#my 10 years of therapy and my years of text analysis are being put to good use i guess
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wingsofescape · 1 year ago
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Well well well if it isn't the consequences of my own actions...(screenshots from my FMA Twitter, which you can follow here!
(Also I wrote calangoh as the user whose meta I follow religiously, it's calangkoh)
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I jokingly posted on Twitter that I could write an entire essay about how the Barry the Chopper episode fundamentally changes Ed’s relationship to intimacy and thus Winry… little did I know people would want the essay so guess who’s outlining now
Let me know if you want the essay on tumblr too I guess?
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prionguy-old · 4 years ago
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hello enderwalk arg people
so i saw a cool thread from @/ranbeans on twitter and it inspired me. so naturally i spent five hours straight analyzing ranboo’s lore playlist
basically i think it’s a timeline of c!ranboo’s life, and it fits kind of eerily
everything’s below the cut (and it’s a lot) :]
prologue from starkid 
 - more clock references. it’s literally just an instrumental of a clock ticking
 - instantly you think of the ender text in that pic he tweeted. like that, this could relate to dream’s clock, or foolish’s clock (reading 10:33 always iirc) 
 - note that butler in tales from the smp: masquerade kept staring at a clock
 - it could also mean a theme of running out of time, or fighting with time
 - in the thread i linked, the person also points out that there are 23 clock ticks in prologue, and angel number 23 means that you are meant to be a servant
 - this would be his beginning
introduction to the snow by miracle musical
 - the first of many songs from the hawaii: part ii album on this playlist
 - i’ve seen that album described as an arg and i find it funny if ranboo just went no. my arg now 
 - introduction to the snow only has one verse, and the rest is instrumental
 - the whole hawaii album has themes of loneliness and death, especially loneliness for this song
 - it talks about feeling isolated, which gives hints about his childhood maybe?
 - the “you’ll live forever tonight” lyric also gives off a hopeful vibe, like that of a child
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dream sweet in sea major by miracle musical
 - starts with a changed reprise of introduction to the snow
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 - "Rather than trying to “live forever”, it seems that the time has come for something else" from the analysis of the first part in genius
 - odd because this song is meant as a finale to the album, but it's towards the beginning of the playlist (could mean that there was almost an ending of sorts early on for c!ranboo, like a near death experience?)
turn the lights off by tally hall
 - okay this one confused me when i was first going through, but when the timeline started coming together it made more sense
 - about adolescence, and being uncomfortable with growing up, so it fits with the timeline playlist theory 
 - also about phobias and stuff like that in a way?? hm
the mind electric by miracle musical
 - the song starts out in reverse, then plays the stuff from the beginning normally
 - feels like a rls honestly i wish he could use this song
 - it's about someone put in an infirmary and condemned to electroshock therapy because they're insane. fun
 - this is where the timeline started to come together in a way. as soon as i saw the mood get darker i remembered ranboo’s line from the festival i think? “don’t let it happen again” or something like that
 - because of this, if the timeline theory is true, at some point before he joined the dream smp he did something which caused him to be condemned
 - also this
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 - the mind electric isn’t the only song where the narrator glorifies themself in a way, we’ll get into this later
 - also the rejecting fanatical views,, i am thinking about that theory that endermen are servants to the ender dragon. if c!ranboo rejected that, the consequences could have been awful
live and let die by paul mccartney
 - if i wasn’t sold on the timeline theory before, i am now. after the mind electric, the mood changes drastically in terms of ideology and theme
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 - this specifically made me say “holy shit” because like. that verse means that when you’re young, you’re open minded and say “live and let live” which resembles the optimistic but lonely attitude of the beginning of the playlist
 - but then when the world fucks you over, you begin to say “live and let die.”
 - “live and let die” i take to mean as him no longer caring about the people around him. how before, he wanted to help others, but then the mind electric happened, and he just. stopped caring
 - fun right!! /s
ruler of everything by tally hall
 - there are so many clock and time references in this. we get it
 - "mechanical hands" when it says “mechanical hands are the ruler of everything” refer to hands on a clock, saying how time rules over everything
 - the narrator is talking back and forth with time itself in this, which is interesting because i believe he joins the dream smp in the next song
 - the narrator appears very insecure and looking for a quick way to appeal to everyone (like how c!ranboo at the beginning was trying to be everyone's friend)
 - this is the second song with the narrator glorifying themself out of insecurity. what are you trying to tell us about your character buddy
 - also we can’t ignore this shit
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 -  i don’t need to explain why this scared me right. right
merry go round of life from howl’s moving castle
 - this is a change huh
 - god i haven’t seen this movie in years, but i saw looking it up that it plays at the beginning introducing the main character, sophie
 - this is before everything changed for her
 - maybe this is when he joins dream smp? and ruler of everything is him talking to dream prior?
 - or maybe im reaching who the fuck knows
 - but him joining dream smp to this song would make sense. it feels like a clean slate and starting over, which would match with how he doesn’t. y’know. remember things
 - which begs the question: if ranboo forgot everything from before this song in the timeline, and after that i’m assuming his memory issues started,, what happened to cause this?
 - i’d say the mind electric could have caused this, but it was awhile back in the playlist. so whoever he’s talking to in ruler of everything, which could very well be dream, i believe messed with his memory somehow.
killer queen by queen
 - c!ranboo girlboss arc canon??
 - i got lost here ngl. it has a very specific vibe that doesn’t match well with what i know of c!ranboo im sorry
 - but two songs later, i get a hint kind of which makes me believe this could be him burning george’s house with tommy
 - also this song is a banger and i’m pretty sure he put it on there to scare the crown arg people because of the “baroness” line /j
mr. bad guy by freddie mercury
 - literally just more funky villain vibes. i love this
 - no more angst only girlboss
 - since cc!ranboo has said he doesn't want to do a villain arc, i take this to maybe be how he sees himself?? credit to the crown arg discord for that idea they’re smart and cool
 - if that is true, i’d say this would be another song for the “glorifying oneself out of insecurity” list because the narrator is like. seeing himself as cool and The Bad Guy, even if he might not be
 - possibly the butcher army if the next song is what i think it is
ain’t no rest for the wicked by cage the elephant
 - i have been informed someone saw ranboo listening to and grabbing songs for this off of a playlist called "my villain arc" king i hate you /lh
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 - in seriousness: the song is about how the world forces people into wicked roles for money. i am getting live and let die vibes, like how both blame the world for making them not care/do bad things
 - c!ranboo take responsibility for your actions challenge /j
 - this definitely reminds me of how when he gave techno his armor, he blamed it on peer pressure. if this aligns with that event, the last two would be burning george’s house and butcher army i think
i can’t decide by the scissor sisters
 - this is probably about enderwalk
 - i really hope it's about enderwalk
 - did mr ranboo commit murder?? manslaughter?? sir
 - i really feel like this is enderwalk or ive forgotten something
stardust crusaders from jjba 
 - thank god for jjba fans, i know nothing about this
 - apparently this is the main theme for jotaro, who's power i think?? is like moving faster than time
 - and his main villain thing is dio, who's power is stopping the flow of time
 - and we're back with the fuckin time references
 - this is pure speculation at this point, but maybe it’s like. him fighting against time in a way, which would draw back to ruler of everything
a mask of my own face by lemon demon
 - the song is about not wanting to take responsibility for their actions again
 - c!ranboo i am begging
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 -  specifically this lyric
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 - also this lyric draws back to the bidding, in which the singer wanted to be enough for someone and showed almost narcissism as a sort of "mask"
 - also just. mask can be correlated with dream or the masquerade, where the butler stared at the clocks
stranded lullaby by miracle musical
 - been awhile since we had a hawaii album song huh
 - and,, a memory reference.
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 - that lyric is talking about forgetting things
 - the rest of the song is,, im not saying time traveler ranboo but time traveler ranboo (look at this post about that theory by my friend pspspspsp)
 - he's talking to a "you" this whole time, and i have no idea who it is lmao
 - there are mentions of dreams and stuff throughout, so i almost want to associate it with the prison visit, but then i think the next song is after the festival so i guess not?
 - might also be him losing the memory book
hidden in the sand by tally hall
 - this is, lyrics wise, a song about a man whose girlfriend left him for someone else and he's upset
 - but if you look at the music video, it shows a cruise ship, on which people are friendly with each other at first, but when it starts to sink, they turn on each other trying to escape
 - i am feeling a connection to c!ranboo's views on "choose people not sides" somehow
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 - i feel like he's called people selfish in lore, but my friends and i are all ranboo kinnies so we cant fuckin remember. if he has, then yeaH this definitely correlates
now i’m here by queen
 - there's a very optimistic and nostalgic tone to this
 - this one’s barely annotated on genius so i don’t have a lot for it, but i feel like it's after the dream voice disappeared or something? timeline's gettin a little funky
 - it could also be right before the festival, as he used optimism as a shield there
& by tally hall
 - this. yeah. & deals with opposites, especially good and evil. the singer talks about how everyone sees the world from their own perspective and doesn't look from another
 - and that definitely ties back to how ranboo wanted l’manburg people, like tubbo, to see from techno’s perspective
 - i feel like this is right after the festival. it resembles a lot of ranboo's speech from then, where he basically told everyone “sides dumb. just vibe”
 - and then the outro changes tone, almost like a warning?? which. yeah. a warning to choose people not sides before doomsday, or else they won’t be able to stop l’manburg from being blown up
i’m gonna win by rob cantor
 - this song is about someone fighting their inner demons
 - sounds familiar!! looks directly at dream voice
 - specifically, the singer is optimistic about winning their fight with the inner demons
 - it seems kind of chilling to me though, but it's also late at night when i’m doing these notes so it may just be me
 - if the timeline theory is true, this is where c!ranboo is mentally atm, which tracks honestly
=), an unplayable track
 - ranboo why do you hate us
tl;dr: ranboo’s songs that he would use for lore playlist might very well be a timeline of c!ranboo’s life, from even before dream smp and that’d be super cool
if you read all the way through this just know i would die for you
anyways feel free to drop your interpretations of the songs in the notes :0
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elizabethrobertajones · 6 years ago
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It’s interesting how we interpret things diff in fandom. For ex, I’ve always felt negatively towards dean’s use of sex as comfort Bc of my own experiences w csa but to some other people this reads as more positive on the whole. Do you think that maybe this is what makes people have such astronomically different takes on a character/plot event ?? Maybe this would also apply to 8x17 being read as conversion therapy while others wouldn’t see it. Not original thoughts but interesting nonetheless
Yeah, this is a whole thing in literature/media interpretation classes… You know what’s wild, it’s a pretty postmodern concept that everyone has their own interpretations and there’s rational reasons why we would see things very differently based on our own experiences. Incredibly this wasn’t always the case, and it used to be that there were definitive interpretations and analysis created by a sage literary critic which were then the be all and end all of the interpretation, even if with modern eyes those might seem inherently flawed. It’s why when we learn about historical texts they teach us both the context that the original audience would have interpreted it in, the stuffy academic opinion, a range of other thinkers, and importantly the modes of interpretation to attack it for ourselves, and a chance to write our own opinions. 
When it comes to fandom, people as a whole seem very set in the original stuffy one true interpretation thing, which is completely wild to me. I don’t see it as contradictory to read and reblog a dozen different metas on a scene and even if there’s one I personally lean towards, I find it fascinating to consider multiple interpretations and how they come across to people. And, often circumstantially, certain things seem to fit better than others. For example there are a few Dean hook ups I’m quite positive towards that he seemed to be in a healthy place and it wasn’t too weird, while others are quite tellingly wrongbad to me where he’s in a very poor place and it makes me very sad to see him trying to apply that comfort to very little effect. If someone writes meta that ALL of them are good or ALL of them are bad then I’m probably going to end up reblogging meta that says both to get both viewpoints to have the meta background to pick and choose to where it seems more suited to me to say either.
But I guess a lot cases people get really invested in their particular theory or analysis and can’t see past it either to how other people could think different things, or to find it interesting that they do, and to see how those ideas can be equally merited either talking about the same instance or how it can’t be applied uniformly. Some people just aren’t very flexible and get very angry about their one idea being challenged, even though something like a very specific read of a scene, like that 8x17 reads as Naomi putting Cas through conversion therapy, could be given a few different readings but it never hurts to say “this scene also can be interpreted as…” even if when you have your overall opinion of what’s going on there it might not mean as much overall. 
I personally read a huge overall narrative of Cas vs Heaven as a queer kid in a conservative family so it makes a lot of sense for me to read it that way. Someone who generally leans towards interpreting him as various other things such as portrayed as a soldier first or a metaphor for him being an immigrant among humanity, or other ways in which this metaphor don’t apply so neatly might have much less use for that interpretation but I find it super weird to think of the ones that apply less to a personal read as therefore wrong. There shouldn’t be a right and wrong in this case, but a collection of interpretations you can understand, respect, see the reasoning for, but at the end of the day are not the ones you fall back on for your overall personal meaning and understanding of the show. 
But then at the end of the day, I think the way we all approach the story differently and that leading to different interpretations also comes down to our need for validation etc. I approach it with a somewhat detached academic curiosity when it comes to the fandom’s meta project, as much as the story and characters mean to me, the analysis can be super fascinating but also not particularly relevant or “useful” in the sense of getting a clear grounding in tools to keep on understanding the ongoing show like abstract literary parallels to old episodes or whatever. Like, I just like reading essays branching off and exploring themes and parallels and such, while a lot of people are more interested just in hashing out a clear picture of what happened in each episode, what influenced it, and how to use those tools to guess what happens next or something, which is a fascinating practical application of analysis which is really a hallmark of fandom for ongoing projects and something I’d never even thought you could use analysis for before I got to fandom… 
But for people who are much more interested in a clear interpretation of validation of their readings of characters an plot, they just want the things which will prove to be the most accurate to canon and give them the clearest answer and vindication with new episodes, and that means a lot less room for theoretical asides, and for clear answers for what things mean so that when that thread of the story continues there’s certain ground on what it’s telling them… It means a lot less room for having multiple points of views on events and knowing clear right and wrong interpretations means that it’s easy to determine how things are going. 
Which I think in some ways can lead to quite aggressive fandom behaviour, not just in the obvious gatekeeping of ideas and fighting over interpretations, or refusing to engage with theories that contradict the one you’re most invested in instead of dabbling in them all, but also that when new content appears, people get upset or argumentative about events in very odd ways about what things meant. Obviously you can see it most with anti-factions which are aggressive about people applying interpretations about ships and stuff, but also with getting so rigid about a reading that if the story changes meaning, people are left in the lurch. 
To not be contentious about any current specific stuff so I’ll just use a large vague example, Carver era had very clearly defined symbolism and themes and tropes, but Dabb era didn’t use these and Dabb’s approach to storytelling is very subtle in some ways and really brash in others, none of which can be read like the carefully weighted symbolism of Carver era. I find a LOT more use in analysing the emotional arcs than the symbolism between showrunner eras, even when there is symbolism, it’s often… topically applied? Presifer sat with flames burning behind him in his staff meeting, but Cas sat in front of a similar open flame pit in 14x01 and I don’t think there was any parallel in their intent or behaviour, and I wouldn’t draw the two together, but to take the symbolism of each. But for some people who had been really hugely into the language of Carver era, Dabb era completely threw them, and was physically enraging by how much Dabb wasn’t writing like Carver used to, and there was a lot of upset about how basic his writing was and how wonderful Carver’s symbolism was, and how the show didn’t MEAN anything any more. Of course it still meant TONS, but it wasn’t being expressed in the same way any more, and by running headlong into Dabb era still trying to read it like Carver era, these people bounced off completely and could never get into it in the same way as when there were very prescriptive symbolic and metaphoric rules to follow which made understanding events so easy you could just take a glance at a single screenshot towards the end and explain everything about the scene and its wider meaning in the mytharc. 
(What’s interesting is that the show wasn’t previously written like this - Kripke era runs on mirrors and flips in a way which is actually more similar to Dabb era but minus, of course, 10 years of show history which makes Dabb have such a meta, kaleidoscope version of this, and it was in a very heightened, dramatic form which is very elegant and sublime and worked well as the tragedy it was set up to be… Gamble era was more like Dabb era in running more off emotions but lacked a clear symbolic language AND didn’t have the back to front structure Kripke did, being caught in the middle of completely overhauling the story, and I honestly don’t blame her showrunning in a sense that it was an almost impossible job to salvage the subtextual telling of the show from itself in the wake of Kripke essentially ending the show in 5x22 with raised middle fingers at anyone who dare continue past the original vision. Leaning into their trauma and the story’s trauma was a sensible bridge, all things considered, but it makes hers the least elegant storytelling >.> Anyway this is a total aside… it’s early in the morning and I’m just sitting here :P)
Anyway. Yeah, you can tell I do find it interesting to think about how everyone has all their own interpretations :P I mean I know it’s my own experiences which make me so annoying about having this uwu all interpretations are valid sort of approach to it as well, which is just another interpretation at the end of the day. Though I will be snobby and say I do think it’s better that people could read each other’s analysis and even if it doesn’t go hand in hand perfectly with their pet interpretations at least acknowledge it’s interesting and has its own merits, rather than dumping on it in a knee jerk reaction. But then, some people come to the show and end up with their interpretations because the emotional meaning they give is so intrinsically personal, another interpretation DOES feel like an attack, and trying to deal with people who CAN’T accept that some of us are just shooting the breeze and aren’t in a death grip to any one meaning can get very sticky. Especially when someone seems rational for a while but then on disagreeing they get very emotionally violent and it takes you completely by surprise when you thought you were just chatting and then it turns out you’ve hurt them in their most deep emotional place by being like, anyway lol whatever I still mostly ascribe to this other idea - OH NO SORRY D: WE WEREN’T ON LOL WHATEVER TERMS OH GOD OH - 
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icewindandboringhorror · 6 years ago
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I’m trying to be better about responding to things, so another small ask response post! I feel like the answers are short enough to not actually require putting a ‘read more’ but I ended up doing it anyway just because I have no idea what the standards for length are and I don’t want people to get mad or something lol.. (responses under read more) 
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 (note: I’m not going to write the questions completely as they were asked/shown in images above, just type summaries of them since that’s faster, so this is why the text varies)
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1. “do you have any goals for the coming new year?”
gHHgg, mostly the same goals as last year since of course I didn’t get everything done lol. Mainly I want to: finish my game, finish the information on the Avirre’thel and a few other worldbuilding posts, make more sculptures (5 this year), and do at least like... 10 costumes this year (since I’ve kind of been ignoring that stuff to focus on other projects, but I still enjoy it and have ideas!). Some of my goals in therapy are to leave the house at least once every 2 weeks without panicking and find friends in my area to play board-games with/do creative things with/etc. in person, but those are kind of less in my control (me being able to go places is somewhat dependent on the schedules of those around me, finding friends is a matter of luck and coming across the right people at the right time, etc.). 
Mostly I just really want to get the gourddamned game and worldbuilding stuff done since those have been longer projects, and I’m always getting new ideas for stuff I COULD work on before I’m even done with older things lol. In my head I’m already planning the elven religion and things happening far in other corners of Nanyevimi and it’s like “we’re not even DONE with the vampires yet!!!", as well as already having like 2 new games I could make (one of which I really like the idea of and have already nearly completely planned against my will, like my brain just keeps shooting information at me while I’m trying to focus on other stuff ghgh), some animations and a bunch of other things and it’s like oghHH... blease.. Finish Something for once before mentally checking out and moving onto the next hundred ideas you fool 
(also I told myself I can’t play any games until I finish my own (aside from like, sims builds on occasion) so I especially want to get it done soon since I always feel sick in the summer (no matter how much water I drink or how cool I try to stay, I’m just really heat sensitive and don’t live in a place with air conditioning)  and sitting around and playing games while I’m deliriously exhausted / nauseous / have constant heat headaches is a prime summer activity lol)
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2. “do you know where to get a witch hat?”
Unfortunately I have no idea where to get a witch hat lol, aside from maybe the costume aisle of stores around halloween?? (and even then, usually they only come in black). I’ve made sloppy ones myself by like, hot-gluing stuff to a regular hat, but I’ve never actually bought one. If anyone has any suggestions, feel free to list them in the replies or something so maybe anon can find where to get one lol
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3. “can i use your costumes as inspiration for drawings/what social media should I credit you with?”
 It’s fine to use my costumes and etc. as inspirations for art/etc! If you’re posting it on instagram it could be easier to just link my instagram since that’s on the same platform, but really it doesn’t matter to me. As I evolve into more of a hermit wizard I lose social media literacy and don’t understand which accounts are best to link people to or what social media is currently most popular lol 
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4. “do you watch Worldbuilding Notes on youtube?”
I actually hadn’t before (basically all I watch on youtube are like... video game/fantasy media lore analysis/information videos, general educational channels/documentaries/lectures, leftist video essays, and like.. the occasional let’s plays of games I can’t afford (if I can manage to find gaming youtubers who aren’t insufferable ggh). But weirdly I haven’t really looked into much worldbuilding content?? despite that being something I focus on so much (and also that I watch conlanging and linguistics stuff, which often seems to intersect with writing/worldbuilding youtube)), but thanks for recommending them! The concepts presented seem very interesting!
 I always really really wish I could condense information and make clear concise videos like that (audience wise, probably way preferable to just writing long text posts), but I just have such an inherent inability to make brief points (aka why no matter how good I was at a subject in school, I’d still fail/barely pass any essay/long form answer assignments.. I just.. can NOT organize my thoughts for the life of me for some reason). The best I could do is a more rambling podcast style lore explanation thing where I just speak naturally about stuff, but that seems like that’d still be nearly just as weird as long text posts, since I tend to ramble and be very silly when I speak lol, so currently I just don’t know of a more concise and accessible way to present my world information. :V   But anyway, thanks for suggesting it! The videos seem really cool, I like the ideas I’ve seen so far, and mostly am just in awe of their sheer power and expert ability to like... present detailed information in such a neat/clean/cohesive way aaaaAA (like.. the exact opposite of me but in a good way lol)
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And that’s all for this short group of replies lol! I still have other things in my inbox and etc. to reply to so sorry if I haven’t got to yours yet, I just wanted to get a few quick ones out of the way!!
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#replies#I'm actually making okay progress on the game stuff but I think the last parts (like.. finding people to test it out and etc) will be where#it really drags out and takes longer than I expected. Also it looks like I will finish stuff about the elven religion before even finishing#all the posts about the Avirre'thel because I already have the infromation on the elven relaigion nearly done gghhh#jumping ahead again... But I've been sick for like a week now and haven't been able to do much so doing the images of the elven#gods are a good mindless task like.. put on videos in the background and just color in lines or etc. I also have I think 4 worldbuilding#posts in the art blog drafts right now that I'm like 98% done with each so I can post those soon#AGAIN that's my problem.. I like.. start one thing.. and then by the time thing A is 50% done I already have thing B which I start#then thing A is 60% done and thing B is 20% done and now a thing C is 10% done. then I end up having like.. literally NO actually#cOMPLETE projects.. but a bunch of ongoing ones. It's like I'm constantly doing work but never actually FINISHING anything. whcih in turn#mkes me feel like I'm NOT doing work since i never see any tangible progress or completion. which demotivates me and makes#me feel bad an unproductive despite the fact that I am indeed constantly doing things ghhh. But anyway! I have like 4-5 worldbuulding posts#that I'll probably end up finishing all around the same time. And like 8 outfit photos I've had sitting on my computer for months but never#posted. and i also have 2 costumes laid out that I want to do but have to wait until I'm not sick anymore lol#then hopefully after that I can just drop almost all my other projects and over-focus on just doing the game again. At least those are#my january 2019 goals lol.. finish all the random 75% finished tasks that I have looming around all at once and then finally get back#on track with my more primary focus task.#Also I think I have seen worldbuilding notes's videos like.. recommended to me but I just never looked at them? since now that I'm#browsing some of the thumbnails like the art style seems familiar and etc. But I'm currently not getting recommended worldbuilding videos or#anything like that. I've been watching like.. video game developer conference speakers and I watched a single film analysis video so#now all of my reccomendations are like weird gaming youtubers and 45 munute video essays about the themes in the little mermaid movie or etc#ghgh.. youtube is very strange and has an interesting algorithm.. I love thinking about youtube since it was one of the first websites I was#really into when I was younger and first strated using computers and have  been regularly checking in there on and off since#like mid or late 2006 i think#so I've seen like.. the rise and fall of so many different trends and eras and like.. back before anyone even had 1million subscribers and#everyone like knew all the top youtubers and etc. and people just doing shitty skits in their bedrooms and etc. and it's just really interes#ting (if not like.. a bit sad to see how it is now) to see the development and how things change so much. people who have stuck around#and those who have left or trends that went away and etc. idk.. I Just Think It's Neat#anyway though!!! those are some questions answered.. hopefuly I can keep up with them better this year!
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malachitelibrary · 7 years ago
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Magical Research Tips
This is a post to help streamline the search for decent info during your metaphysical studies. Note that this post is a collection of tips and for the most part is not in any chronological order. 
What type of resource should I go for?
I. If you’re looking for: How to do it, Reading about someone’s own personal magic experience, A perspective from the magical side, go for magical books written by magical people
II. If you’re looking for: possible evidence of how it works in the physical world, analyzing a practice from a non-magical standpoint: non-magical sources written by non-magical people
What sources/subjects for what? (For point II above)  
Anthropology sources/databases will serve you better than magic books, when researching for traditions/culture-specific paths. They're less likely to bastardize/butcher things past a certain time period.
Theological books will serve you better than some traditional religion/practice books.
Scientific, Medical,  and Psychological sources/databases will serve you better than healing books.
Why not magic books for proof, analyzation, or history?
Magic books WILL cherry pick evidence and case studies/experiments. And often, these experiments will be severely outdated (from the 1900’s), and they will have a meager amount of them; maybe 5 experiments throughout the entire book, while compared to the at least 10-20 of a typical scientific journal. And of course, these 5 experiments will be used as the Ultimate Proof, instead of treated like the coincidental evidence they are.
Their explanations of how the magic/practice works in this physical realm will be “because it’s magic!!”, instead of in science/medical journals where you will get actual possible scientific/notable psychological bases behind it such as neuroplasticity, the applied placebo effect, the impact of human willpower, etc.
As for analyzation....lmao literally what magic books written by a magical person have good analysis. Sarcastic tone aside, I mean this in a legitimate matter; most magical books focus on the practice itself rather than an analyzation of that practice.
As for anthropological books versus magic books, this is because most magic books will not get the history and other anthropological information correct. They do not provide a good scope of the whole of the culture or the history, and there may be a bit of bastardization as well.
When looking for case studies/experiments, these phrases are your friends:
Randomized controlled trial
Double blind
Also check how many times the experiment was cited in others’ experiments/research. Being cited more times, and even continuing to be cited several years into the future shows an excellent experiment with results that are trusted. 
For further research into who exactly conducted the experiment, pay attention to the order of the names. Usually the ones listed first will be those who did the most work on the research. 
Doing the Research:
When searching, databases with full text will be your friend. Full-text is when a database has the entire copy of a source or portion of a source, rather than only a summary or the abstract. There will often be a checkmark box in the advanced search to show only full-text options.
Reference books/encyclopedias for the most part actually suck ass (sorry britannica); information is usually shallow and not well-researched. At best it could be used to find other sources of information to look at, as they will list the citations.
!!PLEASE DO NOT REUPLOAD THE FULL TEXT TO PUBLIC WEBSITES!! This is why most databases aren’t free; to protect against people pirating.
If you want FREE:
PUBLIC LIBRARIES: Public libraries are your FRIEND. They are public for a reason! Most public libraries in the US will let you get a library card at no cost at all. Borrowing books costs nothing as long as you return them on time. Also, public libraries often have access to databases that do expect you to pay, and provide that database info for free! And to top it off with a touch of morality brownie points, libraries help to support many rising authors as they are often how many previously obscure books break the ice.
University/Academic Libraries: Many universities provide their library services to the public. Like public libraries, they will often have access to the paid databases provided for free! It is usually based on the university’s wi-fi so you shouldn’t need to create an account. Academic libraries also often have a large reference staff on hand; the job of reference staff is to provide research assistance to people and be specialized in a certain subject of information. Meaning, you can totally hit them up for an interview to ask questions about the subject, and/or for research help!
Make friends with students (especially graduate students), professors, or researchers of the subject you want to look into: That’s what friends are for! There’s a good chance they may have had to write a paper (or MANY) on the subject you’re looking into. Even if not, they could point you towards better sources. 
Not all sources are made equal:
Some sources fucking suck; they’re inaccurate, don’t have the best wording, aren’t too well researched, or they’re just plain wrong. It’s going to be hard to judge sources when you’re just getting started in your research, but the more you know, the quicker you’ll be able to spot bullshit. Note that you’re going to waste a lot of time initially reading something you later found out was bullshit; that’s okay! Finding out something previous that you read was bullshit shows that you are learning. Plus, as you get a better grasp of what sources are shit and what’s not, you’ll be able to decrease that “wasted time” by a lot- so, it pays to be selective. Of course you should take everything in metaphysical stuff with a grain of salt, but if you’re taking everything as grains of salt, then how do you know which sources are better? The answer is experience and continued research.
Some sources can also be good for certain things, and terrible for others- even though they are both written about in equal measures. Take that into consideration when analyzing a source- perhaps their information on working with fae and other nature spirits is absolutely solid! However, perhaps their information/views on harm by large spirits such as deities, etc, or their views on mundane magic (such as employment spells) is rather...absolutely terrible.
Also. Sometimes you’ll think someone’s the absolute best when you start out in your craft. Hell, they may even be someone who inspired your practice at the beginning. But maybe you’ll come back a few years later, with experience under your belt and realize...they were actually shit the entire time. Hey, it happens. But remember that it shows you’re growing.
Signs of a shit source:
Few/no citations for something that is obviously not their personal practice or something they are the creator of
Author is extremely opinionated but tries to pass their opinions as fact with no sources or poor arguments
For healing magic books, trying to tell you that it’s totally okay to not go to the doctor/therapist, and/or that magic can absolutely replace legit medical assistance or therapy. Or, the author makes outlandish claims such as “I was able to cure someone’s celiac disease (a chronic disease) through my healing touch practice.”
Words that say nothing (and it’s not because of scholarly grammar); signs of this: you read a paragraph like 3 times and nothing sticks, or it doesn’t make sense.
Any form of “you shouldn’t have to X for Y result because I don’t have to X” that is written in a factual/”all people should” tone instead of in a tone reflective of or an article specifically about personal experience
At first something sounds nice, but then think on what the author said, and you go “???” or “sure jan.” Example of this plus the above bullet: “With money spells, everyone puts too much focus on sending out job applications. I don’t think that’s necessary, I’m such a good and wanted employee that employers are literally calling me to ask if I want to work for them!”
Tone matters. While not always, tone can be indicative as quality in certain ways.
Arrogant with no backing tone; the author keeps jacking off to themself- they keep building up how “complex” and “difficult” their Uneeq practice is and then it ends up being something low-level like sending energy
It’s a baby-ish tone that focuses on hurt feelings. Example: I saw some post saying how “we shouldn't use the term UPG because it leads to hurt feelings.” Uh, no. It’s the inability to handle the disagreement often associated with the term UPG that leads to hurt feelings, not the term UPG itself like lmao grow up, with people like that it doesn’t matter what term you use, disagreement will hurt their feelings anyways  
Complains about “over-intellectualizing” in certain ways; tone of this type often disagree about UPG for stupid (not automatically mutually exclusive) reasons. I will write a post about Stupid Reasons UPG Conflicts in the future, but I’ll provide you with a short example for now: Person A: Ummm Spirit Species X looks blue to my. Person B: Uh no they look red!! That means you can’t be working with the same spirit species! (They continue to argue). Actual reason behind it: Spirit Species X has multiple races/ethnicities and countries of origin on their plane, and both individuals jumped to hasty conclusions about the entire race based on the One (1) individual they worked with.
Some examples of shit magic books (with explanations as to why, of course):
The Chaos Protocols by Gordon White - A long, long explanation that I could still add on even more here. Fits the first two bullets under “signs of a shit source”.
DJ Conway’s books:
Explanation 1
Explanation 2
Saving Time: You don’t have to read a book/article cover to cover.
You don’t have to. You don’t. Unless the information is extremely cumulative (such as in storybooks), you will almost never have to read the entire book/article. Nonfiction books are generally well-sorted into sections by topic, so as long as you know the general information of the topic you can absolutely skip around and get only what you need.
About Topics
Topics that have little to no historical resources/traditions (if any at all):
Energy work of anything besides humans
Energy work in general that goes beyond “meditate!! Energy balls!”
Energy systems of spirits
Energy Signatures
Energy parasites (as in spiritual energy parasites)
Classifications of energy elements that go beyond the main four (5 if you include “spirit)
Discernment of types of spirits from one another (Note: you’ll likely just find a LOT of ableism and misogyny, especially in texts concerning differentiating angelic possessions versus “demonic”)
Discernment/vetting of spirits in general
Any spirits that aren’t already established in lore
Astral travel (the non golden standard that most people use today)
Actual anthropology of spirits (what their culture is like, what languages they speak, how their children are raised, etc); at best you will find only their mythologies, which represent only a minor portion of the spirit’s population or a single individual that is commonly mistaken for a whole species (The One(1) Minotaur  in Greek myth)  
Differentiating between varying levels of astral planes
Differentiating between energy system layers (and how they may relate to astral planes)
How humans can be shards/facets of large spirits such as deities, archangels, etc
Ways to repel/defend against Large Spirits that are harming you where the human(s) actually win (so NOT giving them offerings so they leave you alone, which was a trend for more merciless deities)
Biases/Perceptual filters, Discernment/Judgement in general
Energetic/Psychic Vampires (as in humans who are dependent on outside magical energy intake; NOT the spiritual species)
Eldritch spirits (actual working Info about the spirits besides lore)
Energetic Source wells (as in,those “ultimate”, apparently endless sources of energy)
So for these topics, you will likely be doing most of the writing/discovering yourself; these topics have little to no, if any at all, historical books for them.
Topics that have history but are rarely spoken in-depth (specifics given), or much in-depth knowledge has been lost:
Correspondences (such as herbs, crystals, etc)
Sex magic
Topics that are commonly spoken about but have much contradicting information:
Human energy systems (tip: ime people can have diff energy systems)
Topics that you’ll need to sift through fluffy, incorrect, shallow information, or extremist views for:
Anything involving angels
Chakras
Reiki
Any sort of “healing touch” practice
Empath/Empathic Abilities; also little to no info for how it works energy work wise 
How crystals work energy-work wise
Any sort of demonic spirit work (most demon workers vary from extremely fearful/hating of them or revering them as wholly benevolent)
Ars Goetia/Lesser Key of Solomon (in addition to above point, there are some views claiming Every Single One Is Actually Secretly A Deity which...I have opinions on in here)
Topics that are generally oral-tradition, secretive, closed in some form, or people are just overall not willing to disclose:
Soul retrieval
Energy work for the soul
Most forms of shamanism
Most indigenous traditions
Traditional witchcraft (though note some sects are more open than others)
Spiritual Conjuration (as in calling for a specific spirit with a billion protections/filters to make sure you get the right one)
Hereditary Witchcraft
Hedge Witchcraft
Feri traditional witchcraft
Clan of Tubal Cain aka Cochrane tradition of witchcraft
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Current Post Version: 21 December 2017
As with all of my posts, please check the permalink for the most updated version as I do regularly come back and make additions/edits.
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doctorsanddetectives · 4 years ago
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hey! so, the thing is I used to be really involved in tjlc pre s4 and it pretty much crushed me when the season aired and I just made a hard cut and distanced myself completely from it all. though I just kept on missing it, I didn't dare return to it, not even other adaptations. but recently, I just felt such a strong need to come back and it started with granada and tplosh but in the end, I just couldn't help myself and here I am thinking about Them again. and I've realised there are actually still a few people actually believing in tjlc, even some new ones. and I don't know, I guess I was just wondering if you could tell me why you still believe, if you really think they're actually going to make them canonically in love/in a relationship after all, what you think about a possible season 5 etc.? I know it's a lot to ask, I guess I just want to be convinced again haha
anyway, thank you for your time if you indeed answer this and of not then thank you anyway!
oh, hi! i'd sort of forgotten my ask box was open, so sorry for the late answer! this got a bit long, so i'll put it under a cut
[[MORE]]
first off, if you do rejoin the fandom, believing in tjlc or not, welcome back and i hope you have fun!
for me still believing in tjlc mostly boils down to this: 1. all the things that we saw in canon pre-s4 still exist, they are still in the text of the show. s4 doesn't change that just because it didn't go how we thought it would. 2. s4 doesn't make sense in ways that are too specific to not be on purpose.
number 1 is pretty self-explanatory i think, but just to throw some stuff you might remember back at you:
sherlock never denying insinuations that he's gay or that he and john are a couple, despite being mr. 'i get the last word'
sherlock saying 'into battle' while psyching himself up for john's wedding. sherlock watching sadly during john and mary's first dance and then leaving the wedding early. mind palace mary wearing her wedding dress while shooting sherlock in the heart.
john not being able to say the words he always meant to say to sherlock, even during therapy (what could they have been? i know what i think)
irene saying 'somebody loves you' to sherlock when she realises john was careful to not actually hurt him when punching him in the face. irene immediately following that up with asking john 'are you feeling exposed?'
john being sherlock's pressure point
i'm sorry, i gotta come back to the beginning real quick, everyone thinks sherlock is gay. mrs hudson (two rooms?). mycroft (happy announcement?). angelo (nice and romantic). janine (i know what kind of man you are).
that one post from the mofftiss tumblr q&a where the question is 'is sherlock saying i love you to john' and gatiss is like 'no, unless he's talking to a mirror' and we find out sherlock's talking to molly! john's main narrative mirror! mindboggling
that's just what comes to my mind right now, but there's of course still so much more. i sadly don't have a collection of all the old metas at hand but i know other people do, so i'd recommend you go searching for those.
as for 2. there's two pieces of particularly brilliant s4 meta that are keeping me afloat (and that i think i stole most of the points i make here from), i'll link them here and here. believe me, if you wanna believe in tjlc again, this is what you wanna read.
there was also a post that links weird things happening in s4 to bits from the earlier seasons, but i can't find it rn, i will link it if i do find it later.
but the one big thing that tells me s4 being the way it is was planned, is mary's death.
in s3 we get a 'how not to: death by gunshot' and it's
you don't get thrown across the room
you only have a few seconds of consciousness. choose wisely what to do
(if john watson is there, he will act like the army doctor he is)
in s4 we get
mary has time to throw herself in front of the bullet, then gets thrown across the room because of the bullet impact
mary holds a full 60 second monologue while bleeding out
(instead of trying to stop the bleeding or calling an ambulance, john just moos sadly)
it's the exact opposite. that is on purpose. whether it is on purpose to tip us off that s4 is not reliable narration - or if mofftiss genuinely decided to just say, fuck it, let's be weird as hell for no reason - that i can't promise. i choose to believe it is the former.
and, in terms of the five act structure: act 4 is supposed to hurt. usually, it's supposed to hurt, and seem so bad that it can't be fixed, to the *characters* not to the *fans* - but when have mofftiss ever done anything in a normal way, eh? because act 4 is when you lose all hope before the grand finale in act 5.
as for s5, idk if you know this or not but there was a 10 year anniversary q&a (it's on yt) in which mark gatiss said something about us being the most patient fans ever or so (i don't have the exact words). that made me go 👀 with regards to a potential s5 for sure.
also also, sherlock never officially got cancelled. and they were originally signed for 5 seasons from what i understand. everyone just thinks it's over because it seems over.
so long story short, i still think most of the original meta and analysis from before s4 holds up, i think mofftiss are willing to do some weird abstract shit that maybe we just don't understand yet (but that ultimately, hopefully, has purpose) and they always said there'd be 5 seasons
that was a long ramble, oops! but i hope it helps a little bit.
lastly, i should also point out that if it sizzles out and we never hear anything about sherlock again, that would not be the end of the world for me. i believe canon johnlock is the thing that makes the most sense for how the show is set up - but i'm well aware of the possibility that there might be things behind the scenes that we're not privy to and that might have changed the original course of the show. i do like to keep entertaining the idea of a s5 that proves tjlc until we have reason to think otherwise though!
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kiyabujayniah1996 · 4 years ago
Text
Reiki Session 9 Mind Blowing Unique Ideas
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What Is Reiki Level 4
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Reiki Therapy Table
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juniperpublishers-ttsr · 5 years ago
Text
Is Your Child at Risk? - Juniper publishers
Journal of Trends in Technical and Scientific Research
Tumblr media
Keywords
Posture problems, Back pain, Cavities, Whispering, Giggling, Slouching, Beautifully, Slender
    Opinion
Posture problems in youth is rising right under your nose. Are you a parent reading this article? Do you suffer from neck or back pain after a long day at work? Headaches maybe? Did you wake up with pain? Maybe you didn’t, but the other 65% of working population did, dose and do go thru their days in discomfort. You don’t stop eating because you are afraid of cavities? Then why do you expect the millennial to give up their smart devices? How many children do you see already in poor state of health? How many do you know personally? Just like cavities, using smart devices puts us at risk. It’s not about “What is wrong?” it’s about how are were reacting to it individually? What is the compelling reason to make a change before becoming the victim of the consequences?
    Let me share a personal story
It was a hot summer day, their laughter echoed like angles singing, Tina, Melisa and Helen, the 14 year old splashing around the pool as the parents Barbecued and talked sports. Tom was watching his Tina, with a smile of joy, with his cousins. As a doctor her knew the long hours was rewarded by watching his family joyful. The girls stood outside the pool, whispering and giggling, he noticed Tina is standing a bit crooked, and is really slouching compared to his cousins. It caught his eye, the smile change slowing to an objective analysis. He watched Tina walk to grab towels from the other side of the garden when he knew something is off, she IS crooked. What happened? He calls his wife, Fay, a protective Jewish Mom, who despite work, social life, and community involvement monitored her children like mother bear. He turns to her with fearful concern, “What is going on with Tina?” she proudly replies, “I know she is growing up so beautifully, she reminds me of my self at her age, tall and slender.” as she flaunts her hair with a smile. he looks at her, “what the hell are you talking about, look at her pelvis, her back, it’s not right!”
Fay, wide eyed looks at her, then at him.” “Tina, sweetheart come here, come here!” Uninterestedly and dutifully, she walks over with her head and neck forward, long wavy hair covering her slender thin body, and rounded shoulders. Fay watches her daughter’s hips, posture, and remembers how she is more introverted with others, how her baby is all crooked in her bikini. This can’t be happening, Fay a doctor herself, immediately dose a posture analysis, “Stand up straight” she checks her Head, ears, shoulder blades, Back, Pelvis, Hip, Knees. “Turn around honey”. John stands there and looks at her daughter and wife, a unsettling feeling of concern wraps around his stomach. Tina’s head is 6” over her shoulders. Her right scapula is notably rotated back, and her right pelvis is 3” higher than the left side. “Mom, are you done. Girls are waiting for me?” Fay and John look at each other in concern, Fay, eagerly says; “Honey we’ll make an appointment with Romina she is her god-daughter. She will take care of her”.
I greet my best friend Fay and Tina, (as smiled and thought, love these girls, last time they visited my Clinic was when she was 4 years old. Then she fell of the kitchen counter). They usually see the local Chiropractor, only urgent matters start with me. I know there is a problem! We walk to the exam room. Fay shares her concern about Tina’s posture and how in past year she has been laying on her beanie bag, creating movies, playing games and doing her homework on her laptop. She has been complaining of neck and back pain, with frequent headaches, that Tylenol helps. “We have been telling her to standup straight, and she slouches” maybe she listens to you. Last week at BBQ party we noticed that her pelvis is off, can you check her?”
I proceed with my examination, which was obvious for Forward head position (phase II) and pelvis unleveling, postural distortion. X-rays, will determine if her posture problems are skeletal or muscular, and to what ratio of physiological involvement of muscles to bone effect. I sat in my office, looking at Tina’s X-rays, shocked! Tears pour down, how do I share this with Fay? From the mirror window in my office I can see them giggling over her nail polish. My voice is muted holding back the tears as I draw lines, angles, and measurements on her X-rays, wiping off the unstoppable tears. OMG, OMG, why did this happen? This is my baby girl! This is my god daughter.
I put myself together as I wear my white coat, maybe the coat can give me strength. I pull myself together, pull my hair back, clear my throat, stand up, and force a smile. I call them to the consultation room, prior to showing the X-rays I start my explanation. “Recently within the past few years there has been a notable rise in number of young adolescents and adults suffering from neck, upper back and lower back pains.” In past we blamed heavy back packs, now we have an added insult to the growing fragile bodies of our children. The side effects of smart devices integration in children’s lives. In fact; Kaiser family research states “An average 8-18 year old spends about 7.5hrs a day on some form of smart device.”
You see, there are 3 common factors that contribute to poor posture are:
a) Muscular problem
b) Structural problem
c) Functional problem
• Muscular Problems are poor muscle balance, usually due to developed bad habits. Such as beanie bags, text neck, playing games on hand held devices. In adults it could be poor ergonomics at work or when driving. Usually most noticed with stiffness, and muscle aches (Figure 1).
• Structural problems are deeper issues. Specifically speaking is changes to the skeletal system. This generically is known as “Scoliosis”. An X-ray can identify the source being born with (congenital) or if it is developed later in life (structural).
• Functional Problems are when the skeletal system and the muscular systems changes to the point that the joints have lost their integrity and are not moving in correct aligned synchronicity. This will lead to early wear and tears at joint lets and create bones spurs, fusions and early arthritis. (Reported cases of bone spurs in teenagers are becoming a health concern.)
I show Tina what normal X-ray looks like from front and from side. Explaining the importance of correct alignment. I open the view to reveal her X-rays. Fay gasps, tears weld in her eyes, as she knows what this means. Tina’s jaw drops, in a nervous joke she says “Ahhhh, That’s not straight!”. Based on your X-rays, it is evident that you do not have a congenital problem. You have a condition called “Adult Onset Idiopathic Scoliosis”. I believe your spine is reacting to the abnormal postures over the past few years and it caught up with you on your growth spurs. Your body has changed due to the pressures loads as result of poor postural habits and demands. This is noted in many ergonomic evaluations on adults. In past children were more physically active and did not spend their time looking down other than homework for few hours a day. That has changed dramatically with phones, tablets, laptops now your body is reacting to these changes.
For every 1” that your head is off its center, there is between 10-15 lb. of pressure loading on your spine. kepangi&white
    Radiology Report
X-Ray Impression
Reverse C/S curve of-12’/45’
Early onset of posterior bone spur at C7
Scoliosis is simple from T8-L5
Right Concave Scoliosis
Pelvis rotation (Compensatory change due to Right Rotation of Vertebral bodies from L3- T9 creates a Complex Scoliosis
DDX
Reverse C/S curve= Alordosis
Compensatory Rotary Scoliosis (Thoraco-Lumbar spine)
Non-Congenital Scoliosis
    Discussion
Range of Scoliosis
phase I- 5’-2’degrees:
Conservative method.
Care: Physical Rehabilitation & Chiropractic Alignment. Duration of care 3-6 months, full spine X-ray every 3-6 months.
Phase II 25’-45’ degrees
Milwaukee/ Other custom made brace and Surgical Candidate.
Care: Aggressive Physical Rehabilitation & Chiropractic Alignment. Duration of care 6-24 months full spine X-ray every 3-6 months.
phase III >45’ degrees:
Care: Surgery
From that day on we put Tina on strict program of chiropractic, physical therapy, yoga therapy, hard bracing and 9 months later $30,000.00 + in out of pocket expense we were able to make some changes to her spine. Tina has to wear a customized brace for many years on daily basis. As a doctor we look at anatomical changes and fail to share with parents the psychological ramifications. A growing child needs to develop his/her personality in society, matters such as confidence, ambition, social interaction are building blocks of a child’s emotional IQ. If a child feels he/she is different, has an imperfection, or has to hide a secret, to avoid being ridiculed or bullied. That child’s future is at risk (Figures 2-5).
As parents it’s important to check your children posture. To raise our future presidents, senators, world leaders not insecure, introverts, make wrong decision as result of poor self image. A simple posture analysis and prevention will change your child’s future, Just Maybe! see posture score at www. BAX-U.com
    Conclusion
I share this story, as a godmother, doctor and advocate for better posture better health. My effort is to help adults have better work ergonomic, but prevention starts from home. Find out what your posture Risk Score is and how together we can Stand taller, Feel Better and Look Amazing. This personal story is to impress upon you the importance of educating today’s parents for healthier children. Together we can make a difference in more ways than you can imagine. I speak out because “I Care”. Join our team to educate, empower and promote better health thru early detection and prevention.
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dinafbrownil · 5 years ago
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Readers React: UVA Doctors Outraged Over Their Own Health System’s Billing Practices
Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.
First Do No Harm: When Financing Health Care Becomes Unethical
We attribute the oldest text of ethics in Western medical practice to Hippocrates (460-370 A.D.), a Greek physician whose oath instructs, “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing.” Most doctors, having pledged that oath upon entering the profession, recall best its later paraphrasing primum non nocere, first do no harm.
As physicians at UVA Health and educators at the University of Virginia, we were appalled by the revelations of the aggressive, pitiless billing and collections practices, first reported in The Washington Post based on an investigation by Kaiser Health News (“‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes,” Sept. 10). We felt betrayed and we had, by extension, betrayed those who had relied on us. We had harmed.
When we began our positions at UVA, we did so with the understanding that, as clinicians at a public institution, we were privileged to care for all people, including those with limited ability to pay. Many of us chose academic medicine, and UVA specifically, so that we could partner with our patients to improve health and well-being thanks to the social contract specific to tax-exempt hospitals to provide low-cost care to people of all incomes. As we have learned recently about UVA and from stories reported from other states and institutions for more than a decade, avaricious billing and collections practices have broken the spirit, if not the letter, of that social contract (“UVA Doctors Decry Aggressive Billing Practices By Their Own Hospital,” Nov. 23).
The individual stories are heart-rending, and the extent of the collective impact is staggering. Indeed, based on an analysis by the Consumer Financial Protection Bureau in 2014, over half of all collections items in credit reports are associated with medical debt. A recent study of people with new diagnoses of cancer and a representative insurance mix, including the uniquely American categorization of people underinsured, found 42% had depleted their life savings 2½ years after their diagnosis. To be sure, academic medical centers must function within the competitive and revenue-driven environment of our country’s approach to health care, and some, like Hahnemann Hospital in Pennsylvania, have not survived. However, the survival of not-for-profit hospitals cannot be assured by the relentless pursuit of debt from the very patients for whom we are expected to be the safety net.
Senate Finance Committee Chairman Chuck Grassley (R-Iowa) sent a letter on Oct. 17 to the UVA Health System’s acting executive vice president for Health Affairs that detailed questions about billing and collections practices at our institution. We have similar questions. While we applaud UVA for the rapidity with which it has announced reforms aimed at reducing the numbers of lawsuits and making more financial support available, we are uncertain how many future lawsuits will be prevented by restricting that punitive action to those with bills of more than $1,000, and why UVA cannot join other public hospitals that have effectively stopped suing patients altogether?
We simply cannot accept one-off solutions. Over half of all hospitals in the U.S. are not-for-profits, and the regulations that govern billing and collections practices vary by state and fail to offer adequate protection in most. Continued identification of egregious practices at individual institutions is essential, and we are grateful for the work of health care journalists and of members of Congress who have prioritized these issues in the national discourse. Public pressure placed on hospitals has frequently resulted in forgiveness of debt and, in some cases, changes in billing practices. Yet, until we achieve a truly universal health system modeled after other countries with similarly vast monetary wealth but more concrete social moorings, we must pursue an immediate solution to address health care pricing and billing. Such a solution must ensure transparency, as Sen. Grassley rightly highlights in his requests of UVA, and therefore allows for honest conversations about how we, as a country, hope to continue to provide excellent care to all Americans. The National Consumer Law Center’s Model Medical Debt Protection Act could serve as an important starting point.
To be clear, we are outraged. We stand with those that have been financially injured, whose bank accounts have been looted, whose homes have been swallowed as if they were built on quicksand, whose credit scores were ruined and whose mental health and energy were spent in a courtroom or in anxious conversations with lawyers — all as a result of having sought our care. We commit to working at UVA, our beloved professional home, to advocate for leaders of high moral integrity, to regain the trust of our patients and to repair to the greatest extent possible the damage that has been done. We call on our community, and especially our fellow clinicians, to demand that the precious resource of our public, not-for-profit hospitals protect our ethical responsibility to first do no harm.
— Drs. Scott K. Heysell, Michael D. Williams and Rebecca A. Dillingham, University of Virginia, Charlottesville, Va.
It’s good news that predatory hospital billing and collection practices are being questioned (this time at a location we get care from): https://t.co/rT2MlRdnZo
— Jan Oldenburg (@janoldenburg) October 18, 2019
— Jan Oldenburg, Richmond, Va.
The Slippery Slope Of Preventing Falls
I commend Kaiser Health News for shining a light on the dangers of senior falls ― the most common cause of nonfatal trauma-related hospital admissions (“‘Fear Of Falling’: How Hospitals Do Even More Harm By Keeping Patients In Bed,” Oct. 17).
Fears over patient falls are warranted; however, steps should be taken to provide patients with access to physical therapy while in the hospital to prevent loss of strength and mobility. Further, access to physical therapy can help reduce the steep costs associated with falls, which total roughly $50 billion annually.
In the outpatient setting, physical therapists are uniquely qualified to improve a patient’s functional ability and recommend the home modifications necessary to allow them to remain independent.
Whether inside the hospital or in the outpatient setting, patients need to be allowed and encouraged to move and walk under the supervision of a physical therapist. Promoting access to physical therapy will ultimately keep our seniors independent, prevent adverse events and drive down health care costs.
― Nikesh Patel, PT, DPT, executive director of the Alliance for Physical Therapy Quality & Innovation, Washington, D.C.
Another poorly thought through CMS regulation. Quality healthcare cannot be reduced to yes or no questions. ‘Fear Of Falling’: How Hospitals Do Even More Harm By Keeping Patients In Bed https://t.co/GTO1xLTDU6 via @khnews
— Cat Shah (@CatherineShah8) October 22, 2019
— Catherine Shah, Charlotte, N.C.
Kaiser Permanente Therapists Sing The Blues
I’ve been a Kaiser Permanente psychologist for over 25 years. I have seen many changes with Kaiser and I am tired of having to shortchange my patients of much-needed treatment services (“Bruising Labor Battles Put Kaiser Permanente’s Reputation On The Line,” Nov. 8). I wrote this song on behalf of my therapist colleagues in protest for better working conditions for patient care in the Department of Psychiatry at Kaiser. I recorded it with another colleague, Matt Torres, and two musician friends who are Kaiser members and sympathetic to the NUHW cause.
― Eugenie Hsu, Oakland, Calif.
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Not Either/Or, But Sometimes Both
The article “Meth Trip Or Mental Illness? Police Who Need To Know Often Can’t Tell” (Nov. 1) failed to delve into how often individuals whom police interact with are experiencing mental health or behavioral problems in conjunction with substance use disorders.
The police in this article said they need to know whether they’re dealing with a mental health issue or drugs in order to respond appropriately. In Substance Abuse and Mental Health Services Administration’s 2018 report “Key Substance Use and Mental Health Indicators in the United States,” the percentages of adults who used illicit drugs in the past year were higher among those with serious mental illness (49.4%) and adults with any mental illness (36.7%), compared with those without any mental illness (15.7%).
Since there is such a high chance that people with mental illness are also using substances that can alter their clinical presentation, the police should be trained to prepare for modalities that can accommodate that, keeping themselves and those they serve safe.
― Xi Lucy Shi, Pittsburgh
Standing By Drug Treatment For ADHD
I am a child psychiatrist with a research and clinical focus on treatment of attention deficit hyperactivity disorder. I recently submitted a grant to the National Institute of Mental Health examining the evidence for and against stimulant treatment. The individuals quoted in the article “Pediatricians Stand By Meds For ADHD, But Some Say Therapy Should Come First” (Sept. 30), arguing that behavioral interventions are effective enough to be considered the first choice in ADHD treatment, aren’t correct.
Repeated, large-scale, well-controlled double-blind studies have shown that, with the exception of preschool/kindergarten children: (1) Medication for ADHD is shown to be significantly more effective than behavioral interventions, with behavioral treatments for ADHD only mildly effective or not effective at all. (2) Medication improves long-term outcomes, such as reduction of motor vehicle accidents, accidental physical injury and delayed educational progression. (3) Untreated ADHD is associated with increases in suicide risk, legal issues, divorce rate, job loss, substance use, motor vehicle accidents and self-esteem issues.
While the 6-year-old child in this article has tantrums (which might improve with only behavioral interventions), a school-aged or older child with ADHD would have problems with attention and concentration in school ― hurting his/her early learning. Symptoms of attention and concentration are particularly poorly responsive to behavioral interventions.
Behavioral treatment is not the first choice because delaying treatment can quickly have consequences, while medication treatment is very low-risk, yet dramatically effective.
― Dr. Ryan S. Sultan, New York City
Modifying classroom instruction and using behavioral supports should be first. Then meds if they are needed at the lowest effective dose along with modification and behavioral support. Jeez
— Terri Lewis, PhD 和平抵抗 (@tal7291) October 1, 2019
— Terri Lewis, Silver Point, Tenn.
On Astronomical Air Ambulance Costs
Your recent story about the cost of air ambulance services (“Bill of the Month: The Air Ambulance Billed More Than His Surgeon Did For A Lung Transplant,” Nov. 6) failed to paint the full picture. Recently, my wife had a Type A aortic dissection. She was transported to emergency surgery via helicopter air ambulance for a six-hour-long heart operation that saved her life. Our bill for the air ambulance was over $81,000 for the hour-long flight. What I learned from this incident is that there are only four hospitals in all of California where this operation is performed. Without the air ambulance, I would have likely been planning a funeral instead of dealing with over $750,000 in medical bills. The highly trained crews of these operations save lives every day. Most fly a helicopter, which costs $6,000,000 before it is equipped as a flying ICU. Most fly between one and three flights in a 24-hour period, on average. They are manned 24/7, equipped to fly in the clouds and equipped with night-vision capability. Nearly all are single-pilot crews (to keep costs lower) and have at least one flight nurse (most have two). All have training and qualification maintenance costs for the equipment and personnel. In consideration of all of these costs (note: I did not include facility or insurance costs), I think their cost to the patient is not out of line with other medical costs today.
I noted there was no talk of using a ground ambulance in the article. Was it time-critical for the patient? In other words, would it have had a similar outcome if a ground ambulance been used? In our case, the two extra hours a ground ambulance would have consumed would have likely concluded in a fatality.
The other side of this conversation revolves around how patients are billed and how our current system works to be the most expensive system in the world with only mediocre results. Nearly all billing is reduced by some amount by the insurance ― often called a discount. Because doctors and hospitals know they will receive only between half and three-quarters of what they bill, they inflate the billing so they get what the need to cover most costs. The big loser is the patient, who is underinsured or not insured at all.
The article as written is a very incomplete picture of the air ambulance world and a disservice to your readers.
― Dennis Lyons, Paso Robles, Calif.
Just read your article about helicopter charges. Why not educate the public that they can purchase helicopter insurance, which is very cheap? I highly recommend it to friends who live in rural areas with hospitals that do not offer a full range of services or who need transportation to receive a higher level of trauma care. A bigger problem: the huge health care systems ― whether privately managed or government-run ― that have associates with these rural hospitals or own them. They want patients to stay in their system and will bypass other hospitals that are closer and offer the same services. Choices of care are not always given to patients, or when they are given, they are brief and come in a moment of crisis when patients and families can’t take it all in. How about educating the public on what really is happening and how we continue to waste health care dollars and how they can protect themselves in advance? Call the air transport company and learn about their insurance.
― Nina Jeffords, Miramar Beach, Fla.
The associated "fact sheet" was equally bizarre and rather incoherent..this is a far cry from the normal professional and policy-oriented communications we expect from HHS.
— Dr. Cheryl Phillips (@phillic58) October 4, 2019
— Dr. Cheryl Phillips, Washington, D.C.
Don’t Let Fact Check Undermine Facts
Shefali Luthra did an excellent point-for-point takedown of President Donald Trump’s speech at a conservative retirement community in Florida, which amounted to a cynical gambit of frightening Caucasian seniors into believing that their long-cherished Medicare was under attack from the Democratic “socialist” and the freeloading communities they represent (“KHN & PolitiFact HealthCheck: Trump Speech Offers Dizzying Preview Of His Health Care Campaign Strategy,” Oct. 3).
One critical point that she and others, including the Democratic candidates for president, however, have failed to give sufficient emphasis to, is the degree that household income will actually increase in response to a “Medicare for All” plan. Trump stated in this speech, with no evidence, that household income will go down $17,000 a year with Medicare for all. Although there will be a tax increase to fund this program, the increase will pale in comparison to what we are already paying in premiums and deductibles to a predatory insurance industry. Ms. Luthra only went so far as to question the accuracy of that absurd assertion. Failure to drive this point home will invariably allow the masses to revert to the default mode of “socialized equals a tax increase ― end of story,” and put its long-overdue implementation at risk.
― Samantha Derrick, Berkeley, Calif.
Good, in-story fact check.But could context that current efforts aimed at serious reducing protections through ACA and #GOP has never offered any legitimate alternative > Trump Speech Offers Dizzying Preview Of His Health Care Campaign Strategy https://t.co/8waboBoT1B via @khnews
— jerrymberger (@jerrymberger) October 4, 2019
— Jerry M. Berger, Boston
Under Pressure To Treat Lymphedema
Great story about a little-known expense patients have for compression garments (“Compression Garments Can Ease Lymphedema. Covering Costs? Not So Easy,” Oct. 23). I had to purchase some to wear for a short time for lupus-related swelling and I was shocked at how much they cost. They definitely make a big difference in comfort, and I really think insurers should pay. As they also help to prevent infection, it may make coverage cost-effective in the long run. Is there a petition I can sign to support legislation? I will call my Congress members as well. Thanks for the article!
― Kristan Thompson, Savannah, Ga.
Penalties Run Afoul
In response to Jordan Rau’s article on Medscape.com (“New Round of Medicare Readmission Penalties Hits 2,583 Hospitals,” Oct. 1): If the hospital does not want to be penalized for readmission, well, the hospital staff can just let the patient die. On the contrary, the hospital should be rewarded for saving the life of the patient, and that is all that should concern Medicare. The hospital should be penalized for any patient deaths, period! Because the way around that penalty from Medicare is to just let the patient die in the hospital. It should be that the hospital is recognized for giving treatment to the best quality care that the hospital can provide! Someone should look into Medicare’s revolting penalty system.
― Lois Greene, Sacramento, Calif.
Wow! 2,583 hospitals were penalized for heart failure readmissions in 2020, including @BrighamWomens, @MassGeneralNews, and @BIDMChealth. If everyone is penalized, is the program actually effective? @kejoynt @rkwadhera https://t.co/KAIELu819A
— Aaron Paul Kithcart (@APKithcartMDPhD) October 2, 2019
— Dr. Aaron Paul Kithcart, Boston
Entrenched Stigma
The cumulative effect of “experts” telling the public there is a stigma to mental illnesses (“Taking The Cops Out Of Mental Health-Related 911 Rescues,” Oct. 11) ought to draw considerably more attention.
― Harold A. Maio, Fort Myers, Fla., former editor of Boston University’s Psychiatric Rehabilitation Journal
I had injured/panicked bipolar client strapped on board call me frm accident scene bc cops on the way. She was afraid they’d shoot her. I get there, find Fire Capt next 2 her ready 2 protect her. Taking The Cops Out Of Mental Health-Related 911 Rescues – https://t.co/6f7k9Ehdf7
— R. Ruth Linden, PhD (@TOLHlthAdvocate) October 21, 2019
― R. Ruth Linden, San Francisco
Nurse Practitioners Answer The Call
Your Oct. 9 article “They Enrolled In Medical School To Practice Rural Medicine. What Happened?” underscores the growing primary care provider crisis in rural America. Nationwide, the demand and need for primary care, especially in rural areas, leaves patients without care.
According to the U.S. Department of Health and Human Services, 80 million Americans lack access to primary care, with the most significant shortages in rural areas. By 2030, the country is expected to face shortages of more than 120,000 primary care physicians.
The nation’s 270,000 nurse practitioners (NPs) can address the shortage. In fact, a study in Health Affairs found NPs now represent 1 out of 4 health care providers in rural health practices. NPs assess patients, order and interpret tests, develop treatment plans and prescribe medications in all 50 states ― yet outdated state laws stand in the way.
Forty percent of states authorize full practice authority (FPA) for NPs, ensuring patients full and direct access to NP care. The remaining states limit NPs from practicing to the top of their education and training.
NPs can meet the demand for high-quality primary care nationwide. It’s time the remaining states update their laws so that all patients can access the care they deserve.
― Sophia L. Thomas, president of the American Association of Nurse Practitioners, Austin, Texas
The Plus Side Of 3D Mammograms
As a clinical researcher and diagnostic radiologist who reads thousands of mammograms each year, I was dismayed to read the KHN investigation “A Million-Dollar Marketing Juggernaut Pushes 3D Mammograms” (Oct. 22), which stated “there’s no evidence they are more effective than traditional screenings.” Hundreds of peer-reviewed scientific articles substantiate improved recall rates and cancer detection rates associated with 3D mammography. This article fails to present this information to readers and causes significant confusion in patients and physicians nationwide.
Recalls ― or “callbacks” — from screening mammography impose a tremendous psychosocial and economic burden on patients. Not only do patients and their families experience fear and anxiety due to a potential cancer diagnosis, but recalls also lead to downstream noncompliance with future screening recommendations and, on average, a 13-month delay to returning to screening mammography. Experiencing a recall or false positive increases the risk of late-stage diagnosis, when breast cancers are larger and harder to treat.
The experience of radiologists reading thousands of mammograms is not anecdotal. It is rooted in evidence-based medicine and data. These are not my opinions, they are facts.
― Dr. Nila H. Alsheik, chair of breast imaging, Advocate Aurora Health Care, Chicago
How High Is High?
The article “Employers Are Scaling Back Their Dependence On High-Deductible Health Plans” (Oct. 29) did not provide enough detail to confirm whether the cost to the employer of the PPO options was the same, more or less than the cost of the “high”-deductible health option. For example, it wasn’t clear whether the employer was making a contribution to the Health Savings Account or Health Reimbursement Account for the high-deductible health option.
Assuming the PPOs and the high-deductible health option all use an 80%-20% coinsurance formula after the deductible up to the same out-of-pocket expense maximum, the employee contributions you quoted give the appearance that the PPO options are much more attractive to almost every employee. For that result to occur, the cost to the employer for the PPO options would have to be substantially greater than the cost to the employer of the high-deductible health option.
― Jack Towarnicky, Powell, Ohio
from Updates By Dina https://khn.org/news/readers-tweeters-letters-to-editor-uva-doctors-outraged-over-their-health-systems-billing-practices/
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suzannemcappsca · 6 years ago
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Let Mediation Be Mediation: Conciliation Versus Mediation in Brazil
Maria de Nazareth Serpa
In 1999, I had just returned to Brazil from the United States with a Ph.D. thesis on ADR when a mediator colleague invited me to attend and appraise a mediation session. I was eager to do that and observed, minute by minute, the rich communication interaction between him and the parties. At the end my colleague asked me for comments on the session, which I promptly critiqued. It was fast, beautifully done and effective – except for the fact that it was not a mediation but a conciliation (at least as those terms are understood in Brazil) because the session was focused on a discussion of rights and law between the parties and the intervenor.
And this is what still happens in Brazil. Since mediation began primarily with lawyers, they brought their baggage of rights and laws to mediation sessions, putting aside the principles of the process, such as party control, autonomy, mediator neutrality, etc. This is especially so in what was later institutionalized as “judicial mediation” following the enactment of the Brazilian Mediation Law in 2015.
Mediation and conciliation have different meanings in different countries. In Brazil, as indicated below, conciliation is always a law-based procedure with a legal evaluation at the core of the process – who is right, who is wrong, and who has the law on their side, whereas mediation is a more flexible process, centred on party control of the process, their interests, tailored to individual circumstances and conducted by a third party intervenor with a different role. This role is focused on uncovering and working with the parties’ real interests (personal, commercial, etc.) underlying their stated positions, rather than evaluating purely legal arguments. Conciliation is an objective process dealing with rights and laws. Mediation is a subjective process dealing with parties’ dispositions, recognition and acceptance.
There is nothing wrong with conciliation per se, but it must not be confused or interchanged with mediation, nor put into the same definitional category as mediation. This has been done elsewhere, causing a certain amount of confusion. UNCITRAL used the terms interchangeably in its 2002 Model Law on International Commercial Conciliation1) See https://www.uncitral.org/pdf/english/texts/arbitration/ml-conc/03-90953_Ebook.pdf jQuery("#footnote_plugin_tooltip_9171_1").tooltip({ tip: "#footnote_plugin_tooltip_text_9171_1", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });, which it finally changed in a 2018 revision of that Model Law.2)See UNCITRAL Model Law on International Commercial Mediation and International Settlement Agreements Resulting from Mediation, 2018 (amending the UNCITRAL Model Law on International Commercial Conciliation, 2002), at http://www.uncitral.org/uncitral/en/uncitral_texts/arbitration/2002Model_conciliation.html jQuery("#footnote_plugin_tooltip_9171_2").tooltip({ tip: "#footnote_plugin_tooltip_text_9171_2", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] }); This may have been because diplomats have been using the term “conciliation” in a very broad sense, whereas lawyers use it in a more technical sense. Substituting or confusing conciliation with mediation will damage the institution of mediation and seriously impede its development in Brazil.
We observe, especially in family mediation where unique particular personal situations arise which are not specifically covered by statutory laws and rights, that there is a strong necessity for more accurate research into the arsenal of resources available to the parties to satisfy their needs and interests. These resources may come from the fields of psychology or family therapy which lie outside of law, for example.
Here a real situation described by a mediator colleague in Brazil provides a good picture of the issue, even when such situations do fall within the scope of codified laws and rights. A couple came to consult this mediator-lawyer about the support and guardianship of their child. There was a heavy imbalance of power between the spouses. The man stepped into the office, yelling “Which law is going to support my case?” to which the mediator responded: “You can choose whichever law that suits what you think your child deserves. As you can see, we have on the shelves lots of codes with lots of laws, including King Solomon’s law to cut the child in half for each interested person. Or… you can create your own law – that’s your choice”.
I confess I used that answer in many opportunities to lead parties along the real track of mediation. Conciliation, in Brazil at least, means finding the law on the books to justify what you want, while mediation involves going beyond that to create your own resolution – in effect, a private law to govern the parties’ particular situation. More than anything, the conciliator has to recognize the applicable precedents which impact the case being conciliated.
Without formal training, I had used conciliation in my law office starting in 1973. But only after my research on mediation in the United States in 1995 – 97 did I realize that it was up to me, as manager of my clients’ conflicts, to determine which process was suitable for each specific scenario, especially taking psychological factors into account. I have always found situations where, although legal resources were plentiful, we still found issues where one more key resource was required that was not provided or stated in any code. This resource might have a very short shelf life and be useful for just one moment, one case among only two parties, but still necessary and required by them. It is often the analysis by the parties themselves to see if they are ready to at least recognize and accept the other parties’ point of view and feelings, even if they don’t agree with them. If not, they can still choose facilitation, conciliation, arbitration or other mode of dispute resolution.
In the Brazilian mediation community very few people defend the unique quality of mediation and the necessity of real and consistent education about it. Legal education, which in Brazil takes at least five years, is perfect for the performance of a conciliator or a lawyer in the conciliation process to appraise or suggest law-based proposals and solutions, but not to conduct a negotiation process without interference in the legal merits of the dispute. The problems arising from this crucial lack of qualification are exacerbated because the Brazilian Bar Association (OAB) overreacted and decided to produce a draft law (PL) 5511/2016 requiring the presence of lawyers in all mediations and changing the role of lawyers in the process to help mediate their own clients’ cases, especially in so-called “judicial mediations” although this draft law does not itself contain any limitations on the types of mediation requiring lawyers’ participation.3)See http://mediationblog.kluwerarbitration.com/2018/07/08/brazil-edge-making-lawyers-mandatory-mediation/ jQuery("#footnote_plugin_tooltip_9171_3").tooltip({ tip: "#footnote_plugin_tooltip_text_9171_3", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });
We understand that the case in a conciliation process is sub judice, i.e. there is an evaluation at the core of the process – who is right, who is wrong, and who has the law on their side. So it is acceptable to call conciliation in the judiciary “judicial conciliation”. The same does not apply to mediation which does not include any kind of judgment of right or wrong. Mediation and judgment definitely do not fit together. They are opposites, use different techniques, and perform different functions – mediation is centered on interests while conciliation is based on law and legal rights. Of course, mediation may also take legal rights into account but is not based or focused only on them.
To further blur the distinctions, the Brazilian Mediation Law of 2015 created a creature known as “judicial mediation”. This is an attempt by the judiciary using very limited resources to administer mediations for the multitude of cases filed in the courts, as opposed to private mediations conducted via ADR institutions or independently. Judicial mediation is not mediation in the true sense because there is very little party autonomy or control. Parties have no control over the choice of the mediator which is done by lot, over the time allotted for mediations which is normally set to a very short limit – sometimes 20 minutes (this is not a typo), or over the remuneration of the judicial mediator which has also been very limited4)As we go to press, a brand new Resolution of the National Council of Justice (CNJ) which controls administration of the courts, is calling for remuneration of judicial mediators according to a scale: I – voluntary; II – basic; III – intermediate; IV – advanced; or V – extraordinary. See CNJ Resolution 271 of 11 December 2018. jQuery("#footnote_plugin_tooltip_9171_4").tooltip({ tip: "#footnote_plugin_tooltip_text_9171_4", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });, hence failing to attract the most experienced mediators.
In Brazil, the understanding of the difference between mediation and conciliation is important because each process of dispute resolution entails very different techniques and performance from the mediator or conciliator and the parties. It is possible to think of a judicial conciliation which would mirror a subsequent judgment, but mediation would not ordinarily do so.
Conflicts are differences between people which are not manifested. When they are manifested, they become disputes5)See Mediação – Uma Solução Judiciosa Para Conflitos (Mediation: A Judicious Solution for Conflicts), book in Portuguese by Maria de Nazareth Serpa, DelRey Publishers, Belo Horizonte – MG, Brazil, 2017, capítulo (chapter) IV, “Tipología dos Conflitos” (“Typology of Conflicts”), at pp. 22 et seq. jQuery("#footnote_plugin_tooltip_9171_5").tooltip({ tip: "#footnote_plugin_tooltip_text_9171_5", tipClass: "footnote_tooltip", effect: "fade", fadeOutSpeed: 100, predelay: 400, position: "top right", relative: true, offset: [10, 10] });. Solving means coming to a final decision, whereas resolving means taking care of the shorter-range situation at hand. In this sense, conciliation is designed to solve disputes while mediation is tailored to take care of eventual disputes by discovering and resolving underlying conflicts, which most of the time are camouflaged issues that the law does not cover. This the conciliator can ignore, but the mediator cannot.
Let’s protect the institution of mediation and keep it as it is intended to be, not confused with or diluted by concepts and practices of conciliation.
References   [ + ]
1. ↑ See https://www.uncitral.org/pdf/english/texts/arbitration/ml-conc/03-90953_Ebook.pdf 2. ↑ See UNCITRAL Model Law on International Commercial Mediation and International Settlement Agreements Resulting from Mediation, 2018 (amending the UNCITRAL Model Law on International Commercial Conciliation, 2002), at http://www.uncitral.org/uncitral/en/uncitral_texts/arbitration/2002Model_conciliation.html 3. ↑ See http://mediationblog.kluwerarbitration.com/2018/07/08/brazil-edge-making-lawyers-mandatory-mediation/ 4. ↑ As we go to press, a brand new Resolution of the National Council of Justice (CNJ) which controls administration of the courts, is calling for remuneration of judicial mediators according to a scale: I – voluntary; II – basic; III – intermediate; IV – advanced; or V – extraordinary. See CNJ Resolution 271 of 11 December 2018. 5. ↑ See Mediação – Uma Solução Judiciosa Para Conflitos (Mediation: A Judicious Solution for Conflicts), book in Portuguese by Maria de Nazareth Serpa, DelRey Publishers, Belo Horizonte – MG, Brazil, 2017, capítulo (chapter) IV, “Tipología dos Conflitos” (“Typology of Conflicts”), at pp. 22 et seq.
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More from our authors:
EU Mediation Law Handbook: Regulatory Robustness Ratings for Mediation Regimes by Nadja Alexander, Sabine Walsh, Martin Svatos (eds.) € 195 Essays on Mediation: Dealing with Disputes in the 21st Century by Ian Macduff (ed.) € 160.00
from Updates By Suzanne http://mediationblog.kluwerarbitration.com/2018/12/14/let-mediation-be-mediation-conciliation-versus-mediation-in-brazil/
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locutius · 7 years ago
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Locutius Letter 13: 🤖Bots, ❄️Iceland, and 👂Soundscapes
The Most Important Design Skill For An AI-Dominated World
Admission: I tried reading John Maeda’s Design in Tech Report while standing in line at Passport Control and I had to give up on page 21 (consulting firms M&A) because it was literally unreadable on my phone. Argh. Ranting about abandoned and/or poorly maintained acquisitions aside, this quote stuck with me:
“Computers aren’t good at inclusion,” he says. “They’re good at exclusion, because they’re only based on past data. The business opportunity for the future-thinking designer is in inclusion.”
🖥🖥🖥
Microsoft Soundscape
So often we think about accessibility in terms of telling people about what’s right in front of them (or obstacles in the way), but if you’ve ever travelled to an unfamiliar place, you know that discovery comes from paying attention to what’s off the beaten path as well.
“Obstacle avoidance is not the problem, we have a dog, a cane and our blindness skills for that,” said Erin Lauridsen, Access Technology Director, LightHouse for the Blind in San Francisco. “The gap is knowing where things are and being able to decide what's of interest.”
When I travelled to Tokyo I ran into a lot of problems because I couldn’t read street signs or business names. This is a problem that visually impaired people deal with every day. I recommend watching the video to get an idea of what the app can do. Read more:
Watch the video on the project site (It’s the best explainer)
Soundscape app empowers people who are Blind or have Low Vision to explore the world
Download the app (iOS only, sorry)
👂👂👂
Bots! Why your chatbot needs to care about context
When it comes to conversation design, chatbots and VUIs have a lot in common (and a lot not-in-common..ephemerality, cough, cough). In this article, Gillian Armstrong covers some of the context your chatbot should care about, beyond When, Where, and What (these are things your VUI should care about, too). Read it: Why your chatbot needs to care about context
🤖🤖🤖
More bots: Mental health AI platform, Woebot lands $8M in funding
What makes Woebot different? Before founding the company, Alison Darcy was a clinical psychologist at Stanford. How rare (and great?!?) is it to see someone with subject matter expertise founding a company. Interested in working at Woebot? They’re hiring a creative writer who can specialize in Cognitive Behavioral Therapy: https://woebot.workable.com/jobs/655376 Read more about Woebot:
The Chatbot Therapist Will See You Now and
I spent 2 weeks texting a bot about my anxiety — and found it to be surprisingly helpful
😞😞😞
Facebook / Iceland / Linguistics
When I interviewed at Facebook, one thing the Groups team was excited about was that most women on Facebook in Iceland belong to the same Facebook group. Yeah, like Pantsuit Nation, but for *all* of the ladies in Iceland. Granted, there are only 167,000 women of any age in Iceland, but when you’re talking about cultural decimation, those numbers become even more important. In an article in The Guardian, Jon Henley details how digital language chips away at Iceland’s language and culture, one phone at a time, in interviews with Icelandic professors of linguistics and digital media. “Once, outside school you’d do sport, learn an instrument, read, watch the same TV, play the same computer games,”...“Now on phones, tablets, computers, TVs, there are countless games, films, series, videos, songs. You converse with Google Home or Alexa. All in English.” Read more:
Icelandic language battles threat of digital extinction
No mean girls: Why one-third of this nation's women joined same Facebook group
❄❄❄
Locutius Links
Oral-B made a 2-minute podcast for when your kids brush their teeth. It’s marketed for Alexa, but it works on Google, too. / Gimlet Media
Alexa has follow-up mode Now you don’t have to say “Alexa, turn on the kitchen lights.” and then “Alexa, turn on the dining room lights.” You can’t say “Alexa, turn on the kitchen and dining room lights” or “Alexa, turn on the lights for dinner.” But baby steps, eh? / Apple Insider
Microsoft drops ‘Hey Cortana’ in favor of just ‘Cortana’ on smart speakers / The Verge
How Otto, a German ecommerce giant, uses artificial intelligence. This one you'll need to read for yourself. Automation isn't going away. / The Economist
Why you Shouldn’t Skip a Linguistics Analysis Before you Pick a Company Name “The three basic metrics to test for are pronounceability, negative meanings, and existing brand associations.” / Rewind and Capture
Review: I tried Levi's $350 denim jacket featuring Google technology — and it made my commute so much better I’ve tried this jacket, too. All I can say is that I wish they made a ladies version because the cut on this one is strictly for guys with trim waists and big shoulder muscles. Also how 'alterable' is "smart" clothing? / Business Insider
The Feds Can Now (Probably) Unlock Every iPhone Model In Existence / Forbes
Now we know why Siri was so dumb for so long / Mashable
It turns out that humans don’t like robots that don’t like humans. Who could have predicted this?!?! / AV Club (no, not The Onion - this is a real story about people putting BBQ sauce on robots)
Robotic Tortoise Helps Kids to Learn That Robot Abuse Is a Bad Thing. What are the ethical implications of harming a robot? Do we get mad if people hurt their cars? Or are robots more like pets? Is there something predictive about how we treat robots? Or are humans actually smart enough to know that robots don’t have feelings and they’re just machines? Why do we describe breaking a robot as immoral, but we wouldn’t use the same description for a vacuum cleaner? I mean, unless it was a robot vacuum cleaner. / IEEE Spectrum
Robot ethics aside, here are the best things I bought this week:
Melatonin. I just returned from Tokyo and right now I’m confused by two things: 1. Which side of the sidewalk to walk on, and 2. How there is a 16 hour difference between Tokyo and San Francisco, and yet I am somehow not jet-lagged? I’m chalking this up to 3 mg of melatonin on my first night in each place (Yeah, just one pill, one time, each way - for $8.00 you get more melatonin than you'll use in 10 years). At this point, I don’t care if Melatonin is a placebo. I just know that I feel like a normal human being, which should be impossible.
Make your kid happy with a set of My First Temporary Tattoos: Adventure, Creatures, Sports, and More. These temporary tattoos are easy to apply and look cool for a week. The only downside is that a) they're an add-on item, and b) you have to use rubbing alcohol to remove them.
A PURSE THAT CAN FIT A 10.5” iPAD PRO IN A CASE INSIDE OF IT. And that’s all you need to know. Okay, also it is leather, it’s on sale for 70% off of the regular price. And it is SUCH A NICE BAG, with zipper pockets and places to put your charger and your wallet and even your pens.
Until next week! Abi Jones Editor, Locutius Is there something I missed? Reply to this email with a link! Want to chat? I’m on Twitter at @jonesabi Disclaimers: Yes, this newsletter includes affiliate links! I've made $2.14. Thank you, whoever clicked on a link in this newsletter and ended up buying The Hobbit: The Motion Picture Trilogy. And yes, I work at Google. The views in this newsletter are mine, not Google’s, obvs.
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caredogstips · 7 years ago
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How dames could vote Hillary Clinton into the White House
A presidential election with the first female nominee for a major party was always going to be about gender but its own language and action of Donald Trump has galvanized dames got to make sure he never goes near the Oval Office
Moments into the final presidential dialogue, as the topic turned to abortion, Hillary Clinton gave an impassioned and unapologetic subject for the status of women right to choose.
Donald Trump had just described in graphic expressions his opinion of the methods used, falsely differentiating Clinton as being in favor of rend[ ping] the child out of the womb of the mother just days prior to birth.
An unfazed Clinton hinted the Republican nominee meet maidens she personally knew “whos been” undergone one of the worst possible choices imaginable, or travel to countries where restrictive laws obliged ladies to either undergo abortions or grow children involuntarily.
Clinton went farther than any of her precedes on an issue that often fractions the American public.Undecided voters in a CNN focus group conducted that night in October said it was her strongest minute.
But maidens find it especially poignant. Natalie, one of those undecided voters, said of Clintons response: It was important to me because I dont see the government should have hold over a womans person just like they wouldnt have limit of a mans torso.
Gender was always going to play a pivotal role in a campaign that could terminate in the election of the members of the first girl president in Americas 240 -year history and seems likely to a verify a historically huge gender chink at the polls. But it has been amplified as a result of Trumps language and behavior, startling many female voters is so that a human who boasted on tape of sexually assaulting females is not elevated to the highest part in the land.
Trump calls Clinton a nasty girl during final conversation
I wish I didnt have to say this, but, certainly, glory and respect for women and girls is also included in the ballot this election, Clinton told a audience of 11, 000 beings, many of them women and students, who came to see her share a stage with first lady Michelle Obama in Winston-Salem, North Carolina, in the final weeks of her campaign.
Natasha McKay, of Charlotte, left the rally in situations of euphoria. Im certainly uplifted right now. Im in a dazzle, she alleged. Hillary is so powerful. Michelle Obama is incredibly strong. Those two together is an awesome force.
McKay mentioned the sharp distinguish between Clintons message of female empowerment and Trumps history of preparing cheapening explains about women.
Like Michelle Obama read: When they travel low, “theres going” high-pitched, McKay responded. Except Donald Trump going to be home lower and lower and lower.
The gender gap has long favored Democrats. Harmonizing to the Roper Center for Public Opinion Research at Cornell University, maidens favored the Democratic nominee in 2012 by 11 objects, 2008 by 13, 2004 by three, and 2000 by 10 points.
Nevadas ladies stand divided over Trump and Clinton on eve of poll
But this year Clinton ogles set to match or even outstrip the historical 17 -point lead her husband held among women over Bob Dole in 1996. Ten recent referendums taken in October range from eight to 22 percentage points conducts, with an average advantage of 17.( In 1980 and 1984 maidens favored the Republican Ronald Reagan over his Democratic opponents Jimmy Carter and Walter Mondale .)
Whereas Clinton balk away from the historic sort of her candidacy during her first bid for president in 2008, this time around the prospect of electing a woman to the White House has been a most important pillars of her narrative. But the former secretary of state could not have predicted she would be handed an opponent who has in the past referred to women as fat animals, slobs and dogs, and both bragged about and been accused of sexual assault.( He has disavowed the accusations .)
A new analysis by the Pew Research Center found that majorities of both men( 58%) and women( 62%) do Trump has little or no respect for women. Exclusively 38% of respondents conceive the Republican nominee has a great deal or a fair sum of respect for women, compared with 76% who believe that Clinton does.
And so Clinton and her allies have worked hard to target ladies from the millennials who readily distinguish as feminists to the suburban married women who typically fluctuating toward Republican but may be repelled by the believed to be casting a vote for Trump.
Hillary Clinton and first lady Michelle Obama embracing before they address the crowd at a campaign stop in Winston-Salem, North Carolina, last week. Photo: Logan Cyrus/ AFP/ Getty Images
Emilys List, the group that works to elect pro-choice Democratic wives to public power, has targeted its outreach toward millennial women in the key battleground countries where they could play a decisive role: New Hampshire, North Carolina, Pennsylvania, Florida and Nevada. Through a predominantly digital, multimillion-dollar safarus, the group has extended ads that include a young woman evidencing her sorenes in reading aloud paroles spoken by Trump, such as Putting a partner to work is a very dangerous act, and are used in advertise on social media scaffolds used by younger voters.
Jennifer Lawless, the director of the Women& Politics Institute at American University, did Clinton had an extraordinary grassroots enterprise. The instant Donald Trump says something, theyre be permitted to micro-target females, she said.
The most significant shift, Lawless lent, has been among marriage dames a demographic that advantages Republican and elect Romney over Obama by seven percentage points in 2012. The tape disclosed last month peculiarity Trump boasting in 2005 about groping and kissing ladies without their consent seemed to give married females a sense that they did not have to vote exclusively along party lines.
What that strip did was, especially to women who were undecided or find some appreciation of party loyalty[ to the GOP ], the strip dedicated a lot of Republican political nobilities ammunition to say, vote your shame, Lawless told, and that freed up people who might be loyal partisans to reconsider.
Meghan Milloy, a lifelong Republican, reached her breaking point with Trump well before he became the partys campaigner and courted controversy with allegations of sexual assault.
Milloy said she was appalled when Trump sparred with Megyn Kelly and insinuated the Fox News anchor asked tough questions during the first Republican primary debate because she was menstruating.
Thats when I decided he wasnt fit to be president, she remarked. I dont even think he is fit to manage a local Papa Johns.
People gather in front of Trump Tower last month to protest against Donald Trumps therapy of the status of women. Picture: Timothy A Clary/ AFP/ Getty Images
When Trump won the nomination, Milloy facilitated launch Republican Women for Hillary. Though she still considers herself a member of the Republican party and a strong republican, Milloy is disappointed with her defendant for not disavowing Trump.
If the party comes back from this and recognizes that it get crazy this year with Trump and the platform then I would certainly stick around and “il do my best” to help them rebuild after this year, Milloy mentioned. But if they redouble down like Trump has done, then I certainly wont become members of that.
Seeking to weaponize Trumps rhetoric against him, the Clinton campaign has aired a strong ad in which young girls look at themselves in the reflect against the background of the real estate moguls bullying texts. The commercial-grade aimed to target, including with regard to, married women in the suburbs of swaying positions Colorado, North Carolina, Ohio and Pennsylvania.
As the sex crime videotape came to light-footed, Clinton intensified her lurch against her foes management of women.
Addressing a Women for Hillary a conference call, one week before such elections, Clinton appealed to supporters on a personal level.
I are well aware that parts of such elections have been distressing to numerous dames, especially hearing about Donald Trumps behavior towards ladies over the years, she said. He enjoys stirring girls was terrible about themselves in every possible practice. He ponders defaming dames manufactures him a bigger man.
We is responsible to ensure that he and his attitude what he suggests, what he makes, what he does to girls never goes him near the White House.
Clinton too emerged with top female surrogates, from Michelle Obama to prominent women rights rulers such as the Planned Parenthood Action Fund president, Cecile Richards, and Emilys List president, Stephanie Schriock, to make a final lurch to women in must-win battlegrounds.
To be elected as a woman, you have to be 20 experiences as good as your opponent, replied Richards, whose late mother Ann Richards was herself a colonist and as district treasurer of Texas became the first woman elected statewide in roughly 50 times in 1982.
We are not comfortable in its own country with women who are strong. It is remarkable that this woman, as our own president remarks, has more event, more preparation to go into the Oval Office than anyone we can recollect, and it was just always going to be hard.
But the gendered circumstances of Clintons battle, according to Richards from the emphasis placed on her robes to her speaking mode to whether she smiles enough is what motivates females voters to make their voices heard on 8 November.
Women feel this is about much more than Hillary, “its about” make that has been going on for decades, she did. These wives seem an enormous appreciation of dignity and possession in this election.
Perhaps few moments solidified that feeling better than when Trump leaned into his microphone during the final presidential dialogue and snarled: Such a nasty woman.
Women substantiating Clinton instantly regained the term and swerved it into a rallying cry, and it became a recurring theme at safarus occasions to find women with Nasty Women shirts. Elizabeth Warren, the Massachusetts senator and influential Clinton surrogate, problem a fiery castigation of Trump at a campaign rally in New Hampshire late last-place month: Nasty ladies vote.
Nasty maidens poll: Elizabeth Warren takes a swipe at Trump
It is not simply a distaste for Trump driving prospective turnout among women, according to longtime spectators of the intersection of gender issues and politics.
Theres a policy contention for why unmarried women in particular are more drawn to a Democratic programme, answered Rebecca Traister, writer of the book All the Single Dame: Unmarried Women and the Rise of an Independent Nation.
They are no longer the class of Americans who are living economically, socially or professionally is dependant on husbands in the way that they used to be. Barack Obama drove the Democratic advantage among unmarried women to historic degrees in 2008, with 70% support to John McCains 29%, while in 2012 single females preferred the president over Mitt Romney by a whopping margin of 36 percentage points.
With women currently holding activities, and serving as breadwinners be they unmarried, married, or same-sex spouses in large numerals, as an electorate they are increasingly moved by policies that address their concerns, Traister added.
This is why unmarried females have specially been drawn toward Clintons platform of equal pay for women, easing the burden of student lend obligation, paid kinfolk leave and protecting reproductive claims, she alleged. Clinton has emphasized her commitment to such issues since launching her safarus, and likewise focused on conjuring the minimum wage, an issue inextricably tied to gender in that wives even out two-thirds of minimum wage earners.
Jess OConnell, the executive director of Emilys List, announced Trump was simply vocalizing in politically faulty terms what Republican have long preached in more concealed language.
Single ladies are afraid the Republicans are going to turn back the clocks on them, OConnell alleged. Rejecting the gender chink in payments or wanting to punish women for the purpose of having an abortion demo a real shortage of understanding about women and their lives today.
This is when womens expressions are going to be heard.
Read more: www.theguardian.com
The post How dames could vote Hillary Clinton into the White House appeared first on caredogstips.com.
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luxus4me · 7 years ago
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Webmonkey http://j.mp/2rNn8H7
Chatbots are taking over the world. Over the past few years, virtual help agents have taken on surprisingly sensitive jobs in modern society: counseling Syrian refugees fleeing civil war, creating quiet spaces of contemplation for millions of Chinese living in densely populated cities, and helping Australians access national disability benefits. Bots have offered help, support, and companionship. But there’s one line none of them have yet crossed: actually treating patients.
That’s just changed, with the release of a talk therapy chatbot that goes by … wait for it … Woebot. Created by a team of Stanford psychologists and AI experts, Woebot uses brief daily chat conversations, mood tracking, curated videos, and word games to help people manage mental health. After spending the last year building a beta and collecting clinical data, Woebot Labs Inc. just launched the full commercial product—a cheeky, personalized chatbot that checks on you once a day for the price of $39 a month.
Finding the time and money to pay for talk therapy sessions is out of reach for many, so a chatbot could be a helpful stopgap for psychiatry. But Woebot’s creators believe it has the potential to actually improve on human therapists. “It’s almost borderline illegal to say this in my profession, but there’s a lot of noise in human relationships,” says Alison Darcy, one of the psychologists behind Woebot, and the company’s CEO. “Noise is the fear of being judged. That’s what stigma really is.” There’s nothing like venting to an anonymous algorithm to lift that fear of judgement.
Of course, promising real medical results from a chatbot introduces new legal and ethical issues. While Woebot might seem like a person, it clearly tells patient that it’s actually closer to a “choose your own adventure self-help book.” Rather than running on machine learning technologies that would allow it to improvise on the fly, Woebot is much more deterministic. As it gathers mood data and processes any texts and emojis that a patient might enter, the bot traces the branches of a decision tree to offer personal responses and follow-ups for 10 minutes tops. Mostly, it asks questions.
“What is your energy like today?”
“How are you feeling?”
“What’s going on in your world right now?”
Those prompts are modeled on today’s most popular form of talk therapy—cognitive behavioral therapy—which asks people to recast their negative thoughts in a more objective light. Patients are encouraged to talk about their emotional responses to life events, and then stop to identify the psychological traps that cause their stress, anxiety, and depression. “A good CBT therapist should facilitate someone else’s process, not become a part of it,” says Darcy.
In some ways, a CBT chatbot is the ultimate manifestation of that philosophy. “Woebot is a robot you can tell anything to,” says Darcy. “It’s not an AI that’s going to tell you stuff you don’t know about yourself by detecting some magic you’re not even aware of.” Woebot only knows as much as you reveal to it—and it can only help as much as you decide to help yourself.
It’s not an unfounded concept. In 2014, Darpa funded a study of a virtual therapist named Ellie, an embodied avatar developed at the University of California’s Institute for Creative Technologies. Two groups of 239 participants talked to Ellie: One thought they were talking to a fully automated bot, and the other was told there was a real person behind the machine. In reality, all participants were randomly assigned a fully or semi-automated virtual human—but the participants who thought they were talking to a robot were way more likely to open up and reveal their deepest and darkest secrets. Removing even the idea of a human in the room led to more productive sessions.
Ellie was a research project, not a commercially available product, but it did provide some of the strongest proof that computers can actually make great therapists. And there’s evidence that removing the “talk” from talk therapy seems to help, too. Scientists who recently looked at text-chat as a supplement to videoconferencing therapy sessions observed that the texting option actually reduced interpersonal anxiety, allowing patients to more fully disclose and discuss issues espoused in shame, guilt, and embarrassment.
Recognizing the value—both therapeutic and monetary—some mental health care startups are incorporating texting into treatment. One, called Therachat, sells a customizable chatbot that therapists can use to keep their patients engaged. It gives the doctor a full record of the chats, along with an analysis of frequently used positive and negative words. X2AI, the company that deployed its Arabic-speaking bot, Karim, to Syria in the spring of 2016, has a polylingual portfolio of chatbots to help people with everything from mild anxieties to pediatric diabetes.
Clinical Chatbot
X2AI describes its bots as therapeutic assistants, meaning they offer help and support rather than treatment. For the most part, these bots are in a supportive role—more tool than therapy. In this way, Woebot is different. It’s billed as a treatment in its own right, an accessible option for those who have no sort of care for their struggles with mental health. Darcy sees it kind of like a “gateway therapy,” to give people a good first experience, and even help them realize when they need a more intense form of intervention.
Woebot is obviously not a licensed physician, and it doesn’t make diagnoses or write scrips. It’s not equipped to deal with real mental health crises either. When it senses someone is in trouble it suggests they seek help in the real world and provides text and hotline resources.
But Darcy says her data supports the claim that chatting to Woebot is in fact a therapeutic experience. Yesterday, Darcy and a team of co-authors at Stanford published a peer-reviewed study in the Journal of Medical Internet Research, Mental Health that randomized 70 college students and asked them to engage with Woebot or a self-help e-book for two weeks. The students who used Woebot self-reported a significant reduction in their symptoms of depression and anxiety.
From an experimental design standpoint, it’s far from perfect. Self-report is notoriously unreliable. And the control group isn’t ideal: A better comparison would be between Woebot and text messaging with a human therapist, at least according to Steven Chan, who worked with the American Psychiatric Association to create a set of guidelines for mental health apps before becoming UCSF’s first fellow of clinical informatics. “If the point it’s trying to make is that it’s better than nothing, then it’s a good first step which shows a lot of potential,” he says. Beyond that, there’s not much we can tell about Woebot’s therapeutic value over the long term.
Being the only therapy chatbot with peer-reviewed clinical data to back it up separates Woebot from the pack. But using those results to claim it can significantly reduce depression may expose Woebot to legal liabilities that bots in supporting roles have managed to avoid. Without moral agency, autonomous code can't be found guilty of any criminal acts. But if it causes harm, it could be subject to civil laws governing product liability. Most manufacturers deal with those risks by putting labels on their products warning of possible hazards; Woebot has a somewhat synonymous disclaimer that states people shouldn't use it as a replacement for getting help.
There’s one other big issue with Woebot in its current incarnation: It only talks to you through Facebook Messenger. Facebook’s services aren’t HIPAA-compliant, but in this case that wouldn’t matter anyway. Because Woebot isn’t a licensed medical provider, any conversations with it aren’t protected by medical data privacy and security law in the first place. While Darcy’s team has built a wall on their end to keep all of Woebot’s users anonymous, Facebook knows exactly who you are. And Facebook, not you or Woebot, owns all your conversations.
That’s why Darcy’s team is trying to raise funds to build standalone apps outside of the Facebook universe. But at least for now, the privacy concerns haven’t prevented people from signing up.
Woebot has about 150 long-term beta users who say they like the ease of checking in quickly on Facebook. Chan says that jives with a trend he’s seen in real life: Patients are demanding their doctors be available to them at all hours via text message, a communication channel that's far from secure. “It’s kind of funny,” he says. “If people get the sense that it’s safe then they’ll disclose anything. Their desire to reach somebody overrides those privacy concerns because they’re much more intangible and ephemeral.” And for Woebot's users, an intangible and ephemeral listener may be just what they need.
http://j.mp/2rhVXke via Webmonkey URL : http://www.wired.com
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surveyjunkie · 8 years ago
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Do you sit on the couch or the floor?  The couch...
How many different colleges have you gone to? Just one
How much stress can you handle? An embarrassingly low amount. 
What is something you have to do before you go to sleep every night? Nothing. A lot of times I just pass out because I’m so mentally exhausted from work and chores I have to do when I get home, not to mention some of the shit I put up with from my stepdad. On days I can’t fall asleep, I watch Netflix or play video games. 
How confident are you in achieving your dreams? Maybe like 10%? I know for a fact at this point I’ll never be an accomplished doctor like I dreamed of. My ADD is absolutely out of control and my self-confidence is too low to ever put myself out there like that, not to mention that my motivation to even APPLY for doctoral school is too low for me to even think that I would get through it in the first place. I’ve learned from working in this position and who I choose to associate myself with in life that I do not have what it takes to succeed in this field. I’m NOT a Type A, and I value my personal life and relationships wayyy more than becoming a slave to school or work. It’s just not for everybody, and I guess I need to stop fooling myself into thinking that I’m this smart, ambitious person when I’d honestly rather be doing nothing. 
Do you ever get tired of all the army stuff you see all over the place? I don’t see it all over the place, but no I wouldn’t get tired of it. I have the utmost respect for our troops. << Absolutely. What a disrespectful question. Those people put their lives on the line for us so the least we can do is acknowledge their existence. 
What is one thing you thought you’d never do but have done or are doing? I didn’t think I’d get this far, honestly. And the thing is, I know I don’t belong here. I’m really happy that I was able to graduate with my bachelor’s degree and just get it over with, but I sure as hell don’t deserve to be working at a job like this. 
Have you ever disowned a friend or family member for their beliefs? No. I have trump supporters in my family and as much as I disagree with their political views I don’t let it get to me because it has nothing to do with our relationship. 
At what point in your life do you think you will be truly happy? Who konws
Do you ever make pictures or shapes out of the markings in the ceilings? Maybe in my mind
Do you ever feel like your life is too boring or predictable? My life is definitely not predictable. Sometimes I feel like it could be more exciting and glamorous, but when you live with bipolar disorder like I do, it’s definitely not predictable. 
Would you rather things be predictable or unpredictable? I like having some routine, but at the same time it would be nice to switch it up now and then. In a good way, that is. I don’t need any more of life’s curve balls. << Pretty much this. 
Do you really think money will buy your, or anyone else’s, happiness? Honestly, yes. I’ve been a lot happier recently because of the money I’ve been making from this job. I don’t have to worry about making my bills on time, and I’m able to buy and do things that make me happy. If I didn’t have money, I’d be pretty miserable, and if I had more, I’d be even happier. 
Do you think you will die happy? Maybe. 
Is shopping a form of therapy for you? Yeah, in a way. Especially if it’s stuff like candles or decor that will make my surroundings nicer. Or stuff for my dog haha. 
Do you have to take medication for any mental illness? I take Prozac for my anxiety and depression symptoms, but I probably need more than just that. 
Do you believe it is possible for someone to change? Well, yes of course. If they want to change that is. It has to be for them. Even then they likely will stumble and relapse, but that doesn’t mean they can never change. It’s a work in progress. A daily thing. <<
What is your favorite food to snack on when watching t.v.? Pizza counts as a snack, right?
Do you like looking at pictures? I like through old photos. Like from when I was younger. << Same, I like to reminisce about the simpler times in my life. 
Have you ever set 2 people up and it actually worked out? Lol, indirectly I guess. I won’t get into that though. 
Are you good at persuading? Lol sometimes. A lot of times I just bribe people with food or something. 
Are you a submissive person? Kind of. I’m trying to get better at though. 
Do you think the professional personality tests are bogus? They’re not “bogus”, but I do agree that they can be inaccurate because it’s hard to put a personality into one neat little box. You can define certain aspects of it, but it’s ever-changing and often times requires more analysis than just self-report. Sorry, the psych major in me just came out.  
Do you believe everyone should learn another language while still a child? I do, actually, but not only because it’s much easier to learn a language while you’re still a child, but because I think it’s important for the population in general to become bilingual in order to reduce racial/cultural prejudices and things like that. 
How do you feel about tattoos and piercings? I think they’re beautiful if they’re done right. I’m all about self-expression. 
Do you care what people think? Way too much. 
How many dirty looks have you received today? Who knows, I’ve been around a lot of different people today so maybe one person did. I didn’t do anything to deserve one though. 
If a loved one who’d died showed up at your door, what would you do? I’d probably faint, honestly. That would be some next-level shit. 
Do you believe the dead can have connections with the living? I do. There’s a lot we don’t know about this universe yet, it’s possible. 
How many times have you looked at a picture and wished you were there? I can’t put a number on it, but it happens sometimes.
What is the most consecutive miles you have ran? 3.5
Are there any words you absolutely hate? I mean, sure. I can’t think of any at the moment though. 
How many picture messages have you received? Ever? I have absolutely no idea.
Sent? Again, I have no idea. That is over a span of years of being able to send and receive picture messages.
Did you like kissing the last person you kissed or the one before that more? The last person.
What is your favorite pair of shoes that you own? My wine-colored vans. I haven’t even taken them out of the box yet because it’s been too cold to wear them, but once spring comes you can bet I’m wearing them almost every day. 
One person people think you look similar to? My mom.
Who is the most recent addition to your contacts? Who knows
Are tongue piercings slutty? No
What is the worst physical pain you have ever felt? Not sure. 
What is the fourth picture on your phone? It’s a picture of Josh and I on New Years. It’s actually one my favorites. 
What is the worst thing about winter? The chapped lips, dry skin and frizzy hair. That’s three things I suppose but whatever. 
Where do you order your pizza? Marco’s or Pizza Hut. Sometimes I’ll pick some up from Little Caesar’s. 
Do you think you would lose some friends if you gained 100 pounds? My friends aren’t my friends because of what I weigh or how I look. That would be really, really shitty. << Lol, yep
Last cuss word you said? I think an F-bomb.
Do you usually say too much or too little? Too much. Always too much. 
Lyrics to the song you are listening to: I’m not listening to a song.
Two things you are tired of: This job. 
What tv show do you wish your life was most like? Friends. 
What person of the opposite sex makes you laugh most? My boyfriend. 
Best purchase you ever made? It’s between my laptop and my TV
Do you have pictures up in your room? Yeah, I have a photo of Jo and I on our senior spring break trip up on my desk, and a picture of my mom and I when I was four or five. 
Is there anybody you think is hot over the age of 40? Sure
Have you ever been caught sneaking out? No 
Does your school have any rivals? I’m no longer in school.
Which one of your friends causes the most drama? None.
How many Facebooks have you had? Just the one I have.
Who is the most inappropriate old person you know? My fucking stepdad. He’s not really “old” though, but yeah. 
Have you ever been punched in the face? By my little brother back when we were kids, yeah. 
When was the last time you talked to the first person you kissed? An hour or two ago. 
What is the latest you have ever slept in? Until almost 3.
Do you know what your name would have been if you were the opposite sex? I’m guessing my brother’s name, Daniel. 
Are you embarrassed to buy condoms? Kind of, but I don’t ever buy them sooooo. 
Do you have to watch yourself in the mirror while you brush your teeth? Yes.
What year in your life do you think you were the least attractive? LOL 7th grade. I had the choppiest Great Clips haircut, bushy eyebrows, crooked teeth, and wirey glasses. And I thought it was cool to put giant bows in my hair. I was a hot mess. 
Do you have any nicknames? Tash, Basha, Tashie, Tosh.0, Tersha, Tayesha, yeah it goes on and on
How often do you wear necklaces? I wear chokers every now and then. 
Did anything bad happen to you in August? No
Do you have a morning routine? Wake up, pee, brush my teeth, take the dog out, change, brush my hair, feed the dog, leave
Is the first text in your inbox saved? My phone keeps all my texts already. I don’t go through and delete any.
Was the last time you logged into your email? I’m logged in right now
If you are getting up early on a saturday it’s most likely…because I drank too much the night before, or because I have a doctor’s appointment. 
What are the first 3 channels you check when you first turn on the tv? We don’t get any cable
What was your last halloween costume? Louise from Bob’s Burgers
Have you discovered your passion? I like to write, and act. 
Do you get tan in the summer? I get black.
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juniperpublishers-ttsr · 5 years ago
Text
Is Your Child at Risk? - Juniper publishers
Journal of Trends in Technical and Scientific Research
Tumblr media
Keywords
Posture problems, Back pain, Cavities, Whispering, Giggling, Slouching, Beautifully, Slender
    Opinion
Posture problems in youth is rising right under your nose. Are you a parent reading this article? Do you suffer from neck or back pain after a long day at work? Headaches maybe? Did you wake up with pain? Maybe you didn’t, but the other 65% of working population did, dose and do go thru their days in discomfort. You don’t stop eating because you are afraid of cavities? Then why do you expect the millennial to give up their smart devices? How many children do you see already in poor state of health? How many do you know personally? Just like cavities, using smart devices puts us at risk. It’s not about “What is wrong?” it’s about how are were reacting to it individually? What is the compelling reason to make a change before becoming the victim of the consequences?
    Let me share a personal story
It was a hot summer day, their laughter echoed like angles singing, Tina, Melisa and Helen, the 14 year old splashing around the pool as the parents Barbecued and talked sports. Tom was watching his Tina, with a smile of joy, with his cousins. As a doctor her knew the long hours was rewarded by watching his family joyful. The girls stood outside the pool, whispering and giggling, he noticed Tina is standing a bit crooked, and is really slouching compared to his cousins. It caught his eye, the smile change slowing to an objective analysis. He watched Tina walk to grab towels from the other side of the garden when he knew something is off, she IS crooked. What happened? He calls his wife, Fay, a protective Jewish Mom, who despite work, social life, and community involvement monitored her children like mother bear. He turns to her with fearful concern, “What is going on with Tina?” she proudly replies, “I know she is growing up so beautifully, she reminds me of my self at her age, tall and slender.” as she flaunts her hair with a smile. he looks at her, “what the hell are you talking about, look at her pelvis, her back, it’s not right!”
Fay, wide eyed looks at her, then at him.” “Tina, sweetheart come here, come here!” Uninterestedly and dutifully, she walks over with her head and neck forward, long wavy hair covering her slender thin body, and rounded shoulders. Fay watches her daughter’s hips, posture, and remembers how she is more introverted with others, how her baby is all crooked in her bikini. This can’t be happening, Fay a doctor herself, immediately dose a posture analysis, “Stand up straight” she checks her Head, ears, shoulder blades, Back, Pelvis, Hip, Knees. “Turn around honey”. John stands there and looks at her daughter and wife, a unsettling feeling of concern wraps around his stomach. Tina’s head is 6” over her shoulders. Her right scapula is notably rotated back, and her right pelvis is 3” higher than the left side. “Mom, are you done. Girls are waiting for me?” Fay and John look at each other in concern, Fay, eagerly says; “Honey we’ll make an appointment with Romina she is her god-daughter. She will take care of her”.
I greet my best friend Fay and Tina, (as smiled and thought, love these girls, last time they visited my Clinic was when she was 4 years old. Then she fell of the kitchen counter). They usually see the local Chiropractor, only urgent matters start with me. I know there is a problem! We walk to the exam room. Fay shares her concern about Tina’s posture and how in past year she has been laying on her beanie bag, creating movies, playing games and doing her homework on her laptop. She has been complaining of neck and back pain, with frequent headaches, that Tylenol helps. “We have been telling her to standup straight, and she slouches” maybe she listens to you. Last week at BBQ party we noticed that her pelvis is off, can you check her?”
I proceed with my examination, which was obvious for Forward head position (phase II) and pelvis unleveling, postural distortion. X-rays, will determine if her posture problems are skeletal or muscular, and to what ratio of physiological involvement of muscles to bone effect. I sat in my office, looking at Tina’s X-rays, shocked! Tears pour down, how do I share this with Fay? From the mirror window in my office I can see them giggling over her nail polish. My voice is muted holding back the tears as I draw lines, angles, and measurements on her X-rays, wiping off the unstoppable tears. OMG, OMG, why did this happen? This is my baby girl! This is my god daughter.
I put myself together as I wear my white coat, maybe the coat can give me strength. I pull myself together, pull my hair back, clear my throat, stand up, and force a smile. I call them to the consultation room, prior to showing the X-rays I start my explanation. “Recently within the past few years there has been a notable rise in number of young adolescents and adults suffering from neck, upper back and lower back pains.” In past we blamed heavy back packs, now we have an added insult to the growing fragile bodies of our children. The side effects of smart devices integration in children’s lives. In fact; Kaiser family research states “An average 8-18 year old spends about 7.5hrs a day on some form of smart device.”
You see, there are 3 common factors that contribute to poor posture are:
a) Muscular problem
b) Structural problem
c) Functional problem
• Muscular Problems are poor muscle balance, usually due to developed bad habits. Such as beanie bags, text neck, playing games on hand held devices. In adults it could be poor ergonomics at work or when driving. Usually most noticed with stiffness, and muscle aches (Figure 1).
• Structural problems are deeper issues. Specifically speaking is changes to the skeletal system. This generically is known as “Scoliosis”. An X-ray can identify the source being born with (congenital) or if it is developed later in life (structural).
• Functional Problems are when the skeletal system and the muscular systems changes to the point that the joints have lost their integrity and are not moving in correct aligned synchronicity. This will lead to early wear and tears at joint lets and create bones spurs, fusions and early arthritis. (Reported cases of bone spurs in teenagers are becoming a health concern.)
I show Tina what normal X-ray looks like from front and from side. Explaining the importance of correct alignment. I open the view to reveal her X-rays. Fay gasps, tears weld in her eyes, as she knows what this means. Tina’s jaw drops, in a nervous joke she says “Ahhhh, That’s not straight!”. Based on your X-rays, it is evident that you do not have a congenital problem. You have a condition called “Adult Onset Idiopathic Scoliosis”. I believe your spine is reacting to the abnormal postures over the past few years and it caught up with you on your growth spurs. Your body has changed due to the pressures loads as result of poor postural habits and demands. This is noted in many ergonomic evaluations on adults. In past children were more physically active and did not spend their time looking down other than homework for few hours a day. That has changed dramatically with phones, tablets, laptops now your body is reacting to these changes.
For every 1” that your head is off its center, there is between 10-15 lb. of pressure loading on your spine. kepangi&white
    Radiology Report
X-Ray Impression
Reverse C/S curve of-12’/45’
Early onset of posterior bone spur at C7
Scoliosis is simple from T8-L5
Right Concave Scoliosis
Pelvis rotation (Compensatory change due to Right Rotation of Vertebral bodies from L3- T9 creates a Complex Scoliosis
DDX
Reverse C/S curve= Alordosis
Compensatory Rotary Scoliosis (Thoraco-Lumbar spine)
Non-Congenital Scoliosis
    Discussion
Range of Scoliosis
phase I- 5’-2’degrees:
Conservative method.
Care: Physical Rehabilitation & Chiropractic Alignment. Duration of care 3-6 months, full spine X-ray every 3-6 months.
Phase II 25’-45’ degrees
Milwaukee/ Other custom made brace and Surgical Candidate.
Care: Aggressive Physical Rehabilitation & Chiropractic Alignment. Duration of care 6-24 months full spine X-ray every 3-6 months.
phase III >45’ degrees:
Care: Surgery
From that day on we put Tina on strict program of chiropractic, physical therapy, yoga therapy, hard bracing and 9 months later $30,000.00 + in out of pocket expense we were able to make some changes to her spine. Tina has to wear a customized brace for many years on daily basis. As a doctor we look at anatomical changes and fail to share with parents the psychological ramifications. A growing child needs to develop his/her personality in society, matters such as confidence, ambition, social interaction are building blocks of a child’s emotional IQ. If a child feels he/she is different, has an imperfection, or has to hide a secret, to avoid being ridiculed or bullied. That child’s future is at risk (Figures 2-5).
As parents it’s important to check your children posture. To raise our future presidents, senators, world leaders not insecure, introverts, make wrong decision as result of poor self image. A simple posture analysis and prevention will change your child’s future, Just Maybe! see posture score at www. BAX-U.com
    Conclusion
I share this story, as a godmother, doctor and advocate for better posture better health. My effort is to help adults have better work ergonomic, but prevention starts from home. Find out what your posture Risk Score is and how together we can Stand taller, Feel Better and Look Amazing. This personal story is to impress upon you the importance of educating today’s parents for healthier children. Together we can make a difference in more ways than you can imagine. I speak out because “I Care”. Join our team to educate, empower and promote better health thru early detection and prevention.
To Know More About Trends in Technical and Scientific Research click on: https://juniperpublishers.com/ttsr/index.php
To Know More About Open Access Journals Please click on: https://juniperpublishers.com/index.php
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