Some of the problems transcend POSIX. Someone I know maintains a non-relational db on IBM mainframes. When diving into a data issue, he was gob-smacked to find out that sync'd writes did not necessarily make it to the disk. They were cached in the drive memory and (I think) the disk controller memory. If all failed, data was lost.
This is precisely why well-designed enterprise-grade storage systems disable the drive cache and rely upon some variant of striping to achieve good I/O performance.
