Shoblongoo
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16 hours ago, Rezzy said:
That link's a bit long for me to fully read right now. Full disclosure on my end: I'm not a pain specialist. I see patients who have pain, but for chronic pain patients or suspected CRPS (Complex Regional Pain Syndrome) cases, I refer to a pain specialist. Part of the reason I didn't want to go into pain management is that it's such a litigious field.
1: I do not use opiates indefinitely, unless they are hospice patients. If a patient requires ongoing pain management, I refer them to a specialist. Anyone who enters a pain clinic, at least from me has genuine chronic uncontrolled pain, or is a drug seeker who claims to have pain. Sadly, the latter is hard to differentiate in many cases.
2: Clinic guidelines are and have always been a vague point of contention. You can get experts who will both support your decisions and challenge your decisions. If a case goes to litigation, the standard is whatever the court says it is. I cannot say one way or another as to whether they are correct and accurate, because they are not universal.
3: No, since as I said earlier, opiates are the only drug that can do what they do as effectively as they do. They aren't the only medication, but they should not be demonized either. There are non-traditional methods of pain control like acupuncture, meditation, and other things, but the research on them is more equivocal.
To the bolded; whats your opinion on medical marijuana?
My experience as a patient has been that cannabis has therapeutic pain management value, in situations where current guidelines hold that the use of cannabis is neither lawful nor medically appropriate and instead direct the use of opiate drugs.
My understanding—and you can correct me if this is wrong—is that the barrier to broader use of THC-based drugs as a substitute for opiates in routine pain management is more of a legal one then a medical or scientific one, as the technology to make THC-based pain relievers that do not carry the same risk of chemical dependency as opiates today exists. But it is heavily frowned upon by lawmakers and policy setters; in no small part due to the influence exerted by opiate manufacturers.
Current law and guidelines are based upon the (very misguided, IMO) policy supposition that medical marijuana poses a greater threat of public nuisance and introducing patients to illicit drug use then opiates, such that opiates should be the more commonly used substance for everything from muscle cramps to toothaches and cannabis should be used only in such exceptional circumstances as a cancer patient requiring pain management during chemotherapy. I'm thinking it should be the reverse; opiates as the rare treatment for only the most extreme forms of pain, where the benefits of pain management clearly outweigh the risks of dependency, and THC-based medications as a safer remedy of common use for routine pain management.
Am I completely out of line here, or is there some sense to that? -
Think the terrorist attacks had any influence on the outcome, or is this the same way people would have voted anyway?
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14 hours ago, Tryhard said:
You voted for McCain and Romney over Obama? I had you pegged for a liberal from your posts, but are you a disgruntled Republican/Conservative who just doesn't like Trump? Was there any reasons for disliking him compared to the candidates you voted for before beyond what you've already said and why do you think so many conservatives stick by Trump as a sense of loyalty?
I mean--I am pretty liberal. But I consider other things like character and experience when I vote for president; I look at the full package and strictly vote for who I think is the better candidate. For me it was:
McCaain > Romney > Obama > Hillary > Trump
And I would vote accordingly in any match-up between them, real or theoretical.
McCain = An eminently qualified and good and honorable man. Served in the armed forces. 30+ years in the Senate without a hint of scandal or impropriety. Always conducts himself in a statesmanlike manner. Republican in name, but frequently works with Democrats on bipartisan deals. Puts country over party and goes against fellow Republicans when he believes the Party is clearly in the wrong. Would have been the best president we’ve had in a long, long time TBH.
Romney = Criminally underappreciated. He was a successful Republican governor in the most liberal of Democratic states; a reasonable and friendly fellow who could reach out to all sides and see value in what everyone was bringing to the table. He ran a multimillion dollar business without sleaze or fraud. He was a devout family man and pious to his faith—the real thing—not one of these political fakers smiling for the cameras. Strict ethics. Good business sense. Good foreign policy instincts (there’s that now-forgotten exchange from the 2012 debates where Romney said Russia was our greatest geopolitical foe. Obama laughed, said “the 1980s called. They want their foreign policy back,” and said our greatest geopolitical foe was Al Qaeda. The next 4 years proved Romney right.)
Obama = Good man and the most gifted public speaker of our day, to which he owes his political fortunes. But a young and inexperienced leader. Went straight from freshman Senator to President of the United States, which is kind of sketchy. He did not have a strong background in foreign policy or good foreign policy instincts, and he made some really bad mistakes because of it. Still; a man of sound character who did some good things as president.Hillary = Pretty much the walking embodiment of every negative stereotype of the career politician. Talks in rehearsed platitudes, and out of both sides of her mouth. Can’t give a straight answer to the most basic questions about her positions or her conduct in public office. Frequently changes positions for political expediency, then tries to act like she didn’t change positions and that was the position she’s held all along. Self-serving. Untrustworthy. Her one redeeming trait is that she at least understands how government works and can conduct herself in a statesmanlike manner, when the situation calls for it.
Trump = Worst of the worst. Habitual liar. Shameless narcist. Treats other people like trash then expects them to treat him like a saint. Just a grand-royal-asshole of the highest order, with no redeeming qualities. He insults our allies. He bolsters himself by attacking immigrants, the intelligence community, the free press—anyone he can set up as a scapegoat or who attempts to hold him accountable for his bad behavior. He says and does whatever he wants with no sense that bad behavior has consequences, then when he gets in trouble its always someone else’s fault for treating him “very unfairly.” His presidency is an embarrassment to America and to the World.
Trump's base sticks by him because he's a con-artist, and he attracts a segment of the population that is stupidly easy to con.
First it was "the Negro." Then it was "The Commies." Then it was "The Gay Agenda." Now its The Immigrants, the Globalists, and the Refugees. They're always looking for a scapegoat; If you sell it to them, they will come. -
35 minutes ago, Tryhard said:
It's not like he's the only one to be compared to such, it just happens in political discourse.
But he is certainly adept at telling The Big Lie - he's the only authority you should listen to!
The Obama/Hitler comparisons were pretty crazy. I’m not a huge fan of Obama (voted against him both times) and there’s quite a bit that I think he did wrong. But that was purely just demagogues and closet-racists who couldn’t produce a coherent reason for why they so vehemently disliked the guy racing to the bottom of the moral barrel.
Obama was a proponent of globalism and multiculturalism, an opponent of excessive nationalism, and the product of an interracial union educated by liberal Jews at an elite university.
i.e. he was everything Hitler wanted to gas to death -
...ohhhhh...Newgrounds...I remember you...
Surprised to hear its even still up-and-running. Its been many, many years since I've visited Newgrounds.
Pico was silliness. Madness was brutal. And the 18+ section was the first time I ever learned that hentai was a thing. (that was a surreal moment of "...wait...you can do that!?")
Good times.
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1 minute ago, Cerberus87 said:
...that awkward moment when the comparison is actually appropriate though...
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31 minutes ago, Augestein said:
But Hitler had a lot of other things that helped him. For instance, he spoke that he wanted to overthrow the government to help the people. His retorts held weight because he convinced people that it was bad that WW1 ended the way it did, and to a certain extent, he did have a point. The way WW1 ended left Germany in a pretty bad state comparatively to how they were beforehand, so it was easier to rally people up in this case.
The US isn't even remotely close to the state that post WW1-Germany was in. So it's really not comparable. I'm no Hitler sympathizer by any stretch of the imagination, but there's quite a large number of differences.
Quite a few similarities too though--Trump is far-and-away the most Hitleresque politician I've seen in my lifetime.
Before Hitler was a genocidal dictator, he was a politician. And Hitler the Politician comes on the scene at a time when the German people are depressed by a sense that their best days are behind them, that their once-great nation is in decline, and that their entire government is run by globalist stooges who only care about enriching themselves and their cronies and are entirely unresponsive to the big national problems facing post-WWI Germany.
Hitler comes along, being the charismatic devil that he is, and he has a message. A powerful message. A message that his countrymen are in just the right state-of-mind to receive. That message is:
“Germany is the greatest country in all the world. There are no people like the German people. Germany is supposed to win at everything. Germany is losing because its politicians are stupid and corrupt and do not serve the German people. They serve The Jew. The Jew is the reason that [insert laundry list of social, political, and economic grievances here]. Give me power and I will make Germany great again, because I will fight The Jew. I am the only one who can make Germany great again. I am the only one even talking about this problem. Everyone else in government and academia and the lying media—everyone who is saying that I'm wrong; everyone who doesn’t want me to have power—they do not work for you. They are all working for The Jew. I will work for you.”
…and that sounds really good...its a nice simple answer to complex problems…people want to believe that there are nice simple answers to complex problems. They buy into it…
-Replace “Germany” with “America.”
-Replace “Hitler” with “Trump”
-Replace “The Jew” with The Mexicans. The Chinese. The Muslims.
…and you can pretty much trace out the exact same path of our current President’s rise from political obscurity to High Office.
We fell for it again.
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57 minutes ago, アリサ ラインフォルト said:
I watched a part of Comey's interrogation.
He gave very controversial information.
It's just the question for me how it exactly will affect Trump (if it can't be proven).
Its hard to say.
On the one hand, Trump has already gotten away with sooooooooooo much that he shouldn’t have gotten away with. And what new information continues to drip out concerning what a truly dishonest and reprehensible human being he truly is, its blunted by the fact that there’s already so much out there and its just another drop in the bucket at this point.
Like—its already out there and known that the guy admitted to sexual assault on audio, ran a fake university scam to cheat dupes out of tuition money, stole from a children’s hospital, bankrupted a casino, harassed topless underaged girls at his teenager beauty pageants, has been a named party in over 3,000 lawsuits alleging everything from business fraud to sexual harassment to embezzlement of charity funds, and maintains a general reputation of being an egomaniac and pathological liar who humiliates people for fun.…and that was before he even became president…
On the other hand, there has to come a tipping point where people say enough is enough. And decide that they just aren’t going to put up with his nonsense anymore.
But every time something new comes out you have to get to thinking: if the last 10 things he did didn’t bring him down, why is this going to do it?
I hope they get him though. I really do. -
Serra's supports were particularly notorious for taking FOREVER to build. SERRA (T) : Sain (W) - 41 +40 (81) +40(121): Lucius (L) - 41 +40 (81) +40(121)
: Hector (T) - 66 +80(146) +80(226)
: Oswin (A) - 71 +80(151) +80(231)
: Matthew (W) - 76 +80(156) +80(236)
: Erk (T) - 79 +80(159) +80(239)
: Florina (L) - 81 +80(161) +80(241)
...I always interpreted this as the games way of telling us that Serra is a particularly hard person to build a relationship with or tolerate being around.
Because…well…Serra… -
Something to be aware of when you fight him. Because I wasn't aware of it the first time, and it fucked me. (I was skipping all the animations outside of player phase, and the game punished me for it)
Attacks from illusions summoned with invoke count towards Jedah's 4-8-12 count.
If illusions are up, make sure you're keeping an exact count of how many are attacking Jedah outside of player phase. -
16 minutes ago, Glaceon Sage said:
There is an exception to this, Hector has a support with Serra that does not affect the ending in any way.
So mostly but not entirely true.
lol I completely forgot that Hector had a support chain with Serra.
Its funny, because the implication there is that she's too annoying to love. And this coming from a man who will marry Farina. -
7 minutes ago, StahlTheStall said:
So I'm at chapter 20 right now. Is it possible to farm for the Eliwood-Ninian ending? And if Ninian dies after getting the Eliwood-Ninian A Support then will the main ending get changed?
Yes...you can get the ending.
No..Ninian/Nils can't die (except...you know...to the plot...)
Ninian has to stand next to Eliwood for 17 turns to hit C-Support.
Then another 16 turns to hit B-Support.
Then another 16 turns to hit A-Support
Thats 49 turns total. Just beat everyone in a chapter except the boss, then leave them next to eachother and hit "end turn" over and over again to cheese it.
You can only get one level of support per chapter though. -
Ninian/Eliwood is the only support that actually drastically changes the ending. But any A support between one of the male lords and a female partner (Eliwood/Fiora, Hector/Florina, etc.) will unlock a special scene of in-game art that would not have otherwise been viewable.
Also, if Lyn and Hector are at A-Support on the final chapter where you fight Nergal, there is a special "talk" option that comes up if you put them next to each other. And an otherwise unavailable exchange of dialogue between them.
As to Eliwood's father not dying on Valor...I don't know of any ROMhack where that happens. But there's a fanfic where he survives and makes it back to Pharae (among many other things that never happened in FE7) -
18 hours ago, Rezzy said:
I'm a doctor and have full prescribing privileges and prescribe narcotics when warranted. I probably have more experience here than most.
...then I definitely want to get your thoughts on the allegations raised on Page #23 of the State's complaint. (By way of background--I'm an attorney. My practice areas pertinent to this line of inquiry include personal injury, criminal defense, professional liability, and consumer fraud)
A copy of the verified complaint is attached hereto, for viewing by any interested persons:
https://assets.documentcloud.org/documents/3761767/Ohio-opioid-drug-lawsuit.pdf
It is alleged by The State of Ohio that defendant drug companies have perpetrated a fraud upon the medical community by operating “front groups” purporting to be independent institutions of medical oversight and education, which are in fact staffed by and receive almost the entirety of their operating budget from the drug companies. These groups include the “American Academy of Pain Medicine (AAPM),” the “American Society of Pain Education (ASPE),” "the American Chronic Pain Association" (ACPA),” and the now-defunct “American Pain Foundation (APF).” Doctors in leadership positions at these organizations regularly attend defendant’s corporate-sponsored events, receive instruction from the defendant’s as to what statements and guidelines they would like to see produced, and produce statements and guidelines consistent with those instructions rather than with scientific literature or independently verifiable claims.
It is further alleged that the identified “front groups” have produced the clinical guidelines for routine pain management, establishing uniform practices and industry standard-of-care for patient treatment. That said guidelines are demonstrably false and misleading insofar as they over-emphasize the pain management benefits or prescription opiates, under-emphasize the risks of dependency and habit-forming behaviors, and unduly dismiss alternative courses of treatment as less viable. And that a doctor of ordinary skill and knowledge will in fact rely upon the clinical guidelines in setting forth course of treatment, as a basis for sound medical judgment.So…My questions for you…
1) In making it your practice to prescribe opiates for routine management of acute and chronic pain, and in forming your medical opinion that this is good practice, to what extent did you rely upon clinical guidelines?
2) Do you believe current clinical guidelines for pain management are correct and accurate?
3) If it were to be demonstrated that defendant drug companies exercised undue influence in drafting the current clinical guidelines for pain management, and that said guidelines are NOT correct and accurate, would that change your opinion as to the appropriateness of using opiates for routine pain management?
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Comey testifying to Congress tomorrow; transcript of Comey's prepared opening statements have been made available for public viewing, ahead of the hearing. Link below for anyone interested:
https://www.scribd.com/document/3506...817#from_embed
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"My son has to live in the middle of fuck-off nowhere then kill me and can't know he's my son until after I'm dead because...reasons..."
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All the cavaliers in FE7 are potentially great, but can potentially get RNG screwed.
I'll generally try to use them all at some point in the early game, promote + keep using whichever one(s) get good growths, and bench whichever one(s) don't. (i.e. Lowen gets benched if he doesn't get enough strength growth to actually hurt things, which he sometimes won't. Sain gets benched if the goes on a streak of only consistently leveling strength, and starts to fall behind in other vital stats. Which he sometimes will.)
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6 hours ago, Gustavos said:
File Trump's tweet under "concrete evidence he's actually illiterate"
...the thing you have to remember about Donald Trump is that the man just absolutely doesn't care whether anything he says is true or untrue; only if he can get people to believe its true. He's a morally defunct con-man whose gotten away with lying and cheating and treating people like garbage his entire life, and made billions of dollars doing it.
Its not illiteracy. Its purposeful. He knows exactly what hes doing.
He's counting on his supporters being daft enough to lap it right up and go: "THAT'S RIGHT! YOU TELL 'EM! These liberal European bed-wetters just don't get it; Thank God for Donald Trump!" (And they will. There's a cult-of-personality around this guy that will swallow absolutely anything he feeds them.)
Also--Trump's desperately trying to make the week's big headline anything other then Comey's testimony to Congress on Thursday. So expect more twitter shit-posts and wild antics, ahead of the main event. -
40 minutes ago, Dark Holy Elf said:
Laslow needs promotion (or a Friendship/Partner Seal) to even start on building a bow rank. Niles has had bows since Chapter 8. Shura is only a few chapters off (probably joining soon after Laslow's promotion), and possibly Nina as well; both join with bow ranks. If you want a project bow-user who starts at E rank, Mozu exists: she can get started before Laslow and has rather clearly better stats once she gets rolling.
Niles doesn't actually have much less strength than Laslow; about 4-5 less when both are Bow Knights. Considering he will have access to better bows AND has about 6-8 points more speed (often the difference between doubling and not), I think it's fair to say Niles is the one with better offence as a bow user, in addition to his utility advantages (Locktouch, Move+1, Capture vs. a slightly stronger Rally).
I'm not really seeing what an archer with mediocre speed and no bow rank until promotion offers my team, or many others. Conquest isn't that archer-starved.
On the other hand it's easy to see what Peri offers the team: more cavaliers/Shelter-users is never a bad thing, and she actually has a good stat build (she is strong in two of the three most important stats and average in the third). If you're allergic to any frontliners with less-than-great def (but for some reason don't mind raising Laslow as a Merc for 8 levels with the same durability) then that's your prerogative, but it doesn't make her a bad unit.
I also disagree that benching someone in chapter 13 is that hard. You have 15 units who join before Laslow/Peri (assuming you got them all and none have died), and can use 10 in Chapter 13, so you'd have to bench six of them by now to use Peri (or Laslow). Arthur is a frontliner who is squishier than Peri (he may have 1-2 more Def, but luck/res are a thing). Mozu will often not be bothered with. Both dark mages are highly problematic (Odin is middling across the board, Nyx is horrid at everything that isn't Mag/Spd). Selena is basically Peri with slghtly shifted stats (a bit more def/spd, a bit less atk) but a far worse class. Kaze has 7 less effective strength (as well as weaker weapons) than Peri which is huge at this point. Silas vs. Peri at this point will depend on how Silas's early levels have treated him. And so on. Any of these units are reasonable to bench at this point, as well as potentially anyone else who the RNG hasn't been kind to (except Corrin, Camilla, and Azura) of course.
...I think you're overstating the value of adding Peri to your roster by a priori writing off units you get before her, and understating what you lose by not continuing to use them.
Like--okay--Nyx and Odin are terrible (without DLC anyway. Dark Flier Odin is boss, and Witch Nyx can put in work). Bench immediately.
But Kaze??? Arthur??? I'm thinking long-and-hard before I retire those badboys.
And if we're considering the availability of children that makes it even harder to justify raising Peri, at a time when she's first going to start catching up to the rest of your army as you're looking to Cut lagging Gen 1 units to make room for Gen 2. Now you're looking at even fewer empty mid to late-game teamslots. And now you have a unit with very flexible availability who outclasses her completely in Sophie. (Silas tends to be one of the first units on any given playthrough to hit S-Support) -
5 hours ago, TheSilentChloey said:
Then I guess Grima wouldn't awaken.
What if Tiki had a child that wasn't Morgan.
The Avatar would try to marry it.
What if Cordelia and Chrom had a one-night-stand? -
On 6/1/2017 at 10:23 AM, Dragoncat said:
Honestly though, all three of them would be...interesting drunks.
Lusamine would be classy about it.
Kukui would probably try to bang your mom.
Guzma would destroy himself and everything around him. -
9 hours ago, Dark Holy Elf said:
I'll focus on Laslow since they join at the same time making that the easiest comparison. Peri is quite easily superior to Laslow. They join with rather similar base stats, but Peri is in a better class. She has lances and swords where Laslow just has swords. She has 2 less strength but Elbow Room means it's 1 more strength in practice (before any consideration for her weaponry). She has 2 extra move, and Shelter which is pretty great. She is also 2 levels lower... and despite that Laslow's only stat wins are in Skill (mitigated to a significant degree by Peri having more weapon triangle control), luck, and HP, hardly the stats you would want to be winning in a direct comparison. Peri's growths (and 2 extra levels to gain) then give her a significant lead in speed and to a lesser degree strength, which means she ends up with a better stat build in a better class. And for all that you criticsed her defence for a front-liner, Laslow's is no better at base and falls behind when Peri promotes to Great Knight and he doesn't (barring a Xander Friendship Seal or similar).
Though the comparison isn't as direct, I don't see what Selena offers that Peri doesn't either, aside from some marginal C10-11 contributions. Being a mono sword user kinda sucks in Conquest since there's only one Kodachi and we're already using Corrin (though you could reclass him/her to a non-sword user to be fair), and Selena has quite low strength to boot.
I’ll make the case for Laslow above Peri, I guess.
…Here’s the thing about Laslow and Peri.By the time you get them, you should have a full squad of units that are substantially better then them, at their current level. You get them and they’re immediately serviceable. But you’re in a position where you have to justify benching someone to put work into either one. And they’ll drop off rather quickly if you don’t immediately start putting work into them.
The question then becomes: what is this unit going to contribute to my team, If I level them, to justify building up this unit from scratch and benching a unit I've already started putting work into?
…Peri gets you a frontline unit with poor survivability and—well—that’s it. Not a whole lot else going on for her. Shelter utility I guess; Silas and Xander do that better.
…Laslow gets you another bow user. And Conquest is EXTREMELY stingy with its bow users. Whereas niles is not going to get much in the way of strength growth and is usually going to wind up relying on the shining bow if you’re still using him by the endgame, Laslow actually hits hard on the physical end with his bows. His most direct competition in this role is Selena, whose prone to getting strength screwed, and who performs better as a tank in the hero class with defensive growths and access to sol.
Laslow as a bow night answers kotaro’s ninjas, Hinoka’s skyknights, ryoma’s ninjas ninjas, and has generally good utility as a ranged attacker with high mobility.
Defense is not a liability for him as it is for Peri because Bows—he doesn’t need to be exposing himself on the frontline to do his job.
And the otherwise underwhelming [rally skill] ability of the Bow Knight has good synergy with his personal skill—effectively letting you rally for +1 STR/ +4 SKILL / +1 SPD in a single action.
Making Laslow a respectably decent rallybot.
This can justify benching a unit to add him to your squad.
On the other hand—I just can’t ever imagine a scenario where I’d want to bench a unit to use Peri. -
On 6/1/2017 at 10:26 AM, Mortarion said:
I'd argue that having a diverse selection of political parties in the system is important since it ensures that different view points actually get represented, whereas Libertarians for example either have to go for the protest vote or eat shit and choose which flavour of 'big government' they like the best.
…consider the case of the American Socialist Party…
In the early 20th century, the American Socialist Party formed in response to a sense that the existing 2 Party System was completely owned by industrialist interests, and that neither Democrats or Republicans were willing to adopt the kinds of progressive reforms that were needed to reign in abuses of the system + address the plight of the ordinary citizen.
And the American Socialist Party had some really good ideas: Minimum Wage Laws. Occupational Health and Safety Regulations. Antitrust Law.The American Socialist Party never grew into a mainstream party, never had any electoral success, and was never in a position to implement any of its policies. Yet today we have minimum wage laws, occupational health and safety regulations, and antitrust law.
Why?
Because progressive reformers like Woodrow Wilson and FDR—instead of bemoaning that progressives had no voice in the 2 party system and running to 3rd parties—ran for high office as progressive Democrats. WON. Moved the parties with the force of their victories. And implemented through their mastery of the system the very changes that 3rd parties had gone outside the system to attempt to bring about, thinking the system incapable of addressing them. While the 3rd parties themselves--for all their discontent and aspirations—didn't do a damn thing.
…that’s the way of it, and so it is today with the libertarians…
You want libertarian policies in government?Find a force-of-personality and gifted speaker and visionary leader on par with an FDR or a JFK, who extols libertarian values and supports libertarian policy. Run him as a Republican or a Democrat—not as a libertarian. WIN. Implement libertarian policy under title of a Republican or Democratic administration.
And the way Wilson and FDR brought Progressivism into the mainstream of the 2 Party System where previously it was dismissed as the fringe-brainchild of 3rd party socialists and the like—endorsing progressive ideas and implementing progressive policies under title of the Democratic platform—that gets you to mainstream libertarianism. -
49 minutes ago, Dark Holy Elf said:
Aside from Beruka I'm not sure who below her is better.
Arthur, Selena, Beruka, Laslow, and Felicia2--i would all place solidly above peri
Ohio Suing Painkiller Manufacturers for Opioid Epidemic
in Serious Discussion
Posted
Anddddddd with that--a civil litigator and a physician are in complete, 100% agreement.