specific information from their own files and experiences. The World Wide Web provided much information about additional organizations and counterterrorism activities, and IOM staff assembled a library of over 350 documents, published and unpublished, bearing on federal, state, and local preparations for managing the consequences of CBR terrorism incidents. These documents and other written materials presented to the committee are maintained by the Public Access Office of the National Research Council Library. Appointments to view these materials may be made by telephoning the library at (202) 334–3543 or by sending electronic mail to email@example.com.
The present report was the result of extensive discussion among the committee members at a two-day meeting in May during which draft answers were formulated and initial preparedness indicators compiled. Subsequent versions of each were reviewed and modified via email, and committee members "signed off" on the review draft in late July.
The MMRS program context presents some special challenges for evaluation. First, there is much to be learned from analysis of the local, state and federal responses to the terrorist attacks on the World Trade Center and the Pentagon in September 2001, but the committee believes that CBR terrorism incidents of the scale envisioned by OEP are unlikely to occur on a regular basis. As a result, any evaluation of a response system will have to be indirect, in that it will have to measure the intermediate consequences of the MMRS program rather than the ultimate goal, which is to save lives and minimize morbidity from a terrorism incident.
Second, every city's MMRS encompasses a web of planning activities, resources, intergovernmental agreements, and exercises at multiple levels of government. This web of activities is illustrated in Figure 1. The many activities in the box beneath "Emergency Capacity" represent only some of the capabilities required for an effective response to CBR terrorism events. Producing those capabilities is the concern of a wide variety of governmental and private-sector institutions through an equally wide variety of mechanisms, including the MMRS program. The MMRS program itself represents an effort to coordinate multiple entities and activities that are independently funded and that receive the authority for their activities from other sources. This complexity means that isolation and quantification of OEP's role in creating readiness for a CBR terrorism incident will be nearly impossible, regardless of how well one might measure readiness in any given city. It also suggests that caution is
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necessary in making changes in any part of the web of activities, for they may have unintended consequences far from the locus of change.
Third, although many of the pieces of a response plan may be thoroughly evaluated, evaluation of response capacity as a whole will, by necessity, be inferential; that is, assumptions must be made about how the component parts should work together.
Fourth, the wide variations in the resources and vulnerabilities of the MMRS municipalities may preclude use of a single yardstick or measure that places all the MMRS cities along a single scale of readiness. For example, Washington, D.C., must anticipate attacks on numerous federal facilities and embassies, whereas Baton Rouge, Louisiana, has a variety of chemical plants that are vulnerable to attack. Some cities operate their own emergency medical services; others depend on county or state assets. OEP has dealt with this variation by not attempting to impose a single model or acceptable plan on all its MMRS cities, instead opting to encourage cities to build their own plans around available structures, resources, and vulnerabilities. This flexible approach results in a substantial reduction in the ability to impose universal performance measures and standards and a corresponding difficulty in devising fair and comparable evaluation tools.
Finally, the committee has been persuaded by both the first five observations and the written and oral explications of OEP that it should approach its tasks with a strong bias toward a formative rather than a summative evaluation. That is, the committee takes as a given that the primary goal of the proposed evaluation is constructive feedback both to OEP staff and to the MMRS cities.
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Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report
FIGURE 1 MMRS Program Participants, Policy Instruments, Development Activities, Emergency Capacity, and Follow-up Activities
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Unlike many federal programs of assistance to state and local governments that provide funds by means of grants or cooperative agreements, OEP chose to use contracts as the mechanism for providing funds to participating MMRS cities. A distinguishing characteristic of contracts is the level of detail provided in the "statement of work." Unlike grants, which often support desired processes and activities without specifying the expected product in any detail, contracts focus more closely on the products ("deliverables," in government jargon) and less closely on how the contractor is to produce them. The monetary value of the contracts have varied slightly with the size of the metropolitan area involved, but have averaged about $500,000. This is delivered in installments as the deliverables are produced. For example, contracts awarded to the fiscal year (FY) 2000 MMRS cities are 18 months in duration and call for phased delivery of 12 products:
Meeting with project officer (within 2 weeks of contract award);
MMRS Development Plan (within 3 months of contract award) [The plan for developing a plan]
Primary MMRS Plan (within 6 months of contract award);
Component MMRS plan for forward movement of patients utilizing the NDMS (within 8 months of contract award);
Component MMRS plan for responding to a chemical, radiological, or explosive WMD event (not a biological WMD event) (within 9 months of contract award);
Component plan for MMST if it is a component of the municipality's MMRS (within 12 months of contract award);
Component plan for managing the health consequences of a biological WMD (within 18 months of contract award);
Component plan for local hospital system (within 18 months of contract award);
MMRS training plan including training requirements and a follow-on training plan (within 18 months of contract award);
MMRS pharmaceutical and equipment plan that includes a maintenance plan and a timetable for procurement of equipment and pharmaceuticals that have been approved by the project officer (within 18 months of contract award);
Monthly progress reports; and
Final report.
The products of these contracts are thus a series of plans for organizing and responding to large-scale acts of CBR terrorism. Current MMSR contracts explicitly demand coordination with county government and neighboring jurisdictions, e.g. the Los Angeles MMRS involves 88 jurisdictions.
As noted above, the program has changed since its initiation in FY 1997, and that is reflected in the number and nature of the deliverables demanded by contracts let in subsequent years. Contracts awarded in fiscal years 1999, 2000, and 2001 are very similar to one another, although they differ in a number of respects from the FY 1997 contracts. The 1997 cities' "bioterrorism supplement" was incorporated into the body of the contract in subsequent years, and post-1997
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Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report
cities were given the option to build the capabilities of an MMST into their existing response organizations rather than create a stand-alone team. Smaller changes clarified OEP intent in a number of places and provided cities with additional information about acceptable actions in others. No substantive requirements were added or deleted, and so, in the interests of brevity, only the provisions of the fiscal year 2000 contract are presented here.
OEP provides considerable guidance on the required elements of an acceptable plan, and those required elements form the basis for the organization of the committee's collection of preparedness indicators in a subsequent section of this report (see Appendix). The committee used the FY 2000 contract for that purpose, but the major substantive elements have been present in some form in every contract, and no city should be disadvantaged by the minor differences in wording or order of presentation that exist.
This IOM project is divided into two phases. In Phase I the committee was asked to identify performance measures and systems to assess the effectiveness of and identify barriers related to the MMRS development process at the site, jurisdictional, and governmental levels. OEP further asked the committee to "include the following considerations":
QUESTION A: How can OEP determine, at the program level, whether the strategies, resources, mechanisms, technical assistance, and monitoring processes provided to the MMRS development process are effective?
ANSWER A: This question concerns the performance of the OEP staff, as opposed to the performances of the MMRS cities, which are the focus of most of the succeeding questions. That said, the simple answer to this question is straightforward: ask the contractors, that is, the MMRS cities, about the extent to which they used OEP technical assistance and resources (e.g., the Public Health Service officers serving as Regional Emergency Coordinators) in fulfilling the terms of the contract, their perception of the value of OEP's technical assistance and resources, and to what extent community preparedness was improved by fulfilling the terms of the contract. That answer, however, assumes that fulfilling the terms of the contract is synonymous with the ultimate goal of the program: an enhanced local capability for coping with the consequences of a CBR terrorism incident. That is not the case. Although the contracts call for establishing a stockpile of appropriate pharmaceuticals, equipment, and supplies in the community, the primary demand on the contractor is the production of a series of plans. Although written plans, like a stockpile of equipment and supplies, are a necessary part of preparedness, they are not sufficient. OEP has recognized this in asking IOM not just for some tools to evaluate how OEP helps the MMRS cities fulfill the terms of the contracts but also for advice on the terms of the contracts themselves and for tools to evaluate preparedness at the local level. This Phase I report deals primarily, although not exclusively, with the last of these three tasks, but the final report will address all three in detail. It cannot be overemphasized, however, that whatever the state of local preparedness, many programs and initiatives—those of the federal government, state and local governments, and the private sector—as well as preexisting conditions in each jurisdiction contribute to preparedness. It is therefore impossible to disentangle the causal effects of the MMRS program from the effects of these other influences.
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QUESTION B: How can OEP identify whether the performance objectives identified in the MMRS contract lead communities to preparedness?
ANSWER B: This question seeks the committee's opinions on the adequacy of the contract deliverables. Are they the right ones? Should there be more? That is, are the actions demanded of the MMRS communities by their contracts with OEP necessary and sufficient for preparedness? Although this is a question for which input from the contractors themselves would again be helpful, it is probably impossible even for them to unequivocally assert a causal link between the MMRS program and preparedness because of myriad confounding variables such as U.S. Department of Defense (DOD) and DOJ programs and professional society activities. The question also assumes an independent measure of preparedness, which is the major task of the committee. The committee nevertheless believes that several modifications and additions to the contract objectives (deliverables) will likely enhance a community's response to a CBR terrorism event. These modifications and additions are explained below in the response to Question C.
QUESTION C: What modifications, additions, or subtractions should be made to these performance objectives to assist communities throughout the development process?
ANSWER C: The evaluation of local preparedness that presumably will follow this committee's report should result in contract modifications appropriate to its findings. In the interim, the committee offers the following observations on the scope and appropriateness of the current objectives (i.e., the deliverables). OEP staff, PHS project officers, and contractors have identified two objectives as being especially important: Deliverable 2 (the MMRS development plan) and Deliverable 8 (Component Plan for Local Hospital and Healthcare System).
The required elements of Deliverable 2 include specification of the proposed leadership and membership of a development team and the roster of a steering committee that will assist in the planning and development of the MMRS. The contract suggests a number of organizations and agencies that should be considered, but variations among communities probably ensure that no list of suggested members would be appropriate for all communities. More importantly, the committee has repeatedly heard that the real value of assembling a steering committee lies in the personal relationships established in the course of preparing the plan. Yet, nowhere in the guidance to the contractor on this deliverable is that stated explicitly.
Also missing from this deliverable is a preliminary assessment of the planning environment, that is, the community's strengths, weaknesses, opportunities, or threats and any barriers and resources that might be unique to the community. A plan to enhance local capabilities should begin by identifying those capabilities in most need of enhancement. This should be a multidisciplinary effort offered by multiple voices in the community (e.g., members of the police force, firefighters, emergency medical technicians and paramedics, public health officials, and hospital personnel, among others), with participation attested to by the signatures of all parties. The committee recognizes that this proposed addition to the list of deliverables comes too late for the 122 cities already under contract but believes that it would be the most logical start to any OEP initiative to provide follow-on support to sustain their readiness.
Deliverable 8 does not distinguish between public and private health care facilities, although it is clear by now that MMRS program contractors have had great difficulty involving private hospitals and clinics. The contract's guidance on this deliverable should include or refer the contractor to some strategies, mechanisms, or incentives that have proved successful in other cities. In addition, the committee has identified two important
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elements of coping with a mass-casualty event that are not addressed in the objective: staff callback procedures and replenishment of medical and ancillary (food, laundry, housekeeping, etc.) supplies and services.
The committee also identified several other essential activities or MMRS functions that are not addressed at all in the current contracts:
Receipt and distribution of materials from the National Pharmaceutical Stockpile;
Refugee holding (providing shelters for healthy people fleeing an area of real or perceived contamination);
Volunteer utilization and management;
Traffic control at the scene, at health care facilities, and in the community as a whole;
Evidence development, collection, and protection;
Evacuation and disease-containment decisions and procedures;
Post-event follow-up of the health of responders and caregivers; and
Plans for postevent amelioration of anxiety and feelings of vulnerability among the community at large.
It might be argued that several of these functions are not medical in nature and therefore do not fall within the scope of this DHHS project. However, all of these functions are essential to the ability of medical personnel to perform their jobs, even if, as seems likely, public safety personnel carry out the required actions. A realistic plan should therefore address these areas.
QUESTION D: How can existing standards be used to validate these performance objectives? If standards do not exist, how can new standards be created or how can the performance objectives be validated?
ANSWER D: Many of the personnel, professions, organizations, and jobs referred to in the plans of MMRS cities are governed by existing standards; some of these are legally mandated (Occupational Safety and Health Administration [OSHA] regulations) and others are voluntary. The following is a partial list of potentially relevant standards that the committee examined:
Joint Commission for Accreditation of Healthcare Organizations (JCAHCO)
Standard EC.1.4—Emergency preparedness management plan
Standard EC.2.9.1—Emergency preparedness drills
Standard EC.1.4 (1997)—Security management plan
Standard EC.1.5 (1997)—Hazardous materials and waste management plan
Commission on Accreditation of Ambulance Services Standards
Organization (includes disaster plan, yearly disaster simulations)
Community relations and public affairs
Mutual aid agreements
Human resources
Clinical services
Equipment and facilities
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National Public Health Performance Standards (CDC)
National Fire Protection Association Standards
NFPA 471—Recommended Practice for Responding to Hazardous Materials Incidents
NFPA 472—Standard for Professional Competence of Responders to Hazardous Materials Incidents
NFPA 473—Standard for Competencies for EMS Personnel Responding to Hazardous Materials Incidents
NFPA 1600—Standard on Disaster/Emergency Management and Business Continuity Programs
OSHA Standard 29CFR1910.120—Hazardous waste operations and emergency response
Nuclear Regulatory Agency/FEMA Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants (NUREG-0654/FEMA-REP-1)
Department of Transportation National Highway Transportation Safety Agency Emergency Medical Services National Standard Curriculums
American College of Emergency Physicians Task Force Recommendations on Objectives, Content, and Competencies for training of Emergency Medical Technicians, Emergency Physicians, and Emergency Nurses on Caring for Casualties of NBC Incidents
With only a few exceptions, the committee deemed these standards to be of limited utility in assessing the preparedness of local communities for coping with a CBR terrorism incident. Most are qualitative in nature and are "enforced" only by well-publicized and infrequent inspections. None explicitly addresses CBR terrorism or an emergency of the scale described in the MMRS program contract, and attempts to apply these standards to such scenarios in the past have often proved counterproductive (e.g., misinterpretation of OSHA hazardous waste operations standards has led to expectations that hospital emergency department [ED] personnel should have Level A chemical protective suits). Furthermore, each standard applies to only one element, discipline, or agency involved in an MMRS. It is difficult to envision a successful MMRS in which any of the constituent elements fails to meet its own narrow standards, but it is also true that a collection of individually competent elements does not guarantee a successful system. Each of the standards listed above was nevertheless examined for elements that could be incorporated into an MMRS program-specific evaluation, and a number of those have been incorporated into the matrix of preparedness indicators provided later in this report.
QUESTION E: What strategies have communities used to enhance their existing capabilities? What are the most effective means to measure these additional capabilities?
ANSWER E: It is probably fair to say that before 1995 few of the MMRS cities had given much thought to preparedness for CBR terrorism events at all. Certainly, all the nation's largest
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cities had preexisting hazmat teams; those with nuclear power plants in close proximity had plans and equipment for coping with radiation releases; and all-hazards emergency response plans were influenced heavily by the frequency with which they had experienced earthquakes, floods, tornadoes, and so forth. To the extent that any of the cities had begun to address coping with a CBR terrorism incident, they were reacting to the attack with a nerve agent on the Tokyo subway and therefore emphasized chemical agents. Although biological agents were not ignored, DOD and DOJ training and equipment programs begun in 1997 reinforced that emphasis on chemical agents, and as a result their equipment money and training was most often directed at firefighters and emergency medical technicians rather than hospital personnel.
Most cities used their MMRS program contracts to expand their capabilities by incorporating CBR-specific training and equipment for city personnel, primarily those involved with public safety, into existing all-hazard plans. In some cities, for example, in Honolulu, the MMRS program appears to have been extremely successful in promoting extensive mutual-aid agreements with surrounding communities and nearby military facilities.
The committee expects that cities with such extensive aid networks will enhance their preparedness not just for CBR terrorism incidents but for all hazards. In retrospect it appears that such "relationship building" across disciplines and communities may be a critical element in meeting the demands of the MMRS program contract and, along with dual-use equipment and procedures, may be the key to sustaining preparedness. Although a lack of pre-MMRS measures or control cities precludes a causal analysis, finding ways to measure these additional capabilities is a central element of the committee's task and will be fully addressed in the final report. The committee cannot provide a concise answer to this question at this stage of the project.
QUESTION F: Can the relationships between traditional first responders-public safety officials and their supporting hospitals and public health offices be assessed? If so, how?
ANSWER F: A number of complementary strategies can be used to assess these relationships. The MMRS program contract already demands the minutes of all MMRS-related meetings, presumably including those who attended the meetings, in the requisite monthly progress reports. More intrusive measures might include independent oral or written queries of key personnel in each of these sectors regarding the joint actions specified in the community's response plan. An Agency for Healthcare Research and Services (AHRQ) grant is supporting SAIC, Inc and its subcontractor, the Joint Commission for Accreditation of Healthcare Organizations (JCAHCO), in developing an assessment tool for measurement of hospital-community linkages. Designed as a 20-minute self-assessment survey, the draft version made available to the committee demands short answers from hospital administrators to a variety of questions about the hospital's interactions not only with the community's first responder-public safety community but with other hospitals as well.
QUESTION G: What tools and models exist to measure preparedness for natural disasters?
ANSWER G: The committee examined the following assessment tools for possible application in whole or in part to the task of evaluating preparedness for CBR terrorism events:
Capability Assessment for Readiness (CAR)
FEMA self-assessment instrument to evaluate state emergency management
A 1,801-element survey administered to all states and territories in 1997
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"All-hazards" document with only a handful of items related to chemical and biological weapons
Local Capability Assessment for Readiness (LCAR)
FEMA's smaller, local community version of CAR
Currently undergoing pilot testing in selected counties
Hazardous Materials Exercise Evaluation Supplement
Instructions and checklist for peer reviewers in FEMA's Comprehensive HAZMAT Emergency Response-Capability Assessment Program
Sixteen elements, each with 10 to 50 "points of review"
Yes-or-no responses and the time that the specific action was observed
Epidemiologic Capacity Assessment Guide
Step two of a three-step process (Step 1 is document collection, and Step 3 is site visit) designed by the Council of State and Territorial Epidemiologists
Self-assessment questionnaire
Short answers or essays and data on speed of investigation from recent cases
Suggestions for interviews of key personnel
State Domestic Preparedness Equipment Program Assessment and Strategy Development Tool Kit
Instruments developed by DOJ, the Federal Bureau of Investigation, and CDC to evaluate vulnerability, threat, and public health performance combined with assessments of required and current capabilities in the realms of fire services, hazmat, emergency medical service (EMS), law enforcement, public works, public health, and emergency management
A 100-page "Tool Kit" provided for use by the state and local personnel assigned to fill out the forms, but could be the basis of peer interviews
State assessment designed to be a compilation of local assessments, so it is really a local instrument
Public Health Assessment Instrument for Public Health Emergency Preparedness (CDC)
Ten essential public health services amplified specifically for preparedness for CBR terrorism events
Nineteen "indicators," each with multiple subparts requiring mostly yes-or-no answers
Part of DOJ state assessment instrument
Assessment of Community Linkages in Response to a Bioterrorism Event
Draft product of JCAHCO and SAIC for AHRQ due out in June 2001
Forty-item questionnaire for hospitals (yes-or-no and short answers)
Each of these instruments seeks information about elements of disaster preparedness that are directly relevant to CBR terrorism preparedness. All are written self-reports, and either of the
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two most comprehensive assessments, done properly, would take several people many hours or even several days to complete. In addition, the committee believes that self-reports are vulnerable to corruption of indicators. It has long been understood in evaluations of health and social programs that when rewards and punishments result from people's apparent performance on an indicator, that indicator can sometimes change in ways that have no bearing on the actual outcomes of the governmental program. In the MMRS context, at least two possible forces can lead to "corruption of indicators." First, to the extent that municipalities may believe that continued federal funding is contingent on contract compliance, self-reports may make the situation appear to be better than it really is. Second, and alternatively, if local officials believe that further funding is dependent on need, self-reporting may actually lead to an underestimate of preparedness. The committee will reexamine the possible utility of these self-assessment instruments in Phase II of the study, but for the present, the committee views them as providing too little additional assurance for the substantial effort involved.
QUESTION H: Do current federal performance measures for natural disasters or other programs (mitigation and response) have application to preparedness for a terrorism incident involving WMD (e.g., FEMA Project IMPACT)?
ANSWER H: According to Jeff Glick, director of FEMA's Assessment Branch, postdisaster assessments of the performances of federal, state, and local government offices and agencies during natural disasters are ad hoc and very much event specific. He reports that no common template or database of findings is available for possible use in evaluating the preparedness of MMRS program communities. He anticipates that a current effort by FEMA, the National Emergency Management Association, and others to create an emergency management accreditation program will eventually include performance standards as well as preparedness indicators based on LCAR.
QUESTION I: How can casualty assumptions for communities of varying populations be established (percent of population, historical data)?
ANSWER I: Casualty assumptions, including those generated by "plume" models and computer programs showing how a release spreads, all depend heavily on fairly extensive knowledge of the agent—how much, what kind, and how dispersed—but these are all facts that are least likely to be known in a terrorist incident. Modest changes in these "initial terms" lead to casualty predictions that can vary by orders of magnitude. Computers, of course, can be used to generate a potentially huge table or series of tables by systematically varying the initial terms, but the committee sees little to be gained by this approach, the rationale for which is presumably the requirement to estimate the need for hospital beds, medications, other supplies and equipment, and personnel.
OEP's arbitrary selection of 1,000 casualties from release of a chemical agent as a target figure for use in preparation of plans is probably a better approach. The same holds for biological agent incidents, for which the MMRS program contracts demand three levels of planning: one plan for handling an event with less than 100 victims, a second plan for handling an event with 100 to 10,000 casualties, and a third plan for handling events with greater than 10,000 casualties.
Given the infinite number of possible incidents, an even better approach may be to turn 180 degrees and seek estimates of capacity rather than estimates of numbers of casualties. That is, ask cities how many patients they can currently care for with current staffing levels and standards of care; how many patients they could care for in a true mass-casualty situation,
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allowing for some attrition of regular staff but with help from outside the community and a different standard of care; and finally, how many patients would truly overwhelm the system, with or without outside help.
QUESTION J: How can OEP measure the preexisting systems, methodologies, and plans that public safety, public health, and health services agencies use to communicate during day-to-day operations? How can OEP measure the impact that the MMRS development process has had on the level of this communication or the expectations for this communication, or both?
ANSWER J: The committee suggested above, in its answer to Question C, that a missing but important part of Deliverable 2 is a prospective assessment of community strengths and weaknesses. This would certainly have to include communication among the fire department, the police department, EDs, trauma centers, poison control centers, EMSs, hazmat units, medical evacuation (Medevac) units, and other state and local agencies and institutions. Examination of existing mutual aid agreements or lack thereof should certainly be included.
As noted previously, even with pre- and postcontract measures, which will not actually be possible for at least the 122 cities that have already contracted with OEP, it would be very difficult to analyze the effects of the MMRS program independently of the effects of other concurrent federal, state, and private-sector initiatives. Asking cities directly is probably better than no assessment, but the current status is really all that can be objectively determined. That assessment could be carried out by independent questioning, written or oral, of essential participants in the public safety, public health, and health services sectors or through evidence from periodic testing of emergency communication systems under adverse conditions and at times of typically low activity. Some of the communications-related areas that might be probed would be access to a common radio frequency and how often it is used, the numbers and compatibilities of cell phones, existing agreements and mechanisms for gaining priority use of wireless and landline phones, and Internet and intranet connectivity.
The committee cautions that although it is possible that under some circumstances planning for an extraordinary event might improve the ability to conduct ordinary activities, it is by no means certain. Planning for detection of and coping with epidemics caused by bioterrorism may well make detection of and coping with a meningitis outbreak more efficient, but it is not likely that everyday care of individual patients with infectious diseases will be similarly affected. Certainly, it would be a mistake to judge preparations for a rare mass-casualty event solely by changes, or lack of changes, in everyday effectiveness or efficiency.
QUESTION K: How can financial barriers related to WMD preparedness be identified and measured?
ANSWER K: In the course of its data collection effort, the committee has become aware of some financial barriers (no doubt known to OEP as well) that hinder preparedness in at least some MMRS cities. Most prominent is the difficulty of sharing funding or material purchased with OEP contract dollars with adjacent jurisdictions and private-sector entities, especially hospitals and physicians. In the former case, political, and sometimes legal considerations underlie a predictable reluctance of elected officials to spend "their" money on others' constituents. In the case of private-sector hospitals, financial pressures from the current adverse economic climate in health care, including competition from other local hospitals, have led most hospitals to eliminate all spare or surge capacity to cope with disasters of any sort. Even "free" equipment results in an obligation to provide expensive maintenance and training to staff.
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Indeed, participation in the local MMRS at all results in a similar training obligation, and as a result, cities unable to provide financial incentives have had great difficulty in bringing about the participation of private hospitals. This MMRS program is a direct response to a "national security threat" and as such should be funded by the federal government at a level and in a manner that will both cover all initial costs and the continuing costs of sustaining preparedness. This does not seem to be an unreasonable expectation given the very large increases in funding for counter-terrorism programs being proposed in the FY 2002 federal budget.
As to the larger methodological question of how OEP can identify and measure such financial barriers, it would seem that a large piece of the committee's Phase II task will be to put together a postcontract questionnaire (or final deliverable) that asks cities about this question and any changes in the way in which they carry out everyday business might be attributable to the MMRS program (see Questions and Answers A, B, C, E, and J).
The MMRS contract deliverables are all written plans, and although written plans are certainly necessary elements of preparedness, they are in most cases only the beginning of a continuing process. Some elements of these plans can be carried out only during or after an actual incident or a very realistic exercise, but many require advance preparations, such as the purchase of equipment, hiring or training of personnel, or even changes in the way in which everyday business is conducted (for example, citywide electronic surveillance of ED calls). Even though these advance preparations and their documentation are actions, and are necessary for preparedness, they are not the same sort of performances that might be assessed in an actual mass-casualty event (whether it involves CBR terrorism or not) or a drill or field exercise. Measures related to advance preparations are generally easier and cheaper to access, however, and can provide a measure of effective response capability or potential (although, in the absence of an act of mass-casualty-producing CBR terrorism, there are no data that can validate the relationship between the selected indicators and actual performance). The committee therefore prefers the more inclusive term "preparedness indicators" to "performance measures."
The committee's recommended preparedness indicators are presented in Attachment 2 as a series of tables. A separate table is provided for each of the substantive deliverables of the MMRS program's fiscal year (FY) 2000 contract (omitted are deliverables calling for a meeting with the project officer, monthly progress reports, and a final report). In each table the far left column, labeled "Plan Elements," lists the required elements of the deliverable, numbered in accord with the checklist supplied to FY 2000 MMRS cities by OEP under the title "2000 MMRS Contract Deliverable Evaluation Instrument."
The remaining three columns of the tables present the committee's suggested preparedness indicators for each plan element. These fall into three categories: inputs, processes, and outputs.
Inputs are the constituent parts called for, implicitly or explicitly, by a given deliverable. An adequate plan itself would contain at least one input for nearly every deliverable, assuming that the required plans would have been completed at the point that assessment is being undertaken. Other inputs could be designated personnel; standard operating procedures; equipment and supplies; or schedules of planned meetings, training, and other future activities.
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Processes are evidence of actions taken to support or implement the plan. Evidence that such actions had been taken or are under way might include minutes of meetings, agreements prepared, training sessions conducted, or the numbers or percentages of personnel trained to use CBR detection equipment.
Outputs are indicators of effective capabilities developed through the actions included under processes, that is, indicators of the effectiveness of actions taken to support or implement the MMRS plan. They would include preparations that have been completed, for example, establishment of a stockpile of antidotes and antibiotics appropriate for the agents that pose the greatest threat, with evidence of adequate maintenance and deployment procedures. Another output would be demonstration of critical knowledge, skills, and abilities in tabletop exercises, full-scale drills, or surrogate incidents (hoaxes, nondeliberate chemical releases, naturally occurring epidemics, or isolated cases of rare diseases). Outputs may be evaluated through expert judgment by peer reviewers of answers to written questions or on-site probes. In all cases care should be taken to avoid inappropriate generalization from chemical to biological incidents and vice versa.
The best evidence for preparedness will always be outputs, which are the end products of processes undertaken with inputs. A variety of circumstances, including the timing of the assessment, may make collection of output data impossible or impractical. In this circumstance evidence for preparedness might be sought among inputs and processes. All three types of indicators are, however, merely surrogate or proxy measures of MMRS effectiveness that are based on the judgment of knowledgeable students of the field but that have never been truly validated (and cannot be, short of an actual mass-casualty CBR terrorism incident).
The tables in the Appendix present many preparedness indicators, in part because of the committee's decision to derive indicators for each of the items on OEP's checklist of elements required in the plan. In fact, no practical evaluation program could or should use all the indicators listed. Use of the output-based indicators, presented in the far right column of each table, provides the best means of assessing readiness, and whenever possible these indicators should be used in preference to process- or input-based indicators. In fact, the importance of the output-based indicators, especially those obtained from exercises or careful evaluation of real disasters, cannot be overemphasized. The committee will expand on this point in Phase II of the study, but an important advantage of outputs is that they reflect intangibles not easily captured by the input and process indicators we suggest. For example, a strong MMRS takes a champion with desire and commitment to continually advocate for the project, individuals who are willing to cooperate, a change in attitude by organizational leadership that will adopt an inter-organizational and systemic approach to the MMRS, and leaders from local, state, federal, and private agencies with trust and sensitivity to each other's missions, goals, strengths and weaknesses.
Similarly, process-based indicators should take preference over input-based indicators. In addition, it should be clear that every element of the plan need not be given equal weight in the evaluation of preparedness. Indeed, it may not be necessary to include every element in even a very comprehensive evaluation. This selection and prioritization process will constitute a significant focus of the committee's work in Phase II of this project, as will determination of the most effective and efficient means of collecting the desired information and attempting to specify some minimum standards for preparedness, whenever possible.
At a more general level, the committee has been favorably impressed by the catalytic role of the MMRS program in many communities. As noted above, the concurrent efforts of three
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federal agencies in the nation's largest cities make it impossible to unequivocally assign credit for improvements in preparedness. However, the committee believes that OEP's emphasis on collaboration, the use of existing agencies and programs, and the promotion of local discretion in addressing preparedness gaps, although difficult to measure, has been an undeniable contribution. One of the challenges of Phase II will be to ensure that assessment gives that collaboration appropriate weight.
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Dr. Michael A. Gass, MD
Diagnostic Radiology, Virginia Mason Medical Center Clinic
- 1100 9th Ave
Seattle, WA 98101 - 2 Office Locations
- (206) 624-1144
Dr. Michael A. Gass graduated from the University of Washington SOM in 1980. He works in Seattle, WA and 1 other location and specializes in Diagnostic Radiology and Nuclear Medicine. Dr. Gass is affiliated with St Francis Hospital and Virginia Mason Medical Center.
Gender: Male
Years in Practice: 35 Years
Languages Spoken: English
Medical School: University of Washington SOM
Graduation Date: 1980
Hospital Affiliations: St Francis Hospital, Virginia Mason Medical Center
Specialties: Diagnostic Radiology, Nuclear Medicine
*This physician has multiple office locations. See Appointments for details.


text:
Restaurant is no longer in business. It is closed for good. A new restaurant is going in to the location.
Restaurant is no longer in business. It is closed for good. A new restaurant is going in to the location.
This restaurant is no longer in business....CLOSED. I'm not sure if they're closed forever or if they plan on relocating the business. Rumor is they had issues with the building and the owner refused to help.
Molcajete, Molcajete, Molcajete, Molcajete. Why are you ordering something else? What is wrong with you? What are you thinking? Once, I was being stupid and ordered something else (the pork carnitas) and it was not good. That was dumb. Then, I didn't do that again. You shouldn't either. Seriously - order this dish - but you need at least one... More
Located on the main street in Show Low, you can't miss this pink, adobe restaurant. Everytime we eat here, it's like taking a trip to Mexico. They specialize in creative seafood dishes but also offer traditional Mexican food. Always excellent service. Can be a little expensive if you order beer, sangria, margaritas, etc...with meal, so beware. Portions are huge, so... More
Very friendly staff. Food that was a step or two above most Mexican places. Very fresh and tasty, nothing was overwhelmed by the cheese like most Mexican places in the US. Oh I can taste it still thinking about it. Service was kind but the food was slow to come, so much so they apologized. Were there at lunch, for... More
The food and service was excellent. I had the carne asada burrito combo and my date had a chicken burrito combo. We both loved our food and I would highly recommend the place. Maybe a little pricey for a Mexican restaurant, but delicious. We were there for dinner and had two plates with two drinks for around $33.
Good fish Tacos for lent, good salsa, friendly staff, clean, tasty food and there are alot of mexican food resturants in ShowLow, but I would go back to this one for sure!
Being from Texas and Colorado...Lots of experience with Mexican food. This was EXCELLENT! Try the bowl of queso to start. Fabulous! move onto most anything else on and menu and I think you will be very pleased. When my friend and I ar in Show Low next time, we will not consider going anywhere else. As a sidebar, we brought... More
Three of us ate dinner there after a day of hunting. The price was higher than we would have thought but the portions were very large that we all took doggie bags back with us and finished off the meals for lunch the following day. Very good flavor and the large portions offset the prices that we all agreed it... More
There's not a lot to pick from in Show Low but I had a very nice dinner here. Food and service were very good.
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Denver, Colorado
Member since Dec 2009
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Reviewed Pistachio Crusted Rack of Lamb with Goat's Cheese Mashed Potatoes and Peasant Style Sauce
Nov 23, 2011 in Food Network Community Toolbox on FoodNetwork.com
"Delicious and well thought-out recipe. I'm not the biggest fan of goat cheese, so next time I make this (and there will be a next time) I'll probably try a different kind of cheese. Still, a fantastic - and just challenging enough - recipe"""


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SuperShuttle International Inc., The Largest Airport Ground Transportation Company, Announces New Service In Orlando, Florida
PHOENIX, Nov. 9, 2011 /PRNewswire/ -- SuperShuttle International, Inc. announced today it will begin shared ride van service from Orlando International Airport to/from Orlando hotels in the downtown, convention center, and major attraction areas beginning February 1, 2012. Customers can book reservations beginning November 9, 2011 at www.supershuttle.com/orlando or 1-800-Blue-Van (258-3826).
(Logo: http://photos.prnewswire.com/prnh/20071030/LATU031LOGO)
SuperShuttle has begun hiring independent operators to drive for SuperShuttle and more drivers will be needed as the service expands to the suburbs and surrounding area. Gregg Moulton has been named the SuperShuttle general manager for the Orlando area.
"We are really excited about the Orlando area and can't wait to get going," said Tom Gahan, vice-president of operations for the area. "Being a SuperShuttle franchisee is an excellent opportunity for someone who is a self starter and wants to run their own business. We think the Orlando area will be excellent business opportunity for the right people."
As with all SuperShuttle services the service in Orlando will be also be eligible for earning airline miles or points on participating carriers including; Delta Air Lines SkyMiles®, Frontier Airlines EarlyReturns®, Southwest Airlines Rapid Rewards®, United Airlines Mileage Plus® ,or US Airways Dividend Miles® programs. SuperShuttle International, based in Phoenix, AZ is a division of Veolia Transportation On Demand and a subsidiary of Veolia Environment (Euronext: VIE, NYSE: VE). SuperShuttle serves 33 airports, carrying more than eight million passengers a year. Airports served by SuperShuttle include some of the largest in the country including Los Angeles, New York, Dallas/Ft. Worth, Washington, D.C. and Miami. Please go to www.supershuttle.com for more information Veolia Transportation, Inc. Veolia Transportation is the leading provider of passenger ground transportation services on the North American continent, operating bus, rail, taxi, shuttle and para-transit systems in over 120 locations in the US and Canada. Veolia Transportation entered the North American market in 2001 and has quickly expanded to a national presence, with over 16,000 employees and annual revenues approaching $1 billion. SOURCE SuperShuttle InternationalCheck Out Our Best Services for Investors
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Italian style
For now, the 500's principal appeal is not so much as a gas miser or as a tear-around funster, but as a design object. The exterior styling is just right and will be augmented by an unusually large selection of colors, fourteen in all, as well as various graphics packages. The interior is far more highly styled than one usually sees in this category, with a big swath of body-color trim on the dash; large, upholstered door armrests; off-white switches; and a detailed steering wheel, yet it's far more logically arranged than the style-over-substance instrument panel of the Mini Cooper. There are also fourteen available interior colors, rather than the typical choice of tan or gray. Fiat says there are more than 500,000 possible ways to spec out a 500.
Small car, big ambition
Fiat hopes to sell 50,000 cars in North America this year between the hardtop and the Cabrio that goes on sale this spring. For its part, Mini, a much more established brand, sold only 45,000 cars annually in the United States in 2009 and 2010, so even with the addition of the 500 Abarth next year and an electric 500 in late 2012, Fiat's goals are very ambitious. Whatever the volume, we're glad to see the 500 in America. With sales of the smallest cars in a long-term uptrend, we need more variety in the small-car arena and, in particular, more models that don't feel like lesser versions of larger cars. That's certainly the case here.
2012 Fiat 500
Base price: $15,500 (plus destination)
Powertrain: 16-valve DOHC I-4
Displacement: 1.4 liters
Power: 101 hp @ 6500 rpm
Torque: 98 lb-ft @ 4000 rpm
Transmission: 5-speed manual or 6-speed automatic
Drive: Front-wheel
EPA Fuel Economy: 30/38 mpg (manual); 27/34 mpg (automatic)
Suspension, front: Strut-type, coil springs
Suspension, rear: Beam axle, coil springs
Wheels: 15 x 6.0 in, 16 x 6.5 in (Sport)
Tire size: 185/55R15, 195/45R16XL (Sport)
Wheelbase: 90.6 in
L x W x H: 139.6 x 64.1 x 59.8 in
Curb weight: 2350-2430 lb
Fuel capacity: 10.5 gallons


text:
New York Color • Browser • Brows
(188 reviews)
Average Rating. | 4.0 |
Would buy this product again. | 77% |
Ingredients |
tapatiadivina4u on 11/10/2009 2:25:00 PM more reviews by tapatiadivina4u
Age: 19-24 Skin: Acne-prone, Medium Hair: Black, Straight Eyes: Brown
Love this product. I have been using this for about 5 years now. No way will i change it for another brand, plus is super cheap. I run through about 3 of this a year or so...I use it every single day in the dark brown. Love it.
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reenxor on 11/10/2009 2:20:00 PM more reviews by reenxor
Age: 25-29 Skin: Acne-prone, Fair Hair: Brunette, Wavy, Fine Eyes: Black
I definitely prefer this product over brow pencils--it looks more natural and is super easy to apply. I also really like getting the tiny tweezers. I would prefer if it flipped open and had a mirror. Great quality for the price!
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*TOP REVIEWER* anabolina on 9/17/2009 11:03:00 PM more reviews by anabolina
Age: 25-29 Skin: Acne-prone, Fair-Medium Hair: Blond Eyes: Blue
I gave this a 3 despite it being an awesome product because they seem to have gotten rid of every color except brunette. erg. I loved the taupe/blonde shade they had last year, but brunette is the only shade listed on the website, so the other colors must have been dc'ed. :( It lasts a long time and the blonde one was perfect for me. The brunette is much too dark for a blonde unless you want the brown brow with blonde hair look. The product also lasts a long time and the wax keeps everything in place. It used to be so awesome.
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rosetta1123 on 8/16/2009 9:07:00 PM more reviews by rosetta1123
Age: 30-35 Skin: Combination, Fair-Medium Hair: Black Eyes: Brown
Okay product but I don't think it's right for me with my dark Asian hair. The product comes with a brow wax and shadow colour and tweezers. I got the Brunette which is more suited for someone with dark brown hair with reddish highlights versus black hair (like myself). The brow shadow has tints of red in it which don't look natural on me.
3 out of 4 people found this review helpful. Was this review helpful to you? Yes No
_starry on 7/28/2009 9:18:00 PM more reviews by _starry
Age: 18 & Under Skin: Dry, Fair-Medium Hair: Brunette, Straight, Fine Eyes: Brown
This stuff is amazing! The powder is super pigmented and lasts all day even without the brow wax. I don't use the brow wax; be careful of the brow wax melting in hot weather, it can get very messy in the plastic container. I don't use the brush it comes with because the brush isn't percise enough.
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Sumshine88 on 7/25/2009 1:10:00 PM more reviews by Sumshine88
Age: 19-24 Skin: Normal, Olive Hair: Black Eyes: Brown
I bought the Brunette kit!
The Good: If I want my brows to look strong, defined, yet natural, I must must must use the wax. Hands down. The wax enhances the shadow I use, making it darker (which is good because I have black hair!) and last much longer than it would normally.
The Bad: I have black hair...soo...the powder wasn't cutting it for me. It was too red, and looked unnatural, plus it is a wee bit chalky, which I could deal with if it colour were a better match! Also, it came with tweezers and a brush which i tossed (clearly ;) )
Conclusion: For $4.99 CDN, just purchasing the product for the wax is fine by me! Will repurchase!
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FadedPainting on 4/1/2009 9:36:00 PM more reviews by FadedPainting
Age: 19-24 Skin: Combination, Fair Hair: Brunette Eyes: Hazel
If one of the two or so colors they offer is a good match for you, these can't be beat.
The "brunette" version definitely does have red undertones - my hair is dark reddish-brown so it's perfect for me. I take an angle brush, tap it slightly on the powder, then tap it in the wax (I find this makes less mess and I don't end up accidentally getting too much color), then *gently* stroke over my brows. I then comb them out (up & over) with a spoolie brush, which shapes them and distributes the color / takes care of any excess. Looks perfectly natural and stays put. The wax is slightly odd in the case (it gets soft and slimey), but is fine on application.
The only downside is that the packaging is not the best (the slider has to be aligned just right and coaxed to close - I would prefer something that flipped open). But for the price, and how easy they are to find (which it doesn't seem there are many drugstore brow products), it's livable. I've gone through at least 3 or 4 of these and will continue to repurchase.
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tsd715 on 3/9/2009 4:18:00 PM more reviews by tsd715
Age: 30-35 Skin: Combination, Medium Hair: Brunette Eyes: Brown
I use this powder every day, and it lasts forever! I don't feel I need to set my brows with wax every day, so I can't fairly weigh in on that. I have always felt pencils made me look harsh, so the dense brush and pigmented powder give just the right natural look for those who are wary of looking "overdone." The price is exactly right, and I hope they continue making this product, as no high end is worth the investment!
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*TOP REVIEWER* thebigtrout on 1/26/2009 8:40:00 AM more reviews by thebigtrout
Age: 36-43 Skin: Acne-prone Hair: Brown Eyes: Brown
Horrible product. Made a complete mess and didn't do what it claimed to do. Not a good product!
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mkeo on 1/17/2009 9:46:00 PM more reviews by mkeo
Age: 25-29 Skin: Combination, Fair-Medium Hair: Black Eyes: Brown
lots of fallout & smudges. colour is flat. wax doesn't do anything. brush & tweezer are useless. wouldn't buy again!
recommend: annabelle.
FYI: NC35. dark brown hair, brown eyes.
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Boards of directors are designed to look out for shareholders' interests and challenge management. Past failures at some firms have put all boards under greater scrutiny.
We look at issues that confront boards, how one busy chief executive juggles his duties as an outside director for other companies, and how one local company's board works. We also list the board members of prominent firms based here and their compensation.
The concept should be simple: The board of directors of a public company should be concerned only about protecting shareholders' investments.
Yet recent scandals have brought to light questions of whether board members have protected management for their own gain, or neglected to keep an eye on management to the detriment of the company and its shareholders.
Now, because of corporate reform enacted by Congress, many boards of directors are facing radical changes as the deadline approaches to ensure their boards are independent of the companies they govern, and therefore are acting in the best interest of the shareholders they represent.
"The practices in the past have been that, oftentimes, the CEO and the senior management have a strong influence in who is selected to sit on the board, and those have never been considered very independent choices," said Tom Keller, a management professor in the W.P. Carey School of Business at Arizona State University. "Some of the troubles that publicly held companies have had in recent years, of the board not doing their job in terms of due-diligence and making sure that accounting practices are adhered to, have caused a lot of concern."
There is clearly a movement toward more independent boards, as mandated by the Sarbanes-Oxley Act of 2002, which requires boards to have more independent representation, Keller said.
"There's been action taken by the government to try and increase the independence of boards and to make them more responsive to shareholders," said Amy Hillman, associate professor of management at ASU. "All corporations will be impacted, except for the smallest ones."
The Sarbanes-Oxley Act specifically targets membership on boards' audit and compensation committees, requiring members to have no financial ties to the corporation.
"I do think these regulations are at least intended to produce much more objective, watchdog-type boards," Hillman said. "The jury is still out, obviously, whether these changes in the composition will truly affect the way boards do business. But they are certainly a step in the right direction."
Marilyn Seymann disagrees. The Tempe resident is president and CEO of her own company, M One Inc., a bank consulting firm in Phoenix, and sits on the boards of four public companies: Maximus Corp., Beverly Enterprises, Community First Bankshares and Northwestern Corp.
"I don't believe you can legislate good governance, and I think it's an attempt to legislate areas where basic ethics should be in place," she said.
The new regulations require directors to spend more time with the companies, and invest a lot more time understanding the boards on which they sit, Hillman said. Many directors, especially of Fortune 500 companies, serve on multiple boards and this could cause them to cut back on that responsibility, she said.
Seymann admits spending more time with the companies is a step in the right direction.
Boards of directors' sole purpose is to make sure management is acting on behalf of the shareholders, Hillman said.
Any problems have usually resulted because of either one of two things: Boards not challenging management enough, or they were unaware of actions that were not in the best interest of shareholders, she said.
"They somehow are insiders, they know the management well, so they perhaps knew that something was going on that wasn't in the best interest of the shareholders and did nothing to stop it," Hillman said. "Or perhaps at its most benign they were just unaware of what was going on when it was their responsibility to know that."
The size and makeup of boards varies from company to company, but general practices suggest that a board should include eight to 12 members, she said.
"If you get fewer than that, you don't have the same level of expertise and the benefits of that many eyes looking at the company," Hillman said. "But if you get larger than that, it's very hard for them to reach consensus on decisions. That's why we see that most companies fall somewhere between that eight and 12 people."
Company officials play an important role on boards, but their numbers and influence should be kept to a minimum, she said.
"If you think about it, if I only come to a company six times a year as a director, I won't have as much inside information as those managers do," Hillman said. "Generally best practices suggest between one and three insiders on the board out of that eight to 12. It wouldn't be very prudent to have a board, for example, where the CEO was not on it, but there are times when it is important for the board to meet without management."
As boards fall under increased scrutiny, it's getting more difficult to find qualified board members who want to serve, Keller said.
"A lot of people are saying 'Now why would I want to be on a board and expose myself to that scrutiny?' " he said.
Sarbanes-Oxley isn't going to stop people from defrauding shareholders because "you can't legislate ethics and honesty," Seymann said. Instead, it's creating additional costs and headaches for corporations, and directors are being distracted from focusing on the future of the corporations they govern, she said.
"Boards were just starting to get really focused on diversity and competence," she said. "Now everybody's so totally focused on who they can get to chair the audit committee, who's independent and was never with a tainted firm, and this and that and the other thing."
The mandate for more independence will improve some boards decision-making authority, but for many corporations, Sarbanes-Oxley is becoming a business strategy, Seymann said.
"I sit on four publicly held boards, and you spend so much time going through all of the legislative requirements, where you're in compliance, where you're not, who's doing what, what's the cost of doing this, that the reason you're there as a board member is almost obscured," she said.
Seymann co-authored with Michael Rosenbaum, the former president of the Financial Relations Board, a book examining corporate governance, titled "The Governance Game: Restoring Excellence & Credibility in Corporate America."
She is forming a group that will include 10 high-profile directors who sit on the boards of several Fortune 500 and Fortune 100 companies, and whose purpose will be to seek out a diverse group of qualified people to serve on boards.
According to the 2002 Spencer Stuart Board Index, 12 percent of companies in the Standard & Poor's 500 included women on their boards, with an average of 1.3 women per board. Also, three-quarters of boards had at least one black director, one-quarter had at least one Hispanic director and one-tenth had at least one Asian director. Minority representation was up dramatically since 1997.
There's no shortage of qualified people to serve on boards, it's just a matter of knowing where to look, Seymann said.
"We're going to do peer-topeer director placement, so that we each sit on four or five boards, and each of the people on the boards we sit on sit on another four to five boards, so we know thousands of people," Seymann said. "We know thousands of very, very good women who are ethnically diverse, very qualified, major corporate people. They may not be CEOs, they may be one level down and have not gotten tapped yet."
America West Holding Corp.
Business: Airlines and travel
Headquarters: Tempe
Officers on board: W. Douglas Parker, 41, CEO
Outside Directors:
Herbert M. Baum, 66, CEO, Dial Corp. John L. Goolsby, 61, retired, former CEO of The Hughes Corp. Walter T. Klenz, 57, CEO, Beringer Blass Wine Estates. Richard C. Kraemer, 59, president, Chartwell Capital Robert J. Miller, 58, senior partner, Nevada law firm Jones Vargas. Denise M. O'Leary, 45, private investor Richard P. Schifter, 49, managing partner, Texas Pacific Group John F. Tierney, 57, managing director, Castletown Financial Services J. Steven Whisler, 48, CEO, Phelps Dodge Corp.
Annual compensation for outside directors: $20,000, $1,000 for each board meeting and $4,000 for chairing a committee.
Dial Corp.
Business: Consumer products manufacturer and marketer
Headquarters: Scottsdale
Officers on board: Herbert Baum, Dial CEO
Outside Directors:
Joy A. Amundson, a principal in Amundson Partners Inc. Joe T. Ford, chairman of ALLTEL Thomas L. Gossage, retired, former chairman of Hercules Donald E. Guinn, chairman emeritus of Pacific Telesis Group. James E. Oesterreicher, retired, former CEO of J.C. Penney Michael T. Riordan, former chairman and CEO of Paragon Trade Brands Barbara S. Thomas, interim CEO of Ocean Spray Cranberries Salvador M. Villar, CEO of California Commerce Bank, a unit of Citigroup
Annual compensation for outside directors: $35,000
Microchip Technology
Business: Semiconductors
Headquarters: Chandler
Officers on board: Steve Sanghi, chairman president and CEO
Outside Directors:
Matthew W. Chapman, president and CEO, Centrisoft Corp. L.B. Day, president, L.B. Day & Co. Albert J. Hugo-Martinez, CEO, Hugo-Martinez Associates Walter Meyercord, CFO, Rioport.com
Annual compensation for outside directors: $13,000 retainer and $1,600 for each meeting attended.
PF Chang's China Bistro
Business: Restaurants
Headquarters: Scottsdale
Officers on board: Richard L. Federico, CEO
Outside Directors:
F. Lane Cardwell Jr., former president of Eatzi's Market and Bakery. James G. Shennan Jr., general partner, Trinity Ventures, a venture capital firm R. Michael Welborn, executive vice president, Bank One Kenneth J. Wessels, former CEO of Dain Rauscher Wessels M. Ann Rhoades, president of People Ink Lesley H. Howe, former senior partner with KPMG Peat Marwick, LLP
Annual compensation for outside directors: none
Board reform
Boards of directors are facing more guidelines to ensure they act only in the best interest of stockholders.
Limiting membership on a board's audit committee to individuals with no ties to the company.
Board members must spend more time examining company boards they serve on.
Insist on open and honest communication between directors and management.
Know they are empowered to disagree constructively with management when necessary.
Draft and implement guidelines for an active monitoring role for board members and a strict, unalterable focus on ethics.
Maintain a fully involved nominating committee that strives to remain independent in selecting directors.
Fortify the oversight abilities of the audit committee by adding financial management perspective and experience.
SOURCE: Securities and Exchange Commission, Korn/Ferry International


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