Here at nurse and lawyer, the ping-pong post will be a regular feature. These posts will feature discussion between nurse and lawyer using the news as a jumping0ff point.
The recent octuplets case raises several issues in medical ethics, and the extreme nature of this particular case raises questions about when/if there is a role for the law in such situations. Although we dont know many details about the specific situation, there are issues of law and bioethics begging to be debated! Were discussing the case in the framework of some basic ethical issues as a jumping-off point.
JUSTICE
Nurse: The family which now includes 14 children is using an enormous amount of resources, including welfare (financial support) and healthcare and education resources.  No one likes to talk about financial cost when human life is involved, but its really unavoidable. Because the birth of octuplets was the product not of natural conception but of a medical procedure, it becomes a question of whether those resources are being distributed in a way that is just.  Are families and children who were not the outcome of medical interventions more deserving of resources? Should procedures that stretch resources, like IVF, be regulated with an eye towards resource utilization? Distributive justice also comes up in issues like organ transplant.
Lawyer: Unlike organ donation, welfare/healthcare/education is not a zero-sum game. We hand out more if more is needed, taking our loans and raising taxes to pay for it – there’s kind of a “we’ll deal with it later” attitude. Its good that we can do this, because immediate needs get addressed no matter what the resources, but it also means that needs can be created without being as mindful of the potential consequences. (Would people be less likely to take the health risks of smoking seriously if lung transplants were fairly simple and we had an endless supply of lungs, for free?) And it’s not just were dealing with here, but our already overtaxed healthcare and public education systems. Adding eight students to a kindergarten class or caring for eight premies in a NICU is no small matter.
I say this not to shame any particular individual, but to raise questions about protecting our resources. It doesn’t seem like anybody did this on purpose, so how was it allowed to happen? We’re not even talking about limiting the things that people choose to do (if people want to have fourteen kids, and set out to do it themselves, they are allowed,)so much as limiting the possibility for such costly accidents. Which is much more palatable in terms of individual liberties.
BENIFICENCE/NONMALEFICENCE
Nurse: Ideally, the doctor/patient relationship is private, some might even say sacred, and not open to the prying eyes of anyone, including the government. Certainly HIPAA has had a lot to do with how this is approached. By this standard, the law cannot intervene in the decision between doctor and patient to perform IVF, or how to perform it, or when it is and is not appropriate.
Lawyer: This certainly isnt entirely respected in, say, assisted suicide, where politicians get right in the middle of those conversations. Same with abortion.
Nurse: We must ask, then, is IVF a medical treatment that treats a condition (i.e. infertility)? Does that change if the patient already has children? Is there a line there? We react very differently to a woman with six children having IVF than we would to a woman with no other children or with one child.

Lawyer: It seems like it would be pretty much impossible to actually draw a line. (IVF is a medical treatment for women who have four or fewer children, but not in other cases? The number would pretty much have to be arbitrary, because what constitutes a reasonable/safe/responsible number of children varies so much according to circumstances.)
Nurse: Does there need to be psychological and/or social examination of candidates for IVF? Im sure there are standards of care that require at least cursory exploration of a patients understanding of the procedure and its potential outcomes. This is part of basic informed consent!
Lawyer: There are laws in many states that require counseling for an abortion. According to the Guttmacher Institute, “33 states require that women receive counseling before an abortion is performed: 23 of these states detail the information a woman must be given; 10 states have abortion-specific requirements generally following the established principles of informed consent. ” There are guidelines for counseling with an HIV test, but not legal requirements, to my knowledge. In some states, the health authorities are actually required to distribute specific written materials to women seeking abortions. Could similar requirements for IVF – more stringent than a generic informed consent requirement   prevent the accidental birth of “extreme multiples”?
Nurse:Ms. Suleman has claimed she did not know she could be carrying multiples—and this was not her first IVF pregnancy. She was either lying, or did not have enough understanding to consent to the procedure either time. Is she, or is the physician, legally or ethically wrong?

Lawyer: There is a third possibility that the clinician involved was negligent in explaining the procedure and its possible and likely outcomes to her. In this case, there actually might be some legal remedy.
Nurse: Its tricky! She would have had to sign a document indicating her understanding and consent, but that consent needs to be witnessed and the physician should not accept it if he/she feels that the patient has no understanding. Of course, sign here! happens all the time, and once the signature is on the dotted line, its harder to challenge, no?
Lawyer: Yes, but a signature on a waiver that is really quite obscure and packed with fine print isn’t likely to be upheld by a court. That’s part of why we’ve been seeing a lot of waivers and warnings that say things like “Serious injury or death could occur!” on things that seem relatively benign – it needs to be effective as a warning, in addition to a contract, to have value. So if the form she signed was in legalese and medicalese, and written in 10-point font, there may be some wiggle room.
Nurse: Allowing a woman to carry eight fetuses is dangerous to the mother and to all of the fetuses. Of course, IVF is very individual. The number of embryos implanted and the number which can vary widely. Eight is outside of the normal practice. Does that make it wrong? Would it be wrong in a patient when previous attempts at IVF with fewer embryos had failed?
Lawyer: While we clearly cant regulate how many children someone could have (hello, 14th amendment!) I think we could, and probably should, regulate how many fetuses can be implanted at once. I don’t know who would regulate that – the FDA? Perhaps there could be a limit, with an exception for women with a history of unsuccessful implantation. Ms. Suleman had a history of successful implantation, with four single births and a set of twins, all through IVF, never with more than six implanted at once . Such a regulation would likely have prevented her situation without preventing a mother who had tried unsuccessfully with fewer embryos from exploring further solutions to infertility.
AUTONOMY
Nurse: There is not a universal tool or practice for determining a patients understanding of a procedure. There are screening questions and health literacy assessments, but no universal practice that really evaluates understanding. This is not IVF-specific; any invasive procedure requires informed consent. Some institutions use technique requiring the patient to explain the procedure back in their own words before signing the consent document. If a patient cannot do this, do they have the autonomy to make the medical decisions?
Lawyer: I can certainly envision situations in which a procedure is so complicated, or relies on an understanding of how systems function in the body to a degree that a patient with no medical training and/or limited intelligence might not be able to understand it. Does that mean that the patient shouldn’t have the treatment? I wouldn’t want to start down that slope. (Are you smart enough to understand, and thus receive, this treatment?) On the other hand, if the patient is required only to repeat back the possible and likely outcomes (I understand that I could have anywhere from zero to eight fetuses in my womb as a result of this procedure, that carrying more than four at my age could pose a serious health hazard, etc, etc.) then the responsibility is firmly on the patient again.
Nurse: Should selective reduction be mandated in cases of great risk? This is, of course, a very uncomfortable question and I think youd be hard-pressed to find someone who would say yes, but why not? A woman who is pregnant with octuplets due to IVF is at a very high risk for health problems or even death, as are eight fetuses. She is also likely to consume enormous amounts of healthcare resources. We have the ability to reduce that risk substantially. (I am not advocating this as a policy—just exploring the idea!) The objections to selective reduction are generally similar to those to abortion, although its perhaps complicated by the playing god character of IVF.

Lawyer: I think the real question there is, at what point does it become a health decision about other beings (fetuses) who also have rights? Mandating selective reduction would be the state saying that it has the duty to protect those fetuses – which leaves you in quite a pickle, since the means of protecting them include destroying some of the very things you’ve just claimed have the right to protection. Are you dizzy yet?
CLOSING THOUGHTS:
Nurse: While there are standards in medical ethics, they are rarely codified in law. There will always be practitioners who will be willing to push the envelope in ethics—there isnt a way to hold them legally accountable for these questionable actions. Should there be?
Lawyer: Even if there should be – and frankly, I’m not sure they should, since doctors are much better equipped than politicians to make these sorts of decisions, I’m not sure there can be.Many of these things are impossible to make laws about, either because its really too paternalistic to succeed under our constitution (which values personal liberty so highly) or because the issues vary too much from case to case to make any kind of policy that would be effective. Maybe it’s more of an issue for state medical boards and ethics committees?
Healthcare questions:
Nurse: as much as we hate to say it, healthcare providers may patients morally, and this can disrupt the quality of care. As all involved are human, it seems this in inevitable to some degree. Will this woman and these children receive sub-par care? Will they be subject to the same kind of discrimination that happens to others who are financially poorly off?
Lawyer: Purely as a thought experiment, I launched myself down this path: we cant legally limit the number of children. But what if we limited how much help you could get from things like welfare, food stamps, and medicaid? Obviously, the people who would suffer fastest and most from that would be the poor children. But if the mother is not able to care for them with her own resources and whatever is designated as her reasonable share of public resources, she is likely to become a negligent parent I dont know what the rules are, but at a certain point, wouldnt the state remove the children from her home, if she demonstrates an inability to care for them, be that psychologically or financially? Let some poor couple who would otherwise undergo IVF and accidentally have quintuplets take charge of a baby or two. Okay, that last part was purely whimsical. Im just carrying the possible outcomes of something like this to their logical extremes to see where they get us.

Nurse: I think you found the main issue with that, which is that the victims would be the children. If we knew there was a child protective service that was swift and efficient, that would be one thing—but there isnt!

Lawyer: I think this blog post is too long. We’d better stop.
Nurse: Yes, to prevent eye strain for our readers.

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The language poses two separate kinds of concerns. First, some object to the basic policy decision to deny funds for renovations of divinity schools and the like. Second, others do not necessarily disagree with that policy, but fear that the language of the bill is so broad that it may exclude use of funds in situations that were never intended to be excluded. The focus is on the exclusion for facilities "used for sectarian instruction or religious worship."

While that language clearly excludes a school's chapel, what about a regular classroom building that once in a while is used by a student group for prayer? Often student groups can reserve empty classrooms for meetings or events. Suppose a Christian, Jewish or Muslim student group uses a classroom in a science building once a week for an hour for group prayers. Does that preclude use of ARRA funds to remodel the science building? It is certainly unlikely that Congress intended to prevent the building-- where worship was an insubstantial use-- from receiving federal funds, and it is likely that if ever litigated, that is what a court would conclude. The problem however is that careful lawyers must often give legal opinions without court guidance. The fact that a "substantiality" qualification is in one clause of the exclusion and not the other, might give a careful lawyer pause.

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Many are bemoaning the deterioration of physical exam skills that the current generation of doctors are displaying.

Bob Wachter says it may not be that big a deal. "Even if we could create a new generation of expert physical examiners," he writes, "would it be worth the time and trouble?" He doubts it, saying the time spent to learn and perform a comprehensive physical has to be "weighed against cold-hearted considerations of accuracy, reliability, inter-observer consistency, and the cost of time."

Technology has the potential of making parts of the physical exam obsolete. Traditionalists may be arguing for staying with a horse and buggy when cars are rapidly becoming available.

Dr. Wachter instead suggests more time be spent on "timeless" patient communication skills, like "eliciting the history, describing prognosis, discussing alternative treatments, determining the patient’s attitudes about end of life care, and apologizing for medical errors."

In addition to technology, a whole host of other incentives are shifting emphasis away from the physical exam, not least of which are malpractice fears (where an objective study would pull more weight in a trial than a subjective physical exam finding), and the financial pressure to maximize the quality of services (which devalues the time spent doing a physical exam).

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The Good Housekeeping seal of approval, nearing 100 years old, has had some work done over the years: seven face-lifts, starting when it was only two years old.
“The first one was very nice,” said Louise Fili, the graphic designer hired to remake the seal in time for the big anniversary. “It was downhill from there. The last one, that said everything about the 90s. Nineties branding was the client breathing down your neck and saying, ‘Can you get the type bigger?’ You get the type bigger by having it burst out of the oval.’ ”
Introduced in December 1909 with 21 consumer products the New York-based magazine had tested — including a washing machine and an electric iron — the Good Housekeeping seal has become an icon in its own right. Since 1941, the magazine has promised a money-back guarantee if products that carry the seal do not perform as advertised.

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Ive had a week off everything (which I have spent largely on my DS and Xbox, and somewhat less with Mr Dooralthough Im sure hes been around) so decided to come back with a bit of a rant, and a mental health related one at that. Not a huge one, mind, since it is New Year and Im generally feeling positive

Our Trust is now completely paperless. Our offices and filing cabinets are empty of patients notes, and a working pen is no longer an item to be fought for and killed over. It is a new dawn; a period where all nursing notes, care plans and reports are available at the click of a mouse. Simultaneously the confidentiality of all patients is strictly maintained, with only those who need to know being able to access notes. Truly, this is the future of mental health nursing.

Wow, what a load of bollocks.

Does that sound cynical? Good, it was meant to.

I can appreciate the idea behind electronic records. Back when I worked as a ward clerk, I occasionally had cause to venture into the medical records archive room. Ever the intrepid explorer, I would volunteer for these missions as they were guaranteed to consume at least half a day - which was half a day I didnt have to talk to anybody in management. I would don my hat, scarf and gloves and take a packed lunch and a torch, leaving a trail of NHS breadcrumbs (being the only thing the rats wouldnt eat) behind me. Blinking in the daylight I would emerge hours later, a grubby file clasped to my chest and muttering about the spiders. Or, more likely, cursing whichever inconsiderate dick had taken the notes I needed and not signed them out.

So, both I and the rainforests would appreciate a better system. Unfortunately, the new system has some flaws:

1. Every service in the Trust has its own specific paperwork (assessments, care plan formats etc). The new IT system has tried to amalgamate all of these in to one uber-format, and obviously its rubbish. Surely, the information being gathered in an assessment should be client and service driven, not led by what you can fit on the bloody computer program. Drop-down boxes are the nemesis of a mental health service.

2. As a side effect of #1, we still have paper notes. They include all the stuff that we need to know but that there is no place for on the computer system. This just increases confusion when looking for information. Also, things like MAR sheets, s17 leave forms, description forms and clinical notes written by agencies without access to our computer system need keeping somewhere. We also have to print lots of the computer stuff out for when solicitors/doctors/other agencies whose computers cant talk to ours need to see it.

3. Typing. Nurses of a particular generation are not necessarily known for their IT skills (erm, no offence or anything...I'm hardly Bill Gates!) and so the process of doing anything on the computer can be very, very slow. Many of them have taken 10 years to master Word. The IT department came along and assessed how many staff and patients we had, how many computers they thought we needed, and then apparently divided by two. Since inevitably one of the computers is always from the dark ages it just refuses to work. Picture the scene; half an hour before the end of a 12 hour shift, there are 21 patients notes that need entering and the oldest nurse in the universe is using one finger to try and type up a Tribunal report for the next day on the only working computer. Pissed off doesn't cover it.

4. Confidentiality. Anyone with a login can see details of any patient anywhere in the Trust. Great for communication of information, not so great for confidentiality. Of course, youre not supposed to look at anyone who is not under your direct care. There is apparently some sort of almighty information overlord (human or computer, I dont know which) who supervises our clicks and checks we arent going somewhere were not supposed to. Its a disciplinary offence. However, the Trust being the Trust, they have managed to screw up my login information, so to them it will appear as though I have been accessing patients I shouldnt have been. So far I havent been pulled up, as one would expect, so Im beginning to think the overlord is just a scare story, like the bogeyman. Of course, this raises issues if you are a member of staff who is also a service user, as theoretically all your colleagues can look up your notes. But dont worry, if they get found out theyll get told off.This is one of the primary reasons I wouldnt want to seek help if I had mental health problems.

In fact, it is one of the key reasons I didnt go to my GP when I was having my wobble a while ago. Firstly, I would automatically get referred to the Primary Care Mental Health Team. Yes, thats right, the team I am currently on placement with. I even know which Mental Health Worker I would get, and, although shes lovely, Im sure there would be some issues there. It would feel like being an inpatient on the unit you used to work on. Unfortunately, since they cover the entire area I live in, I would have to travel quite far to get appointments with someone I didnt know. Not ideal. Secondly, not only would all my work colleagues be able to see my notes online, but so too would all the other MH nursing students in my university. Not something I could face, frankly, since I have such strong feelings of hate for so many of them. So I decided to plough through and hope things would improve (I like to think of it as watchful waiting and not burying my head in the sand) which they have, so there. I can't say I wouldn't do the same again, and I know my friends feel the same as me. It's one thing having anonymous strangers reading all your intimate secrets, it's another knowing the spotty bloke you knocked back at the Christmas party can have a nosey through them too.

Anyway, I'll stop now because I seem to have gone on a bit there! Nevermind. Hope you all have a good New Yearsee you in 2009.

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During my extensive travels throughout Africa, one of the greatest problems I see for many Africans is having access to health care. There are several organizations working make health care accessible, but one organization is worth mentioning: the Amsterdam-based Health Insurance Fund (http://www.hifund.org). The Fund, established in 2005, is creating an innovative method to accessing quality health care including HIV/AIDS treatment through an innovative approach: building accountable and reliable demand-driven, output-based private health insurance schemes for low-income groups. (Photo courtesy of the Health Insurance Fund)

According to the Fund's website, "The Health Insurance Fund has been established to set up private health insurance programs for low-income communities in different countries in sub-Saharan Africa. PharmAccess has been contracted by the Fund to develop, manage and control the insurance programs. PharmAccess contracts local implementing partners to provide the insurance to the selected communities. Independent operational research organizations measure the impact of the insurance program. The Health Insurance Fund is responsible and accountable for the overall program in the context described above."

I had the pleasure of meeting Mr. Onno Schellekens, Managing Director of the PharmAccess Foundation and Mr. Chris van der Vorm, Health Insurance Fund's Executive Director during their visit to Seattle in September 2008. I learned that the Health Insurance Fund will carry out programs in at least four African countries, which will be implemented by local (African) Health Maintenance Organizations or insurance companies. PharmAccess, in collaboration with the local partner, selects local healthcare providers (clinics, hospitals, laboratories, pharmacies) on the basis of a pre-defined criteria and these providers may be either publicly or privately operated.

In October 2006, the Dutch Ministry of Foreign Affairs awarded the Fund a 100 million grant for the development and implementation of insurance schemes in four countries over a period of six years. The first scheme was launched in Nigeria in January 2007 targeting 115,000 women in Lagos and farmers in Kwara State. A second program is currently being developed in Tanzania.

The Fund's website explains the implementation strategy, "To ensure that the target population will participate in the schemes, an enrollment strategy is applied.

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During my extensive travels throughout Africa, one of the greatest problems I see for many Africans is having access to health care. There are several organizations working make health care accessible, but one organization is worth mentioning: the Amsterdam-based Health Insurance Fund (http://www.hifund.org). The Fund, established in 2005, is creating an innovative method to accessing quality health care including HIV/AIDS treatment through an innovative approach: building accountable and reliable demand-driven, output-based private health insurance schemes for low-income groups. (Photo courtesy of the Health Insurance Fund)

According to the Fund's website, "The Health Insurance Fund has been established to set up private health insurance programs for low-income communities in different countries in sub-Saharan Africa. PharmAccess has been contracted by the Fund to develop, manage and control the insurance programs. PharmAccess contracts local implementing partners to provide the insurance to the selected communities. Independent operational research organizations measure the impact of the insurance program. The Health Insurance Fund is responsible and accountable for the overall program in the context described above."

I had the pleasure of meeting Mr. Onno Schellekens, Managing Director of the PharmAccess Foundation and Mr. Chris van der Vorm, Health Insurance Fund's Executive Director during their visit to Seattle in September 2008. I learned that the Health Insurance Fund will carry out programs in at least four African countries, which will be implemented by local (African) Health Maintenance Organizations or insurance companies. PharmAccess, in collaboration with the local partner, selects local healthcare providers (clinics, hospitals, laboratories, pharmacies) on the basis of a pre-defined criteria and these providers may be either publicly or privately operated.

In October 2006, the Dutch Ministry of Foreign Affairs awarded the Fund a 100 million grant for the development and implementation of insurance schemes in four countries over a period of six years. The first scheme was launched in Nigeria in January 2007 targeting 115,000 women in Lagos and farmers in Kwara State. A second program is currently being developed in Tanzania.

The Fund's website explains the implementation strategy, "To ensure that the target population will participate in the schemes, an enrollment strategy is applied.

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The Boston Globe continues their Spotlight series on Partners HealthCare.

I have previously alluded to an example where a local insurer, Tufts Health Plan, balked at the rates that the Boston hospital conglomerate was demanding.

Instead of negotiating, Partners immediately played hardball knowing that patients demand the "brand-name" services of their top-ranked medical institutions, Massachusetts General and Brigham and Women's Hospitals. They instituted a million-dollar marketing campaign, where "signs went up at Partners reception desks notifying Tufts members that their insurance would soon be denied. A new website told them how to switch insurers. A call center in Texas was set up to field questions from worried patients and doctors."

Patients took action against the possibility of losing their access to the hospitals, and "within days, major employers and thousands of Tufts members began threatening to cancel their policies."

It is no wonder that Tufts surrendered "in little more than a week."

As I mentioned previously, this is a prime example of why Partners HealthCare would not have the clout they currently enjoy without patients clamoring for their services.

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In previous posts, I illustrated the benefits of having consistent interfaces. Consistent interfaces uses our brains’ dual information processing capacity. In my tacit knowing post, I presented need for care for the smallest details in interface design. This post is the how. How should we design these interfaces? Do we need domain specific guides? Two examples of healthcare interface guides are Microsoft Healthcare Common User Interface (MSCUI) guide being developed with UK’s National Health Services (NHS) and the European Helios project. These two projects were perused for practical and economical reasons. Yet, there is significant cost for developing such standards. More, there are unwanted side effects that need to be minimized. Examples of these side effects are decreasing flexibility and decreasing ownership. (Nielsen 1989 p)
One benefit of having healthcare design guidelines is to speed up the development cycle, and still ending up with high quality interfaces. A significant part of the design decisions will have been set by the guidelines developers. This does mean that these developers carry a huge responsibility.
At least for now, UK’s National Health Services (NHS) is going with the guidelines route and mandating the compliance to these guides for systems to be used by NHS. It will be interesting to see how things will unfold.

Nielsen, J., 1989. Coordinating User Interfaces for Consistency, Academic Pr.

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The Bio IT report provides a summary of the transformation and adoption of IT services in the life science, healthcare, and pharma industries, and an in-depth analysis of the current status and prospects of the global Bio IT market, as well as domestic markets in US, Europe, and Asia-Pacific region. The report also contains a roundup of the major trends, outsourcing opportunities in the Bio-IT sector, and the impact of the bioinformatics market on the global Bio-IT market. The report features the products and services from the top 30 Bio-IT vendors, and significant Bio-IT product launches during the period 2007-08.

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Once a medical office starts using an Electronic Medical Records software, paper charting is virtually eliminated. All clinical charting is done on the computer, or in the case of electronic medical records software, on a wireless pen tablet computer, at the point of care. The following lists some of the benefits realized by medical offices that use sophisticated electronic medical record software: * Increased Revenues. Electronic Medical Records software can increase revenues by capturing charges for all services performed and avoid lost revenues. Using the traditional paper charts, many services performed in a doctor's office become lost and never get billed for. Providers who use advanced electronic medical records software can also increase revenues by maximizing E M billing codes that the electronic medical records software will suggest based on the service being accurately documented, without the fear of an audit. Using paper charts, to be on the safe side of the law, many doctors down code (use a lower billing code), rather than proper coding. Medical Economics magazine has estimated that doctors who routinely down-code to avoid audits, lose an average of $40,000 annually. With electronic medical records software, it can allow providers to apply for enhanced sources of revenue from payers associated with higher quality of care. * Reduced Expenses. A typical medical office employs billing and clerical staff such as appointment schedulers, medical billers, collectors, file clerks, etc. While labor costs are soaring, Electronic Medical Records (EMR)s can significantly reduce the labor needed for the functions mentioned above. For example, office staff time will no longer be necessary to hunt down records or file patient charts. Data entry for billing purposes is minimized. Multi-user access will allow staff to access and update patient records simultaneously; saving time that would otherwise would be spent in waiting for access to patient records. Once an office successfully converts to electronic medical records, all costs associated with purchasing, storing or destroying paper charts can be eliminated, too. Additionally, the space typically used for paper patient charts can be utilized for additional exam rooms, or increased office space, resulting in a more profitable use of resources. * Improved Quality of Care. With use of electronic medical records software, quality of care could be improved in numerous ways. Consider the following: EMR software can provide decision support at the point of care; EMR software can be used to track patient’s follow-up activity, patient’s compliance with provider’s orders, and patient’s progress; Conditional clinical alerts can be set to notify the providers of drug interactions, allergies like for example in anti aging skin care products, latest disease management protocols, etc.; In the event of a drug recall, using EMR software would allow healthcare professionals to immediately contact each of their patients who is currently taking a recalled medication; EMR software can facilitate disease management activities by features such as “Outcomes Analysis”, which is the analysis of data collected from a group of patients; EMR software allows for better flow of information and enhanced communication with patients, providers and staff, all resulting in improvement in quality of care; EMR software can improve physician’s efficiency, so that more quality time can be spent with the patient rather than on paperwork demands; * Increased Time Efficiency. Once clinical workflow is automated, most tasks are done in a fraction of the time previously required. Thus, more patients are rendered better care in less time.

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Time was that developers and companies needed to provide their own server infrastructure and architecture to create, develop and launch Web applications or manage their internal IT. Not so much anymore. With Amazon leading the way, and Google among other heavies rolling out solutions of their own, computing and especially the applications we're growing to love are all out in the 'cloud'. Today, Information Week named Amazon's 50-year-old CTO Werner Vogels Chief of the Year for his role in developing and implementing Amazon's cloud computing platform that's now used by approximately 400,000 developers. And, perhaps more importantly, for changing attitudes about how think of computers, networks and applications in relation to the Intertubes. Werner claims it's only "day one" of the cloud. We say, congratulations.

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News
This has been expected.
Rather than protecting health care workers whose consciences are troubled by bioethical issues, this regulation is a none-too-subtle attack on women and their reproductive systems. It isnt only abortion. Under this regulation, doctors can object to birth control, without which, of course, a pregnancy can occur and for which, of course, no abortion is allowed.
What is it that the supporters of this regulation believe women do have the right to do about their own bodies?
Health care settings are supposed to be places where patients rights have standing in law, all the way up to the Supreme Court.
So, when one patients right meets up with a health care workers right of conscience, who yields?
If the Bush administrations regulation holds, it would be the woman.
Wall Street Journal Online
The outgoing Bush administration this week will finalize a regulation establishing a right of conscience allowing medical staff to refuse to participate in any practice they object to on moral grounds, including abortion but possibly birth control and other health care as well.
In transition offices across town, officials in the incoming Obama administration have begun considering how and when to undo it.
The regulation is one of a swath of abortion and other reproductive-health issues under review by the Obama team, which is preparing to reverse a variety of Bush measures, according to officials close to the transition. The review is part of a sweeping scrutiny of Bush-era legislation and regulation on issues across the federal government, from environmental and labor rules to defense spending.
On abortion and related matters, action is expected early on executive, regulatory, budgetary and legislative fronts.
Decisions that the new administration will weigh include: whether to cut funding for sexual abstinence programs; whether to increase funding for comprehensive sex education programs that include discussion of birth control; whether to allow federal health plans to pay for abortions; and whether to overturn regulations such as one that makes fetuses eligible for health-care coverage under the Childrens Health Insurance Program.As one of his first actions, Mr. Obama is likely to issue an executive order lifting President George W. Bushs restrictions on funding for research using embryonic stem cells, a move with bipartisan support. (Emphasis added)
s health advocates also expect early action on the global gag rule, which bars foreign organizations from using their own money for abortion services or advocacy if they accept U.S. aid for family planning. This policy was instituted by President Ronald Reagan, immediately overturned by President Bill Clinton and then reinstated by Mr. Bush.

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Peter Murray has point out to me an interesting report from Franklin Consulting entitled A review of current and developing international practice in the use of social networking (Web 2.0) in higher education which has recently been published.

The report was commissioned by the Committee of Inquiry into the Changing Learner Experience who asked for an international perspective on Web 2.0 tools and their use in universities around the world. The results which cover Australia, The Netherlands, South Africa, United Kingdom and United States of America) highlights the drivers and inhibitors to use and draws some conclusions about the likely direction.

Their findings reflect patchy uptake and a wide variety of ways in which these tools are being used, but suggest "The potential transformation of the practices themselves is yet barely understood or encountered".

There was a remarkably high level of agreement about the issues to be addressed which included:

• Social and professional lives: The use of Web 2.0 for both social and professional purposes has created uncertainties for HEIs. This is reflected in institutions’ current regulatory behaviour codes for use of Web 2.0 for both staff and students.
• Privacy and safety: Issues of privacy and safety have been raised within the international reports as matters of concern for students and institutions.
• Identity: One of the key issues that both students and institutions will face is the nature of students' and staff online identities.
• Issues for Institutions: Traditional frameworks for the development of academic knowledge do not sit comfortably with the speed of information sharing and information production that exists via the Internet.
• A lack of new pedagogic models creating uncertainty for both staff and students.
• Time constraints; administrative overload, high maintenance of the learning process
and learning the new technologies are all time consuming.
• A culture shift for academics: The rapid and huge expansion of information accessible through the web coupled with tools that can be used to repurpose and create new knowledge on-line have created a very different information and a communication environment
• Issues for students :Issues for students are common across all countries where they are engaged in using Web 2.0 tools.

The perceived advantages for co-creation of knowledge and the support for
on-line collaborative activities are balanced against concerns over the
longevity of software applications and reduced institutional control as learning space becomes atomised.

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I participate in a lot of meetings. I enjoy good meetings when the group is charged, working well together and making progress. Even if the topic is not comfortable, if we’re still solving problems or coming to resolution and understanding, it’s a good meeting.

Conversely, I’ve been in meetings that frustrate me completely. Meetings where very little is accomplished and there is a sense of frustration and futility all around. Toxic personalities aside, I’ve discovered that these bad meetings are usually the result of two things:

1) An improper mix of big-picture personalities and detail-task personalities.
2) Lack of an appropriate, focused agenda.

Imagine you are meeting to develop a communications plan that will employ print, web and kiosk delivery methods. You need a high level plan to disseminate team and event information to a large, dispersed group. But one person on the team wants to focus on whether there should be a dash or a hyphen in one of the calendar entries. I’m not making this up. You're solving world hunger, they’re wanting to correct a typo on a nutritional label.

In all fairness, the spelling-checker personality is just as frustrated at this meeting as is the big-picture personality.

I have two suggestions. First, deploy people appropriately: Solve big-picture issues with big-picture people; solve task issues with detail-task people. Of course you will need to blend the personalities so the big-picture types don’t go off on impossible-to-achieve tangents and the detail-task folks don’t bog down in hyphen-dash debates. Both perspectives are required, just not at the same time. Thus, the right blend is a must.

Second, set your agendas accordingly. If you're after a high level plan, have a Big-Picture meeting. Communicate the objectives clearly and keep the meeting on track. Be clear that you want to hear about details only to the degree that a given idea or proposal is not impossible or unworkable. Save working out the details for the Working-Out-The-Details meeting with other detail-task members.

As with the Big-Picture meeting, keep the Working-Out-The-Details meeting flowing with a specific agenda and enough Big-Picture people involved to keep it from bogging down. The mantra at this meeting should be, “we’re looking for excellence, not unattainable perfection”.

I've found that this approach is effective when there is a fairly sizable endeavor, the opportunity is strategic or the threat is somewhat ambiguous.

Feel free to add comments with things you find make meetings more productive.

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RWW Live: Health 2.0 (UPDATE: Recording Now Available) (ReadWriteWeb)
We have been tracking the so-called health 2.0 trend for some time now. Weve covered the top health web apps, the trends to watch in health 2.0, and the latest industry stats . And this morning we published a Health 2.0 update . So in this weeks episode of RWW Live, to be broadcast live at 3.30pm PST Monday (6.

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Some people are constantly seeking a new kick; some prefer to stick to tried and tested things. Which group you belong to seems to be connected, inter alia, with the of specific centres of the brain. This was discovered by scientists at the University of Bonn using a new method. Even how much acceptance people seek is apparently also determined by nerve fibres in the brain.

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Once again following Chance here, who commented on the Grammy Records of the Year. It looked like fun, so I'm joining in.

2008
Winner: Rehab, Amy Winehouse. I didn't join in the showering of praise for it. Meh.
My Favorite Nominee: Umbrella, Rihanna featuring Jay-Z.
My Favorite Single That Year: Shut Up and Drive, Rihanna. It's sexier and more playful than "Umbrella."

2007
Winner: Not Ready to Make Nice, Dixie Chicks. It's not a terrible song, really, but it's such an obvious choice. It Makes a Statement. It's about the only Dixie Chicks song I can listen to, but it's not something I put on intentionally.
My Favorite Nominee: Crazy, Gnarls Barkley. It's perfection.
My Favorite Single That Year: Crazy, Gnarls Barkley. See previous comment.

2006
Winner: Boulevard of Broken Dreams, Green Day. As I've said before on this blog, I'm not a big fan of what Green Day has on offer. I mean, they're kind of okay, this is one of the better songs, but I don't find them as astounding as other people seem to.
My Favorite Nominee: Gold Digger, Kanye West. The only Kanye single I've ever liked or will like.
My Favorite Single That Year: All These Things That I've Done, the Killers.

2005
Winner: Here We Go Again, Ray Charles Norah Jones. You know, I'm not even sure I've ever heard this.
My Favorite Nominee: American Idiot, Green Day. Not much of a crop this year in the nominee pool, but I actually do really like this song.
My Favorite Single That Year: American Idiot, Green Day.

2004
Winner: Clocks, Coldplay. One of the few songs I give them credit for in their endless quest to become the Divine Comedy without anyone noticing. Overrated, but a decent adult contemporary song.
My Favorite Nominee: Hey Ya, OutKast. A perfect pop single. It was overplayed (as was "Clocks"), but it's just so damn good.
My Favorite Single That Year: Hey Ya, OutKast.

2003
Winner: Don't Know Why, Norah Jones. Pretty, but it got old fast. Very adult contemporary, which is still the sound that wins the Grammys. The only Norah Jones song I love is "Sunrise."
My Favorite Nominee: Without Me, Eminem. I hate the guy, but his music is very well-produced. This is pretty much the one song of his I like.
My Favorite Single That Year: Beautiful, Christina Aguilera.

2002
Winner: Walk On, U2. I couldn't pick this song out of a line-up. I like about enough U2 songs to fill a single CD.
My Favorite Nominee: Ms. Jackson, OutKast. I notice "Fallin'" by Alicia Keys was nominated, too. That's a song I'll be thrilled to never hear again.
My Favorite Single That Year: Lady Marmelade, Christina Aguilera, Pink, Mya Li'l Kim. The only thing I liked to come out of Moulin Rouge.

2001
Winner: Beautiful Day, U2. Now that's a U2 song that I like very much. And it makes me feel pretty good.
My Favorite Nominee: Beautiful Day, U2.
My Favorite Single That Year: Beautiful Day, U2.

2000
Winner: Smooth, Santana featuring Rob Thomas. I got so sick of this song playing every minute on every radio station and commercial. I think Santana's pretty overrated, to be honest.
My Favorite Nominee: I don't like any of the songs nominated this year.
My Favorite Single That Year: ...Baby One More Time, Britney Spears. Dopey, sure, but everything that makes a pop single great.

1999
Winner: My Heart Will Go On, Celine Dion. This was very easy to get sick of as well; cloying and over-the-top and insisting on its own epic greatness. Blurg. The music's pretty; I have a string quartet version that didn't make it onto the soundtrack (from a promo CD) that's lovely. It doesn't need Celine Dion or lyrics to work. It sounds better without them.
My Favorite Nominee: Ray of Light, Madonna. I don't have much to say about it, but it works.
My Favorite Single That Year: Flagpole Sitta, Harvey Danger. That song just makes me feel awesome. I love it.

1998
Winner: Sunny Came Home, Shawn Colvin. Music from the nineties has an overwhelming percentage of suck, more than any decade. It's like America went through menopause and could only listen to this kind of sappy pap. I hate this thing, and thanks to the Crap and Crap Lite stations being played where I worked constantly, I heard it way too many fucking times.
My Favorite Nominee: MMMBop, Hanson. It's a default choice; it's the one I think is okay whereas I despise all the others (especially "Where Have All the Cowboys Gone" by Paul Cole, which should be classified a form of abuse).
My Favorite Single That Year: The End Is the Beginning Is the End, Smashing Pumpkins. I love that they used it in the Watchmen trailer.

1997
Winner: Change the World, Eric Clapton. I'm not much of a Clapton fan, really. I did like this song, although it's association with the awful Scientology-promoting John Travolta film Phenomenon counts against it a tad. It's not earth-shaking, but it's a solid, not-unpleasant song.
My Favorite Nominee: 1979, Smashing Pumpkins. Haunting, beautiful, and bittersweet.
My Favorite Single That Year: 1979, Smashing Pumpkins.

1996
Winner: Kiss from a Rose, Seal. I think it's a beautiful song. I used to hear it a lot on the radio as I was driving to work in the winter at a very dark 5 in the morning. That's the perfect time to hear it. It'll take you on a trip.
My Favorite Nominee: Kiss from a Rose, Seal.
My Favorite Single That Year: Kiss from a Rose, Seal.

1995
Winner: All I Wanna Do, Sheryl Crow. Blurg. Not a song I like.
My Favorite Nominee: Streets of Philadelphia, Bruce Springsteen. Beautiful, sad, and seething with quiet ange, disappointment, and acceptance of fear.
My Favorite Single That Year: Streets of Philadelphia, Bruce Springsteen.

1994
Winner: I Will Always Love You, Whitney Houston. Piece of overplayed shit. Especially in comparison to the original Dolly Parton song, which is perfect.
My Favorite Nominee: The River of Dreams, Billy Joel.
My Favorite Single That Year: Fields of Gold, Sting. Kind of a cheesy choice, perhaps, but I can always hear it and always love it. It's simple and pretty.

1993
Winner: Tears in Heaven, Eric Clapton. It doesn't quite hold up for me, honestly, but it's miles better than fellow nominee "Achy Breaky Heart." It's a very pretty song, but not my favorite of Clapton's.
My Favorite Nominee: Constant Craving, k.d. lang. I like the passion.
My Favorite Single That Year: One, U2. One of the most achingly beautiful songs I've ever heard.

1992
Winner: Unforgettable, Natalie Cole. The fact that the Grammys honored that hacky, schlocky, sympathy-begging, cloying bit of grave-robbing Natalie Cole did to cash in on honor her father is as sad as it is unsurprising.
My Favorite Nominee: Losing My Religion, R.E.M. It was overplayed, but if you listen to it now, it sounds almost fresh again. It really is just a good song.
My Favorite Single That Year: Crazy, Seal.

1991
Winner: Another Day in Paradise, Phil Collins. Preachy, annoying, and not even the best song from that Phil Collins album. (Actually, I just checked and sadly, it is. I despise "Something Happened on the Way to Heaven," and "I Wish It Would Rain" just sounds like a rip-off of "Wish You Were Here" with Clapton on guitar.)
My Favorite Nominee: Nothing Compares 2 U, Sinead O'Connor. Of the sappy, preachy, sad sack songs that were nominated this year, this is the one that's actually a good song. (Also, "U Can't Touch This" was nominated this year, but come on, man.)
My Favorite Single This Year: Enjoy the Silence, Depeche Mode. Now there's a love song.

1990
Winner: Wind Beneath My Wings, Bette Midler. I hate this song, and my dad pissed me off by playing it at his wedding reception for his mother, which I specifically told him not to do because it was such a fucking cliche. He said he wouldn't; he did. Wow, my grandma must have been one of 10 million special woman so uniquely honored that year. It's the equivalent of buying your dad a tie on Father's Day.
My Favorite Nominee: The End of the Innocence, Don Henley. Chance is right on when he calls it deceptively angry. It adds some world-weariness on top of that, too. Beautiful song.
My Favorite Single That Year: A Little Respect, Erasure. I usually come out on the side of pop, I guess. Although besides the catchiness, I think the lyrics are beautiful. One of my all time favorite lyrics comes from this song: "What religion or reason could drive a man to forsake his lover?"

1989
Winner: Don't Worry, Be Happy, Bobby McFerrin. I always liked this song, but it sure wasn't the best of the year. I think part of it was the novelty of McFerrin doing the whole thing a cappella. Which is admittedly neat.
My Favorite Nominee: Don't Worry, Be Happy, Bobby McFerrin.
My Favorite Single That Year: Sweet Child O' Mine, Guns 'n' Roses. The most perfect song they ever recorded.

1988
Winner: Graceland, Paul Simon. I'm not a big fan of this song for whatever reason. It's nice, but it's okay. I wouldn't turn it off if it came on the radio station. Really, I just don't dig Paul Simon's solo work that much.
My Favorite Nominee: Back in the High Life Again, Steve Winwood. Admittedly, mostly because it reminds me of better times. But it's pretty.
My Favorite Single That Year: With or Without You, U2. Grammy nominated the more ubiquitous and much less beautiful "I Still Haven't Found What I'm Looking For," a song I don't like. "With or Without You" is real passion.

1987
Winner: Higher Love, Steve Winwood. Meh. It's okay.
My Favorite Nominee: Sledgehammer, Peter Gabriel. It's a lot of sucky nominees this year, but this is a great song.
My Favorite Single That Year: True Colors, Cyndi Lauper. A beautiful love song, especially for people who don't feel so great about themselves. I guess I like genuine songs about understanding, I would say.

1986
Winner: We Are the World, USA for Africa. Of course. Nothing else was going to win this year. As a song, it's okay. The real fun is trying to pick out all the singers. I mean, you know, it's Really Important, but it's just okay.
My Favorite Nominee: Money for Nothing, Dire Straits. One of their couple of songs I like. One of my favorite guitar solos.
My Favorite Single That Year: Take on Me, a-Ha. Pop perfection in all of its catchy, bubblegum glory.

1985
Winner: What's Love Got to Do with It, Tina Turner. There's genuine force behind it (although I think "Private Dancer" is her best song), real heartbreak.
My Favorite Nominee: Dancing in the Dark, Bruce Springsteen. At his most pop. I love this song.
My Favorite Song That Year: Time After Time, Cyndi Lauper. Gorgeous and simple.

1984
Winner: Beat It, Michael Jackson. Not much of a surprise, I guess. And it's a good song. Eddie Van Halen's guitar solo alone...
My Favorite Nominee: Flashdance... What a Feeling, Irene Cara. All of the nominees this year are pretty good but nothing I feel especially attached to. This is one of those cheesy pop songs I like.
My Favorite Single That Year: Our House, Madness. One of the most perfect songs I've ever loved.

1983
Winner: Rosanna, Toto. It's okay.
My Favorite Nominee: Steppin' Out, Joe Jackson. That one always got me and carried me off.
My Favorite Single That Year: Under Pressure, Queen David Bowie. Everything that's shitty about society in four and a half minutes. "And love dares you to care for the people on the edge of the night."

1982
Winner: Bette Davis Eyes, Kim Carnes. Meh. I don't feel strongly either way.
My Favorite Nominee: (Just Like) Starting Over, John Lennon. What a great song. I can't believe it lost to Kim Carnes... greatness versus... well, nothing worth commenting on. As usual, John Lennon just nails life and relationships with this song.
My Favorite Single This Year: In the Air Tonight, Phil Collins. Collins used to be a man who just knew darkness and how it felt to be depressed and angry.

1981
Winner: Sailing, Christopher Cross. Put me to sleep, why don't ya?
My Favorite Nominee: Theme from New York, New York, Frank Sinatra.
My Favorite Single That Year: Let My Love Open the Door, Pete Townshend. As great a song as he ever wrote for the Who, his best solo work, and one of his most genuinely passionate songs.

1980
Winner: What a Fool Believes, the Doobie Brothers. I'm not a fan of theirs. This is probably the one song of theirs I'd say I liked. Still, Record of the Year? Feh.
My Favorite Nominee: I Will Survive, Gloria Gaynor. I like the sweep of it.
My Favorite Single That Year: Video Killed the Radio Star, the Buggles. Another perfect pop record.

1979
Winner: Just the Way You Are, Billy Joel. It is a pretty song, however much Joel claims now that he wrote it accidentally. Is he ever going to stop apologizing for having good commercial instincts? One of his less angry songs, too. I've always liked it.
My Favorite Nominee: Baker Street, Gerry Rafferty. Or as I always used to call it, "That One with the Great Saxophone Part."
My Favorite Single That Year: Who Are You, the Who. My favorite song of theirs, for reasons I can't quite define. But it's a great damn song.

1978
Winner: Hotel California, the Eagles. I hate the Eagles, but I'll give them this one song. This is a damn good song.
My Favorite Nominee: Hotel California, the Eagles.
My Favorite Single That Year: Hotel California, the Eagles.

1977
Winner: This Masquerade, George Benson. I couldn't tell you how this goes.
My Favorite Nominee: Afternoon Delight, Starland Vocal Band. It's delightful.
My Favorite Single That Year: Somebody to Love, Queen. A beautiful epic of emotion. One of my favorite songs ever.

1976
Winner: Love Will Keep Us Together, the Captain Tennille. It's okay.
My Favorite Nominee: At Seventeen, Janis Ian.
My Favorite Single That Year: Young Americans, David Bowie. That one packs a wallop and makes "Love Will Keep Us Together" sound pretty frivolous.

1975
Winner: I Honestly Love You, Olivia Newton-John. I honestly detest this cloying, overwrought song.
My Favorite Nominee: Don't Let the Sun Go Down on Me, Elton John. You want passion? There you go. Skip the other song entirely.
My Favorite Single That Year: Cat's in the Cradle, Harry Chapin. Hey, hey, it's a cliched choice for a reason.

1974
Winner: Killing Me Softly with His Song, Roberta Flack. It's pretty. It's also soporific.
My Favorite Nominee: You're So Vain, Carly Simon. A nice kiss-off song.
My Favorite Single That Year: Mind Games, John Lennon. Gorgeous.

1973
Winner: The First Time Ever I Saw Your Face, Roberta Flack. I've always found this song kind of overwrought.
My Favorite Nominee: American Pie, Don McLean. Come on, how could you pick a different one? (Although I've always loved Gilbert O'Sullivan's "Alone Again (Naturally)," a deceptively bleak and saddening song.)
My Favorite Single That Year: Let's Stay Together, Al Green. You want to get laid? You need some Al Green music.

1972
Winner: It's Too Late, Carole King. I can't place it off the top of my head, but I've never liked Carole King's as a singer.
My Favorite Nominee: My Sweet Lord, George Harrison. It's not much of a song, really, but I didn't like any of the other nominees much.
My Favorite Single That Year: Imagine, John Lennon. I can't believe this was never nominated for Record of the Year. What the hell?

1971
Winner: Bridge Over Troubled Water, Simon and Garfunkel. An undeniably beautiful song.
My Favorite Nominee: Let It Be, the Beatles. Still Paul McCartney's most beautiful effort.
My Favorite Single That Year: Let It Be, the Beatles. Seriously, they didn't pick this?

1970
Winner: Aquarius/Let the Sunshine In, the Fifth Dimension. Definitely a good song.
My Favorite Nominee: A Boy Named Sue, Johnny Cash. It's funny and Cash delivers it well. I'll always pull for Shel Silverstein.
My Favorite Single That Year: Suspicious Minds, Elvis Presley. His final masterpiece, one of his best songs (in my top five).

1969
Winner: Mrs. Robinson, Simon and Garfunkel. Good but not really special.
My Favorite Nominee: Hey Jude, the Beatles. A masterpiece.
My Favorite Single That Year: (Sittin' on) The Dock of the Bay, Otis Redding. One of the most quietly perfect songs I've ever heard.

1968
Winner: Up, Up and Away, the Fifth Dimension. What a lame choice. I mean, it's a cute song, but what a lame choice at this point in music history.
My Favorite Nominee: My Cup Runneth Over, Ed Ames.
My Favorite Single That Year: Can't Take My Eyes Off You, Frankie Valli. But that's the tip of the iceberg; this year produced, off the top of my head, "Heroes and Villains," "All You Need Is Love," "I Was Made to Love Her," "Light My Fire," "A Whiter Shade of Pale," and "(You Make Me Feel Like a) Natural Woman," and Grammy nominates "Ode to Billie Joe"? Lame, lame, lame.

1967
Winner: Strangers in the Night, Frank Sinatra. A good song, one I always liked.
My Favorite Nominee: Strangers in the Night, Frank Sinatra.
My Favorite Single That Year: Good Vibrations, the Beach Boys. Another incredible year for rock, and the Grammys can only acknowledge "Monday, Monday." What a foolish institution to pass over the greatness they did.

1966
Winner: A Taste of Honey, Herb Alpert and the Tijuana Brass. The best of the several thousand versions that seem to be out there.
My Favorite Nominee: Yesterday, the Beatles. As beautiful a song as was ever written.
My Favorite Single That Year: Like a Rolling Stone, Bob Dylan. Transcendent.

1965
Winner: The Girl from Ipanema, Stan Getz João Gilberto. A lovely little song that I've always liked as background music.
My Favorite Nominee: Downtown, Petula Clark. I forget just how beautiful this one is.
My Favorite Single That Year: Don't Worry, Baby, the Beach Boys. Perfect.

1964
Winner: Days of Wine and Roses, Henry Mancini. Nothing song from a rather turgid movie.
My Favorite Nominee: Dominique, the Singing Nun. That's painful to say, but the nominees this year are just that bad. Again, zero acknowledgement of rock and roll or even the great folk music from this time.
My Favorite Single That Year: Surfer Girl, the Beach Boys. Hey, Brian Wilson just knows how to hit me where it counts. Teenage love deified.

1963
Winner: I Left My Heart in San Francisco, Tony Bennett. A beautiful song.
My Favorite Nominee: I Left My Heart in San Francisco, Tony Bennett.
My Favorite Single That Year: Telstar, the Tornados. That one always takes me right off and makes me love being alive.

1962
Winner: Moon River, Henry Mancini. I'm never sorry to have heard this song. It's always beautiful, and always necessary.
My Favorite Nominee: Moon River, Henry Mancini. Infinitesimal second: "Take Five" by Dave Brubeck.
My Favorite Single That Year: Stand by Me, Ben E. King. The best time to hear this song is in the still of the deep night.

1961
Winner: Theme from A Summer Place, Percy Faith. The music is pretty.
My Favorite Nominee: Georgia on My Mind, Ray Charles. It's insane that this didn't win. This is the very definition of a beautiful song.
My Favorite Single That Year: Georgia on My Mind, Ray Charles.

1960
Winner: Mack the Knife, Bobby Darin. I like this song; it's fun as hell to sing along to.
My Favorite Nominee: Mack the Knife, Bobby Darin.
My Favorite Single That Year: Sleepwalk, Santo Johnny. Another great late night song.

1959
Winner: Nel Blu Dipinto Di Blu (Volare), Domenico Modugno. Okay. I can't believe anyone does this song better than Dean Martin, personally. I don't believe I've heard this version.
My Favorite Nominee: The Chipmunk Song (Christmas Don't Be Late), David Seville. I know, I know, but I love this song. It's a Christmas staple to me. It reminds me of being a kid and spending the lead-up to Christmas at my grandmother's house. It's a cozy song for me.
My Favorite Single That Year: Summertime Blues, Eddie Cochran. As vital a song as there is, considering how much rock continues to borrow from it. And more than that, just a catchy tune.

Similar posts: electronic health record

IT is being asked to build storage infrastructures at lower costs. At the same time storage networks are deluged with content, driven by rich digital media and new governance and compliance rules. How can we better prepare for this ongoing onslaught on our storage resources? Join Shane Schick, Editor in Chief of IT World Canada, and his guests John Sloan, Senior Research Analyst, Info-Tech Research Group and Jim Decaires, Storage Product Manager, Fujitsu, for a one-hour webinar that will separate the hype from the reality and enable you to achieve more with less.

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By Andrew Liszewski
You know how it is. Youve just finished renovating your basement into the perfect games room, complete with a pool table, mini bar and even a dogs playing poker painting on the wall, but theres just one tacky piece of the puzzle missing that will make the decor absolutely perfect. Well say hello to that last puzzle piece. While classic jukeboxes might have that retro, hey look what I just wasted my money on! look to them, if you dont have a collection of small vinyl records, what good are they? The IntelliTunes Digital Jukebox on the other hand is not only able to play your existing digital music collection, but you can also rip audio CDs directly to its internal hard drive. And it does all that while looking vaguely reminiscent of the jukeboxes found in a 1950s-era diner.
It has a capacity for about 50,000 songs, and features two LCD displays for controlling and monitoring whats being played. The top 8-inch LCD shows artist and track info as well as a mesmerizing 3D light show visualizer, while the bottom 15-inch touch screen LCD provides the user interface and other controls. Youll want to keep in mind that the IntelliTunes doesnt have any built-in speakers of its own, but it does have an UltraHiFi 360 watt 2 channel amplifier that can be connected to a pair of external speakers or tied into an existing stereo setup. Its even got wifi for streaming internet radio, and if youre not sold by now, Im sure the virtual aquarium screensavers is more than enough to justify the $3,995 price tag.

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