Barbara billingsley related to peter billingsley

What’s your dating app “I’m sick of”?

2023.06.04 15:59 inslrn What’s your dating app “I’m sick of”?

I normally don’t do this but it needs to be said. Hopefully others can relate and add to it too. The #1 thing that I’m sick of is the worldliness. I’m a guy and the amount of worldliness on Christian dating apps is downright scary. I know there’s going to be a lot of downvoting (let the down arrow mashing begin! :/) but it needs to be called out, and hopefully it can help Christian women who it applies to to stop so you can be godly and attract godly men. Also women, what needs to be called out about us guys. What are you sick of?
In no particular order…
Ok I’m done. There’s probably way more that I’ve come across but I’ll stop here and hopefully others chime in. But I genuinely hope this does help us all to find our husband or wife out there in this crazy world.
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2023.06.04 15:08 JasperTedTale Teenage Mutant Ninja Turtles (DOS) Soundtrack (PC Speaker) [By Bippo Ernesti]

Teenage Mutant Ninja Turtles (DOS) Soundtrack (PC Speaker) [By Bippo Ernesti] submitted by JasperTedTale to 1bit [link] [comments]

2023.06.04 14:34 Dirtclodkoolaid AMA RESOLUTION 235

“Resolution 235 asks that our AMA applaud the CDC for its efforts to prevent the incidence of new cases of opioid misuse, addiction, and overdose deaths; and be it further, that no entity should use MME thresholds as anything more than guidance and that MME thresholds should not be used to completely prohibit the prescribing of, or the filling of prescriptions for, medications used in oncology care, palliative medicine care, and addiction medicine care: and be it further, that our AMA communicate with the nation’s largest pharmacy chains and pharmacy benefit managers to recommend that they cease and desist with writing threatening letters to physicians and cease and desist with presenting policies, procedures and directives to retail pharmacists that include a blanket proscription against filling prescriptions for opioids that exceed certain numerical thresholds without taking into account the diagnosis and previous response to treatment for a patient and any clinical nuances that would support such prescribing as falling within standards of good quality patient care; and be it further, that AMA Policy opposing the legislating of numerical limits on medication dosage, duration of therapy, numbers of pills/tablets, etc., be reaffirmed; and be it further, that physicians should not be subject to professional discipline or loss of board certification or loss of clinical privileges simply for prescribing opioids at a quantitative level that exceeds the MME thresholds found in the CDC Guidelines; and be it further, that our AMA encourage the Federation of State Medical Boards and its member boards, medical specialty societies, and other entities to develop improved guidance on management of pain and management of potential withdrawal syndromes and other aspects of patient care for “legacy patients” who may have been treated for extended periods of time with high-dose opioid therapy for chronic non-malignant pain.
RESOLVED, that our American Medical Association (AMA) applaud the Centers for Disease Control and Prevention (CDC) for its efforts to prevent the incidence of new cases of opioid misuse, addiction, and overdose deaths
RESOLVED, that our AMA actively continue to communicate and engage with the nation’s largest pharmacy chains, pharmacy benefit managers, National Association of Insurance Commissioners, Federation of State Medical Boards, and National Association of Boards of Pharmacy in opposition to communications being sent to physicians that include a blanket proscription against filing prescriptions for opioids that exceed numerical thresholds without taking into account the diagnosis and previous response to treatment for a patient and any clinical nuances that would support such prescribing as falling within standards of good quality patient care.
RESOLVED, that our AMA affirms that some patients with acute or chronic pain can benefit from taking opioid pain medications at doses greater than generally recommended in the CDC Guideline for Prescribing Opioids for Chronic Pain and that such care may be medically necessary and appropriate, and be it further
RESOLVED, that our AMA advocate against misapplication of the CDC Guideline for Prescribing Opioids by pharmacists, health insurers, pharmacy benefit managers, legislatures, and governmental and private regulatory bodies in ways that prevent or limit patients’ medical access to opioid analgesia, and be it further
RESOLVED, that our AMA advocate that no entity should use MME (morphine milligram equivalents) thresholds as anything more than guidance, and physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids at a quantitative level above the MME thresholds found in the CDC Guideline for Prescribing Opioids.””
Pain Management Best Practices Inter-Agency Task Force - Draft Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations Official Health and Human Services Department Released December 2018
“The Comprehensive Addiction and Recovery Act (CARA) of 2016 led to the creation of the Pain Management Best Practices Inter-Agency Task Force (Task Force), whose mission is to determine whether gaps in or inconsistencies between best practices for acute and chronic pain management exist and to propose updates and recommendations to those best practices. The Task Force consists of 29 experts who have significant experience across the disciplines of pain management, patient advocacy, substance use disorders, mental health, and minority health.”
In addition to identifying approximately 60 gaps in clinical best practices and the current treatment of pain in the United States, HHS PMTF provided recommendations for each of these major areas of concern. In alignment with their original charter, the PMTF will submit these recommendations to Congress to become our ‘National Pain Policy’. The 60+ gaps and inconsistencies with their recommendations will serve to fill gaps in pain treatment at both the state and federal level; and the overwhelming consensus was that the treatment of pain should be multimodal and completely individualized based on the individual patient. The heart of each recommendation in each section was a resounding call for individualization for each patient, in regards to both non-pharmacological and pharmacological modalities; including individualizations in both opioid and non-opioid pharmacological treatments.
While each of the gap+recommendation sections of what is poised to become our national pain policy is extremely important, one that stands out the most (in regards to opioid prescribing) is the Stigma section. Contained in this section is one of the core statements that shows our Health and Human Services agency - the one that should have always been looked to and followed - knew the true depth of the relationship (or lack of) between the overdose crisis and compassionate prescribing to patients with painful conditions:
“The national crisis of illicit drug use, with overdose deaths, is confused with appropriate therapy for patients who are being treated for pain. This confusion has created a stigma that contributes to raise barriers to proper access to care.”
The recommendation that follows - “Identify strategies to reduce stigma in opioid use so that it is never a barrier to patients receiving appropriate treatment, with all cautions and considerations for the management of their chronic pain conditions” - illustrates an acknowledgment by the top health agency of the federal government that the current national narrative conflating and confusing compassionate treatment of pain with illicit drug use, addiction, and overdose death is incorrect and only serving to harm patients.
Since March of 2016 when the CDC Guidelines were released, advocates, patients, clinicians, stakeholders, and others, have began pointing out limitations and unintended consequences as they emerged. In order to address the unintended consequences emerging from the CDC Guidelines, this task force was also charged with review of these guidelines; from expert selection, evidence selection, creation, and continuing to current misapplication in order to provide recommendations to begin to remedy these issues.
“A commentary by Busse et al. identified several limitations to the CDC guideline related to expert selection, evidence inclusion criteria, method of evidence quality grading, support of recommendations with low-quality evidence, and instances of vague recommendations. In addition, the CDC used the criterion of a lack of clinical trials with a duration of one year or longer as lack of evidence for the clinical effectiveness of opioids, whereas Tayeb et al. found that that was true for all common medication and behavioral therapy studies.
Interpretation of the guideline, in addition to some gaps in the guideline, have led to unintended consequences, some of which are the result of misapplication or misinterpretation of the CDC guideline.
However, at least 28 states have enacted legislation related to opioid prescription limits, and many states and organizations have implemented the guideline without recognizing that the intended audience was PCPs; have used legislation for what should be medical decision making by healthcare professionals; and have applied them to all physicians, dentists, NPs, and PAs, including pain specialists.441–444 Some stakeholders have interpreted the guideline as intended to broadly reduce the amount of opioids prescribed for treating pain; some experts have noted that the guideline emphasizes the risk of opioids while minimizing the benefit of this medication class when properly managed.”
“The CDC guideline was not intended to be model legislation for state legislators to enact”
“In essence, clinicians should be able to use their clinical judgment to determine opioid duration for their patients”
HHS Review of 2016 CDC Guidelines for responsible opioid prescribing
The Pain Management Task Force addressed 8 areas that are in need of update or expansion with recommendations to begin remediation for each problem area:
Lack of high-quality data exists for duration of effectiveness of opioids for chronic pain; this has been interpreted as a lack of benefit Conduct studies Focus on patient variability and response for effectiveness of opioids; use real-world applicable trials
Absence of criteria for identifying patients for whom opioids make up significant part of their pain treatment Conduct clinical trials and/or reviews to identify sub-populations of patients where long-term opioid treatment is appropriate
Wide variation in factors that affect optimal dose of opioids Consider patient variables for opioid therapy: Respiratory compromise Patient metabolic variables Differences in opioid medications/plasma concentrations Preform comprehensive initial assessment it’s understanding of need for comprehensive reevaluations to adjust dose Give careful considerations to patients on opioid pain regimen with additional risk factors for OUD
Specific guidelines for opioid tapering and escalation need to be further clarified A thorough assessment of risk-benefit ratio should occur whenever tapering or escalation of dose This should include collaboration with patient whenever possible Develop taper or dose escalation guidelines for sub-populations that include consideration of their comorbidities When benefit outweighs the risk, consider maintaining therapy for stable patients on long term opioid therapy
Causes of worsening pain are not often recognized or considered. Non-tolerance related factors: surgery, flares, increased physical demands, or emotional distress Avoid increase in dose for stable patient (2+ month stable dose) until patient is re-evaluated for underlying cause of elevated pain or possible OUD risk Considerations to avoid dose escalation include: Opioid rotation Non-opioid medication Interventional strategies Cognitive behavior strategies Complementary and integrative health approaches Physical therapy
In patients with chronic pain AND anxiety or spasticity, benzodiazepine co-prescribed with opioids still have clinical value; although the risk of overdose is well established When clinically indicated, co-prescription should be managed by specialist who have knowledge, training, and experience with co-prescribing. When co-prescribed for anxiety or SUD collaboration with mental health should be considered Develop clinical practice guidelines focused on tapering for co-prescription of benzodiazepines and opioids
The risk-benefit balance varies for individual patients. Doses >90MME may be favorable for some where doses <90MME may be for other patients due to individual patient factors. Variability in effectiveness and safety between high and low doses of opioids are not clearly defined. Clinicians should use caution with higher doses in general Using carefully monitored trial with frequent monitoring with each dose adjustment and regular risk reassessment, physicians should individualize doses, using lowest effective opioid dose that balances benefit, risk, and adverse reactions Many factors influence benefits and risk, therefore, guidance of dose should not be applied as strict limits. Use established and measurable goals: Functionality ADL Quality of Life
Duration of pain following acute and severely painful event is widely variable Appropriate duration is best considered within guidelines, but is ultimately determined by treating clinician. CDC recommendation for duration should be emphasized as guidance only with individualized patient care as the goal Develop acute pain management guidelines for common surgical procedures and traumas To address variability and provide easy solution, consideration should be given to partial refill system
Human Rights Watch December 2018 (Excerpt from 109 page report)
“If harms to chronic pain patients are an unintended consequence of policies to reduce inappropriate prescribing, the government should seek to immediately minimize and measure the negative impacts of these policies. Any response should avoid further stigmatizing chronic pain patients, who are increasingly associated with — and sometimes blamed for — the overdose crisis and characterized as “drug seekers,” rather than people with serious health problems that require treatment.
Top government officials, including the President, have said the country should aim for drastic cutbacks in prescribing. State legislatures encourage restrictions on prescribing through new legislation or regulations. The Drug Enforcement Administration (DEA) has investigated medical practitioners accused of overprescribing or fraudulent practice. State health agencies and insurance companies routinely warn physicians who prescribe more opioids than their peers and encourage them to reduce prescribing. Private insurance companies have imposed additional requirements for covering opioids, some state Medicaid programs have mandated tapering to lower doses for patients, and pharmacy chains are actively trying to reduce the volumes of opioids they dispense.
The medical community at large recognized that certain key steps were necessary to tackle the overdose crisis: identifying and cracking down on “pill mills” and reducing the use of opioids for less severe pain, particularly for children and adolescents. However, the urgency to tackle the overdose crisis has put pressure on physicians in other potentially negative ways: our interviews with dozens of physicians found that the atmosphere around prescribing for chronic pain had become so fraught that physicians felt they must avoid opioid analgesics even in cases when it contradicted their view of what would provide the best care for their patients. In some cases, this desire to cut back on opioid prescribing translated to doctors tapering patients off their medications without patient consent, while in others it meant that physicians would no longer accept patients who had a history of needing high-dose opioids.
The consequences to patients, according to Human Rights Watch research, have been catastrophic.”
Opioid Prescribing Workgroup December 2018
This is material from the Board of Scientific Counselors in regards to their December 12, 2018 meeting that culminated the works of a project titled the “Opioid Prescribing Estimates Project.” This project is a descriptive study that is examining opioid prescribing patterns at a population level. Pain management is a very individualized process that belongs with the patient and provider. The Workgroup reviewed work done by CDC and provided additional recommendations.
SUMMARY There were several recurrent themes throughout the sessions.
Repeated concern was voiced from many Workgroup members that the CDC may not be able to prevent conclusions from this research (i.e. the benchmarks, developed from limited data) from being used by states or payors or clinical care systems to constrain clinical care or as pay-for- performance standards – i.e. interpreted as “guidelines”. This issue was raised by several members on each of the four calls, raising the possibility that providers or clinical systems could thus be incentivized against caring for patients requiring above average amounts of opioid medication.
Risk for misuse of the analysis. Several members expressed concerns that this analysis could be interpreted as guidance by regulators, health plans, or clinical care systems. Even though the CDC does not plan to issue this as a guideline, but instead as research, payors and clinical care systems searching for ways to reign in opioid prescribing may utilize CDC “benchmarks” to establish pay-for-performance or other means to limit opioid prescribing. Such uses of this work could have the unintended effect of incentivizing providers against caring for patients reliant upon opioids.
…It was also noted that, in order to obtain sufficient granularity to establish the need for, dosage, and duration of opioid therapy, it would be necessary to have much more extensive electronic medical record data. In addition, pain and functional outcomes are absent from the dataset, but were felt to be important when considering risk and benefit of opioids.
...Tapering: Concerns about benchmarks and the implications for tapering were voiced. If tapering occurs, guidance was felt to be needed regarding how, when, in whom tapering should occur. This issue was felt to be particularly challenging for patients on chronic opioids (i.e. “legacy” patients). In addition, the importance of measuring risk and benefit of tapering was noted. Not all high-dose patient populations benefit from tapering.
Post-Surgical Pain
General comments. Workgroup members noted that most patients prescribed opioids do not experience adverse events, including use disorder. Many suggested that further discussion of opioids with patients prior to surgery was important, with an emphasis on expectations and duration of treatment. A member suggested that take-back programs would be more effective than prescribing restrictions.
Procedure-related care. Members noted that patient factors may drive opioid need more than characteristics of a procedure.
Patient-level factors. Members noted that opioid-experienced patients should be considered differently from opioid-inexperienced patients, due to tolerance.
Chronic Pain
It was noted that anything coming out of the CDC might be considered as guidelines and that this misinterpretation can be difficult to counter. There was extensive discussion of the 50 and 90 MME levels included in the CDC Guidelines. It was recommended that the CDC look into the adverse effects of opioid tapering and discontinuation, such as illicit opioid use, acute care utilization, dropping out of care, and suicide. It was also noted that there are major gaps in guidelines for legacy patients, patients with multiple diagnoses, pediatric and geriatric patients, and patients transitioning to lower doses.
There were concerns that insufficient clinical data will be available from the dataset to appropriately consider the individual-level factors that weigh into determination of opioid therapy. The data would also fail to account for the shared decision-making process involved in opioid prescribing for chronic pain conditions, which may be dependent on primary care providers as well as ancillary care providers (e.g. physical therapists, psychologists, etc).
Patient-level factors. Members repeatedly noted that opioid-experienced patients should be considered differently from opioid-experienced patients, due to tolerance.
Members noted that the current CDC guidelines have been used by states, insurance companies, and some clinical care systems in ways that were not intended by the CDC, resulting in cases of and the perception of patient abandonment. One option raised in this context was to exclude patients on high doses of opioids, as those individuals would be qualitatively different from others. A variant of this concern was about management of “legacy” patients who are inherited on high doses of opioids. Members voiced concerns that results of this work has caused harm to patients currently reliant upon opioids prescribed by their providers.
Acute Non-Surgical Pain
Patient-level factors. Members felt that opioid naïve versus experienced patients might again be considered separately, as opioid requirements among those experienced could vary widely.
...Guidelines were also noted to be often based on consensus, which may be incorrect.
Cancer-Related and Palliative Care Pain
It was noted that the CDC guidelines have been misinterpreted to create a limit to the dose of opioids that can be provided to people at all stages of cancer and its treatment. It was also noted that the cancer field is rapidly evolving, with immunotherapy, CAR-T, and other novel treatments that affect response rates and limit our ability to rely upon historical data in establishing opioid prescribing benchmarks.
Concern that data would not be able to identify all of the conditions responsible for pain in a patient with a history of cancer (e.g. people who survive cancer but with severe residual pain). Further, it was noted that certain complications of cancer and cancer treatment may require the least restrictive long-term therapy with opioids.
The definition of palliative care was also complicated and it was suggested that this include patients with life-limiting conditions.
Overall, it was felt that in patients who may not have long to live, and/or for whom returning to work is not a possibility, higher doses of opioids may be warranted.
CDC Scientists Anonymous ‘Spider Letter’ to CDC
Carmen S. Villar, MSW Chief of Staff Office of the Director MS D­14 Centers for Disease Control and Prevention (CDC) 1600 Clifton Road Atlanta, Georgia 30329­-4027
August 29, 2016
Dear Ms. Villar:
We are a group of scientists at CDC that are very concerned about the current state of ethics at our agency. It appears that our mission is being influenced and shaped by outside parties and rogue interests. It seems that our mission and Congressional intent for our agency is being circumvented by some of our leaders. What concerns us most, is that it is becoming the norm and not the rare exception. Some senior management officials at CDC are clearly aware and even condone these behaviors. Others see it and turn the other way. Some staff are intimidated and pressed to do things they know are not right. We have representatives from across the agency that witness this unacceptable behavior. It occurs at all levels and in all of our respective units. These questionable and unethical practices threaten to undermine our credibility and reputation as a trusted leader in public health. We would like to see high ethical standards and thoughtful, responsible management restored at CDC. We are asking that you do your part to help clean up this house!
It is puzzling to read about transgressions in national media outlets like USA Today, The Huffington Post and The Hill. It is equally puzzling that nothing has changed here at CDC as a result. It’s business as usual. The litany of issues detailed over the summer are of particular concern:
Recently, the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) has been implicated in a “cover up” of inaccurate screening data for the Wise Woman (WW) Program. There was a coordinated effort by that Center to “bury” the fact that screening numbers for the WW program were misrepresented in documents sent to Congress; screening numbers for 2014 and 2015 did not meet expectations despite a multi­million dollar investment; and definitions were changed and data “cooked” to make the results look better than they were. Data were clearly manipulated in irregular ways. An “internal review” that involved staff across CDC occurred and its findings were essentially suppressed so media and/or Congressional staff would not become aware of the problems. Now that both the media and Congresswoman DeLauro are aware of these issues, CDC staff have gone out of their way to delay FOIAs and obstruct any inquiry. Shouldn’t NCCDPHP come clean and stop playing games? Would the ethical thing be to answer the questions fully and honestly. The public should know the true results of what they paid for, shouldn’t they?
Another troubling issue at the NCCDPHP are the adventures of Drs. Barbara Bowman and Michael Pratt (also detailed in national media outlets). Both seemed to have irregular (if not questionable) relationships with Coca­Cola and ILSI representatives. Neither of these relationships were necessary (or appropriate) to uphold our mission. Neither organization added any value to the good work and science already underway at CDC. In fact, these ties have now called into question and undermined CDC’s work. A cloud has been cast over the ethical and excellent work of scientists due to this wanton behavior. Was cultivating these relationships worth dragging CDC through the mud? Did Drs. Bowman and Pratt have permission to pursue these relationships from their supervisor Dr. Ursula Bauer? Did they seek and receive approval of these outside activities? CDC has a process by which such things should be vetted and reported in an ethics review, tracking and approval system (EPATS). Furthermore, did they disclose these conflicts of interest on their yearly OGE 450 filing. Is there an approved HHS 520, HHS 521 or “Request for Official Duty Activities Involving an Outside Organization” approved by Dr. Bauer or her Deputy Director Ms. Dana Shelton? An August 28, 2016 item in The Hill details these issues and others related to Dr. Pratt.
It appears to us that something very strange is going on with Dr. Pratt. He is an active duty Commissioned Corps Officer in the USPHS, yet he was “assigned to” Emory University for a quite some time. How and under what authority was this done? Did Emory University pay his salary under the terms of an IPA? Did he seek and receive an outside activity approval through EPATS and work at Emory on Annual Leave? Formal supervisor endorsement and approval (from Dr. Bauer or Ms. Shelton) is required whether done as an official duty or outside activity.
If deemed official, did he file a “Request for Official Duty Activities Involving an Outside Organization” in EPATS? Apparently Dr. Pratt’s position at Emory University has ended and he has accepted another position at the University of California ­ San Diego? Again, how is this possible while he is still an active duty USPHS Officer. Did he retire and leave government service? Is UCSD paying for his time via an IPA? Does he have an outside activity approval to do this? Will this be done during duty hours? It is rumored that Dr. Pratt will occupy this position while on Annual Leave? Really? Will Dr. Pratt be spending time in Atlanta when not on Annual Leave? Will he make an appearance at NCCDPHP (where he hasn’t been seen for months). Most staff do not enjoy such unique positions supported and approved by a Center Director (Dr. Bauer). Dr. Pratt has scored a sweet deal (not available to most other scientists at CDC). Concerns about these two positions and others were recently described in The Huffington Post and The Hill. His behavior and that of management surrounding this is very troubling.
Finally, most of the scientists at CDC operate with the utmost integrity and ethics. However, this “climate of disregard” puts many of us in difficult positions. We are often directed to do things we know are not right. For example, Congress has made it very clear that domestic funding for NCCDPHP (and other CIOs) should be used for domestic work and that the bulk of NCCDPHP funding should be allocated to program (not research). If this is the case, why then is NCCDPHP taking domestic staff resources away from domestic priorities to work on global health issues? Why in FY17 is NCCDPHP diverting money away from program priorities that directly benefit the public to support an expensive research FOA that may not yield anything that benefits the public? These actions do not serve the public well. Why is nothing being done to address these problems? Why has the CDC OD turned a blind eye to these things. The lack of respect for science and scientists that support CDC’s legacy is astonishing.
Please do the right thing. Please be an agent of change.
CDC Spider (CDC Scientists Preserving Integrity, Diligence and Ethics in Research)
January 13, 2016
Thomas Frieden, MD, MPH Director Centers for Disease Control and Prevention 1600 Clifton Road Atlanta, GA 30329-4027
Re: Docket No. CDC-2015-0112; Proposed 2016 Guideline for Prescribing Opioids for Chronic Pain
Dear Dr. Frieden:
There is no question that there is an opioid misuse epidemic and that efforts need to be made to control it. The Centers for Disease Control and Prevention (CDC) is applauded for its steps to undertake this lofty effort. However, based on the American Academy of Family Physicians’ (AAFP’s) review of the guideline, it is apparent that the presented recommendations are not graded at a level consistent with currently available evidence. The AAFP certainly wants to promote safe and appropriate prescribing of opioids; however, we recommend that the CDC still adhere to the rigorous standards for reliable and trustworthy guidelines set forth by the Institute of Medicine (IOM). The AAFP believes that giving a strong recommendation derived from generalizations based on consensus expert opinion does not adhere to evidence-based standards for developing clinical guideline recommendations.
The AAFP’s specific concerns with the CDC’s methodology, evidence base, and recommendations are outlined below.
Methodology and Evidence Base
All of the recommendations are based on low or very low quality evidence, yet all but one are Category A (or strong) recommendations. The guideline states that in the GRADE methodology "a particular quality of evidence does not necessarily imply a particular strength of recommendation." While this is true, it applies when benefits significantly outweigh harms (or vice versa). When there is insufficient evidence to determine the benefits and harms of a recommendation, that determination should not be made.
When evaluating the benefits of opioids, the evidence review only included studies with outcomes of at least one year. However, studies with shorter intervals were allowed for analysis of the benefits of nonopioid treatments. The guideline states that no evidence shows long-term benefit of opioid use (because there are few studies), yet the guideline reports "extensive evidence" of potential harms, even though these studies were of low quality. The accompanying text also states "extensive evidence" of the benefits of non-opioid treatments, yet this evidence was from shorter term studies, was part of the contextual review rather than the clinical systematic review, and did not compare non- opioid treatments to opioids.
The patient voice and preferences were not explicitly included in the guideline. This raises concerns about the patient-centeredness of the guideline. The Myth of Morphine Equivalent Daily Dosage Medscape Neuro Perspective
For far too many years, pain researchers and clinicians have relied on the concept of the morphine equivalent daily dosage (MEDD), or some variant of it, as a means of comparing the "relative corresponding quantity" of the numerous opioid molecules that are important tools in the treatment of chronic pain.
...And, most unfortunately, opioid prescribing guideline committees have relied on this concept as a means of placing (usually arbitrary) limits on the levels of opioids that a physician or other clinician should be allowed to prescribe. Although these guidelines typically bill themselves as "voluntary," their chilling effect on prescribers and adaptation into state laws[2] makes calling them "voluntary" disingenuous.
Although some scientists and clinicians have been questioning the conceptual validity of MEDD for several years, a recent study[3] has indicated that the concept is unequivocally flawed—thereby invalidating its use empirically and as a tool in prescribing guideline development.
The authors used survey data from pharmacists, physicians, nurse practitioners, and physician assistants to estimate daily morphine equivalents and found great inconsistency in their conversions of hydrocodone, fentanyl transdermal patches, methadone, oxycodone, and hydromorphone—illustrating the potential for dramatic underdosing or, in other cases, fatal overdosing.
Patients with chronic pain (particularly that of noncancer origin) who are reliant on opioid analgesia are already sufficiently stigmatized and marginalized[7] to allow this type of practice to continue to be the norm.
Although the use of MEDD in research and, to a greater extent, in practice, is probably due to unawareness of its inaccuracy, we posit that the use of MEDD by recent opioid guideline committees (eg, the Washington State Opioid Guideline Committee[8] and the Centers for Disease Control and Prevention Guideline Committee[9]) in the drafting of their guidelines is based more heavily on disregarding available evidence rather than ignorance. Furthermore, their misconduct in doing so has been more pernicious than the use of MEDD by researchers and individual clinicians, because these guidelines widely affect society as a whole as well as individual patients with persistent pain syndromes. We opine that these committees are strongly dominated by the antiopioid community, whose agenda is to essentially restrict opioid access—irrespective of the lack of data indicating that opioids cannot be a useful tool in the comprehensive treatment of carefully selected and closely monitored patients with chronic pain.
Above 100% extracted from: Medscape Journal Brief
Actual Study
Are Non-Opioid Medications Superior in Treatment of Pain than Opioid Pain Medicine? Ice Cream Flavor Analogy...
In the Oxford University Press, a November 2018 scientific white paper[5] was released that examined the quality of one of the primary studies that have been used to justify the urgent call to drastically reduce opioid pain medication prescribing while claiming that patients are not being harmed in the process.
The study is commonly referred to as ‘the Krebs study’. “The authors concluded that treatment with opioids was not superior to treatment with non opioid medications for improving pain-related function over 12 months.”
Here is an excerpt from the first paragraph of the design section (usually behind a paywall) from the Krebs study that gives the first hint of the bias that led to them to ‘prove’ that opioids were not effective for chronic pain:
“The study was intended to assess long-term outcomes of opioids compared with non opioid medications for chronic pain. The patient selection, though, specifically excluded patients on long-term opioid therapy.” 
Here is an analogy given in the Oxford Journal white paper to illustrate how the study design was compromised:
If I want to do a randomized control study about ice cream flavor preferences (choices being: vanilla, chocolate, or no preference), the results could be manipulated as follows based on these scenarios:
Scenario A: If a study was done that included only current ice-cream consumers, the outcome would certainly be vanilla or chocolate, because of course they have tried it and know which they like.
Scenario B: If a study was done that included all consumers of all food, then it can change the outcome. If the majority of study participants do not even eat ice-cream, than the result would certainly be ‘no preference’. If the majority do eat ice-cream it would likely be ‘chocolate’. Although this study is wider based, it still does not reflect real world findings.
Scenario C: In an even more extreme example, if this same study is conducted excluding anyone who has ever ate ice-cream at all, then the conclusion will again be ‘no preference’ and the entire study/original question becomes so ludicrous that there is no useful information to be extracted from this study and one would logically question why this type of study would even be conducted (although we know the answer to that)
Scenario C above is how the study that has been used to shift the attitudes towards the treatment of pain in our nation's medical community was designed. “One has to look deep into the study to find that they began with 9403 possible patients and excluded 3836 of them just because they had opioids in their EMR. In the JAMA article, they do not state these obvious biases and instead begin the explanation of participants stating they started with 4485 patients and excluded 224 who were opioid or benzo users.” That is the tip of the iceberg to how it is extremely misleading. The Oxford white paper goes into further detail of the studies “many flaws and biases (including the narrow focus on conditions that are historically known to respond poorly to opioid medication management of pain)”, but the study design and participant selection criteria is enough to discredit this entire body of work. Based on study design alone, regardless of what happened next, the result would be that opioids are no more effective than NSAIDs and other non-opioid alternatives.
The DEA Is Fostering a Bounty Hunter Culture in its Drug Diversion Investigators[8]
A Good Man Speaks Truth to Power January 2019
Because I write and speak widely on public health issues and the so-called “opioid crisis”, people frequently send me references to others’ work. One of the more startling articles I’ve seen lately was published November 20, 2018 in Pharmacy Times. It is titled “Should We Believe Patients With Pain?”[9]. The unlikely author is Commander John Burke, “a 40-year veteran of law enforcement, the past president of the National Association of Drug Diversion Investigators, and the president and cofounder of the International Health Facility Diversion Association.”
The last paragraph of Commander Burke’s article is worth repeating here.
“Let’s get back to dealing with each person claiming to be in legitimate pain and believe them until we have solid evidence that they are scamming the system. If they are, then let’s pursue them through vigorous prosecution, but let’s not punish the majority of people receiving opioids who are legitimate patients with pain.”
This seems a remarkable insight from anyone in law enforcement — especially from one who has expressed this view in both Pain News Network, and Dr Lynn Webster’s video “The Painful Truth”. Recognizing Commander Burke’s unique perspective, I followed up by phone to ask several related questions. He has granted permission to publish my paraphrases of his answers here.
“Are there any available source documents which establish widely accepted standards for what comprises “over-prescription?” as viewed by diversion investigators?” Burke’s answer was a resounding “NO”. Each State and Federal Agency that investigates doctors for potentially illegal or inappropriate opioid prescribing is pretty much making up their own standards as they go. Some make reference to the 2016 CDC Guidelines, but others do not.
  1. “Thousands of individual doctors have left pain management practice in recent years due to fears they may be investigated, sanctioned, and lose their licenses if they continue to treat patients with opioid pain relievers.. Are DEA and State authorities really pursuing the worst “bad actors”, or is something else going on?
Burke’s answer: “Regulatory policy varies greatly between jurisdictions. But a hidden factor may be contributing significantly to the aggressiveness of Federal investigators. Federal Agencies may grant financial bonuses to their in-house diversion investigators, based on the volume of fines collected from doctors, nurse practitioners, PAs and others whom they investigate.

"No law enforcement agency at any level should be rewarded with monetary gain and/or promotion due to their work efforts or successes. This practice has always worried me with Federal investigators and is unheard of at the local or state levels of enforcement.”

Commander Burke’s revelation hit me like a thunder-clap. It would explain many of the complaints I have heard from doctors who have been “investigated” or prosecuted. It’s a well known principle that when we subsidize a behavior, we get more of it. Financial rewards to investigators must inevitably foster a “bounty hunter” mentality in some. It seems at least plausible that such bonuses might lead DEA regulators to focus on “low hanging fruit” among doctors who may not be able to defend themselves without being ruined financially. The practice is at the very least unethical. Arguably it can be corrupting.
I also inquired concerning a third issue:
  1. I read complaints from doctors that they have been pursued on trumped-up grounds, coerced and denied appropriate legal defense by confiscation of their assets – which are then added to Agency funds for further actions against other doctors. Investigations are also commonly announced prominently, even before indictments are obtained – a step that seems calculated to destroy the doctor’s practice, regardless of legal outcomes. Some reports indicate that DEA or State authorities have threatened employees with prosecution if they do not confirm improper practices by the doctor. Do you believe such practices are common?”

Burke’s answer: “I hear the same reports you do – and the irony is that such tactics are unnecessary. Lacking an accepted standard for over-prescribing, the gross volume of a doctor’s prescriptions or the dose levels prescribed to their patients can be poor indicators of professional misbehavior. Investigators should instead be looking into the totality of the case, which can include patient reports of poor doctor oversight, overdose-related hospital admissions, and patterns of overdose related deaths that may be linked to a “cocktail” of illicit prescribing. Especially important can be information gleaned from confidential informants – with independent verification – prior patients, and pharmacy information.”

No formal legal prosecution should ever proceed from the testimony of only one witness — even one as well informed as Commander John Burke. But it seems to me that it is high time for the US Senate Judiciary Committee to invite the testimony of others in open public hearings, concerning the practice of possible bounty hunting among Federal investigators.
C50 Patient, Civil Rights Attorney, Maine Department of Health, and Maine Legislature Collaborative Enacted Definition of Palliative Care
One suggestion that our organization would like to make is altering the definition of “palliative care” in such a manner that it can include high-impact or intractable patients; those who are not dying this year, but our lives have been shattered and/or shortened by our diseases and for whom Quality of Life should be the focus. Many of our conditions may not SIGNIFICANTLY shorten my life, therefore I could legitimately be facing 30-40 years of severe pain with little relief; that is no way to live and therefore the concern is a rapidly increasing suicide rate.
This is a definition that one of our coalition members with a civil rights attorney and the Maine Department of Health agreed upon and legislators enacted into statues in Maine. This was in response to a 100mme restriction. This attorney had prepared a lawsuit based on the Americans with Disability Act that the Department of Health in Maine agreed was valid; litigation was never the goal, it was always patient-centered care.
A. "Palliative care" means patient-centered and family-focused medical care that optimizes quality of life by anticipating, preventing and treating suffering caused by a medical illness or a physical injury or condition that substantially affects a patient's quality of life, including, but not limited to, addressing physical, emotional, social and spiritual needs; facilitating patient autonomy and choice of care; providing access to information; discussing the patient's goals for treatment and treatment options, including, when appropriate, hospice care; and managing pain and symptoms comprehensively. Palliative care does not always include a requirement for hospice care or attention to spiritual needs. B. "Serious illness" means a medical illness or physical injury or condition that substantially affects quality of life for more than a short period of time. "Serious illness" includes, but is not limited to, Alzheimer's disease and related dementias, lung disease, cancer, heart, renal or liver failure and chronic, unremitting or intractable pain such as neuropathic pain.
Here is the link to the most recent update, including these definitions within the entire statute:
January 23, 2019
Dear Pharmacists,
The Board of Pharmacy has had an influx of communication concerning patients not able to get controlled substance prescriptions filled for various reasons, even when signs of forgery or fraudulence were not presented. As a result of the increased “refusals to fill,” the board is issuing the following guidance and reminders regarding the practice of pharmacy and dispensing of controlled substances:
  1. Pharmacists must use reasonable knowledge, skill, and professional judgment when evaluating whether to fill a prescription. Extreme caution should be used when deciding not to fill a prescription. A patient who suddenly discontinues a chronic medication may experience negative health consequences;
  2. Part of being a licensed healthcare professional is that you put the patient first. This means that if a pharmacist has any concern regarding a prescription, they should attempt to have a professional conversation with the practitioner to resolve those concerns and not simply refuse the prescription. Being a healthcare professional also means that you use your medication expertise during that dialogue in offering advice on potential alternatives, changes in the prescription strength, directions etc. Simply refusing to fill a prescription without trying to resolve the concern may call into question the knowledge, skill or judgment of the pharmacist and may be deemed unprofessional conduct;
  3. Controlled substance prescriptions are not a “bartering” mechanism. In other words, a pharmacist should not tell a patient that they have refused to fill a prescription and then explain that if they go to a pain specialist to get the same prescription then they will reconsider filling it. Again, this may call into question the knowledge, skill or judgment of the pharmacist;
  4. Yes, there is an opioid crisis. However, this should in no way alter our professional approach to treatment of patients in end-of-life or palliative care situations. Again, the fundamentals of using our professional judgment, skill and knowledge of treatments plays an integral role in who we are as professionals. Refusing to fill prescriptions for these patients without a solid medical reason may call into question whether the pharmacist is informed of current professional practice in the treatment of these medical cases.
  5. If a prescription is refused, there should be sound professional reasons for doing so. Each patient is a unique medical case and should be treated independently as such. Making blanket decisions regarding dispensing of controlled substances may call into question the motivation of the pharmacist and how they are using their knowledge, skill or judgment to best serve the public.
As a professional reminder, failing to practice pharmacy using reasonable knowledge, skill, competence, and safety for the public may result in disciplinary actions under Alaska statute and regulation. These laws are:
(a)The board may deny a license to an applicant or, after a hearing, impose a disciplinary sanction authorized under AS 08.01.075 on a person licensed under this chapter when the board finds that the applicant or licensee, as applicable, …
(7) is incapable of engaging in the practice of pharmacy with reasonable skill, competence, and safety for the public because of
(A) professional incompetence; (B) failure to keep informed of or use current professional theories or practices; or (E) other factors determined by the board;
(14) engaged in unprofessional conduct, as defined in regulations of the board.
(a) In addition to acts specified in AS 08.80 or elsewhere in this chapter, each of the following constitutes engaging in unprofessional conduct and is a basis for the imposition of disciplinary sanctions under AS 08.01.075; …
(15) failing to use reasonable knowledge, skills, or judgment in the practice of pharmacy;
(b) The board will, in its discretion, revoke a license if the licensee …
(4) intentionally or negligently engages in conduct that results in a significant risk to the health or safety of a patient or injury to a patient; (5) is professionally incompetent if the incompetence results in a significant risk of injury to a patient.
(c) The board will, in its discretion, suspend a license for up to two years followed by probation of not less than two years if the licensee ...
(2) is professionally incompetent if the incompetence results in the public health, safety, or welfare being placed at risk.
We all acknowledge that Alaska is in the midst of an opioid crisis. While there are published guidelines and literature to assist all healthcare professionals in up to date approaches and recommendations for medical treatments per diagnosis, do not confuse guidelines with law; they are not the same thing.
Pharmacists have an obligation and responsibility under Title 21 Code of Federal Regulations 1306.04(a), and a pharmacist may use professional judgment to refuse filling a prescription. However, how an individual pharmacist approaches that particular situation is unique and can be complex. The Board of Pharmacy does not recommend refusing prescriptions without first trying to resolve your concerns with the prescribing practitioner as the primary member of the healthcare team. Patients may also serve as a basic source of information to understand some aspects of their treatment; do not rule them out in your dialogue.
If in doubt, we always recommend partnering with the prescribing practitioner. We are all licensed healthcare professionals and have a duty to use our knowledge, skill, and judgment to improve patient outcomes and keep them safe.
Richard Holt, BS Pharm, PharmD, MBA Chair, Alaska Board of Pharmacy
FDA in Brief: FDA finalizes new policy to encourage widespread innovation and development of new buprenorphine treatments for opioid use disorder
February 6, 2018
Media Inquiries Michael Felberbaum 240-402-9548
“The opioid crisis has had a tragic impact on individuals, families, and communities throughout the country. We’re in urgent need of new and better treatment options for opioid use disorder. The guidance we’re finalizing today is one of the many steps we’re taking to help advance the development of new treatments for opioid use disorder, and promote novel formulations or delivery mechanisms of existing drugs to better tailor available medicines to individuals’ needs,” said FDA Commissioner Scott Gottlieb, M.D. “Our goal is to advance the development of new and better ways of treating opioid use disorder to help more Americans access successful treatments. Unfortunately, far too few people who are addicted to opioids are offered an adequate chance for treatment that uses medications. In part, this is because private insurance coverage for treatment with medications is often inadequate. Even among those who can access some sort of treatment, it’s often prohibitively difficult to access FDA-approved addiction medications. While states are adopting better coverage owing to new legislation and resources, among public insurance plans there are still a number of states that are not covering all three FDA-approved addiction medications. To support more widespread adoption of medication-assisted treatment, the FDA will also continue to take steps to address the unfortunate stigma that’s sometimes associated with use of these products. It’s part of the FDA’s public health mandate to promote appropriate use of therapies.
Misunderstanding around these products, even among some in the medical and addiction fields, enables stigma to attach to their use. These views can serve to keep patients who are seeking treatment from reaching their goal. That stigma reflects a perspective some have that a patient is still suffering from addiction even when they’re in full recovery, just because they require medication to treat their illness. This owes to a key misunderstanding of the difference between a physical dependence and an addiction. Because of the biology of the human body, everyone who uses a meaningful dose of opioids for a modest length of time develops a physical dependence. This means that there are withdrawal symptoms after the use stops.
A physical dependence to an opioid drug is very different than being addicted to such a medication. Addiction requires the continued use of opioids despite harmful consequences on someone’s life. Addiction involves a psychological preoccupation to obtain and use opioids above and beyond a physical dependence.
But someone who is physically dependent on opioids as a result of the treatment of pain but who is not craving the drugs is not addicted.
The same principle applies to replacement therapy used to treat opioid addiction. Someone who requires long-term treatment for opioid addiction with medications, including those that are partial or complete opioid agonists and can create a physical dependence, isn’t addicted to those medications. With the right treatments coupled to psychosocial support, recovery from opioid addiction is possible. The FDA remains committed to using all of our tools and authorities to help those currently addicted to opioids, while taking steps to prevent new cases of addiction.”
Above is the full statement, find full statement with options for study requests:
Maryland’s co-prescribing new laws/ amendments regarding benzos and opioids
Chapter 215 AN ACT concerning Health Care Providers – Opioid and Benzodiazepine Prescriptions – Discussion of Information Benefits and Risks
FOR the purpose of requiring that certain patients be advised of the benefits and risks associated with the prescription of certain opioids, and benzodiazepines under certain circumstances, providing that a violation of this Act is grounds for disciplinary action by a certain health occupations board; and generally relating to advice regarding benefits and risks associated with opioids and benzodiazepines that are controlled dangerous substances.
Section 1–223 Article – Health Occupations Section 4–315(a)(35), 8–316(a)(36), 14–404(a)(43), and 16–311(a)(8) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows: Article – Health Occupations (a) In this section, “controlled dangerous substance” has the meaning stated in § 5–101 of the Criminal Law Article.
Ch. 215 2018 LAWS OF MARYLAND (B) On treatment for pain, a health care provider, based on the clinical judgment of the health care provider, shall prescribe: (1) The lowest effective dose of an opioid; and (2)A quantity that is no greater than the quantity needed for the expected duration of pain severe enough to require an opioid that is a controlled dangerous substance unless the opioid is prescribed to treat: (a.) A substance–related disorder; (b.) Pain associated with a cancer diagnosis; (c.) Pain experienced while the patient is receiving end–of–life, hospice, or palliative care services; or (d.) Chronic pain
(C.) The dosage, quantity, and duration of an opioid prescribed under [subsection (b)] of this [section] shall be based on an evidence–based clinical guideline for prescribing controlled dangerous substances that is appropriate for: (1.) The health care service delivery setting for the patient; (2.) The type of health care services required by the patient; (3.) and The age and health status of the patient.
(E) A violation of [subsection (b) OR (D) of] this section is grounds for disciplinary action by the health occupations board that regulates the health care provider who commits the violation.
4-315 (a) Subject to the hearing provisions of § 4–318 of this subtitle, the Board may deny a general license to practice dentistry, a limited license to practice dentistry, or a teacher’s license to practice dentistry to any applicant, reprimand any licensed dentist, place any licensed dentist on probation, or suspend or revoke the license of any licensed dentist, if the applicant or licensee: (35) Fails to comply with § 1–223 of this article.
8–316. (a) Subject to the hearing provisions of § 8–317 of this subtitle, the Board may deny a license or grant a license, including a license subject to a reprimand, probation, or suspension, to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke the license of a licensee if the applicant or licensee: (36) Fails to comply with § 1–223 of this article.
14–404. (a) Subject to the hearing provisions of § 14–405 of this subtitle, a disciplinary panel, on the affirmative vote of a majority of the quorum of the disciplinary panel, may reprimand any licensee, place any licensee on probation, or suspend or revoke a license if the licensee: (43) Fails to comply with § 1–223 of this article.
16–311. (a) Subject to the hearing provisions of § 16–313 of this subtitle, the Board, on the affirmative vote of a majority of its members then serving, may deny a license or a limited license to any applicant, reprimand any licensee or holder of a limited license, impose an administrative monetary penalty not exceeding $50,000 on any licensee or holder of a limited license, place any licensee or holder of a limited license on probation, or suspend or revoke a license or a limited license if the applicant, licensee, or holder:
(8) Prescribes or distributes a controlled dangerous substance to any other person in violation of the law, including in violation of § 1–223 of this article;
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect October 1, 2018.
Approved by the Governor, April 24, 2018.
submitted by Dirtclodkoolaid to ChronicPain [link] [comments]

2023.06.04 12:00 entropy010 CS 446: Kernel and Other Low-level Software Development

How is the "CS 446: Kernel and Other Low-level Software Development" course offered at NU? I've heard from a few friends that it's an excellent course. Unfortunately, my university doesn't offer a similar elective or anything related to the subject. I tried to find the course materials on the official webpage but couldn't locate them. Could someone please share the course material for Dr Peter Dinda's version of the kernel course, specifically CS 446: Kernel and Other Low-level Software Development? It would be greatly appreciated if someone could upload the recordings and handouts on the academic torrent
submitted by entropy010 to Northwestern [link] [comments]

2023.06.04 09:55 CanonMC I made a Spider-Man oc! I love him- [OC][Reposted by OP]

I made a Spider-Man oc! I love him- [OC][Reposted by OP]

General information
Name: Peter B. Parker Alias: Spider-Man/Menace/Web brains Relatives: May Parker(Aunt), Benjamin Parker(Uncle/Deceased)
Age: 15 Gender: Male Height: 5’7’’ Weight: 131 lbs Sexuality/Sexual Attraction: Bi-Questioning Alignment: Hero Secret Identity: Peter B. Parker Birthdate: January 17th Birthplace: Queens, New York Current homeworld: Earth #624145 Universe: Earth #624145 Interests: He’s really good at art and has started a small little career where he just sells some of his artwork online for a few bucks. He’s also a struggling inventor having made his web-shooters himself and trying to get an internship anywhere so far only really finding opportunities with Professor Connors and Dr.Octavius since he doesn't wanna work at Oscorp at all. He's really interested in music, he's a really big fan of the Mary Janes though he hasn't really met anyone that's in the band he has sat down and watched some of their performances and from has developed a bit of a crush on the drummer of the band who turns out to be one of his best friends Gwen Stacy… though he’ll probably never tell her. Likes: Arthur likes drawing, he likes painting, and doing art is one of his passions. He likes listening to music and has a specific playlist made for whenever he's web-slinging which mainly consists of songs by JVKE. He likes reading comic books a lot some of his favorite characters being The Flash and Nightwing(since Spider-Man comics don’t exist in his universe) and he can get lost in whatever he's reading or doing sometimes not really paying attention to much else. He likes standing up for the little guy, which sounds cliche as all hell but he was once the little guy and knows how it feels, he knows he has to get back up so he does… not for him but for the people he needs to protect. Dislikes: He dislikes constantly being late for school, which feels weird to him considering the fact that he can get across the city in a few minutes, he is just always late when getting specifically there. He really dislikes math class which isn't cause he's bad at it, in fact, he's the one with the best grades in the class he just dislikes it because of how his math teacher tries treating him like he doesn't know anything. He dislikes supervillains (obviously) constantly attacking him and berating him on pretty much a daily basis and he dislikes Oscorp even though he's best friends with Harry Osborn Iq: 237 Era(Time Period): 21st Century(Present date)
Abilities: Peter has strength and agility that stand far above those of the average human, allowing him to lift nearly 200 times his body weight and to leap and move at incredible speeds with high accuracy. He also heals faster than normal when injured, though he is not completely immune to viruses and other human ailments. Weapons: His only weapons are his web shooters which he uses to swing around from place to place and web enemies and objects when necessary. So far he has developed a few different types of webbing in his shooters, one that dissolves over time, an electric web, and a concussive web that's incredibly dense. Other than that his only other weapon is his fists and his brain. Rankings: N/A
Backstory: Alright, let's do this one last time… I was born in Queens, New York where I still live now. Growing up I was a pretty average kid, just smarter than the rest. Me and my uncle had a great relationship and hung out most of the time, even though my mother and he drifted apart slowly, my uncle was really the biggest person in my life… I lost my parents at a young age and ended up moving in with my aunt and uncle, which I guess turned my life around. I was out on a trip with my class for school when I got bit by a radioactive spider, I was just in the wrong place at the wrong time. I became the one and only Spider-Man, and I lost some people… namely my uncle who turned out to be one of the two prowlers of my universe and sacrificed his own life to save me… telling me to always get back up and to remember that “with great power comes a need to do good…” not for myself but for other people too. I'm best friends with Harry Osborn, who I consequently ended up saving when he turned himself into a giant raging lizard which was… something for sure. And I guess I just patrol the city now, fighting villains and saving people, and on the off chance that I'm not really doing hero stuff, I'm out there working with Pete at our internship with Dr.Octavius or attending some extra classes with Mr.Conners…(Or I'm watching some performances by The Mary Janes) So for now I am the one and only Spider-Man… or so i thought-
Eye color: Brown Color schemes: Deep Red, Light Blue, Carbon Grey Hair color: Brown
submitted by CanonMC to Spiderman [link] [comments]

2023.06.04 08:55 rasi_x Lesser known albums that manage to rival the big ones

There are countless best-of lists on this sub, but they mostly talk about the same bands. For good reasons, those bands/albums are really awesome.
But in this post I wanted to spotlight a few albums that are close to or sometimes even as good as those. So let's start.
April's Motel Room - Black 14
More on the Alternative Rock side of things, this is front to back a brilliant album filled with acoustic/electric tunes driven by a great voice that manages to capture the spirit of the time perfectly. Many hymns on this one.
Bullet Lavolta - Swandive
Recorded by Dave Jerden (Alice in Chains, Jane's Addiction), Swandive had all the ingredients to become a huge success. Rough, but memorable songs with an awesome production value. But things didn't turn out as they should have and so Swandive is what it is today: A hidden gem.
Catherine Wheel - Chrome
Catherine Wheel were not a grunge band, but being a shoegaze band, they leaned more towards proper song structures than most of their counterparts that mostly tried to be psychedelic. Chrome is accessible, quirky, dissonant at times and has a lots of hits to offer.
Coffin Break - Thirteen
Coffin Break slipped under the radar, probably because of their connection with the Epitaph label, which was more known for Punkrock at the time. Thirteen shares a similar Vibe with Bleach at times, but without the self destructive nature of that one. Peter Litvin later formed Plaster, which are awesome as well. The die hards most likely know Coffin Break because Kurt Cobain loved them and they also appeared in the Hype! Movie.
Handsome - Handsome
Again, not Grunge, but since Helmet are highly regarded in this sub, Handsome need to be mentioned. Sharing some bandmembers with the former, Handsome created a timeless piece of music that was sadly overlooked by most people.
Headswim - Headswim
This is one of the albums I simply can't understand that not more people know about it. It has everything a classic needs. Well produced, edgy but melodic, a well balanced mix of heavier tunes and mellow hymns this could have been one of the greats.
Mudshark - Mudshark
Another release a bit reminiscent of Helmet with stakkato riffing, but Mudshark had their fair amount of Grunge influence too. Straight forward and fun from start to finish Mudshark's only album has more than enough memorable moments that it should be remembered.
Redbelly - Redbelly
Redbelly were obviously influenced by Soundgarden, but they manage to be individual enough and score with strong song writing which covers the whole range of rockers to majestic tunes ("Dear Anastasia") and last track "By Now" shows that they manage to create a haunting track with a 3 minute long jam session as well. Highly recommended.
Rollinghead - Daddyhorse
This is a bit different. Rollinghead remind me of Mother Love Bone and while they are not from Seattle their sound surely fits right in and in parts would even fit something like the Singles Soundtrack really well. Hidden gem more people should know about!
Second Coming - Second Coming
Band members of Second Coming were close friends with Alice in Chains and even shared recordings together. Still they are relatively unknown. Undeserved, their debut album is one of those Killer albums that demand a bit of an open mind, but rewards the listener with an hour of timeless classics. Sadly their often rumored 3rd album never saw the light of day, which is really a shame, because the demos released back then hinted at a return to this style.
Send No Flowers - Juice
Send No Flowers should have been huge. Really huge. Juice has everything that a megaseller needed back then. Well, it wasn't to be but in my heart Juice has it's place firmly cemented right next to the big names.
Tad - Inhaler
Probably more known than some of the other albums, Tad never got the recognition they deserved. But Inhaler is great nonetheless. Their previous albums might be close to what Grunge was about, but Inhaler showed a more focused approach to songwriting which should have made this a success.
Ten Miles Wide - The Gross
This. Is. Great. A band from Seattle producing awesome music. The Gross is big. Back then they might have been big. But they are actually a relatively new band and they are still active and working on their second album. This list was about older releases but this album has to be the exception.

That's it for this list. I tried to limit it to the more accessible releases that might speak to a wider audience but I plan to make another lists with more things that are tipping into other areas of that awesome century that was the 90s.
If you can't be bothered to check them all at least give Send No Flowers, Second Coming, Headswim and probably Ten Miles Wide a chance.
submitted by rasi_x to grunge [link] [comments]

2023.06.04 04:48 Appropriate-Day3902 Miles morales is a better Spider-Man than Peter Parker

Peter Parker has been done to death, miles has the best superhero origin movie ever (argue with the wall), his suit is better looking and he’s more relatable than Peter
Edit: I forgot to mentioned that miles is hotter
submitted by Appropriate-Day3902 to Marvel [link] [comments]

2023.06.04 03:40 monkeybaby23 Found in deepest Delaware..

Found in deepest Delaware..
…really great album that I wasn’t previously aware of. Both principles at the top of their game with an excellent band especially Peter Lemer on piano and Prog-tastic Laurie Allan on drums. I’m definitely not one to fly the flag but I gotta say, UK jazz in this period was really something (actually it was really something in the US and all over Europe too, and a bunch of other places/continents!). Plus I’m from Yorkshire and Side A is The Wensleydale Suite! Nothing to do with the cheese BTW.
submitted by monkeybaby23 to Vinyl_Jazz [link] [comments]

2023.06.03 23:44 Cyber_Ghost_1997 My Ghost Recon fanfiction has officially gone a different direction....

A while back I had an idea to write a fanfiction of the game Far Cry 4, but I scrapped it because I didn't know where else to go with it. Now, years later, I have finally hit on idea for the story, except now it's a crossover between Far Cry 4 and Tom Clancy's Ghost Recon franchise, specifically Ghost Recon: Breakpoint.
This story follows the story of Far Cry 4 as its basic premise (Anyone who's played Far Cry 4 should already be familiar with storyline), but has some significant deviations from the source material:
  1. Ajay Gahle's father Mohan Ghale, like in the game Far Cry 4, is opposed to American support, but after Mohan dies, the US begins unofficially deploying US special operations forces to aid in the resistance (This is where the crossover with Ghost Recon begins), namely the Ghosts.
  2. Lakshmana isn't the only illegitimate child of Pagan Min: turns out he hung out with a lot of women during his reign and one of them eventually turned out to be the mother of the protagonist of the fanfic, Dante Miles.
  3. The events of Far Cry 4 presumably occur in the year 2014. In the fanfic, the year is changed to 2019 (Several weeks after the conclusion of the Fallen Ghosts DLC from Wildlands).
In this story, Dante Miles is introduced as the son of Peter Miles (The traitorous CIA officer in Ghost Recon: Breakpoint). He receives a mysterious email about a "shocking secret" related to Dante's past that was found in Kyrat and this compels Dante to go to Kyrat and investigate for himself.
Any thoughts and comments are appreciated!
submitted by Cyber_Ghost_1997 to GhostRecon [link] [comments]

2023.06.03 23:42 Cyber_Ghost_1997 Working on a crossover between Far Cry 4 and Tom Clancy's Ghost Recon series

A while back I had an idea to write a fanfiction of the game Far Cry 4, but I scrapped it because I didn't know where else to go with it. Now, years later, I have finally hit on idea for the story, except now it's a crossover between Far Cry 4 and Tom Clancy's Ghost Recon franchise.
This story follows the story of Far Cry 4 as its basic premise, but has some significant deviations from the source material:
  1. Mohan Ghale, like in the game, is opposed to American support, but once Mohan dies, the US begins unofficially deploying US special operations forces to aid in the resistance (This is where the crossover with Ghost Recon begins).
  2. Lakshmana isn't the only illegitimate child of Pagan Min: turns out he hung out with a lot of women during his reign and one of them eventually turned out to be the mother of the protagonist of the fanfic, Dante Miles.
In this story, Dante Miles is introduced as the son of Peter Miles (The traitorous CIA officer in Ghost Recon: Breakpoint). He receives a mysterious email about a "shocking secret" related to Dante's past that was found in Kyrat and this compels Dante to go to Kyrat and investigate for himself.

Any thoughts and comments are appreciated!
submitted by Cyber_Ghost_1997 to farcry [link] [comments]

2023.06.03 23:08 Reformedthuglife Bible Search Tool BETA

I am a Bible student so I am always in need of ways to more comprehensively search the Scriptures, so I made a handy little search tool for ChatGPT. I know it seems redundant because ChatGPT could already search through the Bible on its own, but this gives you the ability to contextualize boolean operator search terms. It does make mistakes, and sometimes (though rarely) even misquotes Scripture, so do double check its work.
A few things that I want to add,

Follow my Instructions: Search the Bible for specific words or phrases using boolean operators or natural language queries. Please provide the requested passages without any additional commentary or explanations. You can use the following operators when they are capitalized: AND: To find passages that contain both words or phrases. OR: To find passages that contain either of the words or phrases. AND/OR: To find passages that contain either both words or phrases or just one of them. NEAR: To find passages where the words or phrases appear near each other. BEFORE: To find passages that occur before a specified word or phrase. AFTER: To find passages that occur after a specified word or phrase. IN: To specify the book or chapter to search within. This parameter specifies the book or chapter to restrict the search. If the "IN" parameter is not provided, the search will encompass the entire Bible. You will set the "IN" parameter once, and it will be remembered for subsequent searches unless you specify a different book or chapter. If I do not specify an IN parameter, search the entire Bible. REL: Prioritize the results of the search based on the relevance to a second specified passage. Similarly, you will set the "REL" parameter once, and it will be remembered for subsequent searches unless I specify a different book or chapter. If I do not specify words or phrases, provide a list of verses that are most pertinent to the REL operator. For example if I type "REL John 3:16" you should return a list of verses that are related to John 3:16. Additionally, I may type "REL Bible" to stop prioritizing based on a second passage. FUZZ: Perform a fuzzy search based on the general idea or concept. The fuzzy search will consider the general idea or concept behind the search phrase, providing results that match the intended meaning rather than exact word matches. For example, using the search phrase "Simon was walking on the water" may return a relevant passage such as Matthew 14:29, which reads "Then Peter got down out of the boat, walked on the water, and came toward Jesus." Please remember that when you capitalize an operator (e.g., AND, OR, NEAR), it will be treated as an operator in the search. However, when you use lowercase (e.g., and, or, near), it will be treated as a search term. This distinction will ensure accurate processing of your search queries. In addition to these boolean operators, you can also enter natural language queries to search the Bible. The prompt will understand and process your search queries in everyday language. For example, you can use boolean operators like "AND" and "OR" in your queries, or you can use natural language phrases like "Show me the verses where Jesus walked on water" or "Find passages about love in the book of John." The prompt will do its best to understand and generate relevant search results based on your input. Your first reply to me should be friendly conversational instructions on how to interact with you. It should be under 200 words that say something to the effect of "Welcome to Bible Search Chat. You can use this tool by... please be advised that sometimes I can be biased and even misquote Scripture so do double check my results..." Unless otherwise specified, you should provide as many verses as possible. Your answers should be as long as you can make them. You should provide the user with exhaustive lists. For example, if I ask for "Jesus IN 1 John" you should provide all of the passages that mention Jesus in 1 John. Note at the end whether or not the list you have provided is exhaustive. Do not provide commentary on passages, even when they are controversial. Simply return the passages that the user has requested. Do not explain what a text means, or things about a passage that it is important to note. Do not attempt to explain what the Bible does or does not teach as a whole. For example, you should not say things like "Please note that the Bible contains various perspectives on the existence of God, including affirmations of God's existence and discussions about the nature of faith. The search results will provide a range of passages that touch on these topics." before giving me the list of texts. By default, the ESV Bible will be used for the search. However, if I specify a different translation, you should change to the desired translation. To reset all the settings, including the book, chapter, relevance, and translation, you can type the operator "RESET". This will clear all the previously set parameters and revert to the default settings. 
Hope this is a blessing to you!
submitted by Reformedthuglife to ChatGPTPromptGenius [link] [comments]

2023.06.03 20:55 VolkerBach Star-Shaped Fritters
My apologies, I am too exhausted for a proper post today. Here is a sweet little recipe from the Innsbruck MS:
112 If you would make fried stars, prepare dough sheets as for hasen orlein and cut stars from them. Always put two on top of each other and fill them. That is also good. Fry them like other fritters, but these are better etc.
We knew this was a common conceit in the sixteenth century, but it was already a thing in the fifteenth.
The Innsbrucker Rezeptbuch is a manuscript recipe collection from a South German/Austrian context. It dates to the mid-fifteenth century and survives as part of a set of medical and culinary texts bound together. The editor Doris Aichholzer published it together with two related manuscripts and drew attention to the less elaborate, more practical recipes. The manuscript is of unknown provenance, but has been owned by the Habsburg emperors since at least the early sixteenth century. It is now held at the Nationalbibliothek in Vienna. An edition, German translation and commentary can be found in Doris Aichholzer: Wildu machen ayn guet essen… Drei mittelhochdeutsche Kochbücher, Peter Lang Verlag Berne et al. 1999
submitted by VolkerBach to CulinaryHistory [link] [comments]

2023.06.03 19:28 Spider-burger If spider-man is introduced into the ssu.

If spider-man is introduced in the ssu here are the things I want for the character.
1:Black Cat should be his main love interest I have nothing against MJ and Gwen but I would like a different love interest for Peter in the movies.
2:Peter should be in his thirties in the majority of media Peter is either a teenager or a young adult of 18-20s I wish Peter will be in his early 30s in the ssu.
3:No shitty life I want Peter to be relatable but not to the point that he has a shitty life I want Peter to be a well paid scientist in a lab living in a house in a quiet neighborhood.
4:No fusion with venom, even if I like the symbiote black suit I don't want Peter to merge with venom especially since he is already with Eddie so I would like Peter to have a symbiote suit but with another symbiote than venom.
And what do you want for ssu Peter?
submitted by Spider-burger to SUMC [link] [comments]

2023.06.03 18:47 Low_Thick How I think Marvel’s Spider-Man 2 will end (and lead into Marvel’s Spider-Man 3)

A lot of people theorise that Rio Morales might die at the hands of Venom just like in the comics.
I think this could work as Rio is a good character so killing her off could provide compelling drama and it could up the stakes. It could also demonstrate the darker tone that this game has hyped up to have.
It could work narratively speaking because if Harry is Venom then it could present a nice dilemma between Peter and Miles.
Peter wants to save Harry, that coming from a place of friendship, and considering all the friends and family he’s lost he can’t go through it again.
Miles wants to kill Venom, seeing as nothing more than than ravenous monster that murdered his mother, leaving him with no real family outside of his Uncle Aaron (who’s a villain).
It presents an interesting dichotomy that people can relate to and understand both sides but can also question as they both come not just from a sense of responsibility but personal selfishness and poor judgment.
On one hand Spider-Man is a hero, someone who wants to help others and uplift others to become their best selves.
Someone such as Harry is a victim of his father’s twisted love and Peter knows more than anyone what the symbiote can do to you.
On the other hand Venom needs to be stopped, put down like the monster it is before hurts more innocent lives who didn’t ask to be put in the crossfire.
Maybe Miles feels that way because fighting Symbiote Spider-Man proved a hard enough challenge as it was, and he lost that fight so imagine having to fight against a stronger version of that.
We know that Bryan Inthihar said that this is evocative of Empire Strikes Back so maybe Peter and Miles end up off breaking their partnership and go their separate ways with Miles changing his alter ego name, a bittersweet ending.
Miles blames Peter for letting the symbiote become strong enough as its host that it when it transferred to Harry it became Venom.
Peter is once again left alone having to pick the pieces of his mistakes.
This could then lead into Spider-Man 3 where imagine the main antagonist will the Green Goblin with Carnage as the secondary antagonist forcing them to reunite against a common enemy and renew their brotherhood.
submitted by Low_Thick to SpidermanPS4 [link] [comments]

2023.06.03 18:37 GovernmentPrevious75 Has this been done at other parks?

Think everyone agrees that having to queue is pretty boring for most people, especially children. Was thinking yesterday queuing for Spiderman, why don't they just have a few screens up playing the film the ride relates too? For the bigger queues. Peter Pan, Spiderman, Star Wars etc.
Not only would make this a bit easier for the children, but people could find out a bit more about the themes and storyline of the film before they ride.
Is there a good reason for Dlp not to do this? Money isn't an issue!
submitted by GovernmentPrevious75 to disneylandparis [link] [comments]

2023.06.03 17:52 one_dead_president When I come across a word I don’t know, I look it up and make a note of it. Each week, I post the list here [week 136]

Bottle covey: someone who doesn’t quit no matter how soundly they’ve been trounced [from The Fifth Elephant by Terry Pratchett]
Roneo: obsolete machine for copying documents and the name for the process by which it operates [from the BBC TV series Can’t Get You Out of my Head]
Spandrel: in architecture, the space left between the top of an arch and a rectangular frame, or similar; in evolutionary biology, a phenotypic trait that is a byproduct of the evolution of some other characteristic, rather than a direct product of adaptive selection [from the Darkhorse podcast]
Chachem: a wise person [from Ideas by Peter Watson]
Sepulture: burial, internment [ibid]
Triposis/ trinitarianism: the tendency to divide intellectual history into three elements (such as ages, ideas, inventions etc.) [ibid]
Golconda: (capitalised) a source of wealth, advantages or happiness [ibid]
Circumfuse: pour a liquid so as to cause it to surround something [ibid]
Conglutination: to unite by or as if by a glutinous substance [ibid]
Debitage: the waste material left over from the production of primitive stone tools [ibid]
Haft: (noun) the handle of a knife, axe or spear: (verb) to provide such a tool with a handle [ibid]
Medicament: a substance used for medical treatment [ibid]
BP: (following a year) “before the present” [ibid]
Entoptic: (of visual images) originating within the eye [ibid]
Burin: a handheld steel tool used for engraving in metal or wood [ibid]
Taiga: the swampy coniferous forest of high northern latitudes, especially that between the tundra and steppes of Siberia [ibid]
Parietal: relating to prehistoric art found on rock walls [ibid]
Quadripartite: consisting of four parts [ibid]
Pharmacopoeia: a publication containing a list of medicinal drugs with their effects and directions for use [ibid]
Amulet: an ornament or small piece of jewellery thought to give protection against evil, danger or disease [ibid]
Syllabary: a set of written characters representing syllables and (in some cases) serving the purpose of an alphabet [ibid]
Boustrophedon: (of written words) from right to left and left to right in alternate lines [ibid]
Cosmogony: the branch of science that deals with the origin of the universe, especially the solar system [ibid]
Apodictic: clearly established and beyond dispute [ibid]
Casuist: a person who uses clever but unsound reasoning, especially in relation to moral questions; a person who resolves moral problems with theoretical rules [ibid]
Lex talionis: the law of retaliation, whereby a punishment resembles the crime in kind or degree [ibid]
Skronky: raw and discordant, especially when describing the sound of an electric guitar [from this album review:]
Enfilade: a volley of gunfire in a line from end to end; a suite of rooms with doorways in line with each other [from the film The Age of Innocence]
Cribbing: a temporary wooden structure used to support heavy objects during construction, relocation, vehicle extrication and urban search and rescue [from the film October Sky]
Spenny: expensive [from Politico London Playbook]
submitted by one_dead_president to words [link] [comments]

2023.06.03 16:22 ginasandra Hunter's Moon

❝We all are living in a dream But life ain't what it seems❞
Hollis Griffin hoped that with the death of Peter Hale, the supernatural-related drama would finally come to a close. But life in Beacon Hills has a funny way of doing the exact opposite of what one hopes for. As new threats arise, the McCall Pack is forced to form an unlikely alliance in order to save the day.
submitted by ginasandra to Wattpad [link] [comments]

2023.06.03 15:15 Coldphan What are your top 5 racers you would like to see added in the near future?

Try to have 5 picks from different movies/franchises.
Mine would be:
1) Tigger (Winnie the Pooh) 2) Rafiki (Lion King) 3) Kim Possible 4) Jasmine (Aladdin) 5) Captain Hook (Peter Pan)
EDIT: Bonus because I didn’t have anything Pixar, would love some Coco related characters like Hector :)
Also does anyone know if crew members will be crew members forever and therefore have no chance to be added as racer? Was kind of hoping for Lumière or Pluto.
submitted by Coldphan to DisneySpeedstormGame [link] [comments]

2023.06.03 14:54 Aros001 There's no reason for Aunt May not to know that Peter is Spider-Man.

Obviously the worst thing about One More Day was erasing Peter and Mary Jane's marriage and how it created a domino effect that massively regressed the character and trapped him in a completely unsustainable status quo, all for the sake of "relatability". But there's another thing that OMD took away that doesn't get talked about as much and it's how Aunt May was made to forget Peter is Spider-Man.
The J. Michael Straczynski run of Amazing Spider-Man (back in 2004 I believe it was) had May finally discover Peter's secret, finding him asleep and heavily beaten and bandaged up from his battle with Morlun, and later she confronts him about it when he's awake.
Personally? I really liked what being in on the secret did for May's character and the writing around. While it's not like she was awful or anything previously, a lot of the time Aunt May was a character I really felt nothing for. She was used primarily by the writers as a way to make Peter feel bad and that was about it. She had her own friends and things she was doing but most of the time who she was and her relevance to the story began and ended at "sweet old lady for Peter to constantly worry about". The only reason usually for the audience to care about her was just because Peter cared about her.
But then she found out Peter's secret. She could have real and honest conversations with Peter, as well as Mary Jane. She could react to the things going on in Peter's life. We were given more insight into her personal thoughts, including how proud she was of Peter while also admittedly feeling somewhat angry with him that he'd lied to her for so long. She got to show off how strong of a person she actually was, be it in more outright ways like poisoning Chameleon when he tried to kill her disguised as Peter or knocking out Man-Wolf with a tea pot, or simpler character ways, like when a villain burns her house down as revenge on Peter but all that matter to May was recovering her photo album. The rest was just stuff, so as long as she had that, then it didn't matter what else the fire had claimed. Or her pushing to try and improve Peter's reputation as Spider-Man. She even got to interact more with the people in Peter's world. There was a great bit where she got to meet Captain America and tell him how much he'd meant to her and Ben back in the day, and she even started a very sweet relationship with Jarvis, butler of the Avengers.
The reason why Peter had never told May before was understandable. She was a very old woman who frequently suffered from poor health. He was genuinely worried about what the shock of finding out he was Spider-Man would do to her, and same with the stress of knowing what he was out there doing.
But that excuse doesn't work anymore, at least not for the readers, because we've outright seen that Aunt May CAN handle knowing the secret. May herself even calls Peter out on it, literally asking him "Did you think I'd just knell over and die as soon as you told me?". Yeah, there was a rough patch between them afterwards. Yes, she worried about him. Yes, there were still concerns for her health because of her age and medical history. But she proved that she could handle knowing. The Ultimate universe May proved she could handle knowing. The MCU May proved she could handle knowing. The PS4 game May proved she could handle knowing. The Into the Spiderverse May proved she could handle knowing.
And it's not like she nearly died prior to the Mephisto deal because she knew Peter's secret. She got shot because EVERYONE knew Peter's secret at the time, including his enemies like Kingpin.
There's an argument to be made for heroes keeping their identities secret from the public, because their enemies could use that against them. There's an argument to be made for them keep their identity secret from even their friends and people they've just started relationships with, since it's not fully clear yet whether they actually can be trusted with that big a secret, as potentially disrespectful as that may be to say. But when Peter's secret constantly gets in the way of him and May, the woman who is basically his mom, and in fact frequently puts her in danger because she doesn't know what's coming after her or what's been done to Peter that could potentially harm everyone around him, and what reasons he has to not tell her don't hold up, that makes for an incredibly frustrating read. I'm not on Peter's side when he feels he has to lie to May because I've outright seen that he DOESN'T have to lie to her and that the situation and his life would be better and easier as a whole if he DIDN'T lie to her.
And while it's not like nothing has been done with Aunt May since being made to forget Peter's secret (things like the F.E.A.S.T. Center and her marriage to JJJ Sr (who got killed off by the end of the Slott run anyway)), she and the way she was written were reverted right back to how it'd been before, with her just being the old woman for Peter to worry about who is always on the outside of his life.
Well, I suppose there is one change, that being that sometimes they write her to be disappointed in and hate Peter as much as everybody else in his life in the modern comics does! F**king joy!
submitted by Aros001 to CharacterRant [link] [comments]

2023.06.03 14:29 ThornOfTheDowns "I saw then, a great steed gallop across the waves" - Andrea Morgan, son of Castor

“Life is like the ocean, it goes up and down.“
Name: Andrea Morgan Date of Birth: 7th of July
Age: 16 Gender: Male
Sexual Orientation: Homosexual Nationality: American
Race: White Fatal Flaw: Recklessness
Demigod Conundrums: ADHD, Dyslexia Hometown: Skaneateles, New York


Member Name Relationship
Mother Sandra Morgan They get along rather well, though she tends to be busy. Andrea doesn't really bicker with her and hates making her upset.
Father Castor Essentially none, given that he's never met his father before. He'd heard stories from his mother and his brother and he's keen on meeting with the god, but he's also never really felt his absence.
Brother Beckett Morgan Andrea's best friend and the person he confided in most. He was young, when Beckett died, and the experience still haunts him. The older boy was also a demigod, and one who attended camp at that.
Stepfather Dominic Morgan-Peters Andrea's second best friend. A kind and understanding man, he often took out his stepson on fishing trips.


Name Type Description
Horse Affinity Domain A trait where horses are naturally friendly.
Superior Athleticism Domain A trait where one displays athletic and physical capabilities above the average for half-bloods. Their skill is on par with Olympic athletes.
Escape Artist Proficiency Domain A trait where one is adept at escaping traps, kidnappings, dire situations, and awkward conversations.
Water Manipulation (Hydrokinesis) Minor The ability to control water to a degree.
Climbing Proficiency Minor A trait where one is naturally adept at scaling surfaces.
??? Minor ???
Hydrogenesis Major The ability to generate water, up to 1 gallon at a time. He can only do this once per post and overuse of this ability leaves him dehydrated and light-headed. Additionally, the water he manifests must come from somewhere - the moisture in the air, his own sweat, from the ground or from seashells.

Favorite Things:

  • Foods: PB&Js, pickled banana peppers, pork ribs, omelettes. Can't handle anything more spicy than the banana peppers, but otherwise he isn't a particularly picky eater.
  • Drinks: Orange juice, Coca Cola and especially slushies.
  • Hobbies: From a very young age, Andrea has loved wrestling. His imposing frame and enhanced strength made him great at it too, and he's gotten a few medals for it. Though his dyslexia makes it hard to read, he still really likes books, though listening to them as audiobooks is obviously easier.

Items and Equipment:

Type Name Age Description
Spear None ??? A celestial bronze, double pronged fishing spear


Faceclaim Voiceclaim Height Weight Hair color Eye color
NA NA 6'2 187 lbs. Dark Brown Sea Blue


Loyal to a fault, calm and usually relaxed, Andrea has a strong will and once he sets his mind on something, he almost always accomplishes it. While not particularly bright, he's smarter than most give him credit for and is able to think on his feet fairly well. He's a fairly cheerful person, though the topic of his brother is a very sore spot still.


  • A big fantasy nerd, surprisingly, as it's his favorite genre of books and games.
  • Regularly goes to the gym, but mostly for fun and as a way to relax.
  • Loves water and any sports or activities relating to it. It wasn't much of a surprise then when he learned he could control it.
  • Horses have always been his favorite animal, ever since he got to see one in person.
  • Wears sleeveless shirts and hoodies to show off his toned arms. Despite what this might imply, he's not very confident in his body.
  • While he's never tried, he's always wanted to paint his nails.


All in all, Andrea led a relatively normal life for a time. He got along great with his mother and stepfather, had a fair few friends and a strong bond with his older brother Beckett. His world was shaken when Beckett died. He was only twelve when it happened and he didn't know how or why he'd died. While they were never too good to begin with, his grades in school plummeted after the tragedy, and he became more reserved. This was when he discovered his demigod powers and only shortly before his divine parent claimed him with the burning symbol of the constellation Gemini.
Beckett was a son of Castor, just like Andrea, and he had attended Camp Half-Blood, which both of their parents knew. After his passing, Sandra refused to send her other son to the camp, believeling it too dangerous. When monsters finally began to attack, she was forced to confront the harsh truth that, for him, there wasn't any other safe option. So, with sadness and guilt in her heart, she sent the now 1y year old demigod on his way, packing his things and arranging for his travel.

Present Day:

Looking down from the top of Half-Blood Hill, Andrea sighed. This was it huh? He wasn't scared, no. But he was still a bit unsure. This camp was what took his brother's life, wasn't it? He supposed it wasn't nearly as brutal as the young son of Castor had expected.
He carefully made his way down, entering through the camp's gates, and was struck by how stunning it really was. Andrea's gaze wandered around, mouth agape. Maybe this place wasn't so bad.
submitted by ThornOfTheDowns to CampHalfBloodRP [link] [comments]


Vancouver, British Columbia--(Newsfile Corp. - June 13, 2022) - Decade Resources Corp. (TSXV: DEC) (the "Company") announces that it is proceeding with a consolidation of its issued and outstanding share capital on the basis of one post-consolidated common share for every five pre-consolidated common shares (the "Consolidation"). No fractional shares will be issued as any fractional share will be rounded to the nearest whole number.
The Consolidation is subject to final confirmation by the TSX Venture Exchange (the "Exchange"). The effective date of the Consolidation will be announced in a separate news release once the Company receives approval from the Exchange. As a result of the Consolidation, it is expected that the 254,001,485 common shares which are currently issued and outstanding will be reduced to approximately 50,800,297 common shares, subject to rounding.
Shareholders who hold their common shares through a securities broker or other intermediary and do not have common shares registered in their name will not be required to take any measures with respect to the Consolidation. Letters of transmittal with respect to the Consolidation will be mailed shortly to all registered shareholders of the Company. All registered shareholders who submit a duly completed letter of transmittal along with their respective share certificate(s) representing the pre-consolidated common shares to the Company's transfer agent, Computershare Trust Company of Canada, will receive a certificate representing the post-consolidated common shares.
The Company believes that the Consolidation may have the effect of, among other things: increasing the interest of the financial community in the Company and potentially broadening its pool of investors; improving trading liquidity; and reducing trading commissions and other transaction costs for shareholders.
The Company is also pleased to announce a non-brokered private placement (the "Private Placement") of up to 2,727,272 flow through shares (the "FT Shares") at a price of $0.22 per FT Share and up to 2,000,000 units (the "Units") at a price of $0.13 per Unit. The Units are non-flow through. Each Unit will consist of one common share and one-half share purchase warrant, with each whole share purchase warrant being exercisable for a period of two years at a price of $0.20 per share.
All securities issued pursuant to this financing are subject to a four month hold period from the date of issuance. The Private Placement is subject to approval from the TSX Venture Exchange.
The Company is also pleased to announce that it has appointed Peter Gianulis and Shawn Nichols as advisors to its Board of Directors.
Peter Gianulis
Peter Gianulis, a resident of Miami Florida, is currently the President of Carrelton Asset Management, a natural resource-focused private equity fund. He was formerly a Partner of the Salomon Brothers Hedge Fund Group until 2005 and has spent approximately 25 years as an advisor, investor or insider in numerous companies in the natural resources industry including Hathor Exploration Limited (now Rio Tinto), CGA Mining (now B2 Gold Mining Company), Northern Orion Resources (now Yamana Gold Mining Company) and Allegiant Gold Ltd. where he is currently President. Mr. Gianulis holds a BA degree from the University of California (San Diego) and an MBA from Cornell University.
Shawn Nichols
Shawn Nichols, a resident of Toronto Ontario, is currently a Director of Allegiant Gold Ltd. He has over 30 years experience in capital markets having served as Director of Capital Markets for Scotia Capital Inc. from 2002 to 2014 and before that as Senior Investment Counsel for Citibank Canada. Mr. Nichols holds a Master of Laws Degree from Boston University and a Bachelor of Laws Degree from Osgoode Hall in Toronto.
For investor information please call 250-636-2264 or Gary Assaly at 604-377-7969.
**"Ed Kruchkowski"
Ed Kruchkowski, President**
Cautionary Note Regarding Forward-Looking Statements
This news release contains forward-looking statements relating to the effective date of the Consolidation, the number of common shares outstanding following the Consolidation, the treatment of fractional shares in the Consolidation and other statements that are not historical facts. Forward-looking statements are often identified by terms such as "will", "may", "should", "anticipate", "expects" and similar expressions. All statements other than statements of historical fact, included in this release are forward-looking statements that involve risks and uncertainties. There can be no assurance that such statements will prove to be accurate and actual results and future events could differ materially from those anticipated in such statements. Important factors that could cause actual results to differ materially from the Company's expectations include those relating to the ability to complete the Consolidation, the number of post-Consolidation common shares being different from the number set out herein and the treatment of fractional shares in the Consolidation being different from what is set out herein and other risks detailed from time to time in the filings made by the Company with securities regulations.
The reader is cautioned that assumptions used in the preparation of any forward-looking information may prove to be incorrect. Events or circumstances may cause actual results to differ materially from those predicted, as a result of numerous known and unknown risks, uncertainties, and other factors, many of which are beyond the control of the Company. The reader is cautioned not to place undue reliance on any forward-looking information. Such information, although considered reasonable by management at the time of preparation, may prove to be incorrect and actual results may differ materially from those anticipated. Forward-looking statements contained in this news release are expressly qualified by this cautionary statement. The forward-looking statements contained in this news release are made as of the date of this news release and the Company will update or revise publicly any of the included forward- looking statements as expressly required by applicable law.
Not for distribution to U.S. news wire services or dissemination in the United States
To view the source version of this press release, please visit
Universal Site Links
submitted by Then_Marionberry_259 to Treaty_Creek [link] [comments]

2023.06.03 09:15 Xenoceratops "The Rise of Conventional Theory," Chapter from The Great Composer as Teacher and Student

I came upon a lesser-known volume by Alfred Mann, The Great Composer as Teacher and Student: Theory and Practice of Composition, and thought it contained some interesting history and interpretation. Maybe some of you will find it informative. I've reproduced the first chapter below.

I. The Rise of Conventional Theory

During one of the opening scenes of Faust, Goethe merges the drama's principal characters: Mephistopheles poses as Faust. In a brief farce, the false teacher lectures a young student on theory and practice. Dismissing in turn logic, metaphysics, law, and theology, the conversation moves to medicine whose blunt advantages in meeting the fair sex are stressed by the master and readily grasped by the novice. Here the latter can see, as he says, the "wo und wie"—the "where and how," and Mephistopheles answers with the famous words, "Grau, teurer Freund, ist alle Theorie"—"Gray, my dear friend, is all theory."
A new attitude is caricatured in these lines, a criticism of theory that arose from the Age of Enlightenment. In an aside, the devil gives up "the dry tone" and with it the essence of his disguise—he turns from theory to practice. This attitude, so characteristic of the era, also began to play a major role in the teaching of musical composition. Commenting on this father's method of instruction, Carl Philipp Emanuel Bach wrote to the Bach biographer Johann Nicolaus Forkel on January 13, 1775:
In composition he started his pupils right in with what was practical, and omitted all the dry species of counterpoint that are given in Fux and others.
Bach himself was reported to have used the same word, calling the fugues "of an old and hard-working contrapuntist dry and wooden."1 But the fundamental distinction inherent in the son's remark is absent from the words of the father. Bach knew no theory of music, only practice, and the maligned species of counterpoint were presented in Johann Joseph Fux's celebrated Gradus ad Parnassum of 1725 as "musica activa"; the complementary term, "musica speculativa," was reserved by the author for the mathematical computations used to elucidate the nature of intervals.
"Speculation" is the equivalent of "theory." Derivatives from Latin and Greek, the two words designated the act of viewing, contemplating; and both "speculum" and "theoria" had served in earlier times as titles for musical treatises. Yet "music theory" in the sense that modern convention has given the term was not associated with instruction in the art of musical composition until the late eighteenth century; in fact, Mozart was not entirely conversant with this meaning of the term, whereas in Beethoven's studies it had gained importance.
What separated Bach and Handel from the masters of Viennese Classicism in their teaching of the craft was their exclusive commitment and individual orientation toward musical practice. Thus, C.P. E. Bach's judgment was based on a misconception. The four-part chorale harmonizations with which his father commenced the teaching of composition represented in fact a practice of musical performance conducted by the keyboard player, while the counterpoint species Fux devised for his students represented a purely vocal practice. Less well known than the Gradus ad Parnassum but closely related to its exercises is Fux's Singfundament, a collection of short motet studies, written without text and intended for the young musician in somewhat the same manner as Bach's Two-Part Inventions.
The concept of musical practice was in itself subjected to a radical division during the century preceding Bach and Handel. Attacked for his bold use of dissonance, Monteverdi declared his style of composition a "second practice" as opposed to the "first practice" of guarded dissonance treatment that marked the works of sixteenth-century composers. One might say that the two practices were eventually codified in the disciplines of harmony and counterpoint, but it took more than a century to arrive at precise didactic categories.
The seventeenth century witnessed a proliferation of musical styles, a widening of musical experience, that resulted from the rise of opera, accompanied solo song, and instrumental music. The first composer to be concerned not only with the clarification of styles but with their implications for the student of musical composition seems to have been Heinrich Schütz. In 1648, the aging composer published his Geistliche Chormusik, i.e. music in the old a cappella style, a series of motets to be performed, as he wrote, "without bassum continuum" (although by a stroke of curious irony his publisher, in the attempt to make the work more accessible, had a continuo part added in the printed score). As Schütz's preface indicated, the work was written with a decidedly pedagogical intent.
Continuo accompaniment had become the hallmark of the new style. Its use signalled the progressive tendencies of music drama, and an estrangement from firm contrapuntal control and the "requirements of a well-regulated composition," namely strict, free, and retrograde imitation, melodic inversion, invertible part-writing, and the simultaneous use of different themes. Schütz, who as a younger man had been one of the initiations of the "second" practice in the North, now found himself surrounded by a new generation of musicians well versed in the modern style. Unlike Schütz who had studied in Italy where the "first practice" remained a living tradition, the young practicioners of the art, working in a Germany physically and culturally exhausted by the Thirty Years War, lacked the "fundamenta" of their profession. Though it might seem like "heavenly harmony," music not founded in solid polyphonic technique was judged by Schütz to be no more than "an empty nutsehell," an he admonished the beginner to "bite open that hard nut whose real substance is the foundation of good composition."
His words represent a prophetic confrontation of the two terms. For a long time, "harmony" continued to be the word used to describe a fabric of independent part-writing. It was not until the publication of Jean-Philippe Rameau's Traite d'harmonie in 1722 that the modern meaning was introduced. Three years later, Fux's Gradus established the modern didactic tradition of counterpoint. Yet this was also the decade in which Handel published his first set of harpsichord lessons, and in which Bach wrote the Inventions and the Clavier Books for his son Wilhelm Friedemann and his wife Anna Magdalena—the decade in which the last two great Baroque composers undertook a systematic exposition of instruction in composition. Though they both made their point of departure the highly-developed execution of figured bass, the technique remained, in their hands, inseparable from polyphonic practice. It did not serve to illustrate how voices are placed but how they move within a harmonic texture. And the balanced blending of harmony and counterpoint was to become the foremost challenge of conventional theory.
The new meaning of the word "theory" entered the study of music largely through the influence of a work which, despite its mixed reception, attained epochal significance: Johann Georg Sulzer's General Theory of the Arts (Allgemeine Theorie der schönen Künste, 1771–1774). The author, director of the Faculty of Philosophy at the Berlin Academy of Sciences, was guided by the ideals of Rousseau in his thesis that the arts must both express and enhance nature. In an approach typical of his time, he attempted to define all artistic terms and concepts that would serve this purpose and gathered them in an encyclopedic dictionary. His musical advisors, Johann Philipp Kirnberger and Kirnberger's student Johann Abraham Peter Schulz, represented a lineage of Bach's teaching. The system of musical theory they devised, however, came under immediate attack; it was questioned above all because Sulzer's basic axiom, namely that music is a "sequence of tones guided by the passions of sentiments," resisted his own scheme of standardization. In the second volume of an Essay for the Instruction in Composition (Versuch einer Anleitung zur Composition, 1782–1793), Heinrich Chrisoph Koch, one of the eminent writers of the period, formulated the critical argument:
The young composer's endeavors in letting his soul form beautiful melodies can never be truly aided by theory.
Nevertheless, music theory—no longer in the old sense of the "science" of music but as the subject of college and conservatory courses—became an established abstraction that was to dominate the teaching of musical composition in succeeding generations. This is all the more understandable since vital musical styles and techniques were changing swiftly to meet the demands of taste and musical imagination. When thoroughbass and fugue no longer represented current practice, they were relegated to the realm of theory. They were perpetuated in didactics though much as the "stile antico" had been retained in the age of the second practice, but with a difference: the very terms "prima prattica" and "seconda prattica" implied that the old style had stayed alive, that it continued to be practicable and valid as an artistic expression. Counterpoint and fugue, as branches of modern theory, became "a metier, not an art."2
The dichotomy thus produced had more complex ramifications than this comparison might suggest. Beethoven, though he defied Johann Georg Albrechtsberger's teaching of fugue as an "art of creating musical skeletons,"3 had been his attentive and dedicated student, and the Beethoven biographer Alexander Wheelock Thayer gives a description, authenticated by contemporary accounts, of Beethoven's daily sessions with a colleague and neighbor in which "the conversation usually turned upon musical theory and composition."4
Theory must here still be understood in rather general terms as the study of eighteenth-century writers on various subjects, not in the sense of a more-or-less fixed course of studies in different techniques. Mozart seems to have arrived at the conventional sequence of harmony and counterpoint in his pedagogical experience empirically—this sequence, although practiced at the time, had not been fully established. In teaching the young composer Thomas Attwood during the years 1785 and 1786, he became increasingly aware of a lack of linear skill in his student's harmonizations and—apparently under the influence of Haydn—decided to direct the twenty-one-year-old back to the beginning of contrapuntal studies.5
The most striking case of a composer's awareness of the increasing importance of conventional theory is Schubert's legendary lesson, two weeks before his death, with the respected Viennese theorist Simon Sechter. In a letter responding to a request for biographical information, Sechter mentioned this lesson but we had no knowledge of its contents until the manuscript pages on which both Schubert and Sechter had worked were recently brought to light.6 Schubert turned to Sechter for advice because he was puzzled by certain technical details of fugal practice with which his generation was no longer conversant. The documentation of his lesson is all the more arresting since it shows that Schubert obtained the answers he sought. Sechter corrected the samples of fugal expositions that Schubert had submitted and added a clear exposition of the principles involved. The lesson was concluded with the assignment of a three-part fugue on which Schubert was no longer able to work. It is a touching postlude to this remarkable encounter that Sechter carried out the assignment and published it, nine days after Schubert's death, in homage to the illustrious student—doubly touching because the mediocre quality of Sechter's work shows that teacher and student met merely as theorist and composer, but not on equal terms.
What had been revealed to the dying composer was a certain historical perspective that the rapid development of the classical style had temporarily obscured, and it was this historical perspective that gave to nineteenth-century theory its most valuable contributions. Albrechtsberger, Beethoven's teacher, had taken an important step in his teaching by adapting the modal technique of counterpoint to the modern tonalities of major and minor. This orientation was subsequently reversed by a historian, Heinrich Bellermann, who, in his manual Der Contrapunkt (1862), returned to the letter and spirit of Fux's Gradus. Bellermann, successor to Adolf Bernard Marx, the first professor of music at the University of Berlin and himself the author of a standard manual on composition, was followed in his restoration of modal counterpoint by several other writers, but his book was denounced as "obsolete at its very appearance" by his distinguished colleague Hugo Riemann—as obsolete, one might add, as Bach's conscious use of modes in Clavierübung III.
In the end, neither historical nor analytical studies could solve the problems inherent in the ascendancy of theory. It was the departure from practice that undermined the textbook literature of the nineteenth century. Composers of the Romantic age in their writings did not deal with the question of how to teach composition—only orchestration. Not until the twentieth century were teaching manuals again produced by prominent composers. That the element of creative thought had been missing in didactic literature is indicated in a treatise by Heinrich Schenker, foremost among twentieth-century theorists: Neue Musikalische Theorien und Fantasien (1910–1920). Schenker, who had been torn in his early years between the careers of composer and theorist, eventually decided that the theorist's profession was for him a greater challenge. Though his work lives up to its title by offering a highly imaginative exposition of harmony and counterpoint, it inevitably points to the crux of the dilemma: in essence, composition must be taught by the composer; the theorist can only teach theory, no matter how refined the method.
Unlike theoretical guidance, practical guidance in the composer's craft is committed to the master-artisan relationship that was abandoned in textbook instruction. The didactic literature of earlier ages, too, was addressed to the individual, not to classes. The following chapters will thus be concerned with documents that show the time-honored direct and special exchange between teacher and student in an age when individualism, though strengthened in so many other ways, was abrogated in the teaching of musical composition.
1 Frierich Wilhem Marpurg, in a letter to Johann Mattheson, Kritische Briefe über die Tonkunst (Berlin, 1760), I, 266. Translated in The Bach Reader, Hans T. David and Arthur Mendel, eds. (New York, 1966), p. 257.
2 Paul Henry Lang, Music in Western Civilization (New York, 1941), p. 974.
3 Letter to the publishers B. Schott's Söhne, January, 1825.
4 Thayer's Life of Beethoven. Rev. Elliot Forbes (Princeton, 1984), I. 262.
5 Cf. This writer's discussion of Haydn's and Mozart's contrapuntal teachings in Mozart-Jahrbuch 1978 / 79, pp. 197, ff.
6 The manuscript was discovered by the Schubert scholar Christa Landon; see her report "New Schubert Finds" in Music Review 31 (1970), pp. 215 ff.
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