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KELSEYVILLE -- Narcotics Task Force detectives reportedly eradicated more than 700 marijuana plants, seized 39 pounds of processed of marijuana and made one arrest Thursday, according to a press release.
The Lake County Sheriff's Office (LCSO) detectives also found two 55-gallon barrels full of untrimmed processed pot at the marijuana grow in Kelseyville, a loaded .223 caliber rifle and $27,000 in cash after acquiring a search warrant, according to an LCSO press release.
LCSO Narcotics Task Force detectives were allegedly initially near the grow, located at 5555 Konocti Road, conducting surveillance of the area when they saw a white Toyota Tacoma near the site. Detectives conducted a traffic enforcement stop for alleged vehicle code violations, the release stated.
The driver, Angel Lemus Torres, allegedly told detectives he was a Proposition 215 patient, according to the release.
While two detectives interviewed Torres, others who were conducting surveillance of the grow site allegedly saw several people run from the area. Detectives were unable to find them, the release stated.
Detectives later served a search warrant at the Konocti Road grow site, and Torres was allegedly found to be in possession of $10,330 in cash.
Torres was booked in the Lake County Hill Road Correctional Facility on charges of cultivation of marijuana, possession of marijuana for sale, and possession of a weapon in the commission of a felony. He is being held on a $25,000.00 bail and an immigration detainer.
The names of law enforcement personnel were not provided by the LCSO.


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- REST APIs - Adds advanced, scalable application programming interface capabilities, enabling deeper integration across ExactTarget's suite of products and expanding ExactTarget's suite of SOAP APIs and pre-packaged integrations.
- Cross-Channel APIs – Makes ExactTarget's email, mobile, social and Web applications fully accessible via API.
- HubExchange – Expands ExactTarget's existing HubExchange model of select integrations to enable broader application development from developers and technology providers worldwide.
- Gears – Creates a new category of integration within ExactTarget products to extend ExactTarget product functionality with capabilities native in third-party applications.
Global interactive marketing provider ExactTarget (NYSE:ET) announced today it is opening its software as a service platform for software developers, creating the foundation for the largest cloud-based digital marketing app ecosystem. The move makes ExactTarget's Fuel platform open to developers and technology providers to build upon and integrate with ExactTarget's suite of cross-channel marketing and automation applications, creating opportunity for developers to build apps that extend ExactTarget's real-time digital messaging services to products and organizations worldwide. "By opening our Fuel platform for third-party development, ExactTarget is once again revolutionizing the way developers and marketers alike can unlock the power of data and the cloud to connect with their customers," said Scott McCorkle, ExactTarget's president technology and strategy. "Fuel extends our capabilities to power advanced integration and real-time messaging and creates the foundation for an entirely new app ecosystem that will serve as a catalyst for digital marketing innovation worldwide." Developers and technology companies have began developing new applications and innovations on the Fuel platform as part of ExactTarget's early access program that began earlier this year, McCorkle said. Early applications in development range from event marketing to advanced analytics and dashboards. ExactTarget clients, integrated partners, developers and technology companies are expected to have access to the third-party applications via ExactTarget's HubExchange, the company's online app store, during the second quarter of 2013. Key advancements included in ExactTarget's next generation Fuel platform include:

subset: commoncrawl


text:
With Grindhouse in 2007 and Tropic Thunder in 2008, fake movie trailers were briefly all-the-rage in Hollywood. Nothing ever came of Eli Roth's reported interest in a fake trailer feature film (at least, not yet), but Ben Stiller's got the get-up-and-go necessary to get-up-and-make-it-@#$%ing-happen, at least as a web series. Enter The Fake Trailer Project, a new upcoming web series from Stiller's Red Hour Digital, in which "top actors and filmmakers across all genres" (according to Deadline) will participate in the faux-medy madness. Amy Heckerling (Clueless), Reno 9-11's Thomas Lennon & Robert Ben Garant and Stiller's own Tropic Thunder collaborator Justin Theroux have all been confirmed for the series, which is set to premiere late Fall or early winter.
Of course, fake movie trailers weren't invented in the late 2000's. Obviously, sketch comedy shows have been playing with them forever (like Stiller's own Die Hard 12 trailer from The Ben Stiller Show, above), and they go back as least as far as the 1970's with The Kentucky Fried Movie's take on such fake films as Cleopatra Schwartz and That's Armageddon (below, NSFW language).
With the talent they've got involved, it's easy to get excited for The Fake Trailer Project. Will any of them break out enough to turn into the next Hobo with a Shotgun? Time, it seems, will tell.
CRAVE Online will be back with more Fake Trailer Project news after we finish up our pitch for The Fatties Part 4: In Orbit.


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Mental illness, as Kazuhiro Soda notes in his documentary "Seishin" ("Mental"), is one of the big taboos of Japanese society.
In the United States, doctors prescribe psychotropic drugs as commonly as cold tablets and memorists detail their breakdowns and addictions in best-selling books. In Japan, however, the mentally ill often try to hide their condition from employers, family and friends, while seeking treatment only as a last resort.
They fear, rightly in many cases, the stigma of being labeled "weak," "strange" or "crazy" in a conformist society with a culture of shame. Suicide starts to look like the only, tacitly approved, way out.
Soda, a New York-based documentary filmmaker who has screened "Seishin" at film festivals in Busan, Berlin and elsewhere, picking up several prizes along the way, opens a rare window into their lives, but less as an impassioned advocate than as a fly-on-the-wall observer.
In condensing hundreds of hours of footage shot at a mental-health clinic in Okayama in 2005 and 2007, Soda added no editorializing titles, narration or music. He also let his subjects, as much as possible, speak for themselves, minus the digital masking considered de rigeur for television interviews.
|out of 5
|Kazuhiro Soda
|Run Time
|135 minutes
|Opens June 13, 2009
One problem with this minimalistic approach is that we have to piece together even basic information from on-the-fly comments, rather than answers to specific questions. The mysteries of how, when and why Dr. Masatomo Yamamoto, the elderly psychiatrist who is the film's hero, came to run his clinic, which many of his patients regard as a second home, are never quite explained.
Also, Soda's camera can be ruthless in exposing the vulnerabilities, character flaws and even crimes of his subjects. In one chilling scene, a schizophrenic woman confesses to killing her baby in a black fit of frustration — and one wonders at the consequences for her, both social and legal.
But this dedication to showing the bad as well as the good creates more trust between the filmmaker and audience than propagandizing, which can present the mentally ill as saintly victims. True, Soda could have told his story more concisely — his 135-minute film is at least half an hour too long — but by the end I knew his subjects and their world in the raw and in the round, as though I'd spent a few weeks hanging around the clinic.
"Seishin" 's central figure is Yamamoto, now 73, who started the Chorale Okayama clinic in 1997 as a sort of postretirement project. He has since added a milk-delivery and restaurant business, staffed by patients, as well as opening a shelter where patients can stay temporarily. His aim, with the support of a dedicated staff, has been to create a community where the mentally ill can develop the self confidence, survival skills and human connections they need to ease their transition into the larger society.
In his dealing with patients, Yamamoto initially comes across more as the crusty neighborhood sensei (teacher) than the crusading reformer: Doctor-patient conversations are short and drugs are doled out by the fistful. But Yamamoto's methods, such as his habit of tossing his patients' questions back in their faces ("What do think you should you do?") and drawing little diagrams to illustrate his points (a straight line for the stages of life in the West and a circle for the East), have a Zen-like wisdom.
He has not, however, created a happy little utopia — many of his patients are suicidal, socially isolated and living on public assistance. One middle-aged woman tells how, the night before, she ended up in the hospital after overdosing on her medications. She shows her wrists, crisscrossed with scars. Her face tear-strained, she speaks of wanting to die. Several other patients confess to similar thoughts, and after filming was completed, two carried fatally through.
Yamamoto is also no miracle worker, restoring patients to health with a pithy word or two. One, a heavy-set, quick-witted raconteur whose monologues are punctuated by punning gags and party tricks, tells how he had his first breakdown as a high-school student prepping 18 hours a day for his college entrance exams. Instead of answering the questions on his semester tests, he assigned ratings to his teachers, grading them on a scale of 1 to 100. After being tagged as "strange" for this incident, he was referred to Dr. Yamamoto, and has been seeing him for 25 years.
"He's like a god to me," he says. But God can't erase that long-ago trauma or restore the lost time.
What Yamamoto and his staff do provide, though, is a vital lifeline that gives patients the support they need to recover — or simply make it through the day.
But, now, as Soda also shows, the patients are faced with government-mandated cutbacks in services and hikes in payments. They hold meetings and voice their objections, but compared with other, better funded and connected constituencies, they are all but powerless.
"Seishin," which Image Forum theater in Shibuya will screen in an English-subtitled print daily at 6 p.m., and which will later open around the country, ought to be seen by, not only Diet members voting on health-care legislation, but anyone interested in how minds can become sick — and be cured. As Soda so eloquently shows, the mentally ill aren't marginal "others," but like people we see around us every day at work and at home. Even in the mirror.


text: Hi, The spectral howl of the wild fedora is wafting again through my window. And in response, I'm thinking of getting a new one (a fedora, that is, not a window). This time I'm looking for a fur-felt hat with a wide brim around 2 3/4' to 3" and a light-colored felt. The price point above which I start to balk is $150. Currently, the front-runners are the Domanico (made by Guerra for Miller Hats, http://www.millerhats.com/italian_index/italian2.html) and the Chicago (from the Brazilian firm Stefeno, http://www.thefedorastore.com/Stefeno-Premium-Fur-Felt-Chicago-Fedora-Hat-p/chicago.htm). Even though the Domanico is actually over my price point and the more expensive of the two by a solid $40, I'm leaning away from the Stefeno. This is on the grounds that, for all I know, Stefenos are made by the slave labor of imprisoned dissidents, as well as contaminated by enough mercury to set off a TSA metal detector. But, seriously, it's only sized in S/M/L/XL, which isn't a good sign for a hat in its price range. So do any of you own comparable Guerras & Stefenos? Do you have any positive or negative feelings about them that you would share? And does anyone know of any other similar hats in the $150 range? Cheers, Mark


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Spartacus Vengeance/Xena star Lucy Lawless reveals a secret: "I never liked" action scenes
Blood flying toward the camera in a spurting fountain. Swords slicing through flesh as men scream in horror. White hot brands sinking into human flesh as the unfortunate recipient of the mark howls in agony.
These are just a few of the in-your-face action scenes powering Spartacus: Vengeance, the original series on Starz which plays like Gladiator for the small screen – complete with slow-motion, super-explicit sword fights in high definition images.
Focused on the exploits of a band of gladiators who escape their brutal training school during the time of the ancient Roman Empire, Starz's Spatacus is filled with the kind of killing and bloody fights once called "a bit of the old ultra violence" in Kubrick's Clockwork Orange film.
So you'd think Lucy Lawless, who once starred as a behind-kicking Amazon in the classic TV show Xena: Warrior Princess, would miss getting in on all that fun, stuck in a role as Lucretia Batiatus, the scheming wife of the man who owned the gladiator school.
You would be SO wrong.
"I never liked the physical thing," said Lawless, whose '90s-era work as ruthless warlord-turned-heroine Xena remains her best-known role. "I'm strong, but I have no coordination; I was black and blue for two years solid because I would whack myself in the face or get punched. It was God's cosmic joke on me to give me a gig like that."
My fanboy fantasies dashed, I went on to ask Lawless about the challenges of this season, which finds Spartacus trying to carry on after the death of its star, Andy Whitfield, at age 39 last year of non-Hodgkin lymphoma.
The cable channel filmed a Spartacus prequel, Gods of the Arena, without Whitfield which aired early last year. But though he rebounded after his earlier diagnosis, eventually the cancer returned and took his life, requiring the casting of 29-year-old Aussie Liam McIntyre as the new Spartacus.
The Vengeance season marks the first episodes featuring McIntyre playing the same character, picking up the story just weeks after Spartacus and his fellow gladiators killed a houseful of a guards and party guests gathered to watch a death match.
McIntyre seems to pick up the mantle of Spartacus ably, though Lawless admitted the fans will be the final judge of whether he replaced Whitfield adequately.
"It was certainly in the lap of the Gods," Lawless said. "Andy was so supportive of them recasting, because he wanted everybody to keep working. There's been plenty of times when we thought it might not go, and you just sit and watch and wait."
Lawless plays a much less physical role, as the only survivor of the massacre at the gladiator school, who loses a child through a sword wound. As the new season begins, she is found, shellshocked, swimming in the blood of all the guests and guards killed in her house.
(Because Starz is a premium cable channel, there's lots of nudity and graphic scenes, including a closeup shot of a captured gladiator's tongue cut off).
If Spartacus' fights are one side of this unique series, Lawless' Lucretia embodies the other end; a series of political machinations and royal intrigue which lend an R-rated, soap opera flair to the story. Eventually, her character becomes a valued symbol – a sign for the Roman population that the freed gladiators are not all-powerful – which she parlays into the notion that she receives prophecies from the gods.
"She's going to have to go looking for friends in very unlikely places," said Lawless, cagey about revealing too many details. "Her mental state is a very important key to Lucretia from here on out. But I want you to know that by the end Lucretia…all of her dreams will be fulfilled, one way or another."
Another TV critic has compared Spartacus to PBS' genteel World War I drama Dowton Abbey, for both's series' emphasis on social roles, marriages for love, social standing and power, along with a bucketload of political intrigue.
Not sure I would go that far, but the combination of intrigue and blood can be compelling, as Starz present a series as brutally graphic and politically involved as modern television might allow.
"It makes the audience feel clever because nobody's saying what they mean, yet the audience can figure it out," Lawless said. "So the audience is always a little bit ahead of some of the characters in the room."
Spartacus: Vengeance debuts at 10 p.m. Friday on Starz.


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do the motor mounts. i didnt notice any increase in nvh and im running the hardest motor mounts i could find
That's great to hear! Did you have to adjust the pinion angle that Sam mentioned in the above post? I guess that has to do with the angle of the driveshaft with the motor & rear differential...again, I'm a novice at this stuff.


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Quick Takes: At your Domino service
Mental Notes introduces a new Domino code library; Interliant lands a Domino hosting deal; CHC-3 helps outsource Domino administration; L-Soft adds safeguards to its e-mail list software.
This Article Covers
Domino Resources - Part 6
Mental Notes introduces the WebCoach code library
Mental Notes Inc. in New York has introduced WebCoach for Domino, a code library of reusable Web scripts to help speed the development of Domino-based Web sites. WebCoach features more than 100 reusable JavaScript functions and examples to help users with JavaScript field validation, prompt windows, cookies and specific Domino functionality such as Address Book search dialog boxes, the company said.
Download: IT certifications that stand out
Are you looking to advance your career? Expand your knowledge? Boost your credibility? Our editors put together this complimentary 19-page guide on everything you need to know about obtaining an IT certification—with special attention given to cloud and desktop certifications.
By submitting your personal information, you agree that TechTarget and its partners may contact you regarding relevant content, products and special offers.
You also agree that your personal information may be transferred and processed in the United States, and that you have read and agree to the Terms of Use and the Privacy Policy.
Future releases of the product will include other Web technologies such as XML, DHTML, CSS, and Flash. WebCoach, which joins Mental Notes' products like ScriptCoach and JavaSpeak, is priced at $795 per user.
CHC-3 Consulting launches outsourced admin for Domino
CHC-3 Consulting in Woburn, Mass., has launched an outsourced system administration service for Domino and Notes customers. The service is targeted at small organizations that may not be able to dedicate a full-time administrator to managing Notes or larger firms that require outside expertise. Called DominoAdministration.com, the remote service offers help managing user accounts, solving security issues, setting up and troubleshooting email infrastructures, fixing routing and replication problems, correcting broken connection documents, installing new applications, and performing version upgrades.
Interliant to host Domino servers for AguirreIS
Application service provider Interliant, Inc. in Purchase, N.Y., will be hosting its INIT Managed Messaging for Domino service for application development and service firm AguirreIS, in San Mateo, Calif. Interliant will maintain multiple Domino dedicated servers in its data center for AguirreIS and will be responsible for guaranteeing service levels, security and reliability.
Interliant will provide AguirreIS wth Domino infrastructure design, installation and configuration of Domino servers, remote monitoring and management, backup, fail-over and disaster recovery.
L-Soft adds virus protection to list management software
E-mail list management software firm L-Soft in Bethesda, Md., will integrate anti-virus technology from Finish firm F-Secure into its ListServe product line. F-Secure Anti-Virus will check each e-mail attachment sent in mailing lists. If a virus is detected, ListServe will reject the item.
L-Soft is offering the added functionality free of charge to its Windows 2000 and Linux customers.
To include your announcement in Quick Takes, e-mail Jon Panker, news editor


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MOLIERE ONE ACTS, DARK AT THE TOP OF THE STAIRS and More Set for A Noise Within, April-May 2014
A Noise Within (ANW), the acclaimed classical repertory theatre company, announces two free readings, a special free family event for Shakespeare's birthday at the theatre, and added dates for our critically acclaimed production of Molière's Tartuffe upcoming in April and May.
Two Free Readings:
Molière One Acts, Wednesday, April 9 at 7pm - The Flying Doctor and The Imaginary Cuckold
A Noise Within presents a free reading of two Molière One Act comedies - The Flying Doctor and The Imaginary Cuckold. The reading of these Molière one acts complements the main stage presentation of the French comedy master's Tartuffe, now performing. Alison Elliott and Stephen Rockwell direct. Kelly Ehlert produces. Cast to be announced.
The Flying Doctor: Valère is willing to go to any length to marry his sweetheart, Lucile. His only obstacle is her father, Gorgibus. Fortunately, Valère has a clever servant named Sganarelle who is willing to help. Sganarelle creates a diversion by convincing Gorgibus that he is a great doctor. Everything goes according to plan until Gorgibus discovers Sganarelle without his doctor costume. In the end, Valère and Lucile marry, and Sganarelle is rewarded for his cleverness.
The Imaginary Cuckold: Gorgibus wants his daughter, Celie, to marry a rich man, Valère, instead of Lelie, whom she loves. Celie faints; Sganarelle, who happens to be passing, runs over to hold Celie while her maid runs for aid. Sganarelle's wife, however, sees him holding Celie and suspects the worst. She finds a portrait of Lelie, dropped by Celie when she fainted, and admires his good looks. Confusion reigns until Celie's down-to-earth maid resolves everything by setting everyone straight. Just then Valère's father arrives to announce that he has discovered that his son married secretly four months ago, freeing Celie and Lelie to marry.
Dark at the Top of the Stairs by William Inge, Wednesday, May 14 at 7pm
A Noise Within presents a free reading of Dark at the Top of the Stairs by William Inge. The Dark at the Top of the Stairs is Inge's 1957 play about family conflicts during the early 1920s in a small Oklahoma town. It was nominated for the Tony Award for Best Play in 1958 and was made into a film in 1960. The reading complements the main stage presentation of Inge's Come Back, Little Sheba, performing in April and May. Deborah Strang directs. Cast to be announced.
Admission for the readings is free. Please RSVP via phone to 626-356-3100 x1 to reserve your seat.
Shakespeare's 450th Birthday Day Party
A Noise Within celebrates the Bard's 450th birthday on Thursday, April 24 from 5:30-7pm, in front of the theatre and in our lobby, with a family event for you and your children. Come experience our bouncy castle! See sword fight demonstrations and take a lesson. Leave an insult on our Shakespearean Insult wall. Try on period costumes. Sing Happy Birthday to William Shakespeare, who will appear to blow out his candles. Share some birthday cake with the Bard. Free to the public - just show up!
Added Tartuffe Dates
Due to the popularity of our production of Tartuffe by Molière - we have added two additional performances: one on Saturday, April 19 at 2pm and one on Friday, May 23 at 8pm. Tickets for these added performances are now on sale - starting at $34. Call 626-356-3100 x1 or visit www.anoisewithin.org.
About A Noise Within: A Noise Within performs and promotes classical theatre as an essential means for our community to confront the universal human experience, expand personal awareness and challenge individual perspectives. A Noise Within's mission is to produce world-class performances of the great works of drama in rotating repertory with a resident company; to educate and inspire the public through programs that foster an understanding and appreciation of history's great plays and playwrights; and to train the next generation of classical theatre artists.
A Noise Within was founded in 1991. Operating out of a former Masonic Temple in Glendale, they staged a production of Hamlet that was accessible and relevant at a time when classic theatre was not widely performed in Los Angeles. The twenty-year evolution from a small neighborhood theatre to the current acclaimed repertory company has been marked by constantly raising the bar on what great classical theatre can be. The move to a new, permanent home provides A Noise Within with expanded artistic possibilities, a greater scope of educational opportunities, and the capacity to meet demand and reach its full potential.
A Noise Within Producing Artistic Directors Geoff Elliott and Julia Rodriguez-Elliott both hold a Bachelor of Fine Arts from the University of Florida and a Master of Fine Arts from San Francisco's American Conservatory Theatre. In 1991, with a mere $3,000 from their personal savings account, they set an ambitious vision for ANW: to establish a home for the classics that would present a challenging repertory, take artistic risks, and ensure accessibility to diverse audiences. Through their passion and persistence, the theatre now ranks as the leading presenter of great world drama in Southern California. A Noise Within is located on the corner of Foothill Boulevard and Sierra Madre Villa Avenue at 3352 East Foothill Blvd., Pasadena, CA 91107.


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Besides the word ecclesia itself, the New Testament describes the church with several images that further explain its nature and function.
Today we will look at just two crucial concepts regarding the church: the church as the people of God and the church as the body of Christ.
1. The "people of God" as a concept is applied in the Bible to the children of Israel (Deut. 14:2). Read 1 Peter 2:9, where the concept is clearly applied to Christians. How are we to understand what this means for us today?
Notice that even as the concept is applied to Christians, it is still used to describe the nation of Israel (Luke 1:68; Rom. 11:1-2). Evidently the New Testament applies the concept to the church in a way that suggests continuity and consummation.(See Gal. 3:29.)
2. "Body of Christ" – Romans 12:5, 1 Corinthians 12:27, and Ephesians 1:22-23 depict the church as the body of Christ. How do these texts help us to understand better its nature and function?
Numerous ideas can be found within these texts, perhaps the most obvious one being the unity (see Wednesday's lesson) that should be seen in the church. This is an idea expressed elsewhere in the New Testament, especially in 1 Corinthians 12, where Paul writes: "For as the body is one, and hath many members, and all the members of that one body, being many, are one body: so also is Christ. For by one Spirit are we all baptized into one body, whether we be Jews or Gentiles, whether we be bond or free; and have been all made to drink into one Spirit. For the body is not one member, but many. If the foot shall say, Because I am not the hand, I am not of the body; is it therefore not of the body? And if the ear shall say, Because I am not the eye, I am not of the body; is it therefore not of the body? If the whole body were an eye, where were the hearing? If the whole were hearing, where were the smelling?" (1 Cor. 12:12-17).
Some people suffer from what are known as auto-immune diseases: their own immune system, which is supposed to protect the body, attacks it instead. Think about the implications of this analogy for the church as 'the body of Christ'.


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Department of Christian Education announces activities for Ascension, Pentecost
A variety of resources for teaching and celebrating the Great Feasts of the Ascension and Pentecost are available on the web site of the Department of Christian Education.
Activities related to the Ascension, as well as the post-Resurrection appearances of Christ, may be found in PDF format. Pentecost activities, which include craft suggestions, are also available.
The activities are suitable for a variety of age groups and may be used in class and home settings, says Valerie Zahirsky, DCE Chair.
Visit the DCE web site for a wealth of educational resources, many of which can be used in upcoming Vacation Church School and camp programs.


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Download Skyscanner All flights, everywhere! iPhone iPad iOS
Skyscanner , the publisher behind many iOS app (天巡酒店 - 特惠酒店比价 ,Skyscanner - Flights (no ads) ,Skyscanner All flights, everywhere! China ,Skyscanner – Airport Car Rental ,Skyscanner - Hotel Search ,Skyscanner All flights, everywhere!), brings Skyscanner All flights, everywhere! with a number of new features along with the usual bug fixes. Skyscanner All flights, everywhere! app has been update to version 188.8.131.52 with several major changes and improvements. App release that improves performance, provides several new options.
Overall Satisfaction94
Flight search was never as convenient as it is now.
It's the best travel app that I have ever seen.
Really easy to compare dates and times to find the best deals.
I can't find the best deal anymore.
One of my favorite apps - absolutely my favorite travel /flight app.
Very unhappy that my favorite travel app is now not good.
Covers European opportunities better than Kayak.
Best cheap flight finder App out there.
Easiest and covers more airlines than most travel sites.
Needs to include more airlines.
We travel alot and this app makes finding the best flights possible.
Fun & Engaging79
Easiest and covers more airlines than most travel sites.
Needs to include more airlines.
Recommend to have it in your travel tool box.
I've also discovered its awesome for finding the cheapest prices basically anywhere.
I travel all the time and only book from this app.
Very quick and useful for finding flights on any airline.
extremely convenient and useful.
Helpful for travelers of all kinds.
Mostly though it covers everything and gives you a great comparison.
Not sure how I lived without this app in the past.
This app is so helpful and fast.
One of the Essential App for frequent travelers in Asia.
Ease of Use88
This app is user friendly making it easy to compare prices on flights.
makes it easy to monitor flights for my scheduled travel dates.
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Easy interface to use on iPhone.
Very nice app that is easy to use with great information on flying options.
Incredibly easy to use.
Easy and effective.
this app makes it super intuitive to find the best flights.
Updates & Support12
I wish it had an iPad version.
This is the place to save time and money. found in 5 reviews
Covers European opportunities better than Kayak. found in 14 reviews
This one gets the lowest prices 85% of the time. found in 30 reviews
Sky scanner is great for frequent travelers going to obscure destinations. found in 11 reviews
Ideal for everything I need for travel planning. found in 8 reviews
I'm planning a trip to AZ and this has been so helpful. found in 9 reviews
Good for last minute deals for anywhere you could want to go. found in 6 reviews
Flight search was never as convenient as it is now. found in 85 reviews
Most useful air travel price comparison tool I've found yet. found in 11 reviews
Recommend to have it in your travel tool box. found in 8 reviews
a MUST have for the occasional to frequent flyer. found in 11 reviews
This is the best app I have ever seen for travel. found in 2 reviews
Definitely the best flight booking app I have used. found in 5 reviews
Great planning ap for flights. found in 5 reviews
Quickly becoming one of my Favorite apps Ever. found in 1 reviews
The app is visually stylish and very user friendly. found in 54 reviews
Best airfare price search app on the market. found in 14 reviews
Better than most flight search engine apps that are currently out. found in 5 reviews
I couldn't have dreamed up a more useful app for travel. found in 18 reviews
Thanks for making a very easy to use flight search tool. found in 5 reviews
Prices don't match from picking the dates to selecting a flight. found in 4 reviews
Why don't you add an Arabic language in this app. found in 4 reviews
Everything is great except the option for searching business class flights. found in 19 reviews
Ok but prices marked up. found in 1 reviews
Please add the ability to set time format. found in 1 reviews
This application doesn't recognize Newark airport in New Jersey. found in 1 reviews
It would be even better if we could add multiple destinations. found in 14 reviews
I only wish it had a Full calendar month view. found in 3 reviews
Not impressed with important features it lacks that others. found in 3 reviews
Inaccurate prices but good entertainment. found in 5 reviews
but wish I could use it to pay and book. found in 5 reviews
Needs to include more airlines. found in 2 reviews
but multiple date range would be useful. found in 3 reviews
Good app but wish they support multi destination on the iPhone. found in 8 reviews
Missing airlines in search. found in 4 reviews
Wish it could do multi city flight booking. found in 24 reviews
No one way flight searches. found in 6 reviews
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Veggie Cheese Spread Recipe
This easy cheese spread is one of my family's favorite snacks. To make it a bit fancier, sprinkle tiny shrimp over the seafood sauce. It can be made ahead of time and is an ideal addition to an appetizer table.
- 1 package (8 ounces) cream cheese, softened
- 1/2 cup sour cream
- 1/4 cup mayonnaise
- 1 cup seafood cocktail sauce
- 2 cups (8 ounces) shredded part-skim mozzarella cheese
- 1 medium green pepper, chopped
- 3 green onions, chopped
- 1 medium tomato, chopped
- Assorted crackers or tortilla chips
- 1. In a small bowl, beat the cream cheese, sour cream and mayonnaise until smooth. Spread onto a serving plate; top with seafood sauce. Sprinkle with half of the cheese and vegetables; repeat layers.
- 2. Cover and chill until serving. Serve with crackers or tortilla chips. Yield: 6-1/4 cups.
Nutritional Facts
1/4 cup: 90 calories, 7g fat (4g saturated fat), 19mg cholesterol, 149mg sodium, 3g carbohydrate (2g sugars, 0 fiber), 3g protein.
Reviews for Veggie Cheese Spread
Average Rating
Reviewed Jan. 19, 2011
"I have had this recipe for years. my family loves it. I have made it multiple times. the only think i do differently is instead of coctail sauce. I use Heinz chili Sauce in the jar..."
© 2017 RDA Enthusiast Brands, LLC


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It may be TV's ultimate talking-head festival. The producers of The Class of the 20th Century, a 13-week documentary series debuting this week on the Arts & Entertainment Network, have assembled what seems like every prominent American they could round up (Milton Berle, Isaac Stern, Dr. Jonas Salk, Phil Donahue) and invited them to talk about, well, everything. The idea is to recap the major events of the 20th century through the eyes of people who experienced them. The ostensible purpose: to create a "time capsule" of our era for people of the year 3000. "This is not a history," says...
A Talk Show Without Egos THE CLASS OF THE 20TH CENTURY; A&E, Thursdays, 9 p.m. EST
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I didn't realize it when I purchased it but Shiseido Sea Breeze UV Cut & Jelly SPF 25 actually has some sort of bug repellent built in? Don't ask…! I've no idea what that's all about but the good news would be it's a rather nifty little SPF if you're looking for something simple for Winter SPF protection.
Check it!


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The first time we were grocery shopping, having fun and talking and generally being silly, dancing in the aisles and whatnot. On our way out I almost blurted 'Marry me', in response to something cute and loving he said. And I started giggling, because a few months ago I'd have never even thought about it let alone almost said it. And I was surprised to discover I wanted him to ask me. And in the car he wanted me to tell him what was so funny, eventually I told him anbd he went really quiet and just smiled.
And we continued talking and he said something cryptic about surprising me soon. And I of course, not really thinking it would that, badgered him all the way home and all the way into the house with our heavy shopping bags lol. Amd finally while we were unpacking he said 'Ok, do you really want to know?' and at that point my heart stopped and I still said, yes tell me. And he caught me between himself and the fridge in his arms and said 'Will you marry me?' And my stomach dropped to my toes and I started to go into shock lol. And I must have said 'Are you sure?' and 'woah' a billion times and getting 'Yes' as the answer, before he asked me again lol. And I said yes. And he said are you sure lol and I said YES lol. And we started laughing and kissing and holding each other and it felt so amazingly right. I knew I should be scared stiff, we'd only been together maybe 8 months max? And I was 20 and he was almost 22. But it felt so amazingly right, like it was mean to be and it never scared me one bit.
He told his parents pretty soon after, and they were sort of bland about it, sort of 'oh thats nice dear, whatever'. But I couldn't tell mine yet, because it would ahve probably made me parentless. Mum didn't agree with me dating him, actually she said its going to be sufferable that I dated him only if I didn't marry him. So I wokred on her for a few months lol. He even asked her for her blessing, but all she told him was that I was too young and then told me 'I didn't know what to say so I said that, leaves you with an out' and I was like, I dont want an out. That shocked her lol.
We picked out our engagement rings, I bought his on layby lol (I was a lowly dishwasher at the time and had to space out payments) and he had mine handmade. But he wouldn't let me have it until he could propose properly.
I proposed to him with his ring on the eve of his 22nd birthday, right on 12 lol. It was so exciting and romantic and he cried and it was wonderful. BUt he still kept my ring grrr lol.
And then the next month we made the move into our own apartment. I saw it without him, he was at work, and so he didn't see it until the day we moved in. And we ran around looking at everything and and being giddy and happy. I sort of guessed he was planning it for this day. BUt when he dropped to his knee in our new bedroom and said 'Will you marry me, and be mine forever?' my stomach dropped again and all the blood rushed to my head and I was all dizzy with happiness and just said 'yes' a billion times lol.
We went out to dinner at our favourite little resturanut and celebrated and I couldn't stop looking at my ring and feeling so happy and at peace. I called my parents and they were ok with it, not joyous, but not angry. No one was really that interested that we got engaged, it was kind of a non-event for our families and friends, but it was wonderful to us and we just couldn't stop smiling lol.
And that's my story lol. I can't wear my ring now, I have hand problems that causes them to swell, so he bought me a new ring for Christmas last year with eleven freaking diamons in it even though we were broke lol. I am terrorfied of losing it!!! I still have nightmares that the diamonds fall out and I lose them and he leaves me lol.
I cant wait till I can add my own giddy with happiness, brimming with love, joyful and adorable story to this group!<br />
Thank you for sharing yours :)


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LG PCSuiteIV Setup. exe is part of a product called known as LG PC Suite IV and it is developed by LG Electronics .
If you think that this file contains a virus or another malware, please download a virus scanner.
If LG PCSuiteIV Setup. exe is using too much CPU or too much memory in your system, it is possible that your file has been infected with a virus. Try to install an antivirus to see if it helps.
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If you have any problems with LG PCSuiteIV Setup. exe, you may try using a registry cleaner or a speed-up software to check, analyze, and fix problems that are affecting the performance of your computer.
You may try contacting LG Electronics, the developer of LG PCSuiteIV Setup. exe and ask for more information.


text:
Our Certification Partners have successfully completed the PAX Mastery & Certification Program, with a specialty in the topic(s) of their choice. They've conducted research, submitted Research Journals, learned transformational teaching skills, and proven their ability to have an impact on individual lives through rigorous Demonstration Calls. They are authorized to provide workshops, coaching, consulting and programs in all media, utilizing the PAX information for up to 100% of their content. Our standard in certifying these individuals is "I would send a family member or friend to them and tell them they are worth paying for!"
The Heart Matters
Karen Jones
Karen Jones has been joyfully helping women have scrumptious relationships with men since 1997. She learned of Alison Armstrong in 1995, while writing her book, Men are Great. Karen offers private coaching, group coaching, teleclasses and live events. Subscribe for free to her fun, quick bi-monthly video newsletter "Scrumptious Relationships" where she spills the beans on what it takes to love and be loved.com. To set up a Complimentary Coaching Conversation and explore working together, please email her at: firstname.lastname@example.com.
For more information, click here.
The Path to Partnership
Caren Field, MA LLPC, Individual and Couples Counselor
Caren has been fascinated by human nature since kindergarten. It became a full-blown obsession in 2000, when she discovered PAX Programs and got inspired by the possibility of Heaven on Earth between men and women – if only we could see how our instincts were getting in the way, we could prevent so much frustration and hurt. Whether you're single, in a relationship, married, or somewhere in between, and you're tired of suffering, Caren will show you how to set yourself free. Lovingly, with her warm sense of humor, she'll help you find peace of mind and peace in your heart.
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Corinn Giuntoli
Corinn Giuntoli
Corinn is the author of Find Your Extraordinary Love: Creating the Power Partnership of Your Dreams. Her mission is to help people be free from the dense energies that accumulate from past and present hurts, thus allowing them to fully restore in order to generously give and receive love. One of her specialties is providing Noble Healing and Noble Forgiveness. She joyfully helps people, from all over the world with her powerful, intuitive phone readings. Corinn leads the course, "A Path to Restoration & Living Free" to help people disappear emotional pain, anger, shame, and bad habits. She radiates love and blissful energy in her readings and teachings while inspiring participants to restore themselves and confidently step into a life of freedom.
For more information, click here.
Feminine Journey
Patricia Hargil
Patricia is an engineer by training and a successful global business executive. As a PAX Partner, certified in the Extreme Queen series, she helps women develop as leaders who inspire those around them. She combines mentoring, teaching and coaching while helping her clients answer key questions like these: How do we reconcile a life focused on extremely masculine work places and careers with our feminine needs and gifts? How do we live successfully in a material world while satisfying our deepest desire to make a difference and to give voice to our spirits? How do we create an environment where we are empowered and empower those around us?
For more information, click here.
Mandy Ho
Mandy Ho
Mandy had a cookie-cutter successful life as a finance professional, but she wasn't happy or satisfied. In the process of finding her own way, it became her mission to help others find freedom through a deeply satisfying life. Her most successful clients are questioning their apparent successes: is my corporate title worth the blood, sweat and tears to achieve it? Is my relationship giving me the companionship and intimacy I crave? Am I truly satisfied with my life, or secretly disappointed? In Mandy's world, freedom does not come in a cookie-cutter-travel-the-world form. Freedom is a life that deeply satisfies you in a unique way and makes you excited to get up in the morning. Through online courses, workshops, private coaching, and group coaching, she will help you let go of baggage, expectations, and limitations. She will guide you to connect to your intuition and empower you to find freedom and satisfaction.
For more information, click here.


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Authorities in schools look for patterns in behavior that can be passed from older to younger siblings when trying to identify students capable of violent acts.
Violence often trickles into schools from disputes and grudges built up over time outside the classroom, in parks and neighborhoods where students spend their time away from school grounds, according to Officer Anna Walker, a school resource officer at John F. Kennedy and James Hubert Blake high schools in Montgomery County.
Some high school students have attended classes together since elementary school and have lived in the same neighborhoods as well, providing ample time to build up long-standing grudges against each other, she said. In some cases, younger siblings are taught by older brothers and sisters about the disagreements, leading to generational feuds.
"I have the beauty of having worked in the middle and elementary schools [in Montgomery County], so I have some firsthand knowledge of these students," Walker said. "Most of the kids I can speak to are ones who really don't have a clear definition of self. They're followers, ones who fall into peer pressures."
Authorities must roam the halls and seek tips from classrooms to identify students whose classmates suspect may be having violent thoughts or may be planning an act of violence, according to Lt. Kim Babcock, supervisor of the Arlington County Police Department's school resource unit.
Repeat offenders are also common clue; a student who has committed a crime once is susceptible to acting out again.
"Those are the ones where we see the same names keep coming across our desk," Walker said.


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text:
Charity fundraisers are dancing to the tune of more than £840 raised through their efforts with a line dance marathon in Helston.
The Chance to Dance event with Wyn and Merv Groombridge was held at the Godolphin Club in aid of children's hospice Little Harbour in St Austell.
Over the course of eight hours, volunteer line dancers both young and old raised a total of £842.80.
To help with the amount, stalls selling cake and bric-a-brac were set up throughout the day and a |raffle was held.
Wyn and Merv said: "We would like to say a very big thank you to everyone who helped us and those who attended the day, and to the Godolphin Club for the free use of their hall."
Line dancing classes are held every Monday evening at the Godolphin Club, from 7.15pm until 9.15pm, plus Wednesday evenings at Carleen Village Hall from 7pm until 9.30pm.


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As the spring 2014 conference season rolls around, several themes appear to be high on the agenda for some noteworthy industry events. There is the discussion of a recovering world economy and how it could affect scrap commodities markets, and there is also the knowledge that many of the recycling industry's members and suppliers have nonetheless continued to work tirelessly over the past year to expand opportunities and serve colleagues.
Both of these themes should be evident at three recycling industry events, all to be held in the U.S. this year, that traditionally attract some of the biggest crowds. The Institute of Scrap Recycling Industries Inc. (ISRI), the Bureau of International Recycling (BIR) and the combined team of Penton's Waste Industry Group and the National Waste & Recycling Association are gearing up for their hallmark gatherings: ISRI's Convention & Exposition, the World Recycling Convention and WasteExpo, respectively.
A look at the schedule for each of these meetings indicates that attendees will gain industry knowledge, enriching their minds and businesses.
Las Vegas Awaits
The ISRI Convention & Exposition returns this year to Las Vegas, a city that has hosted the event five times over the last decade.
The convention will be held 6-10 April 2014. ISRI Convention Chair Stephen Moss, vice president of the nonferrous metals broker Stanton A. Moss Inc., based in Bryn Mawr, Pa., in the U.S., says the ISRI 2014 Convention & Exposition is likely to post near-record attendance numbers.
On that point, Chuck Carr, vice president of member services for ISRI, says it's possible that attendance could top ISRI's 2012 record of more than 6,400 attendees.
"ISRI attendance is always strong in Las Vegas," observes Carr. "We'll be prepared for a big crowd somewhere just above or below our record."
Carr explains that the event's status as a must-attend annual industry gathering is a function of both the size of the exhibition and the quality and quantity of its workshops. It is also drawing a wider international audience.
"The addition of simultaneous translation in a select number of our workshops is apparently increasing participation from Spanish-, Portuguese- and Mandarin-speaking populations, based on the increase in attendance we have seen," Carr points out.
Attendees can expect more exhibit hall space in 2014: More than 300 exhibiting companies will set up shop on an ISRI-in-Vegas record of 362,000 net square feet.
The convention kicks off Sunday, 6 April, with governance meetings for ISRI members. The Gala Opening of the exhibit hall is scheduled for Monday evening. Activities run through Thursday, 10 April, all taking place at the Mandalay Bay Resort.
The agenda promises two high-profile speakers: Tuesday's General Session brings a keynote speech delivered by Steve Wozniak, co-founder of Apple Computer and an icon of Silicon Valley, while attendees will be treated to an appearance by former Secretary of State Hillary Rodham Clinton, who delivers the closing keynote address as ISRI's Distinguished Speaker, Thursday.
Workshops begin Monday, 7 April, with the two-part electronics recycling training and strategy primer. The next three days of the event bring close to 50 additional workshops and Commodity Spotlight presentations, analyzing a wide range of technical, business, operational and trading topics.
Facilitating networking opportunities continues to be a main driver of many of the schedule's offerings, and Moss says year after year it's the quality of the show's networking opportunities that keeps attendees coming back.
"It's not whether or not your company should come to ISRI," observes Moss, "it's how many people from your company need to attend."
The Consumer's Night Reception, set for Wednesday, 9 April, at 6 p.m., is designed to bring a special focus to the consuming sector of the recycling industry, Moss explains. "Its purpose is to put the focus on them and create a networking event where attendees can find the various companies that consume different commodities," he says.
After more than three days of what can be an insightful and information-packed schedule, ISRI's tradition is to reward attendees with a memorable and fun Closing Event.
"This year's event will be a beach party, outside on the Mandalay Bay Beach, with food, music and entertainment," says Moss. "It's something ISRI has never done before, but we're excited to create something that will hopefully be memorable for the attendees and fun."
Moss, who completes his two-year term as conference chair this year, says planning the 2014 ISRI Convention & Exposition has been a rewarding experience. "We do our best to try to please everyone who attends the convention, providing networking venues, wonderful food, entertainment and knowledge," he says.
Updated information on the conference is available online at www.isriconvention.org.
Miami beckons BIR
The BIR brings its 2014 World Recycling Convention & Exhibition to the States this year, having selected Miami, Fla., as an ideal locale to highlight the Latin American market. The event is set for 1-4 June 2014 and takes place at the opulent Fontainebleau Hotel on Miami Beach. Not to be overlooked is BIR's intention to attract recycling industry decision-makers from the growing South American markets to its annual spring meeting.
The event kicks off with a series of special committee meetings. Plenary session meetings focusing on commodities markets and international trade commence Monday, 2 June, beginning with the Textiles Division, and continue through Wednesday, 4 June, concluding with the Plastics Division session. The other well-attended sessions that are part of this series include Tyres, E-Scrap, Non-Ferrous Metals, International Trade Council, Stainless Steel & Special Alloys, International Environment Council, Paper, Ferrous and the Shredder Committee.
BIR's recently named Executive Director Alexandre Delacoux, who took the post in September of 2013, says the association is always interested in engaging professionals and encouraging business in emerging markets around the wold.
"The BIR conventions are the meeting places for the business people in the recycling industry and all the commodities that we represent," says Delacoux. "As such, they constitute a very visible place for all those who need to buy or sell any of these commodities," he adds.
Delacoux says he expects anywhere from 700 to 1,000 attendees. The spring convention of the BIR, in contrast to its autumn roundtables meeting traditionally held in late October, is traditionally the larger of the two conferences because it is where and when BIR's general assembly meetings take place. However, Delacoux notes that in recent years these two events have become more similar in scale and scope.
New for BIR's annual event this year, says Delacoux, is the addition of a Textile Summit, organised by the BIR's Textile Division in partnership with U.S. groups the Secondary Materials and Recycled Textiles Association (SMART) and the Council for Textile Recycling (CTR). The summit is to be held 2 June, following the BIR's Textile Division meeting.
"It's the first time that we are voluntarily pushing the Textile Division into taking up a full day," says Delacoux. "It should be quite interesting for anyone looking at the recycled textile industry."
While much of the BIR World Recycling Convention agenda, including its Keynote Session speaker, has not been publicized as of press time, says Delacoux, attendees can expect to hear about the efforts of BIR's network of some 40-plus federations from around the world.
Attendees also will learn about the most recent efforts of the BIR secretariat: "How we are working, the efficiency of our help desk, the services we render to our members," Delacoux explains.
What is arguably the BIR event's most anticipated offering is the traditional welcome reception held on the opening night of the conference. In recent years this Welcome Evening typically has taken place at a different venue than the host hotel; however, at the 2014 World Recycling Convention, the party will take place on site at the Fontainebleau Gardens and Poolscape. Registered delegates, guests and spouses are invited to the BIR's "Fiesta Latina," which features exceptional food and colorful entertainment, according to the association.
Delacoux says that while the evening's entertainment will remain a surprise until the last moment, it likely will deliver a decidedly Latin American vibe. "The receptions are usually the personification of the place we are in," Delacoux hints.
He says he hopes that visitors to the BIR World Recycling Convention will ultimately be able to build business and acquire valuable industry information that will keep them busy once they return home. "I hope they will go back with a good vision of where the international business conditions currently are and are possibly developing in the future," Delacoux adds.
Updated information on the BIR World Recycling Convention can be found at www.bir.org/conventionwebsite/miami2014/home.
WasteExpo meets in Atlanta
WasteExpo's website asks "Who's ready for more?" The question will be answered 28 April-1 May at the Georgia World Congress Center in Atlanta.
According the event's website, WasteExpo 2014 brings together all the players in the waste, recycling, organics and sustainability industries. In 2014, the exhibit hall experience will have more to offer attendees, with new pavilions, show floor tours and a presentation theater, according to show organizers.
The event is designed to attract an international audience of waste management companies, equipment suppliers and professionals from the public and private sectors, with 11,000 people expected to attend.
More than 550 exhibitors will showcase equipment and services available to the waste and recycling industry, such as collection trucks, containers, software, grinding and shredding equipment and single-stream recycling systems.
Organizers Penton's Waste Industry Group and the National Waste & Recycling Association recently signed a new five-year agreement they say will expand educational opportunities at the event. Last year, the conference organizers also added a composting/organics track, a construction and demolition (C&D) workshop, a matchmaking program, and an investor summit.
For more information, visit www.wasteexpo.com.
The authors can be reached at email@example.com and email@example.com.


text:
> If this is the same patch that appears at > https://commitfest.postgresql.org/action/patch_view?id=124 then it > would be helpful if you could edit it and mark it as committed. Oops, done. -- Teodor Sigaev E-mail: teodor(at)sigaev(dot)ru WWW: http://www.sigaev.ru/
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You Are Here: AHRQ Archive Home > Future Directions for Residential Long-Term Care Health Services Research > Expert Meeting Summary
This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.
Please go to www.ahrq.gov for current information.
In October 1999, long-term care experts met to help guide the long-term care research agenda and provide advice on alternative approaches to data collection for the Agency for Healthcare Research and Quality (AHRQ, then the Agency for Health Care Policy and Research). The meeting was cosponsored by AHRQ's Center for Organization and Delivery Studies (CODS) and Center for Cost and Financing Studies.
By William D. Spector, D.E.B. Potter, Jan De La Mare
Day One
Long-Term Care Research Questions
Financial and Market Incentives
Consumer Issues
Quality Assurance
Additional Topics of the Morning Discussion
Measuring Indicators of Quality
Dimensions of Quality
Quality of Care
Quality of Life
Process and Structural Measures
Risk Factor Measures
Discussion of Quality Indicators
What is a Quality Indicator?
Data Collection Issues
Quality-of-Life Measures
Medical Management
Potential of the MDS and OSCAR Data
Day Two
Summaries of Data Collection Systems
1996 Medical Expenditure Panel Survey-Nursing Home Component
Medicare Current Beneficiary Survey
National Nursing Home Survey
Online Survey, Certification, Reporting System (OSCAR) and Minimum Data Set
Institutional Consumer Assessment of Health Plans Survey (CAHPS®)
National Long-Term Care Survey
Survey Integration
Summary of Discussion About Data Needs
Financial and Market Incentives
Consumer Issues
Quality Assurance
Current Data
Pros and Cons of Person-Based and Facility-Based Sampling Designs
Overall Limitations of Current Data
Possible Strategies to Improve Data
Build a Broader Residential Frame
Increase the Long-Term Care Sample Size of MCBS
Conduct Specialized Periodic Surveys
Explore Use of Administrative Data
1. Meeting Agenda
2. List of Participants
3. Pre-meeting Questionnaire
1. Framework for Long-Term Care Research Priorities
2. Measuring Long-Term Care Quality
3. Data Needs for Risk Adjustment
4. Comparison of Four National Data Sources
On October 14-15, 1999, AHRQ sponsored Future Directions for Residential Long-Term Care Health Services Research, a meeting to convene long-term care experts to help guide the Agency in developing its long-term care agenda. The meeting was sponsored by AHRQ's Center for Organization and Delivery Studies and Center for Cost (CODs) and Financing Studies (CCFS).
Specifically, the goals of the meeting were to:
The 2-day meeting was based on experts' responses to a series of questions collected prior to the meeting. The questions focused on policy and research priorities, national quality indicators, and data collection methods. (Go to Appendix 3 for pre-meeting questions.)
Return to Contents
Participants were asked to list their top five research and policy questions concerning cost, quality, and outcomes of residential long-term care. Their responses fell into six categories:
Select to access Table 1. Research Questions.
Responses in this category reflected the need for better information on the most cost-effective ways to care for populations needing long-term care and better ways to provide a high quality of life. In some cases, responses stressed the cost side, and in others, they stressed the effectiveness side. Responses included concerns about how processes of care can be made more cost-effective as well as ways structure affects outcomes.
Examples of process concerns included approaches to providing primary care, rehabilitation, and prescription drugs, as well as assistive devices and special care units. Concerns about structure focused on the mix of staff, training of staff, and ways in which staff are organized, including approaches to supervision and communication among staff.
Participants also were concerned about the effect of ownership, including the impact of for-profit versus not-for-profit ownership and chain versus non-chain membership. In addition, experts expressed concern about the impact of the increasing vertical integration of long-term care businesses on cost and quality.
Equity issues included the distribution of long-term care across payment sources and sub-populations. Experts were concerned about the financial burden of long-term care and the cost of long-term care insurance premiums, and the implications of the growth in assisted living on equity and access.
Responses focused on incentives created by Medicaid and Medicare reimbursement and case mix reimbursement. Participants also mentioned the impact of the prospective payment system on the quality and cost of long-term care. Finally, they expressed interest in the role of market competition in fostering innovation and quality.
Participants expressed interest in research that studies consumer decisionmaking. They also mentioned efforts such as quality report cards to improve the quality of information that consumers receive.
Experts were interested in a number of quality assurance topics. They were concerned that currently, quality of care and outcomes of care are measured better than quality of life, although quality of life is a very important issue in residential care. They were interested in using outcomes to assess the quality of providers and to develop ways to assess the quality of the long-term care system as a whole.
Participants listed many different methodology issues related to improving measures, data collection, and forecasting. Several highlighted the importance of measuring quality-of-life outcomes, characterizing processes of care, and determining risk adjustment. In addition, participants ranked measuring consumer preferences as a high priority. In the data collection area, participants emphasized strategies for screening persons at high risk for long-term care use to increase sample size, linking administrative and survey data, and developing a broad residential frame.
Participants discussed the importance of developing measures that could be used to enhance consumers' ability to make informed choices based on their needs. They also noted the challenge of distinguishing between different residential settings of care (e.g., nursing home, assisted living, group homes, etc.). In addition, they mentioned the need to describe variations in residential care and to understand the context in which an individual resides. The role of subcontracting in nursing home care—whether staff are employed by the nursing homes or are subcontractors—also was noted as a gap in knowledge.
One participant underscored the importance of creating client-focused quality indicators rather than institutionally focused indicators. Others stressed the need to have facility-level quality measures, especially given that quality regulation is generally at the facility level.
Participants emphasized the importance of common measures for populations in different settings to allow for comparisons, regardless of where consumers are obtaining services. They also stressed the need to characterize variations in the market.
One goal of the meeting was to elicit expert opinion about quality indicators for residential long-term care that could be used to monitor changes in quality over time. We used a methodology that paralleled the one used to identify the most important policy issues. Prior to the meeting, we sent participants a set of questions and a proposed grid to help standardize responses. (Select Appendix 3 for pre-meeting questions.) The primary goal was to determine the dimensions of quality, and then to specify the most important measures within those dimensions.
We also asked participants, when appropriate, to specify the most important risk factors associated with those measures, time intervals needed for followup, and which risk factors would be likely to change in value over time. They were asked to think about four populations:
At the meeting, we presented a summary of the participants' responses (select to access Dimensions of Quality and Risk Factor Measures) and then discussed issues of feasibility and scope.
Respondents generally defined residential long-term care as all of the care provided in residential care settings. They included personal care for the traditional long-stay population, concerns related to quality of life associated with the home environment of the setting, and aspects of acute and preventive care. Prior to the meeting, we sorted their responses into two dimensions—quality of life and quality of care—and summarized the specific health areas that were specified within these broad dimensions.
Table 2 summarizes areas of health concerns identified by respondents. With respect to quality of care, we divided responses into seven categories: mortality, disability, discomfort, nutritional problems, infections, geriatric syndromes, and preventable complications. These represent the broad range of outcomes that may result from care provided in long-term care institutions. Three quality-of-life dimensions were distinguished using a taxonomy provided by Spilker and Revicki.1
When delineating specific health concerns, respondents typically discussed outcome measures, but some respondents included process and structural measures as well. The respondents generally kept their recommendations at a conceptual level rather than recommending specific instruments.
1. Bert Spilker and Dennis A. Revicki, "Taxonomy of Quality of Life" in Quality of Life and Pharmacoeconomics in Clinical Trials. Edited by Bert Spilker (Philadelphia: Lippincott-Raven Publishers, 1996), pp. 25-31.
Many residents in long-term care facilities are on a downward trajectory so that the goals of the care are delaying mortality and preventing excess morbidity and disability. Therefore, providers' ability to minimize mortality and functional decline is an important factor for judging quality. Respondents stressed particular areas of disability, including:
Respondents also mentioned problems with nutrition (e.g., excess weight loss and dehydration) and infections (e.g., pneumonia, septicemia, and urinary tract infections). A number of other outcomes that could be viewed as geriatric syndromes were also mentioned, including pressure ulcers, incontinence, contractures, and sleep disturbances. In addition, respondents listed pain control as another important aspect of long-term care. The final category included preventable negative outcomes such as some hospitalizations and emergency room use and medical complications, including complications from medicines.
The second dimension of quality of life included areas of concern that are affected more directly by the home environment of institutions rather than the care provided, although care may have an indirect effect on these outcomes as well. These areas of concern can be categorized as follows: personal-internal, personal-social, and external-societal.2 Within the personal-internal domain, the respondents listed choice, dignity, privacy, and meeting life preferences; within the personal-social domain they included social interaction in and outside the facility; and within the external-societal domain, they included safety/abuse, neglect, and community participation.
2. Spilker and Revecki, pp. 25-31.
Although most respondents focused on outcome measures when delineating quality domains, some respondents directly discussed process measures of quality. Rather than speaking about changes in health (e.g., formation of pressure ulcers), they stressed the importance of monitoring in some manner the care (or lack of care) provided and perhaps using guidelines. They specifically mentioned skin care and periodic turning, range of motion exercises, toilet training, and use of restraints. Other examples included the availability of endurance and strength training and appropriateness and timeliness of assessments. One respondent discussed the importance of maintaining updated medical records in the facility to better reflect care in other settings such as hospital and ambulatory visits. Collection of process measures are needed to help fill the gap in the literature that demonstrates the relationship between process measures and outcomes.
Some respondents discussed the importance of including structural measures of quality. These included measures of staffing, the housing environment, planned activities, and other characteristics of facilities (e.g., size and ownership type). Staffing concerns included staff-to-patient ratio measures for nurses and nurse practitioners, physicians, therapists, and social workers; staff turnover and level of compensation; training; and concern about long hours.
Participants were also asked to delineate the most important risk factors. We were interested in risk factors because health outcomes result from the interaction of care provided and the health of the individual being treated. Outcomes can be converted into quality indicators to the extent that the effectiveness of the care can be separated from the influence of the risk factors. This is usually done using "expected outcomes" by controlling for risk factors at the patient level and aggregating to the level of interest. Consequently, it is important to collect data on the most important risk factors.
Table 3 lists important risk factors that participants mentioned prior to the meeting. Based on our questions, participants could have linked risk factors to specific outcomes. Typically, we did not get that level of specificity from the respondents, so the synthesis of responses indicate which risk factors are needed overall for risk adjustment.
Responses about the most important risk factors included demographic characteristics (age, race, and gender), ADLs, mental problems (e.g., cognitive deficits and depression and/or anxiety), physical impairments, sensory impairments, communication problems, diagnoses, terminal prognosis, and socioeconomic factors (e.g., income and marital status). Some respondents also mentioned length of stay.
There was some disagreement about when risk factor information should be collected. Some stressed collection at admission, while others thought that values would change over time so that the admission value, especially for long stayers, would no longer be relevant. Including risk factors that are not collected at admission can be problematic because they may reflect previous levels of quality.
Only a small number of participants responded to the additional questions concerning the appropriate followup interval for quality indicators or the risk adjusters that they thought would be likely to change over time. Respondents generally felt that 3-month, 6-month, and 1-year intervals were sufficient to capture change over time. If respondents made a distinction concerning followup intervals, they thought that quality-of-life measures did not need to be followed any more frequently than every 6 months. Respondents noted that age, disability, and behavior problems are likely to have higher mean values in future years, reflecting the aging of the population and increasing disability levels of residential long-term care residents. It is particularly important, therefore, to control for these variables when making comparisons of outcomes over time.
Meeting participants felt that the list we presented included most of the outcome dimensions. Measures of functioning were seen as central to a study of outcome indicators. There was less consensus about measures of cognitive functioning, however. These are more difficult to use as quality indicators because it is less certain that a facility can influence cognition.
Nevertheless, some participants viewed certain aspects of cognition as more malleable than others. Measures of confusion and depression may be more attributable than pure cognition. It was pointed out that some cognitive problems can be reversible, and inappropriate use of drugs may lead to over-sedation. Many believed that more research is needed for measuring cognition to isolate malleable domains from those that are not.
Additional measures of staffing were also discussed. The discussion focused on the changing roles of staff and the changing mix of functions that staff perform. One participant gave an example of nurses doing some tasks that respiratory therapists normally perform. This may suggest that less skilled staff are being substituted for more skilled staff, indicating that staff ratios should be supplemented by an analysis of functions performed.
Finally, one panel member recommended that we include respect in the quality-of-life measures because it is a separate construct from dignity.
Discussion about an appropriate definition of a quality indicator occurred several times throughout the meeting. Usually, there are two schools of thought among researchers interested in quality: the outcome advocates and the process advocates. Most participants seemed to take a middle ground between these two positions. They felt that for an outcome measure to be used as a quality indicator, there should be evidence that the outcome is malleable and that a facility has control over changing that particular outcome. If a process (or structural) measure is used as a quality indicator, there should be evidence that it affects resident outcomes. The strictness of these standards and the degree to which indicators should be risk adjusted would depend on how the measures are used.
Participants pointed out that national data collection strategies rely heavily on proxy respondents and records. For household-based data collection, it is common for one respondent in each household to answer questions about all household members; for surveys in residential settings, staff are interviewed and records are used. These have been the approaches of the Medical Expenditure Panel Survey Nursing Home Component (MEPS NHC), the National Nursing Home Survey (NNHS), and the Medicare Current Beneficiary Survey (MCBS).
The general feeling was that these approaches work well for collecting expenditure data, but would not work well for developing quality-of-life measures. There was concern that changes in data collection protocols could be very expensive. For example, if the survey involved a structured walk-around and observation of the environment, it would involve a major change in training and instruments, and could also affect the level of cooperation received from the facilities.
Participants cited the development of quality-of-life indicators for residential settings as a high priority. They felt that these measures are not ready to be used now, but that this is an important area for research. They also expressed concern that if quality of life is not monitored while other areas are, quality in this area may suffer.
The group discussed the difficulties of getting valid quality-of-life information from records, or even getting valid responses directly from residents, especially those who are cognitively impaired. There is some evidence that staff in assisted living facilities can provide reliable data on physical and cognitive functioning, communication, and behavioral problems of residents, but not good measures on mood, psychosocial, and activity measures. However, participants agreed that proxy responses are not valid for quality-of-life measures.
With respect to interviewing residents, some participants cautioned against using mental status exams to screen sample persons because mental deficits are very multidimensional. Persons with some deficits may be totally capable of answering certain questions. In addition, it was suggested that if persons with mental deficits are interviewed, the questionnaire should be less complicated than for cognitively intact persons.
The group mentioned that Rosalie Kane is developing quality-of-life measures for nursing home residents under a contract with the Health Care Financing Administration (HCFA) and suggested that this effort might be worth following. HCFA also has a new contract with Research Triangle Institute to develop performance measures for intermediate care facilities for the mentally retarded (ICFMRs).
Participants voiced additional concerns about quality-of-life measures. One concern was the low response rate that would be likely because of a high proportion of cognitively impaired persons. Another concern was how to obtain individual preferences. Discrepancy score approaches were discussed, but the problem of differential expectations makes discrepancy scores difficult to compare. Measures of preferences for everyday living are being developed at the Philadelphia Geriatric Center. This approach seeks to establish preferences before cognitive impairment occurs. One participant suggested that some measures of quality of life are more difficult to measure than others. For example, it may be easier to measure hotel aspects of a facility (e.g., quality of food, physical environment) than to observe neglect and abuse.
In the quality-of-life discussion, participants also stressed the need to have positive measures as well as negative measures (e.g., happiness, not just a focus on depression; meaningful social interactions, not just any social interactions).
A second priority area was management of acute and chronic conditions. The discussion focused on the type of data needed and the importance of being able to compare data across different settings. In some cases, measures involve blood samples, such as hemoglobin A1C to assess the management of diabetes. Participants expressed concern that these types of measures would involve new data collection approaches, and the reliability of these data have not been studied.
Another concern was expressed about the availability of complete medical records. These are generally not available in assisted living facilities, and may not be complete in nursing homes because some of the care is provided through outside clinics. These records are not duplicated in nursing facilities.
A final concern was that there may be small sample size problems resulting in large standard errors for measures that are based on relatively rare conditions. This is especially problematic if measures are facility specific and are used to compare the quality of facilities rather than making comparisons for large populations over time.
The minimum data set (MDS) in nursing homes contains diagnosis and symptom information that may allow some condition-specific measures to be developed for a given condition; however, the ability to develop meaningful quality indicators with these data has not been studied and is likely to be quite limited. For example, for some measures (e.g., pressure ulcers and urinary tract infections), the MDS uses the reference point of "last week." This is a limitation because assessment of infections should be done over the entire stay. It is important to track infections over the entire stay because there can be multiple occurrences and some infections can be cured after a short period of time. The 1996 MEPS Nursing Home Component collected all occurrences of infections, pressure ulcers, and fractures.
Participants discussed a number of plans to augment the MDS data as well as the potential to merge these data with other HCFA data. Currently, MDS is relevant for long-stay nursing home residents only. A subacute care MDS is being developed, but it is not likely to be complete within the next 5 years. To help assess changes in outcomes for short-stay residents, the frequency of assessments for the Medicare population will be increased to Day 4, Day 11, and then in 60 days. Drug data in nursing homes will be collected by October 2000. In addition, a discharge assessment will be done.
The MDS currently does not have discharge outcome information on every resident. The process for getting MDS information from the repository to researchers has not yet been worked out.
In addition, HCFA's Online Survey Certification and Reporting (OSCAR) data are being redesigned. This information is often used to link facility variables with MDS data. There is interest in collecting staffing data, for example, at more points in time. There was also discussion about the usefulness of developing quality measures by linking MDS to Medicare enrollment and claims data and Medicaid claims data.
Most of the discussion related to limitations of information and the fact that these data apply only to nursing home residents. For example, lack of availability of important information (e.g., advanced directive or living will information) in the Medicare data presents a limitation of using these data alone, but some of these limitations could be eliminated when combined with MDS data.
Discussion also focused on Medicaid data that recently were mandated for submission to HCFA. Although these data provide more details on treatments than Medicare data, they are only relevant for long-stay residents. The group expressed concern that the Medicare data currently do not include data from managed care, so as managed care grows, the bill files only will include a very select population. Although patients are typically disenrolled from managed care when entering a long-term care facility, the timing varies by plan and State.
The goal of day two was to get advice from panel members concerning data collection and approaches to integrating national residential care surveys. During the morning session, presenters highlighted the major features of recent national long-term care surveys. During the afternoon session, participants discussed data needs—within the context of the enumerated research goals—and the pros and cons of various data collection approaches.
The following summaries describe the presentations of various data collection systems, as well as a presentation on data integration. Table 4 compares the central design features for some of the data systems discussed. (An earlier version of this table was compiled by AHRQ staff for distribution at the meeting to facilitate discussion.)
Sponsored by the AHRQ and the National Center for Health Statistics (NCHS), the MEPS NHC survey collects basic and ancillary charges for nursing home care and associated billing amounts, amounts received, and payment sources for a sample of residents who spent any time in a nursing home during the calendar year 1996. It provides income and asset information, typically collected from next-of-kin community respondents, and captures transitions in care for the year.
The design is a multi-stage probability design, with nursing homes sampled at the initial stage and persons at the final stage. Data are collected by computer-assisted personal interviewing (CAPI) methods. The 1996 MEPS NHC included a sample of about 800 nursing homes and 6,000 persons—a little more than half were sampled as January 1 residents and the remainder sampled as 1996 admissions.3
3. For additional information, see Potter, DEB. Design and methods of the 1996 Medical Expenditure Panel Survey Nursing Home Component. Rockville (MD): Agency for Health Care Policy and Research; 1998, MEPS Methodology Report No. 3. AHRQ Publication No. 98-0041, and the AHRQ MEPS Web site, http://www.meps.ahrq.gov.
Although the survey does not collect quality measures directly, it collects a large number of health status measures at two points in time (90-day followup for admissions and 1-year followup for January 1 residents), which would allow for analyses of health outcomes. The health status questionnaires were designed to mirror HCFA's MDS instrument.
In addition, the MEPS NHC collects data on any occurrence of infections, pressure ulcers, fractures, and hospitalizations; medicines prescribed over the year, and use of health services for periods of nursing home residence. Data on facility characteristics include nurse staffing (agency and employees), special care units, accreditation, availability of specially trained providers, vaccinations for influenza and pneumonia, and services provided to residents and nonresidents. Facility data, at the unit level, can be linked to persons.
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Senator Golden Continues To Work With Transportation Department To Maintain Safety On Local Streets
Brooklyn- State Senator Marty Golden (R-C-I, 22nd District) today is announcing that in response to his request, the Department of Transportation has agreed to install a traffic light at the intersection of 10th Avenue and 67th Street, upgrading the existing All-way Stop control. The work is scheduled to be completed by May 31, 2006.
"For the vehicular and pedestrian safety at this intersection, I am pleased to have worked with the Department of Transportation to have this safety measure installed," said Senator Marty Golden, "Each time a dangerous and busy intersection is approved for a traffic light, the welfare of the entire community is enhanced. Today, we have the opportunity to see safer streets."
Further, Senator Golden has written to the Department of Transportation and has requested that the dividing yellow lines along Colonial Road, between 88th Street and 75th Street, be reviewed and repainted. Senator Golden has observed that the lines along Colonial Road are fading and are very light, causing it to be unknown as to where the lanes of each direction end and begin.
Senator Golden stated, "I urge residents of the community to contact my office regarding other two-way streets and avenues which may have fading or faded yellow lines. We must insure that our streets are maintained to the highest standards in order to insure safety for both pedestrians and vehicles throughout our neighborhood."
Senator Marty Golden is encouraging local residents to report the presence of potholes, street cave-ins, and streets which require paving, which he will then report to the Brooklyn Department of Transportation, as part of his pothole survey. To file a complaint, contact Golden's offices at either (718) 238-6044 or at (718) 627-3659 or at email@example.com.


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Nashville, TN
The Collaborative Peace Building Center (CPBC) is a full-service conflict resolution firm. The Center provides a safe, confidential, neutral space for individuals, families, businesses, organizations and communities to creatively and constructively resolve their differences. This is accomplished by empowering parties to find creative methods to manage and resolve disputes.
CPBC strives to:
* Provide high quality, cost-effective conflict resolution services to our community
* Seek to diminish the influence of fear, in order to find answers which are in the best interests of all parties through facilitating parties in reaching their own solutions to problems
* Educate the community, so they may better understand conflict and the power of transforming conflict
* Promote alternative dispute resolution in our community, as a way to prevent, reduce and manage conflict, as opposed to the traditional adversarial court process
CPBC's goal is to contribute to the peacemaking and healing of our community, through non-adversarial dispute resolution processes.
Among our services, we offer mediation, workshops/trainings, life and business coaching. Our mediators and coaching all have graduate and post-graduate training in their respective fields.
Services Offered


text: The 25 Best Santa Claus Books For Children December 11, 2014 Robyn Good Leave a Comment Bring the joy of jolly old St. Nick into your home this Christmas with these Santa Claus books. Anyone of these choices will bring that magical sparkle into your children's eyes. Merry Christmas! … [Read more...]


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Son Dam Bi, who recently released her new album 'Dripping Tears', updated fans with a cute selca.
Son Dam Bi shared on Twitter on the 12th, "I'm nervous for this week's comeback~~~ Hehe." She also posted the photo above, which shows the singer giving an adorable puppy face with "dripping tears". She's holding up a sign that reads, "Please give lots of love to 'Dripping Tears'~ <3 -Son Dam Bi <3."
Fans commented, "Son Dam Bi's tearful selca is adorable", "Son Dam Bi transformed from a sexy diva to a cute girl", and "I can't wait for her comeback stage".
Son Dam Bi will perform her first comeback stage for "Dripping Tears" on 'M! Countdown' on the 15th.
Fuse TV's K-Pop podcast canceled after making insulting comments about BTS and G-Friend
16 hours ago 57,437 10,002 901


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Marvel Releases 'Ultimate Spider-Man' Animated Series Promo Image
Marvel's been pretty generous in filling in fans on how the upcoming Disney XD animated adaptation of Brian Michael Bendis and Mark Bagley's Ultimate Spider-Man is being written. A smorgasbord of talent — including Man of Action's Joe Kelly, Steve Seagle, Joe Casey and Duncan Rouleau, plus Paul Dini and Bendis himself — has been tapped to bring the latest iteration of the Webslinger to TV in 2012. The burning question of late's revolved around the look of the show. Will it be based on Bagley's art? Stuart Immonen's? David LaFuente's? Sara Pichelli's? Looking at the show's latest promo image, it looks like maybe a streamlined combo of all of the above.Naturally, to early to really pin down what the show will look like based on a single swinging image, but it's certainly nice to get a taste of what's to come. Fans who picked up the earliest issues of the Ultimate Spider-Man comic series may notice the hero swings from a web lacking an inexplicably green hue, but this decidedly teen-looking hero seems like an otherwise authentic fit for the animated series so far.
Originally teased for a 2011 premiere, Ultimate Spider-Man is now slated to arrive in 2012. The move doesn't seem to reflect a lag in production, but rather an alignment with Sony's The Amazing Spider-Man release date of July 3, 2012.
[Via iFanboy]


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Two East Bay bus systems are offering discounted, unlimited rides to youths this summer, part of a joint promotion between Tri Delta Transit and the Western Contra Costa Transit Authority (WestCAT).
The passes, which are in the form of a waterproof wristband, cost $50 and are available to anyone 17 or younger. They are good for three months of unlimited rides, from June 1 through Aug. 31, on both transit systems.
Tri Delta Transit runs buses in East Contra Costa County. WestCAT runs local buses in West Contra Costa County from Pinole northward, and Express buses between Hercules and the El Cerrito Del Norte BART station. The youth passes are not valid on WestCAT Lynx Transbay buses.
The two transit systems connect at the Martinez Amtrak Station, via the Tri Delta 200 route from Pittsburg/Bay Point BART and the WestCAT 30Z Martinez Link from the Hercules Transit Center.
The passes can be purchased at the Tri Delta administration office, 801 Wilbur Ave., Antioch, from 7 a.m. to 6 p.m. Monday through Thursday and 8 a.m. to 5 p.m. Friday; and at the WestCAT administration office, 601 Walter Ave., Pinole, from 7:30 a.m. to 6 p.m. Monday through Friday.
Transit officials say they hope the program will result in more young people riding the bus during the summer and discovering the ease of using public transit. The program is supported by 511 Contra Costa, Contra Costa Transportation Authority, and the Bay Area Air Quality Transportation Fund for Clean Air.
For more information about the promotion and about either transit agency and its routes and schedules, visit www.trideltatransit.com or www.westcat.org, or call Tri Delta Transit at 925-754-4040 or WestCAT at 510-724-7993.
Contact Tom Lochner at 510-262-2760. Follow him at Twitter.com/tomlochner.