text:
Democratic Socialist Conference Collection, 1984-1991
Call no.: MS 325
Includes transcripts of papers delivered at conferences (1985-1990) on democratic socialism, and correspondence (1984-1991) between Stephen Siteman, former Executive Secretary of the Socialist Party of America, and Frank Zeidler, former Mayor of Milwaukee, Socialist Party candidate for President of the United States, and national chairperson of the Socialist Party USA.
- Socialism--Africa
- Socialist Party of the United States of America
- United States--Politics and government--1981-1989
- United States--Politics and government--1989-1993
- Siteman, Stephen
- Zeidler, Frank P

subset: commoncrawl


text:
2014 West Virginia Chemical Release
On January 9, 2014, an estimated 10,000 gallons of an industrial chemical, 4-Methylcyclohexanemethanol (MCHM), spilled into the Elk River just upstream from the Kanawha County municipal water intake in Charleston, West Virginia. This municipal water system serves nearly 300,000 people whose water was affected by the chemical spill. Due to the uncertainty over the chemical levels in the water supply, the Office of the Governor issued a "Do Not Use" order at 6:00 pm on January 9, 2014. Later that evening, the West Virginia Department of Health and Human Resources contacted CDC about the release and requested assistance to review water sampling data and provide a drinking water screening level for MCHM.
On January 21, 2014, the manufacturer reported that another material was part of the chemical release that occurred on January 9, 2014. This material has been identified as a proprietary mixture primarily composed of propylene glycol phenyl ether (PPH) and dipropylene glycol phenyl ether (DiPPH). It was in the same tank and entered the water system at the same time as the MCHM. This mixture represented a relatively small percentage (approximately 7.3% by weight) of the total amount in the tank.
CASPER Survey Released – 7/7/2014
The West Virginia Department of Health and Human Resources Bureau for Public Health released the Community Assessment for Public Health Emergency Response (CASPER) report which surveyed a representative sampling of households across the nine county area affected by the Elk River Chemical Spill.
Findings of Emergency Department Record Review Released – 4/23/2014
The West Virginia Department of Health and Human Resources Bureau for Public Health released results from the medical chart review of patients who presented themselves to 10 area hospital emergency departments in the 9 counties affected by the Elk River chemical spill between January 9 and 23, 2014.
- Read the Press Release [PDF - 450KB]
- Read the Findings [PDF - 785KB]
What You Should Know
Additional Information
- American Water Updates
- CDC's Letter to the West Virginia Department of Health and Human Resources [PDF - 54KB]
- National Toxicology Program West Virginia Chemical Spill Research
- Toxicological Information on MCHM
- West Virginia Department of Health and Human Resources
- West Virginia Governor's State of Emergency Updates
- Page last updated May 1, 2015
- Page last reviewed July 8, 2014
- Content source: National Center for Environmental Health (NCEH)
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text:
Florida Marlins (85-74) at Philadelphia Phillies (92-67)
Rick Vandenhurk, RHP (2-2, 4.44 ERA) vs. Joe Blanton, RHP (12-7, 3.95 ERA)
Time: 7:05 p.m at Citizens Bank Park
Weather: Mostly Cloudy, 61
TV:Comcast Sportsnet
Twitter: Phillies Nation
It's the final weekend of what has been a roller coaster ride of a season for the Philadelphia Phillies. Just three games remain between the Phils and the start of the postseason, so enjoy regular season baseball while it lasts.
To kick off the weekend festivities, Joe Blanton will try to give his team a push for home field in the playoffs tonight. Blanton scorched through the summer months, but has since hit a bit of a lull. After back-to-back appearances without allowing an earned run, Big Joe gave up five earned against Milwaukee last weekend, but still came away with the win. Against the Marlins, Blanton is 4-1 with a 2.63 ERA in five career starts. If he can continue the torrid trend against the Fish, home field for the duration of the NL Playoffs could be in their sights. Keep an eye on the Rockies and Dodgers match up as well.
Rick Vandenhurk sees the Phillies once again. His last start was against Philly on September 23, when he gave up four earned over six innings of work in the Marlins 7-6 victory. It's just his 11th start of the season. The Phillies would love to pounce on the youngster and push the stakes higher, as the Dodgers sit one game up in the standings, while the Cardinals and Rockies are one behind the Phils.
Bad news: J.C. Romero is feeling pain again in his forearm, and is likely done for the year. According to Todd Zolecki, Romero said, "I'm done bro. I'm done."
LINEUP: Victorino (CF), Cairo (SS), Utley (2B), Howard (1B), Werth (RF), Francisco (LF), Dobbs (3B), Ruiz (C), Blanton (P)
Your Gameday Beer – Lagunitas Lucky 13 Mondo Large Red Ale
For whatever reason, I like to think of red ales as fall beers. This offering from Lagunitas comes in a 22-ounce bottle and certainly fits into that autumn category. Its rich amber flavor is thickened by apples and syrup while also containing a strong hops body. It has a traditional dry finish – common in IPAs. Have it with some pork chops and applesauce.
104 Comments
I bet you all are wondering why I called you here today. We need to work together and throw rotten fruit at any imbecile who pretends to be a deceased announcer. admit it
its just creepy
Go Phillies!
Would like to see Howard hit 45 homers this year and lead the league in RBI's — both goals withing reach. Let's see Big Joe Blanton pitch like a world champ tonight !!!
When will we have an Eric Bruntlett bobble-head day? I really dig the dude and feel he represents the apex of utility players.
Is it possible to have a game where our starter doesn't put us behind the 8ball out of the gun? Christ.
Let's not lose the winning touch. We are stumbling into the post-season. Are we burnt out??? We need CHONE FIGGINS and a reliable CLOSER to compete in 2010
My toenails are really looking bad. Nerves, Nerves, Nerves. I am getting shorter by the minute and my hairline is really receeding. Where is the damn Hair Club For Men when you need them. Nerves, Nerves, Nerves.
You go guuuuuuuuuuuuurl
One more Hoffmann and Big Brown has his 45 bombs.
The roration is looking like they did at the beginning of the season
Dang j reed, don't say that.
I think that thing will land in the Netherlands in a few minutes
For anyone that says Howard isn't clutch, consider this…Howard's average is 50 points lower than Pujols and yet he has 6 more RBI than Pujols.
Great hitter…maybe not. Clutch, absolutely.
Sorry joedad….Freudian slipa
slipa =slip
Too bad for reliever J. C. Romero. Finished for the year now with that forearm pain. Started the regular season with that 50 games suspension for PED use. Wonder if he tried to do too much at some point after he returned in June and injured himself?
Howard has had a great year…improved avg.. fielding and without compromising power. Not to mention carrying us in late August and Sept. I'll take it anyday.
um, has anybody noticed that every starter has been lit up the last few times through the rotation?
I agree j-reed. By comparison, Howard is having the best season of his career from an all around stand point.
Only anyone who watches the games.
In Blanton's case tonight, he is throwing the ball right down Broadway.
Wow might joe looks like mighty blows
I get the feeling that we can expect another bomb from Big Ryan tonight. And yes, Howard may not be Pujols, but he is on the road to the Hall of Fame, especially if he keeps this up and stays healthy. Great player and a real good guy — both Puljos and Howard.
j reed, imagine if he could figure it out earlier in the year? He would blow by Bonds single season mark.
Alright he at least managed to reduce the aterial bleed out
joedad – though I hate how broadcaster abuse the word, Howard has the "athletism" to do it. His flexibility has also improved this year…look at how much more stretch he gets catching throws to first. I don't see how he can't improve on a yet another mvp-like year with the right direction.
bleed out to Blanton not Howard
….you go Cairo…
orange and black up 2-0
Yeah, all the HRs and RBIs are quite a feat themselves but you have to admire the way Howard has raised his BA into the 270s. Has really improved at the plate the last couple of months. Has improved his selection of pitches to swing at which has led to more walks and a slowdown of his strikeout rate.
what happen to that nasty change-up blanton had?
95 pitches through 5….fantastic.
Okay. The Phillies clearly don't give a crap about home field advantage. They drop another one to the lowly Astros yesterday and now Blanton's pitching a crap game. Romero, Moyer are done for the season. Park's missing the first round. Lidge stunk all year. The bullpen is a mess. The team isn't hungry or we would be dominating this last week. Despite clinching the division, September was not a strong month for the Phils, and I am VERY concerned about whether we are ready for the playoffs this year. I don't see the hunger to repeat. It may be an early exit. I hope I'm wrong.
mike B. – a good thing too…imagine what the team strike out total would look like had he been striking at his previous rates. I think if this particular team stat improves we'll see a lift in the team's RISP number
DC, you'll feel better when they come back to win this game.
With the exception of Happ, the starters have not looked good at all the last couple of weeks.
Ed R. – philly's favorite canadiens are winning, that should ease the pain.
Joedad – if they comeback, I will feel better. However, that is the difference between this year's team and last year's. Last year, didn't they have like 10 comeback wins or something (in innings 8 or 9). I feel like this year they had like one. That one against the Pirates.
Horrible performance tonight. The Marlins are playing out the string. You go out there and put your foot down there throat. Home field adv. will cost us. There are good teams this year in the playoffs. poor job. no excuse.
Haven't we lost 5 out of the last 7 against the Marlins? For division champs, that is unacceptable.
the Marlins bp this season is setting new standards on how to blow a lead…remember that series with the Nats…it was like every game the nats were down and came back to win. Remember when we came back from what, 7 in the 9th. not to worry….yet.
Come on chasey get out there and play baby. I know all that money is rough you make and its so hard to play a game that my son plays. you can do it baby. i just got off a 15 hour shift. going back at 2am. only making 19 per hour. you make that when you take a squirt. tired of these athletes today. doesnt matter this year anyway. no pen, no closer, starters are average and offense struggles. first round exit against a hungry team. bye bye
The Phillies jus keep leaving runners on base. I really hope they recharge for the playoffs. If you look at their September, you could easily say they'll be gone after the first round.
J-reed – I hope you are right. I am not confident about the playoffs. I really want to be convinced this week that we are ready to go. It doesn't look good
At least we don't have to deal with the Peskiest Team on the Planet – the Twins. Imagine what it's like for Tigers fans
DC, you forget the beginning of the year. They had many come from behind wins because their starters were horrible. I think they might be near the league lead in come from behind wins
Who would have guessed that the difference between Howard's and Utley's AVG would be so small
it does j-reed, a little.
Utley is in the middle of a 7/46 slump…152 average. That is horrible. Reminds me of 2007 when he just went into the tank at the end of the year and in the series vs the Rockies.
I'm feeling a 2 run bomb by Werth.
nice hit Werth…that must have been gas I was feeling.
I just can't believe the Phillies went 0-3 against the Orioles this year and 2-6 against the Astros.
loud out by Frisco. Son of a B.
DC – this team's psychological make-up…it's unflappability and its talent albeit steaky makes it capable of anything but the BP problems have been there for awhile. Can they catch fire… who knows. one thing that makes the team strong is how they compensate for one another when they are not firing on all cylinders….but compensating for a bad bull pen is very hard in the post season. Sit back and enjoy.
When they played the Orioles they were hitting like they are now.
Which is to say nobody was hitting.
And remember Madson blew a save every night that week.
This is a wildly inconsistent offense prone to brutal slumps.
Like Utley, Werth, and Ibanez are doing as we speak
J-reed – I'm with you. The bullpen is a problem. They need to address that in the offseason. We're stuck with Lidge, no one will want him after the season nor take on his salary for two more years. Maybe need to consider trading Madson, Condrey or Durbin to try and get some proven bullpen arms. Tyler Walker isn't bad, but they could find someone better. They should look at free agents too. Romero should probably staty. Eyre will probably retire which kind of stinks because he was rather consistent. They should lock up Park for another year (or is he in the middle of a two year deal).
Sorry but everyone who thinks they are repeating are nuts. They are not good enough this year. Now we will lose all of home adv. This is a horrible division this year. Lucky we play in it.
After this month. The team is not ready nor hungry for the playoffs. We could very well get swept by the Marlins this weekend. How's that for momentum going into the playoffs? Wake up Phillies!
be careful condrey
Come on! Lets get out of this jam!
Our bullpen sucks. They can't get anybody out.
Bullpen is totally unreliable. Phils are done in the first round.
I'm mad
I certainly hope the phillies are trying to look dead. Definately no drive for home field. :(. Wed was awesome but will the real phillies identify themselves????
Happ deserves to be a 2 or 3 on the starting rotation….if not the 1. Unfortunately they are relying on last year and lee to win. I almost wish happ would have been traded to a team who would use him as the great starting pitcher he is. He is my Philly MVP
The only hitter that has been really producing since Sept. has been Ryan Howard. The rest of the team is baked, cooked and exhausted. Three days off should help, hopefully.
We are lucky the Phils managed to string together two victories against the lowly Astros otherwise I am convinced we would of certainly collapsed like 1964
I hope Charlie plays everyone tomorrow, see if the line up can actually do something before they all just slump.
If the team is exhausted whose fault is that? Charlie's right? Does that mean he doesn't properly rest the players during the season? The Yankees don't have this problem, and right now the trophy is theirs unless one of the NL teams catches fire into the World Series
You forget D.C. Atlanta lost 2 to the Marlins and are losing tonight.
Settle down folks. They don'tt have J Roll, Feliz and Raul playing tonight or 1/3 of their starting lineup. You know what this game feels like? It feels kind of like a tune up game for the playoffs.
I am going to go out on a limb that certainly will not be used but I would have Happ be the starter in game 1. He is about the only one who has his head in the game and isn't all caught up into the whatever everyone else seems to be in. And I would take Cairo and Tracy for the bench…..Tracy was awesome in AAA and I am sick of matt stairs.
I'm predicting a Wes Helms homer here.
I just see no spark….honestly, I feel for the fans……the crowd is dead but can you blame them? Thats why I would take some "new blood" like cairo and/tracy.
Big surprise…Wes Helms gets a hit against the Phils. Isn't he like 20 for 20 since against the Phils since they dumped him.
To say the team is dead is an understatement. They are playing with no fire, and clearly don't care about homefield advantage despite what Charlie says.
Oh look … another Phils bullpen arm puts two men on base. This has been the story all season. There is no 1-2-3 with our bullpen. This is why we will not repeat.
I'm so annoyed. They look like garbage tonight
its like they are sleep walking or something.
can they just flip that switch after Sunday and suddenly try?
Escalona is not ready for the majors but everyone else is injured so I guess we have no choice but to keep him on the roster.
The Phils will not lose a single game in the playoffs. They are getting all their shitty play out of the way during the last part of the season. They will come out next week like musketeers on a mission….hit, hit, hit, pitch, pitch, pitch and will win it all again. GET READY TO PARTY!! Yes, I have just smoked someting special !!!!
Escalona sucks. I'm sorry. He is soooo inconsistent
Phils are getting their asses kicked tonight
any idea who we are playing in the first round?
Is it me or does Charlie leave in the pitchers too long. I mean..shouldn't he have taken Escalona out of the game when he loaded the bases.
I do not see anything in this young pitcher Escalona, not at this time anyway.
Escalona sucks. Okay. Escalona has given up two runs and Charlie has yet to take him out. I'm sorry. Poor managing
If we finish in the top 2, which after tonight we will be tied with St.Louis but be number 2 based on tie breaker. So if we finish number 2 we host Colorado. If we finish number 3 we start in LA.
We as fans and posters suffer thru this boring game tonight and now Charlie treats us to Chad Durbin as the final pitcher to be brought in, hopefully.
I have watched every game this year. I will not watch til the post season. You give me this garbage. watched the flyers play. Atleast they show heart. We will be knocked out in the first round. I promise you this. Cards just moved ahead of us. I hope we GET SWEPT IN THE FIRST ROUND.
And let the sky is falling, all is lost bitching begin again.
i'm wondering if they will show the fox game tomorrow here in TN. I am also wondering if they will put in the third string players and perhaps a nice knuckleballer to pitch.
The bullpen next spring is probably going to be the big interest thing as to who might be added thru trades or free agency and who wins jobs there next season.
dagnabbit…i forgot I can watch the Flyers tonight.
Look, I understand this board is for venting but, wow, there not "playing with fire….no heart….aren't hungry" Did that come from the Philadelphia Sports Fan Handbook under the heading "when in doubt resort to cheap psychological explanations" Or should they put a little more Balboa into it. It's so tired. How many come back wins this year? I believe the offense rescued this team in April and May. Without that performance we would have made it to the post season. Sorry but i respect our champions enough to give them benefit of the doubt before resorting to Oprahed pop pyschological speculation. A sport with the greatest statisical database ever and that's where you go first. unbelievable. THEY PLAY 162 GAMES FOR A REASON. The element of chance being the primary one.
Here comes Batalico…proving why he won't ever be a coach in MLB.
Sorry J reed ricky is right. you cant play like this before the big games start. Team is sleepwalking against a horrible team. You pound them and pound them. Show them who is the team to beat. we just lost home field.
happ or hamels as the game 1 starter… with the way lee has been pitching, he better not start game 1
that's "Without that early season performance we wouldn't have made the post season"
I don't usually watch post game live after Phils losses. Is Botallico always this bipolar?
If the Phillies want to keep their fans somewhat in the game, they need to show some life. Happ would be the perfect game 1 starter….he would also be going 2 extra days rest…but charlie is a rituals man
Joedad – it's been getting worse and increasingly disrespectful to the team. If I was Blanton I'd feel justified in punching the guy. It's not the WIP morning show. Very unprofessional. I can't think HK would approve of this unprofessionalism. Bad form Batalico, bad form.
Jeff – can you field harder when the ball isn't hit to you…can will a base hit…if your not hitting your spots should you throw harder? sounds like a receipe for disaster to me. How about swing harder? Can you will conditioned muscle memory to suddenly change when your reacting to a 90 mph projectile…why do you think it takes awhile for players to correct their swings or pitching mechanics.
Is there any evidence of these guys partying excessively except the night after they clinched. Do you know if any of them suffer from psychological/behavioral problems. Because barring the aforementioned, what evidence was there that they didn't play hard tonight…did they not run out every hit, not slide when they should of, not dive for a flyball, not block a groundball with their bodies, get thrown out of the game….would it be better for them to slam their bats into the ground after a strike out or argue about mistakes with each other on camera… maybe hit someone with a pitch for no reason. If they are sleep walking it still might be fatigue. I explained the different concepts of sports related fatigue in response to a comment you made regarding resting players in last night's post game comments if your interested.
As to Batilico, at what point does his utter lack of objectivity stop. It's downright unprofessional and disrepectful to the team. I don't think criticism is wrong but did he really back his claims tonight because I had to change the channel out of disgust. And if he was dishing out warranted criticism which wasn't the case tonight, he should do so with a modicum of self control unless in a format that welcomes this approach like AM talk radio.
Hmmmm….somehow I am thinking I missed some post game show with botallico. darn it 🙂
Maybe Botalico has it in for the Phillies from years past.
Pingback: Baseballbriefs.com
RickyBo is trying to follow Mitch Williams' recipe to land a job at MLBN, be ANYTHING but boring, the more controversial, the better his chances of moving on up….to the East side, we finally got a piece of the pie…
(sorry, loved The Jeffersons!)
Hoffman Capping Co-were you watcing DNL by any chance yesterday????


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Life is Multiphysics
Fanny Littmarck | August 14, 2012
As an engineer researching and designing new products you really need to consider all aspects of the environment it is going to work within. Most of the time it won't be enough to examine a single situation the product may encounter, because in nature there is always a combination of physical effects taking place — multiphysics.
Some Multiphysics Examples
If you think about it, everything in our daily life is coupled, few things act alone. Take lava lamps, for example. They're more than just glass vessels filled with colorful wax; when viewing lava lamps through a physics lens what you see is a coupling of fluid dynamics and heat transfer. Both are dependent on each other.
Look at a common household item, such as a microwave oven for instance. You just pop in a frozen dinner and wait for the signal that the food is ready. Easy as pie. Have you considered what is happening inside that microwave oven while you're impatiently waiting on the other side? Why, heat transfer and electromagnetics of course. Or in simple terms, what is happening inside the microwave is multiphysics.
And what do beepers, inkjet printers, and ultrasound imaging systems have in common? They all rely on piezoelectricity, which again is a multiphysics problem. The electric fields cause a structural deformation which in turn affects the fields. I could go on, because the world is full of multiphysics, but by now you get the point.
Contrary to how high school physics may have made it seem, we do not live in a vacuum where engineers can rely on simple physics to get the job done. In order to create accurate models to represent real-life situations how they actually occur, researchers and designers need to be able to couple many different physics phenomena into what we call multiphysics. Understanding this can drastically change the outcome of a new design; it can be the difference between success and failure. With COMSOL Multiphysics engineers can optimize their design to endure environments that involve different physical processes that occur simultaneously.
Continue to follow (and add to!) the multiphysics conversation on Twitter using the hashtag #lifeismultiphysics
Engage with us and your peers in social media
NN Misra
August 15, 2012 3:54 am
To add another dimension to this, "Life could be partially understood and analysed on the basis of multiphysics phenomena"
When we breathe it involves mass diffusion (gas exchange), heat transfer, fluid dynamics- simultaneous transport phenomena. We attempt to control this transport phenomena with Yoga.
When we digest food , it involves transport phenomena (active and passive diffusion), structural mechanics (gut movement) within the digestive tract, within stomach.
Functioning of our heart can be described based on current flow, structural mechanics etc.; so is the nerve conduction involving charge transport; blood circulation involving complex fluid flow (structural changes in RBCs and change in fluid properties and so on). Indeed this list could be extended forever.
We live because of multiphysics phenomena.


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Dear Members,
Keep in mind that Character Bashing is now prohibited. Making fun of certain characters/character pairings leads to a pointless thread filled with insults and general rule breaking.
Also, remember that Versus threads are allowed only in the Versus section.
Thank you, NarutoBase Staff
What shinobi do you think has the best mokuton in order of strength.
My list Hashi,Madara,Yamato then Obito..
Both Hashi and Madara
Originally Posted by markdabomb22
Both Hashi and Madara
I agree with you, but I don't know that Yamato is necessarily better than Obito. Sure, we haven't seen much mokuton out of Obito, but he relies on other techniques. Given that, it's possible that he is capable of doing more with it.
I thought this was a thread dedicated to me!
Lol jk..
On topic; Hashirama, Madara, and we haven't seen enough of Obito to compare against Yamato so its a 50/50 for now, leaning to Yamato.
Sounds like a title to one of my threads. Lol.
ot: Hashirama.
Originally Posted by HashiramaDescendant
Sounds like a title to one of my threads. Lol.
ot: Hashirama.
Looks like i "beat you to the wood"
Hashirama is the first known shinobi to use Mokuton, quite obvious that he should be ranked first. Madara is also quite proficient at using it, so is Yamato when he managed to supress the Kyubi's chakra many times in the manga and anime. As for Obito, he is only seen to use Mokuton during his fight against the Kiri ninja along with Kamui and he used Mokuton for Izanagi later on so it is hard to say.
Please keep in mind that it was Edo-Madara who achieved usuage of Mokuton. Normal Madara had no access to the kkg.
Forum Rules


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Ingram has a two-year grade average of 98.45. During his middle school years, Ingram has been active in football, basketball, track and field, National Junior Honor Society, Student Council and band. He is a member of Immaculate Conception Catholic Church.
Ingram has won various academic excellence awards, including having been the top seventh-grade student at the end of last year. He will present the welcome address at the eighth- grade awards program to be held at 6 p.m. Thursday, June 5 at the GHS auditorium.
Dalton Dornburg, son of Brent and Terri Lynn Dornburg, is the second-highest ranked student in this year's eighth-grade class with a 98.10 average. He has been a member of the football and basketball teams, Student Council and NJHS, where he served as historian.
Dornburg is consistently on the "A" Honor Roll. He represented GMS at the district UIL academic contest and placed second in science and number sense. Dornburg is a member of the St. Peter's Lutheran Church youth group and the Weesatche 4-H Club. He has won numerous awards both at the Goliad County and San Antonio Livestock Shows. Dornburg will present the benediction at the awards program.
Two students, Nathan Oliver and Hunter Troell, tied for the third-highest average at 97.35.
Oliver is the son of Veronica Fair and Jeffrey Oliver. He has participated in athletics, band, NJHS and Student Council.
Oliver has continually been a high-ranking student, qualifying for highest honors in the GMS incentive program. He will lead the Pledge of Allegiance for the awards program.
Troell is the son of Brett and Tami Troell. He has been on the "A" honor roll all year and has also taken part in band, football, basketball, track and field, Student Council, NJHS and UIL spelling.
Troell has qualified for highest honors in the incentive program all year and he placed second in spelling at the academic UIL contest. He will present the invocation at the ceremony.
The top two seventh-grade boys and girls will serve as ushers/usherettes at the awards program. The top two girls are Kelly Thomas, daughter of Becky Thomas and Mike Thomas, and Jadan Butler, daughter of Dawn and Rodney Butler. The top two boys are Hayden Reitz, son of Michelle and Paul Reitz, and Tuffy Dornburg, son of Terri Lynn and Brent Dornburg.


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Email Alerts
January 26, 2012
The "patient experience": Is it patient pandering?
Ive been seeing a lot written recently about the patient experience. A recent blog on one of my Linkedin groups states that medical practice is driven by the combination of patient experience and perception of services provided to them. The Cleveland Clinic has gone so far as to appoint a
Chief Experience Office
to ensure care that is consistently patient-centered by partnering with caregivers to exceed the expectations of patients and families. But what exactly is the patient experience? And has the pendulum swung too far, from patient centeredness to patient pandering?
First, let's tackle the definition of patient experience. Jennifer Robison of Gallup Management Journal
describes it
in terms of emotional engagement, as in engaged patients are better for hospitals, and engaged hospitals are better for patients. Engaged patients have a better experience because it is psychologically and emotionally gratifying.
She equates the patient experience to the alliances we feel toward a brand, a restaurant or a sports team. She rightly argues that spiffy lobbies and a full roster of classes, which are the tactics hospital executives usually reach for first to improve patient satisfaction surveys, are not the keys to providing first-class patient experience.
Instead, Robison identifies four psychological elements that inform patients hospital experience: confidence, integrity, pride and passion. She argues that a hospital that provides good hospital care and service, and does so with these four attributes, will score high on the patient experience meter.
Nobody argues that our health system must improve its relationship with our patients. For too long, physicians viewed themselves in a paternalistic role, one in which they possessed all the knowledge and patients were supposed to do what their doctors said, no questions asked. This behaviorcoupled with the spread of malpractice lawsuits, medical scandals, and egregious errors in medical practice, and the cozy relationship between physicians and pharmaceutical and medical device companieseroded the publics confidence on physicians.
Then, the widespread availability of health information on the Internet broke physicians monopoly on medical knowledge and allowed patients to come to the examining room already armed with questions, ready to challenge their doctors on their choice of treatment and diagnosis. The pharmaceutical companies soon followed, filling the airways with direct-to-consumer advertising and telling patients to ask their physicians if name-that-brand medicine is right for you.
Hospital administrators and the federal government noticed this resurgence in patient power, this Examining-Gown Spring, and decided that power now rested in the hands of the infirm, not in the hands of the healers. Patient-centered care gave way to the patient experience and patient satisfaction surveys. Patients became consumersand thus the pendulum swung too far.
There is nothing wrong with informing patients about a hospitals quality or providing them with adequate information about side effects or rates of surgical complications to allow for informed decision-making. But to encapsulate a patients illness within a rubric so shallow as the patient experience, as if a visit to the emergency room could be equated with a visit to Disney World, cheapens the efforts of health providers who work long hours in the face of shrinking reimbursements simply because they love to heal.
It also demeans patients by putting them in a category of consumers. Remember, patients are not consumers in the general sense of the word; they dont pay directly for health services.
And it is demeaning to call patients consumers because health care is not about what happens around the patient. It is not about palm trees, warm beaches and great ski slopes. Health care is what happens to the patient. And while consumers can buy things they want to happen to them, like a massage, most health care (except for preventive care measures and elective procedures) happens when we dont want it. We dont seek to be hospitalized, to have surgery or painful procedures done, unless we have to.
The patient experience as a commercial construct to garner and maintain patient loyalty is folly. Patients go their nearest hospital because of distance or acuity, or because it is the only facility in a rural area or the inner city. Patients sometimes dont have a choice as to where to obtain health care, and they are not consumers looking for an experience. They are looking for answers, support, hope, expertise. A nice grand piano in the lobby does not provide that.
Instead of focusing on experience, lets focus on perspective. Patients need information and choice, but they need their health care providers to guide them along. Patients need clean rooms and healthy food, but not concierge service. They need the ability to compare health facilities and outcomes, but not the right to be so pampered that it obscures the real jobs of nurses, cafeteria workers or the housekeeping staff. Patients are the center of care but as partners, not as dictators. And health administrators should focus on true quality measures that determine the actual benefit of treatment plans and protocols, not the latest score on patient satisfaction surveys.
The French deconstructionist philosopher
Jacques Derrida
wrote that Western civilization has always thought in terms of binary opposites: good and evil, heaven and hell, and yes, patient and physician. He noted that these opposites are not equal but hierarchical, with one governing the other.
For years, physicians were superior in the patient-physician relationship. Now, it seems the patient is on top. Derrida writes that this reversal does not end the struggle of the binary relationship; on the contrary, it maintains the same tension. Eventually, this tension unravelsor deconstructsthe relationship. In deconstruction, a new framework can emerge.
Lets deconstruct the patient-physician relationship. Lets stop calling our patients consumers. Lets create a true partnership between providers and patients, free of pandering and paternalism. That should be the true patient experience.
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5 Comment(s)
Jeff Bennett wrote:
Another tour-de-force from Ruben! In the war of WOW! that hospitals seem to be engaged in, the disconnect between the fluff and the stuff is evident to many patients as well. In the end, value is based on the ability to deliver understanding, comfort and healing. Systems that truly get that have always stood out from the rest (even if they don't have spiffy lobbies).
Lexington, KY | Fri, Jan 27 2012 15:26 PM
Susan Spencer wrote:
I agree that it takes much more than a spiffy lobby and piano music in the background. However, the government has now taken notice of the patient perception of care received or "experienced." Yes, it has taken the government to finally say that the patient's perception of his or her care must improve beyond what our industry has provided in the past many years. I also believe that we can do a much better job in health care in providing a hospital stay that includes the best quality of care with a safe environment.
HCAHPS results are not a measure of patient satisfaction but more the patient perception of the QUALITY of care received while hospitalized. HCAHPS provide the basis for our reimbursement now (value based purchasing). Questions from HCAHPS include, "Did my physician listen, communicate the plan of care and explain things in a way that I can understand?" Other questions target information about medication communication, nurse communication, quiet and clean environment, discharge instructions and pain medication. Answers are based on consistency.
Shouldn't this really be considered the minimum standard for any patient? HCAHPS is not a patient satisfaction survey but rather how well the providers performed these things "always" within a quality, safe environment. What would you want if you or your loved one were the patient?
Canton, Ohio | Fri, Mar 2 2012 10:53 AM
Ruben Nazario wrote:
Jeff, thanks for your comments. Value is definitely linked to understanding our patients and helping them in the healing process.
Ms. Spencer, I dont disagree that we need to provide the best quality of care available to our patients. My concern is how that quality is measured. In my first draft of this post, I actually was going to discuss HCAHPS, so Im glad youve brought it up. Like you said, HCAHPS measures PERCEPTION of quality, so in that sense I find it a useless (and maybe even misleading) measure of true quality.
I agree that a physician who listens to his or her patients is better in terms of humaneness, but what does that have to do with that physicians analytical or procedural skills? If I am nice to my patients but have the highest rate of central line infections in my hospital, how does that improve the patients experience? So, yes, listening to our patients, improving communication, explaining things to patients ARE at least the minimal aspects of the physician-patient relationship. (I would say they are the cornerstone.) But in my mind they are not true measures of health quality.
Falls Church, Va. | Fri, Mar 2 2012 12:47 PM
David Hayes wrote:
The recent article in Archives, "
The Cost of Satisfaction
, " perfectly points out the consequences alluded to by Ruben. What if your patient's only definition of satisfaction is overutilization of narcotics? Where in this "measurement" of patient satisfaction is the control for inappropriate or dangerous expectations?
Read the article. The most satisfied patients also were the most hospitalized, used the greatest amount of pharmaceuticals and medical services, and were at elevated risk of death! Pandering to patient perceptions has serious consequences; more "joy rides" and "pleasure units" in the medical arena have exactly the opposite consequences as the government intends. Certainly, the paternalist model of medicine is long dead, but the current patient satisfaction frenzy essentially nullifies professional judgment, thus satisfying
Murphy's Law
of unintended consequences.
Scottsdale, AZ | Tue, Mar 13 2012 05:56 AM
Frisco Morse wrote:
I could not agree more. It seems like the foucus is on factors that don't make for better care. Our patients are often times more concerned about eating a meal than what I have to say about their condition.
Lawrence, Kansas | Wed, Jun 13 2012 09:27 AM
About Ruben J. Nazario, MD
Ruben J. Nazario, MD, is now medical director at Inovalon, a health care data analytics company, and is medical editor for Elsevier's First Consult. A pediatric hospitalist, Dr. Nazario is a veteran of both community and academic pediatric hospitalist programs. All material represents his own views and does not reflect the views of his employer.
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text:
Wireless access is all the rage. Wireless this, wireless that. Hot spots are turning up everywhere. Many are free. Many have absolutely no security. There are several in my neighborhood. I have no idea who is running them, but at least one is wide open.
This article will show you one method for locking down your wireless network so that nobody but you can use it. This approach will take you beyond WEP and MAC address filtering, both of which are a good start but have known exploits. This article expands upon the IPsec foundation and demonstrates an easy method for securing your Wireless Access Point (WAP).
I will be using FreeBSD 4.10-Stable for this excursion. Please keep your hands and legs within the vehicle at all times. In case of emergency, please follow the directions of your crew. They know what to do.
While writing this article, I have assumed the following:
Related Reading
Building Wireless Community Networks
Wireless is practically wide open for anyone with a laptop, a wireless card, and the appropriate set of tools. WEP is defeatable. MAC addresses are sniffable and spoofable. In short, you need the next level: IPsec.
If wireless is so risky, why use it?
Wireless is convenient. There are no cables to run. Anyone can pop down to the local Future Shop, buy a wireless access point, plug it in, turn it on, and start surfing the 802.11 information superhighway. Does this sound familiar? It should. I did it and I wrote about it. I did the right thing. I filtered by MAC address. I turned on WEP. Then I turned off WEP when I had trouble. Yes, I was vulnerable, but no one compromised my system ... as far as I know.
Since writing that article nearly 18 months ago, I have moved to a new house. I've gone through the same process I did last time, setting up a new rack and running some cables through the walls. This time I convinced myself that I would set up a secure wireless network. It took me a few hours, but I finally figured it out.
To answer the original question of this section and to tie it in with my recent move, I use wireless so I don't have to run cables. I want to use the laptop in the living room, the dining room, or on the front step. (I'm actually typing this into my Windows XP workstation sitting at my desk in the basement, SSH'd into the new Antec box.) As I work wirelessly, I want to keep people off my private network and keep prying eyes away from my communications. I can do that with IPsec.
Also in my mind is my neighbor, I don't know who, but somebody running a WAP nearby, totally unsecured. I know how easy it would be for me to use that internet connection. I don't want someone using mine.
IPsec is short for IP security. It is a set of protocols for securely exchanging packets at the IP layer. VPNs frequently use it. We can use the same approach to secure our wireless network.
IPsec uses shared secrets to encrypt data. It also uses security policies to decide what types of traffic to encrypt between which hosts.
This section outlines some of the details that are specific to IPsec on FreeBSD. Regardless of the operating system you wish to use, you will need an IPsec-enabled kernel. On FreeBSD, add the following directives to your kernel configuration file, and then compile a new kernel:
options IPSEC #IP security
options IPSEC_ESP #IP security (crypto; define w/ IPSEC)
options IPSEC_DEBUG #debug for IP security
I haven't actually used the features of
IPSEC_DEBUG, but it's
there if I need it.
Note: If you are running 5.x, use
FAST_IPSEC instead of the
directives mentioned above. Also remove
INET6, as
FAST_IPSEC does not support it.
Add the following directive to /etc/rc.conf to set up your IPsec database at boot time:
That directive will load your IPsec configuration directives from
/etc/ipsec.conf. (You can configure the actual filename using
ipsec_file="/your/file/here". I will give you examples for that
file later in this article.)
I'm a big believer in starting small and working one's way toward a goal. For my testing, I first tried IPsec over my wired network, then moved it over to the wireless network. You may find this strategy useful too. It allows you to concentrate on the IPsec portion of the problem, make it work, and then concern yourself with any wireless issues. After you have IPsec running properly, you can remove the wire and start using 802.11 instead.
For this testing, I created a new gateway and put two NICs into the box.
This box does NAT (Network Address Translation) using
ipnat and will use
ipf as a
firewall. It's easier to manage with the entire wireless network in a separate
subnet. If necessary, I can disconnect the entire subnet by unplugging a
single cable or powering off the WAP.
Your NAT box will want to do some forwarding of packets. I recommend the use of
ipf and
ipnat. I also use
ipmon. I have
these entries in /etc/rc.conf:
Firewall and NAT rules are beyond the scope of this article, but those two links should give you a running start.
IPsec can create a point-to-point tunnel between two hosts. Being encrypted, the data will be safe from prying eyes, and the gateway won't accept modified packets, since they lack an authentic signature. IPsec can also secure traffic between two networks or a network and a gateway. Other configuration options are available, but I will concentrate on just network, not point to point.
The key point to realize is that IPsec cannot exist on its own. You need to have IPsec at both ends of the communication. You cannot just slap IPsec onto your laptop and expect it to work wherever you go. This is why I have decided to create a wireless gateway through which all my wireless traffic will flow.
The following diagram (created with Xfig) illustrates my wireless network. My laptop sits at 10.0.0.10 and communicates over wireless (802.11) to my WAP. The WAP connects to a dedicated gateway box (via a hub) which sits between the WAP and my LAN.
Figure 1. Wireless network
Any traffic coming in over the wireless network must pass through the WAP and then the wireless gateway. This gateway has two NICs (one at 10.0.0.1, the other at 192.168.0.55). These are conventional, wired NICS. There is no Wifi in this gateway, but there certainly could be. I have chosen to use a WAP instead. The WAP plugs into a hub, and 10.0.0.1 on the gateway plugs into the same HUB. The other NIC plugs into the main LAN.
IPsec uses a database to decide how to treat traffic. The database contains the rules on what traffic to encrypt and how to encrypt it. The two main types of rules are policy and association. The Security Policy Database (SPD) determines what traffic IPsec should handle. The Security Association Database (SAD) specifies how to encrypt that traffic.
The main tool for manipulating the database is setkey(8). I will show you one way to use that tool later. Usually, you place these rules in /etc/ipsec.conf.
These rules cause the encryption of all traffic between the network (10.0.0.0/24) and the gateway (10.0.0.1). We will use ESP (Encapsulating Security Payload) as found in RFC 2406. This ensures that nobody can read your data.
add 10.0.0.1 10.0.0.10 esp 691 -E rijndael-cbc "1234567890123456";
add 10.0.0.10 10.0.0.1 esp 693 -E rijndael-cbc "1234567890123456";
spdadd 10.0.0.0/24 0.0.0.0/0 any -P out ipsec esp/tunnel/10.0.0.10-10.0.0.1/require;
spdadd 0.0.0.0/0 10.0.0.0/24 any -P in ipsec esp/tunnel/10.0.0.1-10.0.0.10/require;
The first two rules (
add) are SAD entries. The next two
rules (
spdadd) are SPD entries.
add items set up the encryption keys for communication
between the two computers. Be sure to use different keys; however, if you use IKE you won't need keys. The values shown are just to keep things easy. The
spdadd items set up the actual tunnel between the two computers.
In brief, the above directives mean:
10.0.0.1 and
10.0.0.10, use the index
691, the encryption algorithm known as
and use a shared secret of
10.0.0.10 and
10.0.0.1, use the index
693, the same encryption
algorithm, and the same shared secret.
and everywhere else (
0.0.0.0) must go (
through a
0.0.0.0) and the network (
10.0.0.0/24) must come
require) from a
The rules for the gateway are very similar to the laptop rules and also are slightly symmetric.
add 10.0.0.1 10.0.0.10 esp 691 -E rijndael-cbc "1234567890123456";
add 10.0.0.10 10.0.0.1 esp 693 -E rijndael-cbc "1234567890123456";
spdadd 10.0.0.0/24 0.0.0.0/0 any -P in ipsec esp/tunnel/10.0.0.10-10.0.0.1/require;
spdadd 0.0.0.0/0 10.0.0.0/24 any -P out ipsec esp/tunnel/10.0.0.1-10.0.0.10/require;
You can add these rules manually using
setkey -c and then
copy and paste the rules from above (after making adjustments so they refer to your
IP addresses, not mine). To exit, press Ctrl-D. When testing, I actually
keep it running and copy and paste the commands directly. I use these commands to
clear out existing database entries before adding new ones.
flush command clears out the SAD entries, while
spdflush clears out the SPD entries.
In the policy statements (
spdadd), the second line above states
that all traffic from
10.0.0.0/24 to anywhere requires
ESP. The fourth line states that all traffic from anywhere to
10.0.0.0/24 also requires
ESP. Combined, these two
directives ensure that all traffic from anywhere to anywhere on this network must use
While I tested these rules, I kept them on a local web site. That made it
easier to copy and paste the rules from the browser. I'm not suggesting that you
publicly publish your rules. This is just a debugging tool. Mind you, the only
parts you need to keep secret are the keys (in my example,
If you place your rules in /etc/ipsec.conf and have
ipsec_enable="YES" in your /etc/rc.conf, the system will
load them at boot-up.
When loading the rules, you'll need to coordinate them. I sat at the gateway console with my laptop beside me. That way, if I messed up the rules, I could reset them without moving. The provided rules worked for me. They should work for you too. If they don't, go back to square one and verify your rules. Ensure that the subnet and the IP addresses are what they should be.
After you implement these rules, the gateway will reject all non-ESP traffic. Furthermore, anyone attempting to communicate with the gateway must have the shared secrets. If you change the secret, nothing will pass the gateway.
By this point, you have IPsec on both machines and you have set the IPsec database rules. Traffic is flowing. Now you want to confirm the encapsulation, so nothing should appear in plain text. Here is how I did that.
On my wireless gateway, the
dc0 device has an IP address of
10.0.0.1. All traffic from the laptop will come in on that NIC. I
issued this command to view that traffic:
# tcpdump -ni dc0 not esp
tcpdump: listening on dc0
13:40:25.651640 0.0.0.0.68 > 255.255.255.255.67: xid:0xebd53d39 [|bootp] [tos 0x10]
13:40:25.656090 10.0.0.1.67 > 10.0.0.10.68: xid:0xebd53d39 Y:10.0.0.10 S:10.0.0.1
[|bootp] [tos 0x10]
The above shows
dhclient starting on the laptop. A bit of ARP
traffic follows. If all you see via
tcpdump is stuff like this,
then you're good to go.
13:42:18.225304 arp who-has 10.0.0.1 tell 10.0.0.10
13:42:18.225450 arp reply 10.0.0.1 is-at 0:32:91:32:91:32
If all you see is
arp, then you're good to go.
You should see what the IPsec traffic looks like. Have a look. Shorten the above command to this:
# tcpdump -ni dc0
tcpdump: listening on dc0
13:44:34.371866 10.0.0.10 > 10.0.0.1: ESP(spi=0x000002b5,seq=0xfe)
13:44:34.385237 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0xec)
(frag 368:1480@0+)
13:44:34.385339 10.0.0.1 > 10.0.0.10: esp (frag 368:48@1480)
13:44:34.387672 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0xed)
(frag 369:1480@0+)
13:44:34.387775 10.0.0.1 > 10.0.0.10: esp (frag 369:48@1480)
13:44:34.390066 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0xee)
(frag 370:1480@0+)
13:44:34.390165 10.0.0.1 > 10.0.0.10: esp (frag 370:48@1480)
13:44:34.390996 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0xef)
13:44:34.393155 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0xf0)
(frag 372:1480@0+)
13:44:34.393260 10.0.0.1 > 10.0.0.10: esp (frag 372:48@1480)
13:44:34.394641 10.0.0.10 > 10.0.0.1: ESP(spi=0x000002b5,seq=0xff)
13:44:34.396986 10.0.0.10 > 10.0.0.1: ESP(spi=0x000002b5,seq=0x100)
13:44:34.398044 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0xf1)
(frag 373:1480@0+)
13:44:34.398142 10.0.0.1 > 10.0.0.10: esp (frag 373:48@1480)
The above tcpdump is of HTTP traffic as my laptop accessed my development copy of FreshPorts.
Here is how a ping looks:
13:45:39.886113 10.0.0.10 > 10.0.0.1: ESP(spi=0x000002b5,seq=0x118)
13:45:39.887436 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0x10a)
13:45:40.898972 10.0.0.10 > 10.0.0.1: ESP(spi=0x000002b5,seq=0x119)
13:45:40.900134 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0x10b)
13:45:41.908735 10.0.0.10 > 10.0.0.1: ESP(spi=0x000002b5,seq=0x11a)
13:45:41.909912 10.0.0.1 > 10.0.0.10: ESP(spi=0x000002b3,seq=0x10c)
Note: this is all ESP. The following is an example of traffic that does not use IPsec:
$ sudo tcpdump -ni fxp1
tcpdump: listening on fxp1
ack 4184487194 win 58400 (DF) [tos 0x10]
13:47:39.151794 192.168.0.99.1763 > 18.104.22.168.6665: . ack 305831024 win 64160 (DF)
13:47:39.252127 192.168.0.99.3077 > 192.168.0.21.22: . ack 44 win 64028 (DF)
13:47:39.621526 192.168.0.18 > 188.8.131.52: icmp: echo request
There you go. All good. Nothing passes through the gateway unless it matches the rules. The shared secret is the key to this security. This would be more secure if the secret changed occasionally, though.
Instead of manually changing the shared secrets in your
/etc/ipsec.conf file, you can keep one shared secret and use the
IKE protocol to negotiate a key. Racoon speaks IKE
(ISAKMP/Oakley), which is a key management protocol.
I installed Racoon from the ports tree. Here are the configuration files from both my laptop and the gateway. The only difference between the two files is that I instruct the gateway to listen on only one address (it has two NICs). Here is the diff, if you are interested:
--- racoon.conf.laptop Wed Sep 15 19:26:03 2004
+++ racoon.conf.gateway Wed Sep 15 19:31:46 2004
@@ -33,6 +33,8 @@
#isakmp 184.108.40.206 [500];
#admin [7002]; # administrative's port by kmpstat.
#strict_address; # required all addresses must be bound.
+ isakmp 10.0.0.1;
# Specification of default various timer.
The configuration file tells Racoon the main things it needs to know. One of the items is the preshared key file. Look for this directive:
# search this file for pre_shared_key with various ID key.
path pre_shared_key "/usr/local/etc/racoon/psk.txt" ;
man racoon.conf:
Pre-shared key File Pre-shared key file defines a pair of the identifier and the shared secret key which are used at Pre-shared key authentication method in phase 1. The pair in each lines are separated by some number of blanks and/or tab characters like hosts(5). Key can be included any blanks because all of the words after 2nd column are interpreted as a secret key. Lines start with #' are ignored. Keys which start with ' are hexa-decimal strings. Note that the file must be owned by the user ID running racoon(8) (usually the privileged user), and must not be accessi- ble by others.
Here is the
/usr/local/etc/racoon/psk.txt file on my
10.0.0.1 MySecretValue
Here is the file from the wireless gateway:
10.0.0.10 MySecretValue
With these values, Racoon on my laptop knows that when it talks to 10.0.0.1
(the gateway) it should use the shared key
Similarly, the Racoon running on the gateway knows to use the same shared key
when speaking to 10.0.0.10 (my laptop).
To start Racoon, issue this command:
/usr/local/etc/rc.d/racoon.sh start
If you're running a recent version of FreeBSD (for example, 4.10-RELEASE),
add this entry in
Ensure that Racoon is running on both the laptop and the gateway. Then remove the SAD entries from both machines, and Racoon should negotiate a new set of keys.
# setkey -c
If that doesn't work, try running Racoon in the foreground (after first stopping the one running in the background):
/usr/local/sbin/racoon -F
It should just work.
I thought it might be interesting to clear out the SAD entries and see what happens when it comes time to negotiate new keys. I started a ping running and ran tcpdump while I issued this command:
# setkey -F
As you can see, the ping missed a few steps. That is understandable.
[dan@laptop:~] $ ping -A 192.168.0.18
PING xeon.unixathome.org (192.168.0.18): 56 data bytes
64 bytes from 192.168.0.18: icmp_seq=0 ttl=63 time=4.880 ms
64 bytes from 192.168.0.18: icmp_seq=1 ttl=63 time=4.847 ms
64 bytes from 192.168.0.18: icmp_seq=2 ttl=63 time=5.126 ms
64 bytes from 192.168.0.18: icmp_seq=3 ttl=63 time=5.209 ms
64 bytes from 192.168.0.18: icmp_seq=6 ttl=63 time=5.468 ms
64 bytes from 192.168.0.18: icmp_seq=7 ttl=63 time=4.838 ms
64 bytes from 192.168.0.18: icmp_seq=8 ttl=63 time=5.270 ms
--- xeon.unixathome.org ping statistics ---
9 packets transmitted, 7 packets received, 22% packet loss
round-trip min/avg/max/stddev = 4.838/5.091/5.468/0.226 ms
[dan@laptop:~] $
Two pings went missing and never reached the machine on the other side of the gateway. Here is some of the tcpdump traffic:
16:36:34.517794 10.0.0.10 > 10.0.0.1: ESP(spi=0x02dc8063,seq=0x1d)
16:36:34.867830 10.0.0.10 > 10.0.0.1: ESP(spi=0x02dc8063,seq=0x1e)
16:36:34.873592 10.0.0.1 > 10.0.0.10: ESP(spi=0x0751ce23,seq=0x1d)
16:36:35.737921 10.0.0.10.500 > 10.0.0.1.500: isakmp: phase 2/others
? inf[E]: [encrypted hash]
16:36:35.904270 10.0.0.10.500 > 10.0.0.1.500: isakmp: phase 2/others
? oakley-quick[E]: [encrypted hash]
16:36:36.604941 10.0.0.1.500 > 10.0.0.10.500: isakmp: phase 2/others
? oakley-quick[E]: [encrypted hash]
16:36:36.605565 10.0.0.10.500 > 10.0.0.1.500: isakmp: phase 2/others
? oakley-quick[E]: [encrypted hash]
16:36:36.887859 10.0.0.10 > 10.0.0.1: ESP(spi=0x01f4fcea,seq=0x1)
16:36:37.897889 10.0.0.10 > 10.0.0.1: ESP(spi=0x01f4fcea,seq=0x2)
The lines that contain
isakmp represent the two
Racoon daemons negotiating a new key.
As an experiment, I turned off IPsec on my laptop by commenting out the
ipsec_enable line in
/etc/rc.conf. Then I rebooted.
Interestingly, I still received an IP address from my DHCP server on the other
side of the wireless gateway. However, I could not get through the gateway.
Even simple pings to the gateway went unanswered. At this time, the firewall on
the wireless gateway allowed all traffic to pass. Therefore, the gateway
rejected the traffic because it did not use IPsec.
To make IPsec work again, I did this while the ping was still running:
[root@laptop:/home/dan] # setkey -f /etc/ipsec.conf
[root@laptop:/home/dan] # tcpdump -ni wi0 tcpdump: listening on wi0
17:21:20.168434 10.0.0.10.500 > 10.0.0.1.500: isakmp: phase 2/others
? oakley-quick[E]: [encrypted hash]
17:21:46.426485 10.0.0.10.500 > 10.0.0.1.500: isakmp: phase 2/others
? oakley-quick[E]: [encrypted hash]
17:21:47.112010 10.0.0.1.500 > 10.0.0.10.500: isakmp: phase 2/others
? oakley-quick[E]: [encrypted hash]
17:21:47.113115 10.0.0.10.500 > 10.0.0.1.500: isakmp: phase 2/others
? oakley-quick[E]: [encrypted hash]
17:21:47.375549 10.0.0.10 > 10.0.0.1: ESP(spi=0x02c19c7a,seq=0x1)
17:21:48.385549 10.0.0.10 > 10.0.0.1: ESP(spi=0x02c19c7a,seq=0x2)
17:21:48.390088 10.0.0.1 > 10.0.0.10: ESP(spi=0x041e48fb,seq=0x1)
17:21:49.395564 10.0.0.10 > 10.0.0.1: ESP(spi=0x02c19c7a,seq=0x3)
17:21:49.399754 10.0.0.1 > 10.0.0.10: ESP(spi=0x041e48fb,seq=0x2)
The first line populates the SPD1 database, based upon the data
within the file
/etc/ipsec.conf. From there, Racoon
must negotiate a new key. It took some time (about 26 seconds), but
Racoon eventually succeeded. Immediately thereafter, the pings
1Actually, the command populates only the SAD because the
file in question contains only
add commands. I commented out
spdadd commands.
I mentioned above that I could still receive an IP address from my DHCP server that was running on my gateway. I had not previously mentioned it, but I think it might be useful to you. Here are the basics; the rest you should be able to piece together yourself.
To install the dhcp server, I did this:
# cd /usr/ports/net/isc-dhcp3-server
# make install clean
This will install /usr/local/etc/rc.d/isc-dhcpd.sh. Remember to add
dhcpd_enable="YES" to /etc/rc.conf, or the script will not
start the server. I also added
dhcpd_ifaces="dc0" so that
dhcpd would listen only on the one NIC--the one attached to the
same hub as the WAP.
The port installs /usr/local/etc/dhcpd.conf. It is full of examples, but here is what I'm using, slightly altered to protect the obvious:
default-lease-time 600;
max-lease-time 7200;
ddns-update-style none;
option domain-name "example.org";
# this points to my local DNS server on the other
# side of the wireless gateway
option domain-name-servers 192.168.0.101;
default-lease-time 86400;
max-lease-time 86400;
# This is a very basic subnet declaration.
subnet 10.0.0.0 netmask 255.255.255.0 {
option routers 10.0.0.1;
range 10.0.0.192 10.0.0.207; # this is 10.0.0.200/27 => (28)
host laptop.example.org {
option dhcp-client-identifier "laptop.example.org";
fixed-address laptop.example.org;
fixed-address relates to the following entry in
send dhcp-client-identifier "laptop.example.org";
This allows the laptop to tell the DHCP server who it is, which I use to assign a specific IP address. Note: this method is convenient, but it is not necessarily secure. If you're like me, sometimes using wireless with your laptop and sometimes connecting via wire, then you might want to give it a different IP address depending on where it is. I do that by having two DHCP servers. I'm sure someone will suggest another method.
Now you have your wireless laptop connected to your LAN, with encrypted and secured traffic. Nobody else can use your gateway unless they guess the secret key. That's not easy. The key will change from time to time, so even if someone guesses a key, there's a new one coming along soon. The only thing you have to secure is the preshared secret. Don't use what I've supplied. Come up with something odd, even some random values. Pick some text from IRC. That should work.
Are you being paranoid enough? I think for one of my next tasks I will look for any unusual traffic coming on the gateway, from any IP other than my laptop. There are whole books written on intrusion detection, and that topic is well beyond what I can cover here.
Dan Langille runs a consulting group in Ottawa, Canada, and lives in a house ruled by felines.
Return to the BSD DevCenter.
Copyright © 2009 O'Reilly Media, Inc.


text:
International Students on "Why the Gillings School Is a Great Fit!" (Video) Watch the Video
UNC Gillings School #1 Public School of Public Health in NIH Funding! Read More
UNC Gillings Students Win $325k Startup Award from Innovation Next! Read More
UNC Gillings Alumni are Local, National and Global! Read More
UNC Gillings Study: Antibodies from Dengue Fever Survivors Can Prevent Zika Infection Read More
Video: The 2016 Commencement
Address by Dr. Dennis Gillings Watch the Video
UNC is Committed to Food for All Read More
In Praise of Diversity, Inclusion and Civility Read More
We Embrace a Culture of Health at Gillings! (Photo by @sportgraphics.com) Read More
Active Duty Military, Vets Embrace Opportunities at Gillings Read More
Meet Some of Our Biostatistics Students! Watch the Videos
Check Out UNC Gillings' Online Programs! Read More
UNC Gillings is a Leader in mHealth! Read More
Healthy Aging is a UNC Gillings Research and Policy Focus Read More
UNC Gillings – An Innovative Public Health Leader, An Amazing Culture Watch the Video
UNC Gillings Again Named #2 Overall,
#1 Public School of Public Health Read More
Reaching across North Carolina and around the world with teaching, research, and service.
Reaching across North Carolina and around the world with teaching, research, and service.


text:
The state's largest police union is suing the Wisconsin Counties Association, alleging it has violated the state's open records law.
The counties association says it's not subject to the open records law. The police union wants financial records, audits and other information from the counties association. The union is fighting efforts by the counties to reclassify their jailers as general employees, rather than protective service employees. A reclassification would limit the jailers' collective bargaining power.
The Journal Sentinel says the union wants a Dane County judge to declare the counties association is a quasi-governmental agency and therefore subject to -- and in violation of -- the open records law.


text:
Welcome to Ison's Nursery and Vineyard's online store.
Welcome to the official site for Ison's Nursery and Vineyards!
Located in beautiful western Georgia, not too far from Atlanta, we have cultivated a tradition of excellence and quality among our vast selection of fruits including our favorite; muscadine vines! We are that largest and oldest producers of muscadine vines in the United State as well as one of the oldest nurseries in the country.
Nothing compares to muscadine grapes from Ison's or some of the delicious muscadine products we also offer such as muscadine wine, jams, candles, salsas, syrups and more. We love muscadines and carry dozens of different types of muscadines so you too can grow a variety of these wonderful grapes. Muscadine grapes are delicious and versatile and as you can see, you can make a lot of tasty treats with them.
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text:
International Bazaar
Mon, 23 Sep 2013 11:00 AM - 3:00 PM
11 a.m.-3 p.m.
The Commons
The International Bazaar is a free event which will feature vendors, music and displays in the heart of campus. Vendors and student groups, bringing merchandise from around the world, will be at the event. Don't forget to bring some cash - this will be a great place to pick up gifts for your friends and family or splurge on something for yourself.
Part of International Week at JMU; for information, check http://www.jmu.edu/international/iweek/highlights.shtml.


text:
You Are Here: Home » News From NINDS » Proceedings »
Parkinson's Disease Research Agenda Implementation Review Meeting Cites Progress, Future Directions, and Common Themes
January 9 and 10th, 2002
Bethesda, MD
Scientists, patient advocates, and representatives of nine National Institutes of Health (NIH) components gathered January 9-10 to review progress made in implementing the agency's Parkinson's Disease Research Agenda. In her welcoming remarks, NIH Director Dr. Ruth Kirschstein spoke of the "unprecedented push, unseen ever before," that the NIH has made in Parkinson's disease research since the document was written. Originally released in March 2000, the Agenda describes areas of significant scientific opportunity in Parkinson's research to be explored over the following five years. The January 2002 meeting reviewed progress made towards accomplishing the goals set forth in the Agenda, identified newly emerging areas of interest, and prioritized future research goals.
The general consensus of the attendees is that the NIH is doing a good job implementing the Agenda's initiatives. However, participants identified additional areas of interest too new to have been stressed in the original document, and at least one area, rehabilitation, where current knowledge of the field indicates that additional efforts would be worthwhile.
Two breakout groups-one on the basic mechanisms of Parkinson's disease, the other on its treatment-discussed goals believed to be obtainable over the next 3 years. At the closing plenary session, participants identified several common themes that reinforce these goals:
Other significant issues targeted by the participants include:
"The feedback from all the participants was extremely gratifying," said Dr. Audrey S. Penn, Acting Director of the National Institute of Neurological Disorders and Stroke, which hosted the meeting, "but I was particularly encouraged by the positive feedback from the patient advocates."
Last Modified April 8, 2011


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#71021 - 05/23/02 05:57 PM Damp Squib
Registered: 03/22/00
Posts: 1981
I made my usual mistake the other day in a letter to a friend and mentioned the expression "damp squid" - it just comes out like that! Googling, I realised that the world is full of people who get it wrong too. It started me thinking about the expression - it is listed in one of the dictionaries that I found as a British and Australian expression. Is this so? Is it used in 'Merka? Canada?
I assume that it has military origins - any thoughts?
Whether you use it or not, can y'all think of good alternatives?
#71022 - 05/23/02 06:05 PM Re: Damp Squib
Carpal Tunnel
Registered: 09/30/01
Posts: 6296
Loc: Piedmont Region of Virginia, U...
This is what I just found on an online dictionary:
damp squib
noun Racing a horse or dog that starts well but finishes terribly. Also, squib.
I'd never heard of the damp squib. Is this racing term the one to which you were referring? This definition doesn't look like a military term. (I'll go look up the URL now...)
#71023 - 05/23/02 06:10 PM Re: Damp Squib
Carpal Tunnel
Registered: 03/15/00
Posts: 6511
Loc: lower upstate New York
It's also new to me, Jo. Can you use it in a sentence?
edit: I see WW LedIU. Odd word!
#71024 - 05/23/02 06:22 PM Re: Damp Squib
Registered: 12/14/00
Posts: 544
Loc: San Francisco, CA
Going with the military origin, I always thought that a squib was a fuse (like on an old-fashioned cannon, or on a stick of dynamite), so a damp squib was something that just wasn't going to fly, or something disappointing, sometimes used in the same sense as a "wet blanket" - a downer.
AHD says:
1a. A small firecracker. b. A broken firecracker that burns but does not explode.
So a damp squib, according to b, is a damp, broken firecracker - talk about a disappointment!
#71025 - 05/23/02 06:51 PM Re: Damp Squib
Carpal Tunnel
Registered: 04/03/00
Posts: 10538
Loc: this too shall pass
a squib, not having much of an explosive effect to begin with, becomes even less efficacious when damp:
[Of obscure origin; perh. intended as imitative of an explosive sound.]
1. a. A common species of firework, in which the burning of the composition is usually terminated by a slight explosion.
Squibs are straight cylindrical cases about 6 inches long, firmly closed at one end, tightly packed with a strong composition, and capped with touch-paper (1886 Encycl. Brit.).
d. fig. or in fig. contexts. damp squib, something that fails ignominiously to satisfy the expectations aroused by it; an anti-climax, a disappointment.
1847 Alb. Smith Chr. Tadpole i. (1879) 20 The literary gentleman having finished, like a damp squib with a good bang, resumed his seat. 1963 Times 6 Mar. 11/3 Possibly because too much was expected of it, the long-range study of Britain's transport needs by a Ministry of Transport group under Sir Robert Hall is something of a damp squib. 1976 Yorkshire Even. Press 9 Dec. 8/5, I came here thinking this Scarborough business would cause fireworks, but I have never known such a damp squib.
I'd say that it's not heard much in the US, outside of the military.
#71026 - 05/23/02 07:02 PM Re: Damp Squib
Registered: 03/22/00
Posts: 1981
>d. fig. or in fig. contexts. damp squib, something that fails ignominiously to satisfy the expectations aroused by it; an anti-climax, a disappointment.
So now you've got the hang of it - can you think of equivalents?
#71027 - 05/23/02 07:09 PM Re: Damp Squib
Carpal Tunnel
Registered: 01/18/01
Posts: 13858
A squib is a small cylinder made of rolled paper, containing gunpowder and a fuse. If the casing is damp, the casing will burst at relatively low pressure, with consequently disappointingly reduced noise.
#71028 - 05/23/02 07:15 PM Re: Damp Squib
Carpal Tunnel
Registered: 04/03/00
Posts: 10538
Loc: this too shall pass
>can you think of equivalents?
devoid of sound and fury, signifying nothing. 8 )
#71029 - 05/23/02 07:26 PM Re: Damp Squib
Carpal Tunnel
Registered: 09/30/01
Posts: 6296
Loc: Piedmont Region of Virginia, U...
devoid of sound and fury, signifying nothing. 8 )
Isn't that a quote from William Faulkner's As Hamlet Lay Dying?
#71030 - 05/23/02 07:31 PM Re: Damp Squib
Registered: 03/22/00
Posts: 1981
>Isn't that a quote from William Faulkner's As Hamlet Lay Dying?
You might need to go back a little further.
To-morrow, and to-morrow, and to-morrow,
Creeps in this petty pace from day to day
To the last syllable of recorded time,
And all our yesterdays have lighted fools
The way to dusty death. Out, out, brief candle!
Life's but a walking shadow, a poor player
That struts and frets his hour upon the stage
And then is heard no more: it is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.
The Bard
[Edit: But you knew that!]
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text: How long does this last? I read info on kellymom but I didn't see how long it lasts and very many options to help with the pain. I know you can use warm virgin olive oil but I still have an open wound that is finally healing and am scared to put the oil on it, a warm wash cloth helps for a few minutes and then I'm in pain again. Help!!


text:
City Secretary Pam Long said approximately 15 people had cast their early votes at City Hall by noon Monday.
Those wanting to cast early votes in the election between incumbent Dick Mollicone and challenger Michelle Reitz for the District 6 school board post must do so at the Goliad ISD Superintendent's Office at 161 N. Welch St.
Those wanting to cast early votes in the city council election for the three places between Buddy Zavesky, Lionel Garcia, Vicki Rubio, Eric Garza, Roney Powell and Liz Holsey must do so at City Hall.
Early voting for the May 11 election ends Tuesday, May 7.


text:
Headlines (Campus Updates)
Future Students - International
TEDxWaterloo event to be streamed live to the Laurier community
Communications, Public Affairs & Marketing
Mar 20/12
Wilfrid Laurier University will provide a live feed to the innovative TEDxWaterloo event at Lauriers Waterloo campus March 21. This is the second year Laurier has provided a live feed to the event.
Twelve inspiring speakers such as Izzeldin Abuelaish, known as "the Gaza Doctor" and the author of I Shall Not Hate, Jean Beliveau, a man who walked around the world, and Roberta Hunt, a jazz and blues musician, will be beamed from the stage at Kitcheners Centre in the Square to Lauriers Waterloo campus via a live feed.
The event is free and you can drop in to watch the event at the following locations:
Wilfs Den 1 p.m. to 8 p.m.
Science Building, N1044, N1056 2:30 p.m. to 6:30 p.m. (just off the Science courtyard)
The theme of the 2012 event is DIS CONNECTED. A full list of 2011 TEDxWaterloo speakers can be found at: http://tedxwaterloo.com/speakers.
The Presidents Innovation Seed Fund (PISF) is sponsoring the live feed of the event, along with the Laurier Centre for Community Service-Learning (CSL). The PISF, which also sponsored the event last year, was established in 2009 and provides seed money to initiate ideas and help them become self-sustaining programs. CSL integrates meaningful community service with classroom instruction and critical reflection to enrich the learning experience and strengthen communities for the common good. The event is also being sponsored by the Faculty of Science Students Association (FOSSA) and the Psych Society.
Laurier will host its own TEDxLaurier event Sept. 26, also featuring 12 speakers who will speak and perform throughout the day. Further details will be provided closer to the date.
TED (Technology, Entertainment, Design) is an annual conference that started in California featuring thought leaders. In the spirit of "ideas worth spreading," TED has created a program called TEDx, which is a program of local, self-organized events that bring people together to share a TED-like experience.
For more information about the Laurier event, please contact Cindy Ward at firstname.lastname@example.com.
View all Future Students - International news
View all Laurier news


text:
A man who was arrested but not charged in the killing of a Cold Spring police officer is denying new charges that he stalked his ex-girlfriend.
The St. Cloud Times reports 34-year-old Ryan Michael Larson is accused of a pattern of stalking that included calling her employer, a health care facility in Buffalo, and trying to get her fired. The charges were filed in Wright County, and a warrant was issued for his arrest Thursday.
Larson was arrested the night Officer Tom Decker was shot behind a Cold Spring bar Nov. 29. He spent four days in jail before being released.
Larson tells the Times he doesn't understand why he's been charged in the new stalking case or why people think he's still a suspect in Decker's death.


text:
Men's Basketball Tournament
Sat, 9 Nov 2013 8:00 AM - Sun, 10 Nov 2013 5:00 PM
Come cheer on Men's Club Basketball as they compete in their home tournament on Saturday and Sunday!
UREC - 9am-9pm in the Main Gym
Godwin - 8am-8pm in the Godwin Gym
UREC - 9am-5pm in the Main Gym
Godwin - 9am-5pm in the Main Gym
Learn more about JMU Men's Club Basketball!
Follow JMU Sport Clubs on Facebook.
UREC Homepage / Facebook / Twitter


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What is in this article?:
- Cotton fertilization hot topic at Expo Field Day
- Hedge toward first square
- Are limits to practice
• There's a lot of late-planted June cotton in Georgia, and there are several key points that should be remembered when adjusting to this situation.
More About:
One of the driest springs on record continues to perplex cotton producers in the lower Southeast as they enter the mid-season mark with many questions about how to handle fertilization of the 2011 crop.
"With the drought this year, we have a lot of late-planted cotton with uneven stands," says Glen Harris, University of Georgia Extension soil scientist. "We're getting a lot of questions about how to fertilize with nitrogen when you've got skippy stands or non-uniform plant stands.
"I'd say when the older cotton gets ready, I might go ahead and pull the trigger because that might be the cotton that does best for you. The only way you can hurt really small cotton with nitrogen is if you dribble right onto it and burn it."
Harris was one of the featured speakers during the recent Sunbelt Agricultural Expo Field Day, held in Moultrie, Ga. Those attending this year's event got the opportunity to see about 200 acres of cotton and the latest in varieties from Deltapine, Bayer, Americot and Dow, in addition to the latest research from the University of Georgia's Extension Cotton Team.
Harris says his work at Expo is focused on potassium nutrition and its interaction with new cotton varieties. "Newer varieties do need a fair bit of potassium, and we've had our share of potassium problems. I've shifted the emphasis this year to how some of these new varieties might respond to some of the things we're doing with potassium. We're splitting applications, foliar-feeding potassium, and foliar-feeding early and late," he says.
Turning to current crop conditions, Harris says there's a lot of late-planted June cotton in Georgia, and there are several key points that should be remembered when adjusting to this situation.
Growers shouldn't try to rush the crop by over-fertilizing with nitrogen, says Harris.
"Unfortunately you cannot fertilize your way out of a drought. I wish you could. And in fact, trying to rush a late-planted crop with extra nitrogen can actually backfire and delay maturity making matters even worse," he says.
Harris advises producers to go with conservative side-dress nitrogen rates on dryland (50 to 60 pounds per acre depending on how much preplant nitrogen was applied) according to yield goals.
"If the rain situation improves as the crop progresses, you can always make up some ground with foliar — up to 20 pounds per acre if you use feed grade urea and are willing to foliar feed more than once."
Side-dress nitrogen should be applied early, he says. The normal "window" for side-dressing nitrogen is from first square to first bloom.


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Unlike the Towns of Bethel, Highland, Tusten and Lumberland, officials in the Town of Callicoon think there may be a place for industrial activity and gas drilling in the town's future.
The draft Comprehensive Plan update is now available on the town's website, townofcallicoon.org, and while it says there are concerns related to the exploitation of the Marcellus Shale, the plan also says there may be benefits.
In the section detailing the industry, the document says that because of being located off main transportation routes and a lack of infrastructure, it "seems unlikely" that any industry would locate in the town with the possible exception of gas drilling, which could come with "both positive and negative" impacts.
The document notes that the town is in the process of doing a road assessment study, which will be important if gas drilling does become a reality because of heavy truck traffic and possible damage to roads associated with "this or any other new industry."
The draft says it is important to ensure the health of the town's plentiful water supply in the face of various possible polluting processes, including "agricultural runoff, road salt, bulk tank storage, wastewater from residential and commercial uses and industrial activities such as natural gas drilling."
Further, it says, "Because of the high volume of water and the chemicals used for hydraulic fracturing, there is concern for the safety of the area's drinking water. The storing of water used during the hydraulic fracturing process also presents a potential source of pollution of our water."
Under a section titled Environment and Natural Resources, gas drilling is listed as an opportunity: "The prospect of natural gas drilling could bring economic benefits to help landowners keep their land." In the same section, it is also listed as a threat: "The prospect of natural gas drilling in the Marcellus Shale could negatively impact our water quality, our rural character and our agricultural base."
Gas drilling is also listed as an opportunity related to the town's transportation network because of the Multi-Municipal Task Force, which is creating a legal framework through which "the costs of road damage associated with high-traffic activities are borne by those who cause the damage, rather than the towns and taxpayers." Here, again, gas drilling is listed as a source of additional revenues to provide for the town's infrastructure.
Finally, with the goal of ensuring that industrial development is compatible with the community character, an implementation step spells out that town officials should "work closely with the New York State Department of Environmental Conservation (DEC) to ensure that any potential new industrial activity, including natural gas drilling, is carried out safely. This includes keeping informed of whether and how the town will be involved in the permitting process, exercising our rights to participate in the process, and advocating for the protection of the important resources named in this comprehensive plan."
A comprehensive plan workshop has been scheduled for April 25 at 7 p.m. at the town hall in Jeffersonville.


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I would, here we go again, do a different crop to make it less middley.
OK so I'm getting a bit carried away - would like to know peoples thoughts on this one
Abbey Fields Kenilworth by CarlMitchell, on Flickr
I love the fact that you have got some detail in the shadows of people in the foreground.
Have you shot this in RAW, if you have you could perhaps keep the foreground detail and rescue the colour of the fireworks, that would give you a real gem.


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Hi Ladies,
I was wondering when you stopped counting hours and waking baby for feedings and allowed baby to tell you when she is hungry (waking on her own)?
My daughter wakes up for feeding on her own during the day half the time, the other half, I have to wake her. Its so much harder when I have to force her awake and would like to move to a more "on demand" schedule. I am much looser about it at night, she slept for 4-6 hour stretches the last 3 nights.
Any thoughts? Should I worry about the long stretches at night?
She is almost 3 weeks, good diaper output, hasn't been weighed this week, but was gaining about an ounce per day last week.
Thanks !