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After yesterday's press conference for the 2008 Prince of Asturias Awards a dapper Rafael Nadal made his way to the official ceremony, with mom Ana María Parera in tow, at the Hotel Reconquista today.
The sexy Spaniard has become the master of wardrobe changes lately and seemingly handles it all with ease: Rafa in his trademark sleeveless Nike, Rafa in green Nike golf wear, Rafa as Roger Federer, Rafa in his birthday suit!
And, thanks to DtL readers Barcelona2012 + Sonja we have motorcross Rafa from yesterday's press conference:
Phew. I'm completely out of breath just blogging about it - how does he do it?
PS - The hair hasn't been so bad lately either. Some guys have all the luck - double drats!
UPDATE: Here's video of a clearly humbled Rafa accepting the Prince of Asturias Award for Sports today in a totally different outfit. So I guess the suit in the very top image was his "arrival" outfit?
Boy, he's even got Shrieka beat now - geesh.
(images via Getty, RafaelNadal.com, ATP Tennis Blog)
Friday, October 24, 2008
(UPDATED) FASHION FIX: Rafa becomes tennis' latest fickle fashionista, birthday suit and all
Labels: fashion, Nike, Rafael Nadal, style, tennis
19 comments:
That was me fainting three times.
This is too much. I say it again: HE CANNOT BE SERIOUS.ReplyDelete
I'm sure Rafa was exclusively invented by some woman (apparently Ana Maria Parera) who wanted to create the perfect guy: good-looking, great hair, indescribable body, angel smile, delicate hands, yummy tooshie, and above all a sweet, humble, funny, dorky, smart, caring personality, good manners, a great sense of style, down to earth, friendly and lovable, successful and ambitious, plus amazingly sexy. He's got it all, dammit!!
And on a side note, the motocross outfit kills me. Thanks Rich, you made my day yet again.
so much beauty and amazing in one post. <3ReplyDelete
natch: good think you cleared that one up - we wouldn't want anything misconstrued on this blog!ReplyDelete
sonja + b2012 - thanks for the tip, can never have enough rafa apparently
That is great to see him so humble accepting that award. It looks like he can barely hold his head up!ReplyDelete
- AnonymousOctober 24, 2008 at 2:38 PM
He looks really happy, shy, proud, humble and appreciative when accepting the award. All a mix- cute to see.ReplyDelete
I really like how he looks in the tux in the first picture. Over the past couple of years he has had a gift of wearing ill-fitting tuxes- but it seems like that one fits him very well.
- AnonymousOctober 24, 2008 at 4:51 PM
The suit in two top pics is from pre-events of the day, the official audience with the Prince of Asturias. Note that Rafa's mother is wearing pants & silk tunic, clearly an afternoon wear.ReplyDelete
Rafa wore all slate-grey outfit for the awards ceremony. The Nadal womenfolk were in gowns there.
But did you see the exquisite dress on Princess of Asturias: dove-gray skin-tight little lace number? Ah, the joys of good taste and plenty of money.
- AnonymousOctober 24, 2008 at 5:26 PM
Sonja - MY THOUGHTS EXACTLY!!!ReplyDelete
Rafa seriously has it all. This is like next level stuff.
And that leather jacket scenario is ridiculously hot. DAMN.
Thanks Rich!
anon 7:51 - thanks for clearing that up! i'm still outta breath...ReplyDelete
- AnonymousOctober 24, 2008 at 7:27 PM
You're welcome.ReplyDelete
And, Rafa's "arrival" outfit was that cute striped sweater with smart neckline tape & tight grey designer jeans. He was filmed for Spanish TV wearing it during his morning flight with family from Mallorca to Spanish mainland. And he was in it arriving in front of the hotel for that short photocall you posted.
Phew, that is clear now. I swear, this boy is becoming more amazing by the day.
- nadalfanOctober 24, 2008 at 8:38 PM
He was always amazing...now everyone else gets to see it too.ReplyDelete
Thanks y'all, for ruining my weekend with wanting. Sigh. Lucky, lucky Xisca. Srsly, look how nicely the jeans molds his legs.ReplyDelete
Adorable little darling.ReplyDelete
You guys seen this one?
- AnonymousOctober 25, 2008 at 9:47 AM
chichi - thanks for the adorable pic of rafa! and his arms look like butter! *sigh* drool....ReplyDelete
babz - we ask that every week, right? It is just impossible yet it happens...*happy sigh*ReplyDelete
chichi that is adorable
Aw, too bad, chichi's link doesn't work for me. *??*ReplyDelete
But I bet it's general delicious Rafaness as always... ;-)
BTW babz I gotta say you look so beautiful in that icon pic of yours!
- AnonymousOctober 25, 2008 at 6:02 PM
*sigh* indeed.....ReplyDelete
don't you just wanna take him home and love him like there's no tomorrow....?
gosh, somebody save me!
Sonja, doesn't the link work for you? Just maximize the comment window, highlight the thing and copy paste on your browser. It poses no problem for me. You MUST see it! CUUUUUUUUUUUUUUUTE.ReplyDelete
Thanks for the compliment *blush* It is part of my campaign to show SAFIN what he's missing by mingling with that... that... popstar.
LOL totally j/k.
B2012: I know!!!! I seem to do this every week. I will try not to lust after him, and then some picture or story will come out and there I go again.
Yeah babz, that's what I did, but I always got an error message. I tried it on another pc today, and it worked - strange..... LOLReplyDelete
Anyways, what an ADORABLE picture. I love Dorky Rafa. He's my fave Rafa after Fighter Rafa (you know, on court animal and all).
LOL, yes you go show Marat what he's missing!! If he sees this and still goes out with that weird Russian lady, well his bad.
I should do that to Rafa, too. You hear me Rafa?! You would look sooo good next to a blonde, extremely stylish girl. And I'm not talkin' Shrieka. LOL


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CPP's Tubular Control Arm Install For 1963-1987 Chevy Trucks - Better Than A Bench PressWritten by on March 1, 2010 CPP's Strong & Safe Tubular Control Arms For '63-87 Chevy Trucks
Isn't it nice when form actually follows function? The factory built lots of good parts for your truck as a production vehicle to work hard-not to look great going down the street while riding inches above it. One of the things often overlooked on trucks is their generally greasy and dirty upper and lower control arms.
Every truck with an IFS has them and they are usually stamped steel from the factory and mounted to the front crossmember with rubber bushings on a cross- shaft. Most people pay attention to the other parts secured by the control arms like ball joints, spindles, and brakes, but not the arms themselves. To be honest with you, neither had I until I noticed the beating the lower control arms on my '72 Chevy C10 were taking from bottoming out. The front lower edge of the control arms sure were getting scraped up from the truck being so low, but what can you do?
Years ago, people used to cut and step control arms to help lower the truck and you could box them, but that's a lot of work, especially if they're already getting hammered. The thing most people don't realize is that while the lowers are getting scraped up, the front lower edge of the control arm is actually being pealed back every time it hits the pavement-not good. That lower front edge could also catch on something in the road and possibly rip the control arm or worse.
Luckily there's a fix. Classic Performance Products (CPP) has been making tubular control arms for cars and trucks for many years now to solve these problems. CPP's Totally Tubular control arms for '63-87 Chevy trucks address the aforementioned problems and more. They are made of heavy-wall tubing that is far more rigid than stamped, unboxed steel, and they mount all their control arms with patented self-lubricating, squeak-free bushings that are superior to rubber or urethane. Their design helps reduce damage due to bottoming out on the road and will work with any of the stock Chevy ball joints from '63-87 as well as stock power steering systems. CPP also uses a graduated bumpstop that provides more suspension travel and a better ride for those pushing the limits, but of course can be used in an otherwise stock truck. CPP also makes them to accept convoluted airbags.
One last improvement over the OE parts is that CPP's engineers incorporated five more degrees of cast in the upper control arms for a more positive road feel and so the steering would return to center quicker. GM did this design change starting in '73 so the steering actually had feedback from the road instead of being very light since the introduction of power steering to the GM line.
CPP stocks most OE and performance suspension and steering parts for your truck, so you can rebuild your complete frontend and have peace of mind. Think about pairing CPP's Totally Tubular control arms with a front sway bar to really make your truck ride, well, less like an old lowered truck! See how Classic Performance Products can help you and your truck.
More Photos From This Article View Slideshow
Here is problem number one that I had with my C10. It looked great stance-wise, but rode on the front bumpstops. Anyone with a lowered truck knows how annoying this is, CPP said their Totally Tubular control arms would help in this department.This is problem number two, which I didn't even know I had until it was pointed out while up in the air at CPP. Because the front edge of the lower control arm bottoms out (common with lowered trucks) with the road, the impact pushes the lower front edge back and bends the stamped steel lower control arm on the cross-shaft that bolts to the front crossmember. You can see here that the front edge of the control arm and the cross-shaft aren't parallel where they are supposed to be.So off come the control arms! Of course the wheels, brakes, and spindles need to be removed to get to the control arms. For anyone thinking about dropped spindles or a brake upgrade, now would be a good time and CPP has it all.Whenever loosening ball joint hardware on a truck that is suspended on a lift or a jackstand be sure to support the lower control arm with a jack before releasing tension. Notice the brake caliper hung on a hook from the frame; you don't need to disconnect your brakes if you aren't replacing the calipers.The stock lower control arms are heavy, so get a friend to help hold them while you undo the cross-shaft U-bolts.The stock upper control arms come off easily once the two nuts are removed. Save your alignment shims and replace them in the same spots to get your truck to the alignment shop before driving anywhere else!The CPP lower control arms bolt-in just like the stock pieces using the factory U-bolts. The bracket on back of the control arm is the lower shock mount; this goes to the rear.Here, we can see CPP's solution to problem number two. While they can't keep the lower control arm from bottoming out, they can control the damage and its effects. The CPP lower is designed to bottom out on the curved cross tube on the inside of the spring pocket. There is no threat of catching the front edge and the curve of the tube helps roll on and over any bit of asphalt. Also shown is CPP's graduated bumpstop.Not only do the CPP upper control arm look nicer, it's more durable than its stock, stamped-steel counterpart. It is more rigid due to the thick-wall tubing it's made from and has better bushings than the OE worn-out rubber bushings. CPP also made them a little longer than stock for easier alignment with a raised or lowered truck.
The CPP upper control arms go on just as easy as the old ones came off, remember to reinstall your alignment shims. CPP designed their control arms to utilize Chevy ball joints for stock spindles, ranging from '63-87, so specify what spindles you have when ordering.Now the spindle and brakes can all be checked out, re-greased, and reinstalled. CPP has just about anything you'd need to do this on a stock or custom truck should you need more parts or want to upgrade.At this time it was a good idea to upgrade an age-old Chevy/GMC truck problem-torn out upper shock mounts. The stock shock mounts on most all these Chevy and GMC trucks were single shear and have since torn the shock stud out of the frame over the years.If so, or to prevent this, CPP has this simple upper shock mount bracket to make it double shear and should last forever. You'll just have to drill a few holes.Since who knows how old all the steering links are in this truck and with it destined to hit the streets in today's traffic, CPP replaced the tie rods so it would handle at its best.After matching up the tie rod alignment and length measurement, Craig installs the new steering links. CPP makes their own billet aluminum tie rod sleeves. These take the place of the pesky stock ones with the clamps that are always a pain to adjust and don't look nearly as nice.The last upgrade is a CPP high-performance 11/4-inch front sway bar. I had never experienced the before and after ride benefits of adding a sway bar to a vehicle, and I was soon in for a treat.CPP tries to make the sway bar go in as easy as possible, but there is one rivet per side that needs to be taken out to make way for the sway bar bracket bolts. Safety first!
With the links in the ends of the sway bar started and secured at the lower control arms, Craig lifts the sway bar up the frame brackets and secures it into the sway bar bushings. Between the extra caster in the spindles, more room on the bumpstops, and the sway bar, the truck was 10 times as comfortable on the freeway than it was before! It really was night and day, and now it doesn't ride like an old lowered truck-it rides good. Do yourself a favor and call CPP today.

subset: commoncrawl


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Gibson 2013 Les Paul Signature T Gold Series Electric Guitar
(White Burst)
Sku #H90725000004000
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A golden tribute to the man who started it all.
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This œT Gold Series model adds extra class to this tribute to the man himself with the elegance of gold-plated hardware.
The Les Paul Signature œT is built on a foundation of the same traditional tonewood combination that helped to make the Les Paul Standard legendary when it first arrived six decades ago. A carved solid Grade-AA figured maple top lends bite and articulation to the sound, while a select mahogany back"treated with Gibsons traditional weight relief to increase playing comfort and enhance resonance"contributes superb warmth and depth. A solid, quarter-sawn mahogany neck is glued in and carved in the fast 60s SlimTaper profile, and topped with a rich brown Grade-A Granadillo fingerboard with 22 medium-jumbo frets and traditional trapezoid inlays.
Traditional touches include cream body and fingerboard binding, pickguard, and pickup rings, along with gold Speed Knobs and a black œbell truss-rod cover with commemorative œT engraving. Classic Gibson construction ensures optimum playability, too, along with traditional specs like a 24 ¾ scale length, a 1 11/16 width across the PLEK-cut Corian nut, and a 12-inch fingerboard radius for smooth, easy bending.
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brick monkey
How Google's "Business Photos" Are Helping Local Businesses
By David Weir on May 15, 2012 9:00 AM
Over the past two years, one of the many programs Google has been testing and developing is called Business Photos. It grew out of the "street view" aspect of Google Maps, which provides a 360-degree panoramic view of the area around a street address.
Business Photos now extends that same technology inside certain local business establishments that want to give it a try. Among the first piloting the technology are the Soma restaurant Ironside, nearby wine bar District, Public Bikes, and the Brick Monkey, in Redwood City.


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This mini-tee for your bouncing baby boy or girl is soft, comfortable and non-irritating to sensitive skin. The overlapping shoulder design promotes free movement for toddlers, cruisers and crawlers alike. This is a great gift for the new bundle of joy in your family.
Basic price without print
still to fill


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The Guru
On February 23, 1967, across the Great Pond at Abbey Road Studios, The Beatles were recording "Lovely Rita" for Sgt. Pepper... Meanwhile, at The Augusta General Hospital, Brian James let out his first cry to world. 20 years later in the summer of '87, Brian played "Lovely Rita" on the radio station he grew up with, WBLM. Taking over the Night Flight for the Captain, who moved to host The WBLM Morning Show, a teenage dream was realized. Brian "The Guru" James is a dyed-in-wool Mainah. In the 80's at Cony High School, He had a different colored Blimp t-shirt for each day of the week. A WBLM Loyal listener who ended up making the team. Pretty frickin' sweet bub! The Guru has been rockin' Blimpville for over 25 years and has hosted The Afternoon Express for nearly a decade. When he not rockin' live with BLM, he's rockin' at home in Westbrook with his wife Sherry, and sons, Sam and Carter. Rip it hahd weekday afternoons at work and on the way home!! Like him on Facebook! Oh yeah…he does weddings and parties with Dom too, visit http://www.maineplatinumdj.com/rockstar.php for more on that. And remember, if the conniption fits, wear it!


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Topic: [SOLVED] iRedAdmin-Pro-LDAP-1.4.1 url hangs
New on iRedMail.
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Changed debug to true at the /var/www/iredadmin/settings.ini with no result
Nothing appears at /var/log/httpd
What could be wrong?
- Urgent issue? Pay iRedMail developer to solve it remotely at $39.


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Zimbra is going to be launching a new product called the Zimbra Collaboration Suite Appliance (ZCA). The Zimbra Appliance is your email and collaboration cloud that is easy to deploy and administer on the VMware vSphere platform. ZCA enables customers to run a single instances of the 'Zimbra Collaboration Suite and operating system' pre-packaged as a virtual appliance, making this product ideal for SMB businesses with up to 1,000 mailboxes.
The Zimbra Collaboration Suite Appliance is available to customers for a private beta. We are looking for 5-10 businesses interested in evaluating the product and providing us with their feedback. The Zimbra Appliance Beta version requires vSphere 4.0 or higher already deployed on-premise.
If you would like to participate in the private beta please send an email to email@example.com.
The ZCA team


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Moot Court Associate Board (6020)
This Board is selected to serve as the leaders of the Moot Court Board as Associate Directors. Additional course information: Enrollment limited to members elected to this position. Students must have an overall GPA of 2.5 to register for academic credit in this course.
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Buy the numbers
In late winter, guests in white rockers sip coffee on the veranda of the clubhouse at Pinehurst Resort, overlooking a lawn that looks like it was clipped by a barber. Visitors stroll streets lined with boutiques and art galleries. Outside of town, wind whispers through longleaf pines: Its a good day for golf. In the heart of the village, daffodils are blooming early this year on the campus of FirstHealth Moore Regional, centerpiece of a three-hospital network that covers 15 counties.
One hundred twenty miles to the west, many businesses are boarded up and cars park behind chain-link fences in downtown Gastonia. Sidewalks are empty, unlike when this was the heart of Tar Heel textiles and busy merchants were updating storefronts with the now-weathered aluminum facades popular in the 1960s. Ten minutes away in the northeast suburbs, CaroMont Healths Gaston Memorial Hospital, with flowing curves and sparkling white exterior, belies Gaston Countys fading industrial heritage.
Despite their dissimilar settings, the hospitals could be twins. With fewer than 450 beds each, they are medium in size but among the states best in various ratings. And both are at the forefront of a revolution in how Tar Heels and their employers pay health-care bills that totaled $60.2 billion in 2010. Value-based healthcare is coming, which means hospitals will increasingly be paid for how successfully they treat patients, not merely for how often they treat them.
In the complex world of medicine, it is a stunningly simple but radical reversal of a compensation model that traditionally rewarded hospitals and physicians for poor results and penalized them for excellence. If, for instance, unsterilized equipment infected a patient, the hospital and surgeons were paid for the operation then paid again to cure the consequences. Thats one reason the states per-capita hospital bill grew to $2,280 in 2009, up an average of 5% a year since 1991.
For the last year, CaroMont and Blue Cross and Blue Shield of North Carolina, the states largest insurer, have replaced gimpy knees for a fixed price that includes preliminary work-ups in doctors offices, surgery and rehabilitation after the patient goes home. FirstHealth will ask Medicare this spring to let it replace hips and knees and perform heart-bypass surgery on the same basis. For competitive reasons, neither will discuss bundle charges, but North Carolina hospitals typically charge $26,000 to nearly $60,000 for joint-replacement surgery alone, depending on the joint and hospital location. Bypass surgery frequently tops $70,000.
On one level, you can ask why the heck we werent doing this all along, says Kevin Schulman, a Duke University physician who also teaches in its business school. Why werent people holding hospitals accountable for the quality of care provided at their sites? What Medicare is pursuing now, along with a variety of private payers, is a step away from just writing checks to hospitals irrespective of whether the service was indicated or provided in the best possible manner and then writing another check to fix it if theres a problem.
Bundled-care plans are value-based. If FirstHealths bypass patient recovers better than expected, the hospital and physicians will receive Medicares fixed price, yet to be negotiated. If the patient falters or has to return to the hospital, perhaps with an infection because doctors and nurses failed to give him antibiotics dictated by surgical protocol, FirstHealth and its physicians could be forced to eat tens of thousands of dollars in extra care. Quality with a carrot and stick? Yes, FirstHealth CEO David Kilarski says. Tying reimbursement to quality certainly ups the stakes for hospitals. These are things weve prided ourselves on doing better than a lot of surrounding institutions, so Id like to think were doing it to provide better patient care and not just because its going to increasingly determine our reimbursement. But no doubt, the stakes have been increased.
Only gradually will patients become aware of the trend. Not so for insurers, hospital administrators and employers, who bear the brunt of health-care costs. At least eight provisions, most embedded in the Affordable Care Act of 2010, link compensation to quality. They began in 2011 with rules that prohibit Medicare from paying extra to treat hospital-acquired infections. More will be phased in through 2015, including across-the-board reductions in payments for patients readmitted within 30 days, additional bundled-care pilot programs and steeper cuts in Medicare and Medicaid payments to treat hospital-acquired conditions and medical accidents. Medicare accounts for 60% or more of many hospital budgets, and private-sector insurers such as Blue Cross typically follow its lead on pricing and policies.
Value-based care is already affecting hospital bottom lines. Insurers and employers are guiding workers to standout hospitals and physicians, bypassing those with less-sterling records. Self-insured Salisbury-based Food Lion LLC, which operates more than 1,100 supermarkets nationwide, provides injured and sick workers information on hospitals and specialists that, based on data filtered from health-care payouts for its 73,000 employees, get better and cheaper results.
However, Food Lion also illustrates a paradox of value-based hospital compensation. Though medicine is quintessentially personal, pay-for-performance relies on huge stores of data that harbor silent stories of medical success and failure. Nowhere is that more obvious than on the outskirts of Chapel Hill, where inside the glass walls of Blue Cross and Blue Shields trapezoidal headquarters, analysts are mining records of more than 3.7 million customers who submitted $11.5 billion in claims in 2010. What emerges is a list of more than 30 Tar Heel hospitals that have outstanding success for procedures ranging from bariatric surgery for weight control to treatment of exotic cancers.
Improving quality of care for our members when theyre in the hospital is better for them fewer poor outcomes and complications and who wants to have to be readmitted? And it ultimately will reduce costs for the health-care system as a whole, says Blue Cross Vice President Eugenie Komives, a physician who is the insurers senior medical director. For several years, Blue Cross has negotiated contracts that financially reward hospitals for better results in treating heart attacks and heart failure, pneumonia and other potential killers and for cutting readmission rates and controlling infections.
Underlying the quality movement is a grim reality: Medical bills were the leading cause of more than 25,000 personal bankruptcies in North Carolina in 2010. Payment reform is absolutely necessary, says Adam Searing, director of the Raleigh-based North Carolina Health Access Coalition, a nonprofit consumer group. We simply must get a handle on costs and improve quality, and things such as bundling payments and linking payments to outcomes are some of the most promising strategies to achieve that end. Behind the promise, though, could lay pain for hospitals.
In Winston-Salem, a city with one foot in the past and the other in the future, researchers grow replacements for diseased human organs, while health-care ironies sprout at every turn. Laboratories in a city built on cigarette manufacturing probe nicotine as a possible treatment for Alzheimers and other neurological ailments. Medicine is the new tobacco, and Wake Forest Baptist Medical Center is widely considered one of the nations best hospitals.
But not by Medicare. As usually happens when hospital rankings are revealed, the federal insurance program for people older than 65 or permanently disabled ignited a storm last fall by ranking Baptist below par in four critical measures. These included heart-attack death rates from 2007 through mid-2010, along with other criteria such as complications after surgery. In contrast, Moses H. Cone Memorial Hospital in Greensboro Cone Healths flagship is highly regarded but lacks Baptists national reputation was zinged only for having a slightly worse-than-average pneumonia death rate. Most hospitals in the state fell in the average range. Such scores are more than ammunition for advertising campaigns theyre quality measures that will increasingly determine billions of dollars in hospital revenue. Are they fair?
We dont question if theyre fair or not, says surgeon Russell Howerton, Baptists chief medical officer. He, like others here, stoutly defends the hospitals quality of care. They are what they are, which is, useful but not perfect. If those are the rules of the game, those are the rules well play by, and well seek to optimize the outcome for our patients. Like medical directors at FirstHealth and other hospitals around the state, Howerton says such ratings are useful yardsticks for improvement. But his sense of resignation goes only so far. Our chief financial officer will tell you that quality has a financial return of its own, as well as benefiting the patient. He wants to make sure were not financially disadvantaged by measuring tools that by virtue of the outcome of only one patient could have a large financial outcome for us. Some Medicare scores that dropped Baptist below national norms turned on minute statistical differences.
At the heart of most ratings, including the methodology Business North Carolina used in its rankings this year, is Medicare data that compares hospitals. Our scores are based on 12 weighted criteria that not only examine patient outcomes but patient satisfaction and how hospitals are rated by other organizations. Some of those include data collected by the Research Triangle Institutes health-care research arm and opinion surveys of hundreds of the nations top doctors and surgeons. The enormous volumes of information gathered by Medicare and closely related Medicaid, which mostly insures patients who cant afford to pay, allows analysts to spot trends and outline deficiencies.
Based on Medicare data, 30.1% of Baptists heart-failure patients were readmitted to the hospital in less than a month, compared with a national average of 24.7%. That drew a rating of worse than the U.S. rate, while smaller Northern Hospital of Surry County in Mount Airy, at 23.2%, was deemed no different than U.S. rate. Does that mean Northern is a better hospital than Baptist, one of a quartet of top teaching and research hospitals in the state Duke University Medical Center, UNC Hospitals and East Carolina Universitys Brody School of Medicine are the others where cardiologists from around the world send some of their most difficult cases? Not even Northerns boosters make that argument.
Its rating is based on 239 patients, fewer than half of Baptists 786. At some small hospitals, data such as heart-attack death rates are based on even smaller numbers, sometimes fewer than 50 cases. Those are levels at which luck good or bad can statistically swing a hospital from above to below average. Other, harder-to-define factors can be involved, too.
One is unintentional screening, which happens when small hospitals with few specialists and little sophisticated equipment send high-risk patients directly to larger hospitals from their emergency rooms rather than admitting them. Patients dont show up in a hospitals data unless theyre admitted. The victim of a serious stroke who arrives at a rural hospital might be sent to a medical center while a patient with a transient ischemic attack, a treatable mini-stroke with a likely good outcome, would be admitted. The tool CMC Centers for Medicare & Medicaid Services devised is obligated to measure every facility from small to large, Howerton says. It does a good job at trying to measure every kind of facility, but when applied to certain kinds, its not as precise as it could be. It just happens that the experience of our organization is not one well measured by that tool.
In February, Medicare released a study that supports his premise. It says higher complication rates at teaching hospitals probably stem from more-complex illnesses and injuries. Such skepticism is not universally shared. At least not by a doctor who in the 1990s collaborated with Medicare on developing its ratings. Thats Duke Universitys Schulman, who says the database, called Hospital Compare, is adjusted for risk. As long as Ive been involved in medicine 20-some years people have been arguing that their patient populations are sicker on average than others. In fact, he adds, because large hospitals are judged on larger numbers of patients, scores typically show less volatility. One or two bad outcomes, for example, wouldnt have a devastating impact.
Others contend that this years ratings, including those by BNC, show that good small hospitals are often overlooked. Nearly half of those that made the list had fewer than 200 beds, and two McDowell Hospital in Marion and Presbyterian Hospital Huntersville had fewer than 100. Small organizations have fewer people, which may give them a more-focused capacity to deliver the best patient care, says Jeff Spade, executive director of the North Carolina Hospital Associations Center for Rural Health Innovation and Performance. They may have only a few nursing units, not the 10s or 20s at big hospitals, and they may have 40 or 50 doctors on the medical staff, not 400 or 500.
While such hospitals might lack the money for a top magnetic-resonance scanner about $3 million, including the suite in which its housed they may partially offset that with tighter teams. An operating-room nurse might be less reluctant to point out a problem to a surgeon he or she knows. Quality care extends to the relationships between patients and their doctors and nurses, which can show up in patient-satisfaction scores that Medicare and other insurers are increasingly tapping to determine how much hospitals are paid.
With only 54 beds, Angel Medical Center in Franklin, deep in the mountains of western North Carolina, ties Duke Medical Center, with nearly 1,000 beds, and UNC Hospitals, with almost 700, for highest patient satisfaction. And if pay-for-performance care brings simplicity to the complex financial world of medicine, improving quality is not always about complex technology. Emphasis on hand-sanitizing by doctors and nurses before and after contact with each patient has made dramatic improvements in controlling infections in the last two decades. Counting scalpels and surgical sponges before and after operations has reduced accidents in which they are left in patients. Many improvements were adopted after a 1999 report by the Institute of Medicine that concluded that as many as 100,000 patients a year died because of medical errors.
Weve known that preoperative, one-time antibiotics within an hour of surgery is the right thing to do since I was a resident 30 years ago, says the medical director of one of the states largest hospitals. But about 15 years ago, when medical organizations started measuring so- called processes such as starting heart-attack victims on preventive aspirin regimens that Medicare uses in grading hospitals, he was shocked. We found out, whoa! Doctors were only doing this 80-some percent of the time. You would not take a flight that landed safely only 80% of the time.
He draws his own conclusion. Thats not an indication were bad people or bad organizations. But it is an indication that if we apply the tools theyve tested in other organizations, we can move from very good to near perfect.
Regenerative knee disease has taken its toll. Now 60, retired from a company that makes nuclear reactors, he has come to this Triangle hospital from Virginia because of its reputation as one of the nations best. A nurse carefully writes wrong limb on his knee with an indelible marker, a practice adopted by orthopedic surgeons to prevent mistakes. In his preoperative haze, he looks down in bed at his knee and is jolted alert. The nurse has written wrong limb on the wrong knee. Value-based care is unfolding in an arena of infinite opportunities for error with the vagaries of human anatomy and illness difficult to reduce to scores and ranks. Few think it will be painless, but many think it will be worth it. Well, you know, Schulman says, they charge an awful lot of money to put you in bed overnight, and you should get something for it.
Administrators fret that hospitals will be expected to take on greater responsibilities, including aspects of health care over which they exercise little control. Health-care reform, for example, establishes hospital Accountable Care Organizations, which might be pressured to take on such community-health threats as diabetes and smoking. Similar to bundled care, these measures would be overseen by hospitals but depend on physicians, clinics and others that might not even be affiliated with the hospital. Were leaning on hospitals to be accountable for what happens within their walls, Schulman says. But one cloud in this is that ACOs say the hospital is now in charge of providing continuity of services, even when patients dont even go to the hospital. Thats a huge leap in terms of the scope of responsibility for hospital management.
Searing, the health-care consumer advocate, says theres also concern that patients will be bypassed as value-based care takes hold. That includes things like releasing data on how patients are doing in the new payment models. Some fear that hospitals and physicians, already under pressure from slim Medicare margins, will cut corners such as gambling on releasing patients prematurely. In a profession equal parts art and science, dramatic change is coming.
In the 90s, when best practices and formal process control took hold, doctors grumbled about being forced to practice what they called cookbook medicine. Those kinds of measurements are what Medicare and private insurers increasingly will rely on to judge quality and compensation. Hospitalist Daniel Barnes, until recently interim chief medical officer and now president of FirstHealth Physician Group, says doctors gradually changed their culture to accept process measures. Theyre evidence-based and have been demonstrated to improve patient care, so theyve become more accepted. At FirstHealth, the same culture shift is already under way.
Weve had a focus on readmissions and a number of these quality indicators now for a number of years. Weve tried to incorporate them into our program and into reimbursement for physicians so quality is really incentivized. Hospitals will be increasingly applying the same principle with value-based care and hoping for similar results for the same reason Barnes says its working at FirstHealth. Its also the right thing to do.
To purchase the issue with the complete Top Hospitals listing, click here.


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Darci Marchese, wtop.com
WASHINGTON — Foreclosures have been weighing down the housing market for years now, but in some states, including Maryland, short sales are surpassing them.
According to RealtyTrac, 2012 saw a big increase in short sales in Maryland.
RealtyTrac Vice President Daren Blomquist says short sales made up of 28 percent of all home sales in Maryland. Foreclosures accounted for 10 percent.
In 2011, foreclosures made up 44 percent of the market.
"Banks are opting in greater numbers for short sales rather than foreclosure," says Blomquist. That's mainly because the foreclosure process is so lengthy in Maryland.
But Maryland isn't seeing an end to foreclosures, Blomquist says. Foreclosure activity has increased for seven consecutive months, and that will eventually result in foreclosure sales. It will take at least another six to 12 months for those foreclosures hit the market.
The trend is similar in D.C. because of city intervention to stop foreclosures there. Blomquist says he expects to see more short sales this year after short sales increased 10 percent last year.
Virginia continues to see fewer short sales and foreclosures. Blomquist says the state has moved through much of its distressed properties and is enjoying a healthier market.
View RealtyTrac's entire report.
Follow @WTOP on Twitter.
Sure, you could grill another hot dog. Or, you could try one of these 30 recipes for foods you never knew you could cook on the grill.


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Current AnnouncementsFROM: PARKING AND TRANSPORTATION RE: Vulcan Flyer - Spring Break Hours
Sent: 3/6/2013 2:04:17 PM
To: Students, Faculty, Staff
Vulcan Flyer – Reduced hours during Spring Break
From March 17th through March 22nd, the Vulcan Flyers will run on a reduced schedule. Hours of operation will be as follows:
8:00 a.m. – 8:00 p.m.
Wal-Mart shuttles will continue to run during Spring Break. The last shuttle from Wal-Mart will be 7:30 p.m.
Thank you,
Parking and Transportation


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The Book of Treasures
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Flip Words
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To beat this addictive puzzler, you'll need to exercise your mental muscles! Start with the first letter of a familiar phrase, then fill in the missing letters. Once you recognize the phrase, you can submit your guess - or better yet, try to reveal all the letters for an extra special bonus. Because you can download new phrases and create your own, you'll never run out of word-flipping fun!
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GREENVILLE, N.C. - The East Carolina women's golf team is one of 24 teams headed to the Central Regional the NCAA Division I Golf Committee announced Monday evening.
The Lady Pirates, who earned their fifth straight at-large bid, were chosen as the No. 19 seed in the Central Regional, which will be played at the Ohio State Scarlet Course in Columbus, Ohio, May 10-12.
"I'm very proud of our team for receiving a bid to compete in the NCAA's," Williams said. "It has been a rewarding year in a lot of ways because we have gotten contribution from a lot of different players and the team has been extremely focused and hard working. It is nice to see that hard work rewarded.
"One of our main goals this year was to receive our fifth-straight bid to the NCAA Regionals. This team has bought into the tradition and standards set by those before them, which makes it even more special and rewarding."
The East Regional is one of three regional tournaments, which will be held to determine the championship field. Regional tournaments are considered preliminary round of NCAA championships competition, and all national championship policies will apply.
A total of 378 participants have been selected for the regional competition. Of these players, 126 will advance to the championships finals May 22-25 at the Vanderbilt Legends Club in Franklin, Tenn. and will be hosted by Vanderbilt University. Eight teams and two individuals will advance from each region.
The Lady Pirates (102-48), in its 12th year of existence, will make their eighth team appearance in the NCAA Regionals dating back to the 2002-03 season, where they garnered a No. 12 seed in the East Regional in Winston-Salem, N.C. finishing tied for 14th. The Pirates were a 15 seed during the 2004-05 campaign in Gainesville, Fla. finishing in 17th.
Former Pirate Adrienne Millican participated in the NCAA Championships as an individual in 2004 placing in a tie for 34th out of 126 golfers, while Lene Krog represented the Pirates at the championships as an individual in 2007 before withdrawing due to an injury after 36 holes.
After claiming its first Conference USA Championship in the spring of 2006, the Pirates earned an automatic bid to the East Regional heading to Greensboro, N.C. as the No. 20 seed and finished tied for 19th. The following year the Pirates returned as a team with a No. 13 ranking in the East Regional where they finished 12th of 24 teams in Athens, Ga.
In 2009, ECU narrowly missed making its first ever NCAA Championship appearance, falling two strokes out of eighth place in Gainesville, Fla. posting a three-day score of 892 (283-313-296) where the Pirates led after the first day of competition.
Two years ago in 2010, the Pirates garnered a 20th seed in the East Regional, which was played in their own back yard at the Ironwood Country Club. ECU finished 12th out of 24 teams shooting a tournament score of 895 (293-305-297).
Last year the Pirates garnered a No. 19 seed in the Central Regional where they finished 20th with a tournament score of 945.
The selection to the 2011-12 East Regional marks the first time ECU has received five consecutive at-large bids and it's the 10th-straight season where the Pirates will be represented in the NCAA Regionals.


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LANSING, Michigan - Get on the inside track of Michigan's transportation future, and learn what's ahead and how it could impact your Michigan community during the Michigan Municipal League's 2012 Capital Conference, March 20-21, 2012. This year's Conference will include a session about the state's transportation future, including the latest updates on where transportation legislation is headed in 2012 from Senator Tom Casperson, Chair of the Senate Transportation Committee, and Representative Paul Opsommer, Chair of the House Transportation Committee.Troy Chamber of Commerce President Michele Hodges will talk about what transportation means to the business community. Let's Save Michigan advocate Sarah Szurpicki will offer insights on why transportation is so vital to Michigan's future. Session moderator will be Linden Mayor David Lossing, vice president of the Michigan Municipal League Board of Trustees. General Session, titled Taking the Inside Track on Transportation is 1:45-2:45 pm Wednesday, March 21.Casperson served in the Michigan House of Representatives for six years, from 2002 to 2008. In 2010, he was elected to the Michigan Senate, making him the first Republican to represent the 38th Senate District. The 38th District serves 13 of the Upper Peninsula's 15 counties, making it bigger geographically than 9 states. He serves as chair of the Transportation Committee and the Natural Resources, Environment and Great Lakes Committee.Read additional posts about the 2012 Capital Conference here:- How Green is Your Government? Find out at Capital Conference- Peter Anastor to Talk Brownfield Tax Credits at Michigan Municipal League Conference- Lt. Gov. Brian Calley to Discuss Personal Property Tax at Capital Conference- Michigan Municipal League Launches Mobile App for Capital Conference- Oklahoma City Mayor Mick Cornett to Discuss Placemaking at Capital Conference- Energy, Environment, Transportation Policy: What's Ahead? Find out at Capital Conference - Capital Conference General Session To Have Transportation FocusMatt Bach is director of communications for the Michigan Municipal League. He can be reached at firstname.lastname@example.com and (734) 669-6317.
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text:
Oct. 24 Calendar
Published: Thursday, October 24, 2013 at 12:30 a.m.
Last Modified: Wednesday, October 23, 2013 at 5:42 p.m.
Bring Calendar information to 30 E. First Ave., email it to email@example.com, or mail it to The Calendar, The Dispatch, P.O. Box 908, Lexington, 27293 so it is at The Dispatch one week prior to its publication date. Include an address for the event. Events listed below are in Lexington, unless otherwise noted. For publication of church and nonprofit yard sales, please call classified advertising at 249-1637.
First Lutheran Church, 320 S. State St., will show for free "Bridge to Terabithia" at 7 p.m. Friday in the Family Life Center, which is entered through the red door in the back. Free popcorn and drinks will be served during the movie. Bring lawn chairs, blankets, or use church chairs. For more information contact the church office at 248-6018.
Ledford High School Class of 1978 will host a class reunion Nov. 1 and 2. On Nov. 1 the class will attend the 6:30 football game at Ledford Stadium. Look for a banner reading Class of 1978. The class will meet at Willow Creek Country Club, 800 Country Club Drive, High Point on Nov. 2. Casual attire. Cost is $30 per person. Calle Debbie Montgomery, Joe Gordan or Terri Wells James at 608-7010 for more information.
Linwood United Methodist Church is selling cookbooks. They are $10 each. If you are interested in purchasing one, call 247-2784.
Meadowview's Seniors are planning a Myrtle Beach trip Nov. 15, 16 and 17. If interested please call the church office at 249-2680. There are a few seats left.
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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Latest Headlines
Cooler than average temperatures this week.
A company said it has faced challenges since seeking approval to put a care ...
The No. 24 Arkansas baseball team (21-13) raced out to an early lead Wednesday ...
Due to the threat of inclement weather, Arkansas baseball's series opener with ...
Boca Raton, FL (Sports Network) - Rocco Mediate fired a course-record, 11-
under 61 on Saturday and moved three strokes clear of the field after two
rounds of the Allianz Championship.
Mediate finished 36 holes at 16-under-par 128. He set both the 18- and 36-hole
scoring records. Craig Stadler had the old 18-hole record of 63 on The Old
Course at Broken Sound Club, while Tim Simpson and Tommy Armour III had posted
131 in 2010.
First-round co-leader Tom Pernice, Jr. carded a 7-under 65 to end two rounds
at minus-13. Bernhard Langer, who shared the first-round lead with Pernice,
shot 67 and is alone in third at 11-under 133.
David Frost fired a 65 of his own and jumped 22 places into fourth at minus-9.
Defending champion Corey Pavin posted a 3-under 69 and is tied for fifth at 8-
under-par 136. He was joined there by Fred Funk (69), Larry Mize (67) and Mark
O'Meara (67).
The Sports Network


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I'm sure some of you have got this email as well but thought I would share it on the forums.
Here is the text from the email I got:
Motion camera pictures outside of Dubois.
One of the ranchers cows died and he set up a motion camera to see what animals might visit the carcass and captured some pretty neat shots.


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Hitachi Deskstar H3IK30003254SW /.0S03230 3000GB / 3TB 5.4K SATA Hard Drive - Brand New
Capacity: 3TB
Spindle Speed: 5,400RPM
Interface Type: SATA
Disk Size: 3.5inx1.0in LFF Hard Drive
Sustained Throughput (MBps):
Average Seek Time (read/write ms):
Electrical Interface Speed: SATA 600 - 6.0Gbps
On-Board Cache: 32MB
Highest capacity and reliability with a proven design
The Deskstar hard drive provides an enormous 3TB capacity and features innovative CoolSpin technology to deliver a greater level of power efficiency and quiet operation for energy-conscious, environmentally-friendly computers. Key to CoolSpin technology is an optimization of motor speed to provide an ideal balance of performance, power utilization and acoustics. The CoolSpin technology, along with other Hitachi power management techniques, gives the Deskstar its 29% power savings over the Deskstar 7K3000. This new 3TB is the first Hitachi CoolSpin hard drive with a 6Gb/s SATA interface. With low power, high capacity and cool operation, the 3.5-inch Deskstar allows manufacturers to leverage the benefits of the latest components and operating systems to deliver more eco-friendly systems. Manufacturers planning to use the highest capacity 3TB drive in systems should consult the Hitachi High Capacity Technology Brief.
Innovation for a more sustainable environmentThe Deskstar 3TB 5400 rpm drive demonstrates Hitachi ecological leadership with its halogen-free design and power-efficient operation. Both of these features helped qualify the drive for the Hitachi EcoTrac classification, which identifies products that minimize environmental impact in the areas of product design, manufacturing, operation and disposal.
Hitachi p/n: 0S03230 /
Hitachi Model: H3IK30003254SW
Manufacturers planning to use the highest capacity 3TB drive in systems should consult the Hitachi High Capacity Technology Brief.
Dell CC852 Tray and PN939 Interposer Kit
IBM 42R4129 / 42R4131 SATA/SAS Hard Drive Tray
Dell F9541 / NF467 / H9122 / G9146 / MF666 / D981C / 0D981C SAS / SATA Hard Drive Tray/Caddy
Toshiba MG03ACA300 3TB Enterprise SATA Hard Drive
HP Compaq 373211-001 SATA / SAS Hard Drive Tray / Caddy
Seagate ST33000650NS SATA Hard Disks


text: Report: TEDGlobal 2011, day 2: viruses and Bad Science David Rowan's Blog 14 July 11 Misha GlennyJames Duncan Davidson / TED David Rowan Editor of Wired magazine Follow @iRowan The strongest session so far at TED Global in Edinburgh was on Wednesday afternoon, titled "The Dark Side". Speakers recounted their experiences challenging corrupt systems -- sharing extraordinary, moving and sometimes hilarious personal encounters. Here are some highlights:Mikko Hypponen, chief research officer at F-Secure Corporation in Finland, has tracked computer viruses since they began -- identifying the Sasser outbreak, and briefing governments about the Stuxnet worm. "I love the internet," he said, as he showed a 5 ¼-inch floppy disk containing BRAIN.A, the first PC virus his team found, back in 1986. "We know where it came from," he said. "It says so inside the code." Which, indeed, it did -- revealing the name, address and phone number of the Pakistan-based writers:Welcome to the Dungeon © 1986 Basit * Amjad (pvt) Ltd. BRAIN COMPUTER SERVICES 730 NIZAM BLOCK ALLAMA IQBAL TOWN LAHORE-PAKISTAN PHONE: 430791,443248,280530. Beware of this VIRUS.... Contact us for vaccination...Six months ago, Hypponen decided to go and visit that address in Lahore -- where, indeed, he knocked on the door and found the two brothers who wrote the virus, Basit and Amjad Farooq Alvi. "And both had had their computers infected dozens of times by other viruses," Hypponen explained. "So there's some sort of justice in the world."It was a way of explaining how viruses are now a global problem: his firm finds hundreds of thousands of pieces of malware every day, much of it now written by organised crime gangs. He showed the Russian website Gangsta Bucks, where infected computers are traded. He showed a live list of available credit card numbers, with matching customer addresses (which I can only hope will be obscured when the video of the talk goes on TED.com). He also explained how he traced a line in another virus's code to St Petersburg: the virus writer had included his car registration in the code as a means of declaring authorship. "But mostly we don't even know which continent they're in," Hypponen said. And mostly the resources to fight such criminals are simply not made available."If we don't fight online crime, we're running a risk of losing," he concluded. "We have to do it globally, and right now. We have to find the people with the skills [to write these viruses] but before they have the opportunity."Former BBC journalist Misha Glenny, author of the great book McMafia, about his journey in the criminal underworld, offered a similar plea for governments to engage with criminal hackers, rather than jail them. He cited a story covered in WIRED a few months ago about Max Butler, who as "Iceman" crowned himself king of a global online fraud network. "I don't think people like [Butler] should be in jail," Glenny said. "Hackers should be recruited and mobilised on behalf of the state. We need to engage and find ways of offering guidance to these people. Or we will be nurturing a monster we cannot tame."The evidence is everywhere that "we are at the beginning of a mighty struggle for control of the internet", Glenny said. He cited Anonymous's targeting of Fox News -- raising a laugh for pointing out "the irony of Rupert Murdoch's News Corp being a victim of hacking for a change". A security friend told Glenny that there are two types of company: those that know they have been hacked, and those that don't. He cited six examples of hackers who learned their skills in their early to mid tenns; who each had an advanced ability in maths and science; who failed to demonstrated any real social skills; and who consistently manifested a degree of Asperger's syndrome (which, Glenny said Simon Baron-Cohen told him, is also evident in Gary McKinnon -- currently facing prosecution in the US). Read page 2 12 Read on one page Latest on wired.co.uk


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I see Pelini might be meeting with Tennessee who Rhoads be a candidate there?
Just worried things scare me and Wisconsin and Nebraska scare me!
Tennessee Volunteers
Names to watch
Larry Fedora - North Carolina State head coachJimbo Fisher - Florida State head coachButch Davis - Former North Carolina head coachButch Jones - Cincinnati head coachDirk Koetter - Atlanta Falcons offensive coordinatorKirby Smart - Alabama defensive coordinatorDan Mullen - Mississippi State head coachChad Morris - Clemson offensive coordinatorBo Pelini - Nebraska head coachJim Tressel - former Ohio State head coach
UPDATE: Louisville's Charlie Strong is the latest candidate to turn down Tennessee. The Volunteers' search is back to square zero. Two directions the team could go at this point.
Tennessee could press to land North Carolina head coach Larry Fedora.
"Sources around North Carolina and Fedora have indicted that he will likely stay at North Carolina,"VolQuest.com wrote.
Nebraska's Bo Pelini may be the next high profile coach Tennessee pursues.
"Sources told Volquest late Wednesday night that Pelini had reached out to some to express interest in the Tennessee job," the website reported.
Pelini was believed to be a frontrunner for the Arkansas opening until the program's 70-31 loss to Wisconsin. Rumblings of Pelini's interest in returning to the SEC have persisted for quite some time. He may be the next candidate on Tennessee's radar.
If you have a problem - if no one else can help - and if you can find
them - maybe you can hire: The A-Team.
I'm more worried about Pezzetti leaving and there being 2 head coach openings in Ankeny.
No more of these threads please.
Worrying about other schools taking other schools coaches so they might take our coach might be reading into things too far.
Should I be worried about CPR taking a not-yet-open position based on the fact that Pelini was included in a list of 10 possible candidates despite taking a monumental *** kicking in his last game?
CPR to the Eagles?
Originally Posted by Clonefan32
CPR to the Eagles?
The Florida Gulf Coast Eagles????
No WAY!
"I'm the one who knocks."
CPR to Manchester United?
Nebraska fans are spoiled and expect conference championships every other year and national championships every five years. Bo would make many people in Nebraska very happy if he would leave on his own. His demeanor, his staff, and his record are not appreciated. There is one huge problem however. If a school fires a coach that averages 9 wins a season it is difficult find attractive candidates for the position.
CPR to the Chiefs?
Let Prohm's Posse Ride: Hallice, Brady, Stu, Lard, Naz, Deonte, Monte, Matt, Simeon, Jordan, and Babb.
Originally Posted by Ciclone
The Florida Gulf Coast Eagles????
No WAY!
now this thread is just stupid at least the other one has some legs.
Can we get a banhammer on the next idiot that makes a thread like this?
Originally Posted by Wesley
#TeamProhm #ProhmanEmpire #ProhmanColiseum
Originally Posted by iowa_wildcat
Nebraska fans are spoiled and expect conference championships every other year and national championships every five years. Bo would make many people in Nebraska very happy if he would leave on his own. His demeanor, his staff, and his record are not appreciated. There is one huge problem however. If a school fires a coach that averages 9 wins a season it is difficult find attractive candidates for the position.
Yeah Nebraska would never make a stupid decision like that. HA!
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