#the maker of this blog aka its god
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Hi! Hello!
Hug? Please?
M: Did they.. pop out of existence?
SN: I hate it here.
#ask are we dead yet#marr (oc)#sanid (oc)#stiches#stripes (oc)#tw stiches#SORRY THIS TOOK SO LONG#Cat draws the ocs that SHE DESIGNED consistently challenge: impossible#btw Cat is me#I am cat#the maker of this blog aka its god
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Hello! I’m actually new to tumblr so please feel free to correct me if I have any errors during my request.
Do you know that one scene in Aladdin where Jasmine gets trapped in an hourglass that’s slowly filling up with sand? I’d like a scenario of that with the Jamil and Kalim, the reason can be because a student overblotted and wanted revenge or because of a spell gone wrong. Feel free to decide! Thank you :DD
A/N: Your wish is my command lol. I'm working on "quality over quantity," with my writing right now. Aka. trying to write short an meaningful works vs. long tangents. I hope that I did good with this one :) 2nd A/N: Oh my goodness, I think this is the best thing I have ever written for this blog. I actually started sweating from my brain not being able to keep up with the ideas.
Kalim Al' Asim
"Did you enjoy yourself? Son of House Asim,"
A decrepit voice sounds throughout the empty room. Wicked, laced with hatred and snapping at every vowel. Kalim can not pinpoint its origin from the echo, yet he does not want to. Does not want to see what is coming for him. Does not want to hear their taunts. Does not want to tear his eyes away from the sight in front of him, afraid the scene will change.
Bright gold sand trickles down from the ceiling and into a rose-stained hourglass connected to the floor. Rays of sunlight peer in from nearby windows, making the grains sparkle like doubloons worth millions. The sound of steady flow is deathly soothing, lulling those who enter into a false sense of security.
In the center of the glass sits Kalim's most valuable treasure. Something he can never truly own. A jewel no money could buy, yet he would give every last gold piece to call his own.
"Pretty things do not suit you, young heir. You are toxic. Poisonous. Yet you still have so much,"
So what. So what if the gods favored him in riches. Kalim has never taken that for granted. So what? Who are they to challenge his heart. To decide if he should be satisfied.
He has never been satisfied. Not fully. Not until the treasure of emotion entered his heart. That is what they should envy, not his gold.
Kalim approaches the looking glass and taps on the glass.
tap tap tap
The glass is thin. The noise echoes in the empty hall, and he sighs in relief, knowing what must come next.
"It is unfair, and so I will even the playing cards. I will take on the burden of humbling you,"
Kalim has always been humble. Always been altruistic. The voice echoing across the walls must know this deep down. With some convincing, they may relinquish Kalim's treasure on their own. He need only wait a bit more.
Yet the sand continues to fall, staining the skin of it's prisoner in comatose. Still as a statue, their chest rises and falls to the rhythm of Kalim's steady heart. Only when their eyes open will he feel calm enough for rationality.
The time has come for him to be selfish.
"Respite in the scalding sands, a never-ending party. Dance. Sing. Oasis Maker,"
A burst of water, the shatter of rose-stained glass, and a jewel.
One Kalim does not own, and all the more valuable for it.
Jamil Viper
"Kill them. You appear to have deluded yourself into thinking I have attachments. So, go ahead and kill them,"
Jamil observes the hourglass cage with disinterest. With a flick of his finger, a chime rings out into the corridor. The noise is delicate, a stark contrast to the heavy atmosphere.
A figure clad in black robes stands tall across the room. Their outfit is eerily similar to Jamil's own overblot form, and bile rises in the back of his throat at the thought.
Not only does this person hate him, but they hate him enough to become what he hates the most. Himself.
The image born of his repressed emotions. His overblot. The nausea grows as Jamil realizes that resemblance is an understatement - this person has been molded into an exact replica. In body and in mind.
"Not even going to think it over? I thought you had improved, Jamil Viper - or was your change of heart a façade?"
His gaze flickers to the imposter's leverage. An hourglass shaped like a viper. It's fang-filled jaw erects from the ground, with its body curving up to the ceiling. All made of glass, stained to look as if tinted grey and red scales decorate the bodice. Pitch black sand trickles from the top, falling through the hole to fall into the viper's awaiting maw.
At the base is it's prey, rooted to the tongue and staring at him with eyes full of fright. Each grain of sand bounces from their head, to their shoulders, and piles at the floor. What the hell are you doing, they appear to be thinking.
"No,"
Jamil's replica laughs, raising his scepter and bringing it down harshly on the floor. They shudder in disbelief, thinking they have won. Believing that Jamil bargained they were bluffing, and that he would undergo a heartbreak worthy of their revenge.
thump. thump
The ground begins to shake as the building begins to collapse. No longer does the sand slowly fall, as the glass easily gives away from the earthquake. With the cage broke, Jamil allows himself one last look at it's prisoner. They pry their feet loose from the maw, and he prepares himself for his biggest challenge yet.
"You seem to have forgotten one thing,"
The imposter placed their faith in replication. The only way to outsmart a genius is to become them. Yet what they did not account for -
"I am always in control,"
-is that Jamil should never be underestimated. He is not the same person as his overblot personification. He is better.
"Snake Charmer,"
It is one thing to take control of another person, and another to outwit a replica of yourself. Had they replicated his current mind, Jamil may have lost. He bet all his cards on their willingness to destroy and manipulate.
As the overblotted student drop to the floor in sleep, Jamil feels arms encase him tightly from behind. With one hand, he holds tight onto theirs and attempts to calm his pounding heart.
Had the student replicated his true self, these warm hands would not be holding him. They would not have been made collateral. Instead, they would be caged somewhere far far away in a place he could never reach. Belonging to a beating heart, forever manipulated to belong to another.
#twst scenarios#twst#twisted wonderland#twst x reader#twst imagines#twisted wonderland scenarios#twisted wonderland x reader#twisted wonderland imagines#kalim al' asim#jamil viper#kalim al' asim x reader#jamil viper x reader#twst jamil viper#twst kalim al' asim#scarabia#scarabia x reader
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hieyyy hiiiiiiiiiiii
oh god when did tumblr app's post editing UI get this bad . oh well anyways hi !! this is a sideblog for my group project about silly little rovers ... ill post a lineup eventually but to kick this off here r 2 images of earth aka ajax mcshit head . put him in a blender and turn him into evil juice .
also i probably wont be the only one posting here so ill introduce myself a bit ! im teo (any prns) and im the main artist and storywriter here . the rest are rosie, carl and schoko! we're all minors so strictly nsfw blogs please dni LOl
also if you recognize me !!! me and my friends used to run a former hetalia/statetalia blog for almost 3 yrs isnt that cool but we've separated ways now oops
its 5 so this is all i can write buuut i hope 2 meet other swag planet makers soon 💥
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I finished watching she-ra yesterday! I decided to watch it after seeing your posts on my dash a lot and watched the whole thing in just over a week. Can you recommend some more she-ra blogs to follow?
i’ve recced blogs before but i barely knew anyone back when i did that. this time i know a couple more people and even tho im not like miss popular nor do i talk to every one i’ll do a blog rec that’s a tiny bit more thorough! (disclaimer, this is low key in order of people that showed up on my blog aka i reblogged something from them etc hgdfjsd not according to like. how much i love them or anything)
@catradoraism mmm i’m p sure i indirectly rec jules as a blog a few times every day, because of how i sometimes. talk about her. anyway i hate jules! but she does have a really great blog, she makes very good posts and is very talented. she can draw and write really well, and is just a lot more talented than me. follow her u will regret it but do it anyway <3
@catralatina mar is unfairly big brained. they are galaxy brained and make incredible posts and they get really good asks too! so if you’re looking for a blog who’s got good rapport w their followers, look no further! also they are a talented writer and i saw some of their art it’s good. one time they posted a picture from an atla comic and i thought they drew it. it was very embarrassing <3 but yes if you’re not following them u should!!
@catralovesgirls yo definitely follow izzy!! he has excellent takes and i’m like scrolling through his top posts section right now and it’s like impeccable. mine are hm! well! but if you’re following me following izzy would definitely be a step up <3 he also writes fic and i uh admittedly have not read any (sorry i have read like less than 20 catradora fics :( all of which came from page 1-2 of the tag filtered according to kudos. i’m still working on this oneshot but i will def check out his fics when i’m done and so should u all!)
@catheriaa yes follow cath!!!!! cath said adora hair down jacket open rights! cath said good posts rights! ur takes are very good congratulations on making excellent meta with excellent points <3 also ur post about the inherent rivalry of people with adora icons vs people with catra icons FGHHGH
@mer-mystery is like straight up excellent. good posts, good reblogs! for some reason i will definitely always list them if u ask me for good she-ra blogs. also like that url. inspired. literally just look at mine n u know immediately who is quality and who isn’t. i also think she leaves great tags, so it’s a treat when she reblogs one of my terrible posts <3
@gfshera karlie is quality!! love her takes love her posts love her tags. things i remember about her aside from this is her new girl au and the one time i reblogged some incorrect killing eve post and she immediately made it into a bfs post, which i wanted to make but didn’t know how. so clearly they are smarter than me <3 although being smarter than me. not the highest praise gdfhsdj
@swordlesbean one of those. god tier blogs. intimidating but in a good way, they write Meta™ and its very articulate and thorough and well put together!! they’ll link to like past meta within one meta sometimes and its like they’re sourcing their work and its kinda cool ngl!!
@marahoping YES definitely follow kenna!!!!! love her gifs like so much it’s the chef’s kissness of it all....... also will post other good things not just gifs, very entertaining blog in general to follow!
@horde-princess yeah!!!! Big Love for their content and posts and they got sick ass meta and they write fic!! (once again i am not sure i have read the fic of anyone listed here. i am very sorry. i know, i should be lynched) very very worth the follow. very value for money <3
@scorpia a perfect character url? how are u not already hitting that follow button. no they are not hogging the url. they run a full very good blog too! definitely makes good posts of a variety of types, like meta, funnie stuff, and this one richard siken post because bro...
@catriadora a great gif maker! scrolled through some of their top posts and they made some gifs/sets that i really liked! you’ll love her too!
@homophobicshadowweaver very funny posts in the top posts section ghdfjshfds also eleanor has read the she-ra books? the ones that like that letter from adora to catra came from? and i remember seeing ur posts about it and it was really fun to follow :) also that url. incredible. just by having that url u prove ur funnier than most people on here congratulations
@egirlcatra i really like u a lot ghdfjsdhdfsj def has good tags and takes and very fun to interact with <3 go send them asks!
@appsa i like LOVE their art and also they are so fun to interact with! they have other good posts too obviously and they have funny tags and buddy. once again love ur art its good as well as being very funny i need like so much more of it
think i will stop here now. my apologies if i follow u and left u out, or if i recced u last time and forget to rec u again ghdfsjfhd. also there are some people i follow that i wanted to rec but their blogs aren’t fully she-ra so i decided not to? idk. this took a while so ya definitely follow these blogs, and to these blogs have a nice day keep doing you <3
#ask#i used some of ur names sorry if thats not ok u can just tell me n i'll remove#also if i got anyone's pronouns feel free to scold me about that too#uh..... if you think u deserve to be recced but weren't#idk what to say#seduce me or something#we'll see what we can do! lmao#also to the people recced sorry if i didn't talk about ur blogs properly or well enough or i said something too wild#unless this made u happy then haha ur welcome uwu#anyway i should stop talking in the tags now bye!#clueless-human
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Sooo, with summer coming to an end (god the passage of time was weird this year), here’s an update about the direction my blog’s going to take.
1. About 9-10 months ago, I started imagining ideas for a Dakavendish fic called “As Time Passes”. Fun fact : the idea started from my very first MML fic, which I wrote on paper but never posted (I know it’s the very first because I mention having a new ship in the beginning). I then started building from this one chapter, turning it into more than a random oneshot. Due to that, I firstly saw “As Time Passes” as a rather short fic and basically made some kind of “skeleton” of a story by dividing the main ideas I had into chapters, thinking that it would be enough to write the story.
Recently though, I decided to take this fic a lot more seriously (maybe a little too much) and so for the last month I’ve been working on really fleshing it out, writing down info for OCs, places, how BOTT works, have a doc with info for the time-periods visited etc and want to write for each chapter what I precisely want to put in, which includes chapters that make the story take its time and progress slowly (hence why just writing down the main chapters ideas doesn’t work anymore for this fic).
As of right now, I’m close to finishing the planning phase and I already have pretty much anything I need to finish the prologues. So I’ll try to finish prologue 2 by the end of the month, but I can’t make any promises (the first prologue is already posted and looking at the date makes me sigh because I’m taking so much time for fuck’s sake !)
Aside from this fic, I also came up with three other ideas for oneshots talking about the rogue arc (because of course I did…) + something about “A Christmas Peril” and maybe something random. But I want to focus on Prologue 2 before working on those.
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2. Miitopia. When the game came out on 3ds, I played the game a lot and made a team with Undertale characters (more precisely Humantale but that’s beside the point).
So when the game came out on switch, I bought it and made characters for the team using my current obsession, aka MML. And with my wish to complete the game 100%, I play it on a daily basis (trying to get my main level 50 for all jobs, currently 6 more to go). This means that I have quite a lot of pics and videos of it.
For a while now I’ve been wishing to share all of those pics and videos but never took the time to do it. So I might as well do so now. Because this game is very dumb and I absolutely ADORE it for that and I really wanna share some of the stuff these miis say.
Btw I don’t trust myself to do cartoon characters with the mii maker tool so my team is made of miis that resemble the characters. I also used other people’s shared miis for any non-team character and some are pretty funny fits.
I’ll probably make a tag like “Milotopia” to put all this spam in since I don’t really want it to show up on the show or the game’s tag .
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3. As mentioned in the part about “As Time Passes”, I made something that describes precisely how I see BOTT work (different jobs possible, rules, how to become an agent, ranks, even emergencies procedures) and I’ve been wishing to share it.
That’s actually why I made a few posts Thursday, I was trying to get myself to post this.
Because the “”“issue””” is, there’s a part in this BOTT infodump about how, no matter how inclusive BOTT is trying to be, agents face discriminations since the agency is about time-traveling. So I talk about the limitations the agents are forced to comply with when time-traveling (you know like how some of my fics have Cavendish worrying about homophobia, forcing the duo to hide their relationship ?).
But since I never talk politics or social issues on this blog (I want my blog to be a space where people can just read about cartoons without worrying about all the stuff going on in our world), I was worried that some people might get the wrong impression from this post.
This worry is actually pretty dumb because, when it comes to social issues, I think my mindset is close to the ones my mutuals have ? To keep it short, let’s just say that, if I had to reblog one post that talks about those topics, it would be that one post saying “this blog supports POC/queer people/autistic people/every religion etc + dni if you’re a p*do, f*cist, exclusionist etc”
Tbh I think I’m going to reblog that post after all. Also I could probably take the time to add something in my bio (like a “exclusionist/f*cist/p*do dni” type of thing).
But still, since I’m afraid for no reason to have troubles with this post, I’ll keep the info about BOTT on the side for now. I’ll most likely post it after Prologue 3 of “As Time Passes” since it’s in the topic.
Though, if some people read this and get really curious about the BOTT info and start requesting it, I guess I’ll consider it okay to post it sooner ? 🤷♂️
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4. Regarding the end of summer : So I’m currently 21 and have been studying for the past few years. But with the pandemic, working from home had been really hard for me.
Right now, I’m at a stage in my studies where I can take a break (I don’t live in the US). And since I’m a privileged bastard with parents who won’t throw me out, I’ll be taking a break in my studies this year. This means that I’ll have the time to be more active here (since I’ll have time to write).
I’ll also start streaming video games by the end of the fall. I haven’t touched a mario game in months and I’m really missing it.
Tbh I’m mostly taking the year off because I know for a fact that, if I study while still forced to stay at home, I’ll fail for sure. So I’m hoping that things will get better next year.
Though, it also feels good to say “fuck you” to the system and simply take a year for myself, trying new things, write more, maybe learn to draw, finally having the time to focus on starting my transition.
But yeah, long story short, I’ll be around more, probably will post more, and I’ll do gaming livestreams in which I would most likely encourage people to talk to me about cartoons (yes I’m going to use streams as an excuse to infodump). I might also take some of my longest posts and make them on a video format, but It’ll take a while since I need some experience on editing for that.
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5. I might start reblogging more texts posts from more shows I never talked about but watched.
#Flor talks#personal#a random little update#like each time I leave tumblr for a while#now time to go back to find that post to reblog#and then go back to write prologue 2#It's going to be such a long chapter...#that's what happens when you get attached to OCs and want to tell their story#then tomorrow I might start posting some mii//topia#(I love this game so much you have no idea)#long post
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hi hello, it’s your fav chaotic disaster here! since it is nearing the end of the decade/2019 here ( i know some of y’all are already enjoying the new year bc timezones lol ) but i just wanted to take the time and mention a few peeps that really kept me grounded this year. this is not a follow forever bc im lazy as fuck so pls enjoy this mess of me rambling lol!
even if you aren’t tagged, there are special mentions for each group im under so please read if you have the time! please note that each and every single one of you has made 2019 so much better cuz we all know it was hella rough so im very thankful for all of you!
this is hella long so everything will be under the cut :)
oc mutuals ⤵
my one and only :: @daisyjohvson my ride or die, my best friend, my beautiful sister, my other half. there are no words that could articulate how much you mean to me. you are my person and nothing could ever change that. i know we both have been busy this year, but im so glad we always do our best to chat no matter what time it is for us. you are my everything and i adore and love you so fucking much. i hope 2020 will finally be the year we meet after being friends for almost five years. i wish you the best of luck for the start of a new decade babe xx.
satanic bitches 2/3 :: @freakingbradleys @fleetwoodmcs god, it still blows my mind that my two idols talk to me on a daily. amanda, kayla, you guys have brought such a new perspective into my life and i cannot thank either of you enough for it. you guys are so encouraging, thoughtful, amazing, and supportive. i know i can tell you guys anything and you would be super honest with me and i cannot explain how much i appreciate that. thank you both for enduring the mess of 2019 with me.
my chaotic twin :: @emiliachrstine emilia, my love, it has been a pleasure talking with you via tumblr and snapchat facetime. you have brought so much laughter in my day while i was at college and i am 100% sincere when i say i needed those talks sO MUCH! you know some of the challenges i was facing so i just wanted to say thank you for being so fun to talk to and always listening to my endless ranting ( especially the cLASS SIX FELONY bit ). im so thankful we got closer this year and i love you so so so so soooo much bb!
the enabler buddy :: @moirei first of all, i cant believe how much we’ve been talking recently! i’ve always wanted to talk to you more and im highkey upset that it took me this long to reach out to you again, but anyways, as john mulaney would say, tHe PaSt Is ThE pAsT. thank you for letting me ask you sooooo many questions about sw, enabling me with all of these spur of the moment ideas, and for being such a wonderful friend! you are so kind, encouraging, and helpful! thank you so much for everything bb!
long lost sister :: @nellie--crain rachel, honey, you are a light in my life. anytime you message me, i already feel 100000x happier. you are like an older sister to me and i love you to the moon and back! i love all of your ocs and our xovers so much ( especially robeck bc otp ) and i hope we come up with more stuff in the near future! i hope 2020 graces you with so much happiness and joy, my love!!
some of my ride or dies :: @chlobenet @peterparcour @hopemikaelsvns @thetenthdoctorscompanion @drewtanner @princes-jasmine @aaudace @killinbills thank you all for being so amazing, talented, and wonderful! you all have played a significant part in my 2019 and i hope you all know that!! y’all are so awesome seriously xx
the rest of my oc mutuals :: thank you guys for sticking around as my hyperfixations constantly change once i find a new thing lol. i hope to chat with you all some more in 2020 and the years to come! please remember that each and every one of you is talented, creative, and beautiful! i wish you all the best of luck for this upcoming year and know that i love and appreciate every single one of you!!
giffing mutuals ⤵
the other half braincell :: @yelenabelovaa fleur, my darling, what an honor it is to be your wife! we got so close sO FAST and i cant imagine my life without you. you’re the jake to my tom, and if that doesn’t explain how chaotic we are then idk what does. thank you for being there right away when my dog died unexpectedly like i cannot tell you how much i appreciated you on the phone with me until someone irl was there to help me. thank you for always being so selfless, kind, and an incredible friend. i love you so much and let’s hope we get to meet in 2020!!!
goddess of parallels :: @andthwip the fact that you follow me is still absolutely mind blowing! also the fact that you tag me in your gifs is eVEN MORE mind blowing! i’ve admired your work for quite a while and let me just say, your ideas are unmatched!! you have such an eye for detail like no one can do what you do!! thank you so much for being a great mutual and i hope 2020 will be a wonderful start of the decade for you xx
the clown :: @robertpattisons okay dont hate me for putting the clown lol its just your icon and i had to im sorry lmao!! anyways, laiba, hi bb! you are such a talented gif maker and im so glad we became mutuals this year! thank you for being so nice, helpful, and a great friend!! i love you lots and have a great 2020!!!!
chaotic duo :: @colins-farrells sakshi, darling, idk if i ever mentioned this to you but you made me feel so comfortable with my blog. i looked up to you and your amazing chaotic posts and i just wanted to thank you for that! you truly are amazing and ily bunches xx i hope 2020 will be epic for you!!
some of my amazing giffing mutuals :: @lzzieolsn @luke-skywalker @ageofultron @brolinjosh @rosiebetzler @bitony you all are so fucking talented like seriously!!!! thank you all for following my trash can of a blog bc i have admired ALL of you from afar and im still in shock about it!! i hope 2020 blesses you all with happiness, success, and joy!!! i love and adore each and every one of you!!!
the rest of my giffing mutuals :: thank you all for being so fucking nice to me! i only began giffing regularly at the beginning of this year and i made SO many wonderful mutuals ( aka you guys ) because of it! you all have been so helpful and supportive of me and i am so fucking grateful for that!!! 2020 is a new year and the start of a new decade for us!! i wish all of you can enjoy this new beginning!!!
to all of my followers ⤵
hi hello! if you got this far down, congrats!!! i just wanted to say i fucking love you guys so damn much!! no matter what im doing, my current hyperfixation, the ENDLESS amount of shitposting, y’all willingly stick with me and i seriously can’t thank you enough! i know i say that so much, but it’s honestly 100% true! i’ve reached INCREDIBLE milestones because of all of you!! so seriously, thank you! 2020 is a fresh start so let’s make this year fucking amazing!!!
#still have an hour left of the decade but happy new year to those already in 2020#i love all of u and i hope u all know that#enjoy the header of the best baby ever#joey talks
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your blog (because you’re amazing and really funny), eternal-bangtan, monojoons, minsbutt, namgination, hopekidoki, jungshiii, dearbangtansonyeondan, itseokjins, eternalbulletproof and so many more!!
this is very sweet of you my darling i had to Take A Moment of dissolving into a giant blushing mess iwjdodnfkenxj
@eternal-bangtan it took me like one (1) millennia to figure out it was karina aka the Queen of ot7 content oh my GOD!!! where do i even BEGIN like their gifs? deserve to be hung in the louvre. their talent? so out of this world the voyager i got jealous. the colouring? so bright and spectacular pop art looks up to them. their style is so distinct you can always always tell its theirs.
@monojoons MISS TAYLOR HELLO MY LOVE WE MEET AGAIN MY DARLING the fact that my followers are all sweethearts with Fantastic tastes we are here again so I can PROPERLY SHOWER YOU IN MY LOVE AGAIN!!!!! hello you incredible human I hope the amount of love all my followers (and more importantly ME!!!) shows you how INCREDIBLE YOU ARE!!!!!!!!!!
@minsbutt ah yes if it’s not THE MOST ICONIC YOONGI STAN OUT THERE like…absolutely adorable theme, the most iconic url, Quality Content Creator like what is there NOT TO LOVE????? theyre out here being the Whole Package and we are all so blessed to have them in this fandom!!!!!
@namgination the only thing more quality than their gifs is their personality and theme like??? i always love seeing their gifs on my dash????? the speed at which i lose my single braincell over their content???? supersonic. ((also, absolutely this is just a namgi world and we just living in it, what an intellectual))
@hopekidoki adorable url, incredible gifs, spectacular theme like wow *clenches fist* excuse me please spare some talent and adorableness for the rest of us thanks!!! anyways, they're incredible and talented and deserving of every good thing this world has to offer.
@jungshiii listen to me. the absolute legend that they are. the actual senpai blog of senpai blogs. one of my fave content makers for their coloring the care they put into their sets the absolute gorgeousness of their work as a whole!!!! i will literally write odes to the sheer talent of her gfx (even tho i can barely punctuate properly like there is not one single break in that previous sentence) what the fuck fam. spare some talent for the rest of us geez.
@dearbangtansonyeondan some of the most distinctive content creators on this hellsite. seriously. sometimes i scroll thru my dash and go, hey is that emma? it looks like emma. and look up and go. yep. the queen has come and blessed us again. thank you queen. those sharpened gifs are sharp enough to make my lose my last tether to my sanity.
@itseokjins hello. it me (again). here to shower you all of my love val. all of it. (again). anyways hello i love you and your incredible heart and awe-inspiring talent and spectacular theme. every time i see you either in my activity or on my dash i squeal like the true fangirl that i am.
@eternalbulletproof i would like to make it known that ur url makes me tear up reflexively and i look at ur content and i wanna cry more the Talent??? a true sweetheart and ur bangtan smiles compilation??? makes me smile everytime i see it on my dash. bless you you incredible human.
Love Letters 💌
#damn fam you really listed out all of my fave content creaters youre incredible!!!!!#one thing im noticing on these is that its always lil ol me and then like....god level content creators#like i dont really make content im just here to dump my emotions out. like that one miscallaneous drawer in ur kitchen.#im glad yall have excellent choices in iconic blogs#hello my loves i hope this finds you well and happy and safe#ans
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22 Apr 2020
Greetings reader, I trust this blog posting finds you well. I am currently 5 weeks, 9 Zoom quizzes, 4 bottles of wine and 3 toad in the holes into my isolation. I find music & film are a big factor in me keeping my sanity otherwise I’d be sitting each night after a days work just staring at the walls. Three more songs this week for you to get your metaphoric teeth into.
First this week and a new single from an old favourite of mine. Damon Gough aka Badly Drawn Boy has returned with a new single and new sound, away from the flowing acoustic he has become best loved for. His first album ‘Hour Of The Bewilderbeast’ in 2000 was a wonderful introduction to the innocence of his lyrics and the simplistic nature of his music. Whilst people will argue it’s not the most exciting music in the world the album clicked with me, with personal highlights from the album being ‘Once Around The Block’ and ‘Another Pearl’. Following the soundtrack album to the film About A Boy in 2002, later that year the album ‘Have You Fed The Fish’ was released and is a firm favourite of mine. Tracks ‘All Possibilities’ and ‘You Were Right’ charted well and are strong tracks in support of other brilliant compositions ‘Born Again’ and ‘What Is It Now?’. Follow up albums have reverted more towards the style of the debut album with fewer of the songs grabbing me the same way. That said, Gough is never afraid to show off a full range of obscure instruments in his music with albums ‘One Plus One Is One’ and ‘Is There Nothing We Can Do?’ containing Gough on clavinets, melotrons and a Wurlitzer Fun-Maker. This new single is his first output for nearly 8 years and listening to the intro you’d never guess it was him. We’ll see in what musical direction the forthcoming album takes us.
Badly Drawn Boy - Banana Skin Shoes - https://youtu.be/9DoVsGK87NM
Second this week and a song I’ve played over and over far too much this last week! The track is called ‘Daddy’s Car’ and is a collaboration between ambient music pioneer & all round musical God Brian Eno and founding member of Underworld Karl Hyde. Eno has collaborated with dozens of artists in the past, U2, Coldplay, Bowie to name drop a few and Eno had worked previously with Hyde as featured artist on an Underworld track ‘Beebop Hurry’. The track I’m sharing is taken from their debut album together, the 2014 release ‘Someday World’ and features, amongst others, guest musicians Will Champion from Coldplay and saxophonist Andy Mackay from Roxy Music. The album sits firmly within the electronic music genre as you would expect but this is one of those albums in my opinion where the average tracks outweigh the good. Another strong track from the album is ‘Who Rings The Bell’ and is only one of the few tracks where Hyde sounds like he wants to be on the album. Tracks ‘The Satellites’ and ‘Strip It Down’ whilst enjoyable musically give Hyde no room for manoeuvre and the involvement of vocals slightly ruins them. When it works, it works very well and in ‘Daddy’s Car’ they have a track which mixes strong vocals and a catchy synth loop which I cannot get out my head! Their second album ‘High Life’ was released only 2 months after the first and is an experimental art rock album with leftover ideas from the first album. Oddly, whilst experimental, the fewer vocals from Hyde allow this album to be musically stronger than ‘Someday World’. Hope you enjoy the track Daddy’s Car as much as I have.
Eno + Hyde - Daddy’s Car - https://youtu.be/rDAuBFLkqpQ
Third and final song this week comes courtesy of Worcester based indie band Peace. I must admit to never hearing of the band before a song of theirs made its way onto my weekly Spotify ‘you should hear this’ type playlist we get every Monday and I thought it special enough to share. Formed in 2009 they received positive feedback from their 2012 debut EP, which is where the track I’m sharing is taken from. This EP lead NME to compare the band and their music to that of contemporaries The Maccabees and Foals although doubt was cast following the release of their debut album ‘In Love’ in 2013 as some reviewers questioned whether the band had developed from the initial hype. Two of the tracks from their EP made it onto the debut album, for me the strongest songs were left behind! I have listened to the first album and consider it to be my favourite of the three. It's a heavier indie sound which I enjoy more and from opening track ‘Higher Than The Sun’ to Maccabees sounding final track ‘Bloodshake’ it is a good debut album and one which is worthy of the positive reviews it garnered. The second album released in 2015 ‘Happy People’ and their latest album, the 2018 ‘Kindness Is The New Rock And Roll’ are good to listen to and have within each of them songs with catchy hooks and clever songwriting but the debut album is still the strongest for me. Combined with their early EP you have to ask the question whether reviews that the group wouldn’t live up to their hype were on the money. Regardless, enjoy this track from their EP, a 10 minute psychedelic journey for you to enjoy!
Peace - 1998 (Delicious) - https://youtu.be/kiGJ8XatRks
Posting done for this week, please stay safe out there in the big bad world. I can heartily recommend getting as much music as you can into your life, whether it be some new sounds to immerse yourself in or some old classics you love hearing again and again I’m finding music as a vital ally in fighting boredom!
#badly drawn boy#badlydrawnboy#eno#hyde#peace#music#new songs#new music#Songs#Spotify#playlist#isolation#tunes
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“Shameless War Criminal Bloody British Bastard Blair” Lectures the World on Military Strategy, With No Word of the Deceit He Engineered For an Illegal Assault on Iraq 🇮🇶, Syria 🇸🇾 and Afghanistan 🇦🇫
— 6 September, 2021 | RT
Former War Criminal Bloody British British PM Tony Blair sees himself as a colossus on the world stage – climate hero, peace maker and thinker for our times – seemingly unaware that many people view him as a ‘War Criminal’ who deserves to be put on trial and throw him behind bars to “Stay, Rest, Rot and Burn in Hell Forever.”
Since he left high office in 2007, there really is no subject in the world on which Tony Blair is reluctant to express an opinion on, buoyed by an unsinkable self-belief and an apparently total absence of self-awareness.
He’s convinced that a huge appetite exists for his latest musings, that French President Emmanuel Macron is desperate for his help in tackling the radical Islamist problems of the Sahel, that US President Joe Biden lies awake at night asking himself, ‘What would Tony do?’ and that the British public has forgotten he took the country into a catastrophic war against Iraq that both the United Nations and even his own government inquiry determined was illegal.
His acquiescence to US demands for an attack on Saddam Hussein earned Blair the US Medal of Freedom from George Bush and 20 years of opprobrium from the British public, which has only increased as the years have passed on par with his own immense personal wealth. A poll in 2017 found a third of the British public would like to see Blair put on trial as a war criminal.
But that’s not something the ex-PM likes to dwell upon. So his speech to the Royal United Services Institute (RUSI), almost 20 years to the day since the terrorist attacks of 9/11, made no mention of what followed those unforgettable events: dodgy dossiers, suggestions of bunkers full of weapons of mass destruction or of the purposeful lying to the British people.
Rather than learn any lessons from recent history, like when to wage war, Blair’s appetite is clearly undiminished, as he moaned, “Western societies and their political leaders have become quite understandably, deeply averse to casualties amongst our Armed Forces.” This, in his view, had become, “an overwhelming political constraint to any commitment to Western boots on the ground, except for Special Forces.”
It’s all Biden’s fault apparently. Blair said, “It is clear now – if it wasn't before – that America has decided that for the foreseeable future, it has a very limited appetite for military engagement.”
‘First order security threat’ akin to revolutionary communism: Afghan war didn’t solve radical Islam, Tony Blair says. War Criminal Bloody British Bastard don’t like to talk about “Radical Christians Terrorists, Radical Saffron Hindu Terrorists, Radical God’s Fucked-up People Zionist Cunt Terrorists,” because they can give him a deep f*** and stop paying him to propagate spew filth against Muslims.
Well, yes, Mr. Former Prime Minister, it is true that the Americans have made no secret of the fact that they are sick of fighting ‘forever wars’. But us Brits also do not like to see the lives of young men and women who have signed up to serve their country sacrificed at the altar of political self-aggrandisement. We are now a little less gullible, a little less obliging when it comes to fighting unwinnable, neverending battles and somewhat more suspicious of our glory-seeking political leaders. And that’s all largely down to one person. You.
It’s strange Blair doesn’t acknowledge this. One thing’s certain, he knows his geopolitics; hell, he even has his own eponymous ‘global institute’ packed with researchers, academics and leading experts to tell him what to think and say about the key issues of our time. With one exception. Do. Not. Mention. Iraq.
The exclusion of that country’s name from the conversation is obvious. In looking forward, Blair said that Europe – insisting “for these purposes Britain is part of Europe like it or not” – faced an immediate challenge from the destabilisation of the Sahel and was “already facing the fallout from Libya, Syria and elsewhere in the Middle East.” Err, by ‘elsewhere in the Middle East’ could Blair possibly mean Iraq? Probably, but let’s not risk spoiling a pleasant chat.
And in the face of that perceived threat, which in the Sahel until now has been largely handled by France, Blair asked, “How do Europe and NATO develop the capability to act when America is unwilling?”
Blair clearly sees military action as an imperative – I’m not sure everyone else agrees – but he also thinks the capacity of Western policymakers to think strategically needs to be reinvigorated.
“For me, one of the most alarming developments of recent times has been the sense the West lacks the capacity to formulate strategy,” he said. “That its short term political imperatives have squeezed the space for long term thinking.
It is this sense more than anything else which gives our allies anxiety and our opponents a belief our time is over.”
Now the picture is starting to become clearer. While Western governments are distracted from war by the need to focus on rebuilding economies, fighting worldwide health crises and seemingly perpetual election cycles which inhibit their ability to think long-term, they need big thinkers, top-shelf statesmen and global heavy hitters to work out how to bomb the citizens of far-off places into oblivion through drone strikes, how to convince a sceptical public that it’s a good idea to send servicemen and women to their deaths and – most importantly of all – how to create the right PR buzz around those decisions, so that everyone feels comfortable about falling into line.
Those Western governments need men just like Tony Blair. He’s free most afternoons, if you’d like to schedule a Zoom call. Just don’t mention the war (on Iraq).
“War Criminal, Boak Bollocks Bloody British Bastard Tony Blair” calls US Afghanistan withdrawal ‘imbecilic’ – What, then, was the Bush-Blair invasion of 2001?
— Neil Clark is a journalist, writer, broadcaster and blogger. His award winning blog can be found at www.neilclark66.blogspot.com. He tweets on politics and world affairs @NeilClark66
— August 22, 2021 | RT
War Criminals Bush and Blair met in Washington to discuss the ongoing operations in Afghanistan, November 7, 2001. © REUTERS/Win McNamee
“Serial Warmonger and War Criminal Bloody British Bastard Tony Blair” has blasted the US decision to pull out from Afghanistan, but history tells us the real madness was invading the unconquerable country in the first place.
Former UK Prime Minister Tony Blair –aka ‘The Blair Creature’– is not a happy bunny this Sunday, folks. He has said that the decision to withdraw western forces from Afghanistan was made “in obedience to an imbecilic slogan about ending the ‘forever wars’.”
What he calls the US’ ‘abandonment’ of Afghanistan was “tragic, dangerous and unnecessary.”
In fact we could say the same about Tony Blair himself – and certainly the wars of choice he promoted.
Imbecilic? That’s the perfect word to describe what happened in October 2001 when Afghanistan was invaded in response, we were told, to the terrorist attacks of 9/11, even though none of the terrorists were Afghan nationals.
Had Blair read just a little bit of history, he would have pursued an exclusively diplomatic path to try and get Osama Bin Laden handed over and not have been so keen to send in the troops.
As I wrote in the Daily Express in 2009 in an article entitled ’Afghanistan: History repeats itself,’ “‘That men do not learn very much from the lessons of history is the most important of all the lessons of history,’ said Aldous Huxley. Nowhere is this more applicable than in the case of the many unsuccessful attempts by foreign powers to conquer Afghanistan.”
I went on: “The mighty forces of the British Empire failed three times between 1839 and 1919. The Soviet Union, which at the time had the largest army in the world, tried in 1979: they too were defeated.”
But in 2001, Blair and the then American President George W. Bush thought they would buck the trend. They could topple the Taliban (which they did) and remake Afghanistan – a deeply conservative and very religious country – in the western secular image. Afghanistan would be transformed from a ‘failed terror state’ into a ‘functioning democracy.’ What folly. What imperial arrogance.
Today, Blair is busily trying to spin the invasion of 2001 as a ‘success.’ But, while some things did improve, 'Operation Enduring Freedom' certainly didn’t bring peace to Afghanistan.
According to the UN Assistance Mission in Afghanistan, 579 civilians were killed in aerial operations between January and September 2019. That’s more than double the amount ten years earlier. Nearly 111,000 civilians have been killed or injured in the country since 2009.
Far from bringing stability, the 2001 western military invasion, just like the 2003 invasion of Iraq, was a major cause of instability.
I recall chatting to a friendly Afghan taxi driver a couple of years ago and saying to him how I’d love to visit the country to see its great natural beauty. “Don’t go,” he said. “It‘s far too dangerous. You would be targeted.”
So much for Afghanistan being ‘safe’ post-invasion.
Whenever the US withdrew, we would have had scenes of chaos. But the Americans had to pull-out at some point otherwise its forces would have been in Afghanistan forever. That doesn’t seem to concern ‘The Blair Creature’ too much. ‘Forever wars’ aren’t a great problem to him or indeed the ‘Inside the Tent‘ political and media figures who promote them. They are, though, for the soldiers who die in them, and for their grieving families.
‘But the US and British forces could have stayed in a support role,’ we’re hearing. But, as was pointed out last week, there is a word for countries whose governments only endure because of foreign military support. The word is “colony.”
Blair and his supporters are tacitly admitting that Afghanistan, billed as a ‘sovereign democratic country’, was actually a colony. I thought ‘imperialism’ was supposed to be a bad thing that we’re all supposed to be ashamed of. So why is it ok when it comes to Afghanistan?
Afghanistan is virtually impossible for foreign powers to subjugate. There’s its hostile terrain, its harsh weather, its fiercely independent people who are very brave, very tough and are highly skilled in mountain warfare. But anyone who’d read the history books would have known all this and not intervened in the first place.
Tony Blair, with his Messiah complex, thought he’d be different. He could succeed in Afghanistan where other, lesser mortals had failed. But the ‘new’ neocon empire met with exactly the same result as the old empire did. Wasn’t it ‘imbecilic’ to think it would be any different?
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@agentwashsims said: I️ knew you wouldn’t disappoint on the curly hairs!
Thank youu! lmao it is a pretty basic edit but I'm glad you like it ;-;
Anonymous said: Could you convert the solid colored EA Cruella DeVille style for girls or tots?
Actually it has already been converted HERE (warning: she uses an ad thing :( )
@verdigreedy said: You're doing a great job! Thank you for sharing with us!
Thank you ;-; RIP imagine that there are cc creators out there that don't share ;-; how much cc are we missing out on
@simmiezoo said: I would love a flipped version of the Zoey hair - I usually use hairs that are flipped the other side. I don't know if it's easy to do. Just a suggestion! It looks great btw. :)
I can try! No promises though lmao it should be pretty easy but sometimes it isn't
Anonymous said: Brady hair won't show up. Do I need to have Pets installed? I don't have it.
Hey! @ayoshi tested it, Braxton, Jordie, and Zoey hairs for me and they all showed up fine for him. He does not have Cats & Dogs installed so that isn't the issue. I think you have to have the most recent game update.
Anonymous said: Hello. Can i find out what kind of lenses do you use on sims?💚💚💚
I actually updated to quartz V2 a few days ago, and recolored them in 20 more swatches! Jade is gonna let me post my non-defaults, I just have to finish the previews
@lizziesimmer said: The link to your post of the clumsy braids are gone! I don't know what happened to them but I need them back!!
Yeah, I had planned on revamping them ;-; I still do! Just haven't worked on them in a few months weeks lmao hopefully I can get them finished soon
Anonymous said: Thank you so much for not using Ad.fly and making it easy for everyone to just download your CC without having to go through an ad hell <3 Talented and considerate.. what more do we need :)
Aaaaah no problem!! There are tons of creators that don't use ad.fly! or at least give you the option of ad.fly or not
Anonymous said: Bless u for editing that middle part curly hair from cats and dogs. It made me feel like my sims was George fucking Washington.
rhfdncv omggg screaming it does look kinda like a George Washington hair
Anonymous said: Will u make a Arilee Hair without the Bangs ? That would be so awesome ❤️ Love u and the cc u make. Such an talented person u are. Lots of love.
Awe thank youu!! Yeah I am gonna finish the no-bangs version sometime this week and get it out <3
Anonymous said: do you know if anyone that has (or could you hehe) remake those toddler camo pants for adult sims
I don't actually :( and I sadly am not that good at cc clothes ;-; maybe another creator will see this and try it out
Anonymous said: I just wanted to say that you're my favorite CC maker c': I just adore your work and how unique your cc is! <3 You have so much talent and I can't wait to see more from you.
SO SWEET!!!!!!!!!! YOU GUYS R LITERALLY SO NICE AND JUST GOOD PEOPLE ;-;
Anonymous said: I think your Jordie Hair may have caused my game to bug, I got the never loading ring of death :/ Cute hair though
Hey! As I said before, @ayoshi tested it and my othe recent hairs for me, and his game was fine :( a lot of mods broke with the patch so it is probably one of them
Anonymous said: I love all the stuff you make! You're super talented!
Omggg no I'm not ;-; thank you though, I'm glad you like it
Anonymous said: Does your username mean anything?
A - Austin, Harris - my last name lolol, 00 - for 2000 aka the year i wss born, Britney - for the legendary Miss Britney Spears
@simnook said: You make the most amazing cc and it’s been cool to see how much you have improved since you first started. love your blog so much 💚
Thank you dude!! Literally I bet it was a journey to see my old cc previews vs now! Like last night I went back and looked at the previews for my Roseanne hair and i didnt fill in the area behind the '18 ea colors' all the way and just GOD I cringe at myself
@cowplant-pizza said: hi love! just wanted to ask if you are working on the middle parted curly hair from cats & dogs! its a tad flat imo, and i trust you more than anyone to do it justice!!! ily ♥
This was sent before I released my Zoey hair :P hope you liked that
@simsinsanmyshuno said: yooo i have a suggestion: can you make that one floofy curly hair from C&D (lmao the bigger curly hair for women) shorter i feel like it would look really cute like shoulder length
I think @wild-pixel is working on a hair like that actually!!
Anonymous said: the jordie hair is so cute!! thank you for everything you do for the community!
<3
Anonymous said:Hi I was wondering if we have to pets for you newest toddler hair to work?
As long as the post/preview says BGC, it means it is Base Game Compatible :) I do think, however, you have to have the most recent update to the base game
@spideywil921 said: Omg could you potentially make a child version of the Half Up Do with the braids from Cats & Dogs???
I might if nobody else has done it by like Tuesday??
Anonymous said: Can you do recolors on some of the male CAS tops in pets? You’re one of my favorite cc makers and I love your stuff 😩😩
Lololol I am not that good of a recolor, I actually recolored 4 CC tops a week ago and have the post in my drafts still contemplating about posting them ;-;
Anonymous said: You should start a gameplay
rip nooooo
Anonymous said: So, I love shaved hair, so I checked out the hairs, and while looking for a hair, I came across Tae Hair, so long story short--- where can I download it? It isn't in the list.
It's in there :) just click the download and you should be able to find it
@deviants said: hey! this is super random but I’ve been watching you create content for a while now and tbh you've gotten so fantastic!! you’re one of my favourite CC makers :)
Aweeeee thank you so much <3 I'm glad you call me one of your favorites
Anonymous said: Hi, where did you get the scar eyebrow in your Rebecca hair? <3
Please check my resource page! It is listed in there on Lora's cc chart
Anonymous said: Hey I love your cc!! Are we able to download the sims you make? They're just so perfect. What's your origin id? xx
Thank you!! I am gonna work on getting Taylor and my male Sim posted this week :)
@itacorcoran said: I wanted to say your content is so amazing! It's the best sims 4 hair i've ever seen its unique and interesting and barely any clipping if at all :D I hope you're well i pretty much download every sim hair i see on here ^^
Thank you!!! My hairs def aren't unique but I appreciate it!
Anonymous said: Which did you prefer, likey or knock knock?
Right now I really like Likey but Knock Knock is soooo good I think it will overpower Likey later down the road. Same thing happened with Signal
@simskru said: I'm literally in love with you and everything you've created, just saying
TYSM!!! That is so nice ;-;
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HEY IT ME AGAIN-- LITERALLY SAME I GOT SICK AND LIKE IM STILL COUGHING AND I WANT IT TO STOP. LIKE. RIGHT. NOW. I hope you feel better soon! I can only imagine how bad you're suffering! Make sure to get lots of rest and binge watch Naruto hehehehe// I got sick around Christmas so it's kinda just here// But yeah lol just excuse me late responses (; 7 ; ) and yas girl just embrace you're inner otaku its okay xD (i wanna re-read Naruto actually//) OMG YES PLZ I LOVE YOUR FICS AND-
{CONT} YO HOW DARE YOU WRITE THAT JUNGKOOK FIC IM SHOOKED JKSDFNKJD// LMAO IF THAT AINT ME IN ANY MATH CLASS FUKFFKFKKFKF BUT ITS OKAY YOU CAN DO IT I BELIEVE IN YOU! There was freezing rain here a day or so ago. That was fun . u . (sobs) IF YOU COULD TWEEK MY BLOG OMG ID LOVE THAT. But the theme isn’t originally mine and I’d assume the original owner wouldn’t want the original code changed?
{CONT} IDK I wanted to change my theme for a while now // Something not endless scroll but just boxes for previews? Also I wanted a minimalistic theme based with pastel colours and black and white hehe/ ANYWAY NO NO WORRIES SOMETIMES IM JUST HERE WONDERING IF YOONGI SUED BIGHIT FOR DYING HIS HAIR TOO FREQUENTLY AND NOW HE BALD (LOL) BUT YEAH APPARENTLY THEY ARE SUPPOSE TO HAVE A COMEBACK IN FEBRUARY AND MY WALLET IS UPSET. I ALSO WANT THE NEW ARMY STICK FOR NO GOOD REASON AT ALL LOL
{CONT 3 xD} I’ve only read Naruto Manga so if you wanna screech with me about that lets do it ahaha/ HECK YES I WILL READ THEIR FIC- I WILL NOT STUDY JAHAJSDSDKJF Shout out to Cat and Fae too like i seriously love their fics- your Christmas series had me shooked!! Anyways I have so much work to do and so i will bother you later :) - Sakura !
IM HEALED AND BETTER NOW THANK YOU I HOPE YOU’RE FINE NOW TOO??!?! but i remember my doctor telling me once that if you’re still coughing like a month later you should get it checked out or something D:
and oh. my. god.
naruto.
LISTEN I LITERALLY CRY EVERYTIME IT MAKES ME SO EMO. I WATCHED NARUTO THE ROAD TO NINJA MOVIE LIKE TWO NIGHTS AGO AND I CRIED LIKE A BABY WATCHING HIM INTERACT WITH HIS PARENTS AND ALL LIKE D’:: highkey still hated on sasuke though
but yeah no it’s okay! i have super late responses as of late…. and it’s really only because i’ve been too emotionally spent by the end of the day or tired or busy or just “not feeling it”
idk, but i hope to get back into being more active. i miss this place. i miss interacting with others, as little of it i seem to be doing right now (guh _ _)
LOL I HAVE SO MANY SEX SCENES ALREADY PREWRITTEN OUT FOR HTE JUNGKOOK FIC AND SO NOW THAT I’VE GOT THE HARDEST PARTS DONE, IT’S JUST DOWN TO FILLING IN THE PLOT AND SUCH. aaaand that’s kinda hard too, but i think i’ll manage. hopefully.
(help)
dude it was rainy and windy and cold today and i had to go outside and the entire time i was walking/running/dying to class i was thinking a) why b) this was a Mistake
ah well in regards to your theme, usually the theme makers are okay with minor changes (sometimes major ones too) as long as you keep the credit and the changes are for personal use (as opposed to commercial use/redistribution, etc). just to be sure, you can just check their rules. they usually have that whole page/pop up or will simply include it in their theme code.
hmm what do you mean by boxes for previews? i don’t think i’ve ever seen such as thing. it sounds interesting, though. are they previews for like posts or…?
YEAH OMG I’M REALLY EXCITED BECAUSE FEBRUARY IS BOTH MINE AND ALSO @taesthetes‘ BIRTHDAY MONTH SO ITS LIKE A BIRTHDAY PRESENT WOOHOO
thank you for loving our collaboration! i’m still amazed on how quickly we got things put together and everything… honestly… cat and @zephyoongist�� are so talented i don’t know what i’m doing here :’) (or where i would be without them)
and now finally…
(for the maaaain event)…
okaY OKAY I WILL SCREECH WITH YOU ABOUT NARUTO. RIGHT HERE. RIGHT NOW. just under the cut because spoilers:
I’M SUCH AN EMOTIONAL WRECK OVER NARUTO THE ONLY BEST WAY I CAN TRULY EXPRESS MY THOUGHTS AND FEELINGS AT THE MOMENT IS JUST THROUGH BULLET POINTS SO:
i love kakashi
i also love gaara. i can’t choose between the two, but lately i’ve been more biased towards kakashi. i blame it on my sister because she’s always had a thing for him
(i still love you gaara its okay my sand child)
kakashi’s backstory had me in tears… like… with obito died and he’s telling kakashi he’ll give him his sharingan (the sharingan that he’d always been talking about that would get him to hokage) to be his eye to see the future…
i just..
fucking broke down man like dude… stop… you’re killing me here… and then how kakashi really changes afterwards
(okay but listen child kakashi was savage as fuck though and it was hilarious)
(also i know it’s a filler but that one episode in which it showed guy and kakashi comparing dick sizes as kids….,,..,.
….,,..i wasn’t expecting that at all but i don’t mind the info heheheheh heh /dies)
OKAY BUT THEN RIN DIES WHY
literally if she hadn’t died a lot of the issues in naruto wouldn’t have occurred but they fucking did
no i’m not blaming her she died for a noble reason okay it just makes me really sad i’m sorry
AND FINALLY MINATO DIES TOO AND KAKASHI IS THE LAST OF HIS TEAM IM EMO
on a side note minato and kushina were cute as fuck
ANYWAYS GAARA OH MY OH MY GOD MY POOR BABY as a kid he was so cute and just wanted some friends and was out helping all those villagers and such but then his damned dad just had to go and screw those things up like STOP IT HE;S MY CHILD
even though i love those two, my favorites are actually the akatsuki
like. they hate each other but istg they secretly love each other like have you seen kakuzu and hidan’s interactions??? they tease and insult and threaten (and have killed) each other but kakuzu is actually patient with hidan’s rituals and such, and hidan will still accompany kakuzu to the collection centers
also, when he sees asuma’s guardian shinobi thing the first thing that comes to mind is kakuzu and how he’d want him for the money and he’s like u gh but like !!!
and AND when hidan at first thinks he’s accidentally killed kakuzu in his fight with shikamaru & co., he has that look of panic ooooh my god I JUST GASHUDFJSDIJASD
also hidan is just hilarious. like when they go to recruit him he’s like “who are you guys, all wearing the same clothes?? are you guys an orchestra or band or something?”
/points at kakuzu/ bet you play the bass
/points at konan/ bet the girl does vocals and keyboards
/points at itachi/ …or do you do vocals…?
and then the first thing hidan and kakuzu do to each other is kill each other
the look of utter disbelief on both of their faces
“what the–why aren’t you dead?”
“bitch that hurt–wait. why aren’t you dead?”
but anyways we can’t forget about itachi and kisame either, now can we?? like. they are actually like the only partner group that openly got along with each other, and they were sad oh my god they were sad upon realizing each other’s death’s
and idk just the way kisame says “itachi-san” does something to me
i t a c h i
oh boy i have so much to say about this kid
but before i move on i must! address! the others!!
okay so like deidara is actually op as fuck and sometimes idk i feel like he doesnt get enough credit?? idk.
BUT LIKE LISTEN OKAY HE GOES THREE DAYS AND THREE NIGHTS TO SEAL THE ICHIBI AKA SHUKAKU AKA GAARA’S TAILED BEAST and then immediately after decides to take on naruto (and kakashi)
AND HE ONLY HAD ONE ARM AT THE TIME HAVING JUST LOST ONE IN HIS FIGHT WITH GAARA LIKE WHAT IS THIS STAMINA AND HOW DOES HE NOT BLEED OUT THIS KID IS FUCKING AMAZING WHAT THE HELL
and he’s 19 like lol what bye
but anyways, after his “fight” he loses his other arm because kakashi and now he’s armless BUT THIS KID STILL HOLDS HIS OWN though completely on the defense AGAINST TEAM GAI LIKE WHAT THE FUCK HE’S AMAZING and then he manages to create a bomb without using any sort of handseals and fools them all into thinking he’s dead
like
i love this boy give him a metal why did he have to die so early why (yet another reason why i dislike sasuke lmfao)
black zetsu scares the fuck out of me (esp when i learned of his true past and intentions) but white zetsu!! he’s such a sweetie holy shit
I JUST REALLY LIKED THAT TIME WHEN HE BURSTS INTO THE 5 KAGE SUMMIT AND HE’S LIKE “HALLLLOOO!!!!!!” WITH THE ARMS AND EVERYTHING DAW OMG
and also unlike so many others he actually likes everyone and when he saves deidara he’s like “you’re a fun guy to be around” and then and then later when he’s talking to tobi he reveals that he’s sad that so many of the akatsuki members died like D::
let’s not forget when black zetsu called him weak (they had split in two at the time) and white zetsu just kind of D: and wilts a little like ooHH NO oo baby it’s okay it’s okay
ahem
konan is so strong… holy crap… like… her ultimate attack? with the bajillion paper explosive tags disguised as a lake?? that go off for 10 minutes? holy fuck.
yahiko’s pretty damn hot if you ask me (yes i know he’s a cadaver in the main time period but listen)
idk my favorite arc of the entire thing was pain’s invasion of konoha… like from the moment jiraiya’s message arrived to when everyone got revived…. and then kakashi almost became hokage…
it was fantastic
i think it’s mainly because it was a mystery, race against time, battle thing all in one and it was so neat i guess
also you could see everyone in the village working together, fighting their hardest, showing their potentials for like, the first time ever
um um um okay sasori mentally scarred me as a child, and now whenever i hear the rattling puppet noises i immediately think of these scary nightmares i had after watching his fight with sakura… yeah, puppets scare me a lot now
orochimaru is a creep ‘nuff said moving on
tobi! i love this alternate ego of obito/”madara” like idk he’s so jumpy and honestly it’s fucking hilarious watching him because he’s so secretly op certain people underestimate him at first (and then others overestimate him because of his association with akatsuki)
like. when he was warding off konoha from itachi vs sasuke’s fight (which i am still emo about) he was just like playing whack-a-mole with them and then he’s like lemme use this ability! frill-necked lizard!
and they all kinda stand and stare at him intensely execting something legit
but in reality that’s it. the extent of htat ability is just him hanging upside down with the cloack falling behind him to look like a frill-necked lizard
and it’s fucking hilarious
i also thought it was fucking adorable when he and deidara first confront sasuke
and the little bitch goes ahead and slices through him
literally through him
and HE MAKES THE MOST ADORABLE NOISE BEFORE FALLING FLAT ON HIS FACE GAH
but sasuke thinks that he actually killed him and sasuke’s all like “one down”
and deidara just kinda
ugh this kid
and tobi gets up and brushes himself off like wow that was rly fast!!! and sasuke just >:/
URM OKAY ENOUGH ABOUT THE AKATSUKI MEMBERS
sorry i thought i should make this clear but i lowkey highkey have this vendetta thing against sasuke like this little shit
i mean ofc i know the reason for his disillusionment really isn’t all his fault like @ itachi really?
like really when he goes back to konoha and sasuke tries to kill him… he goes and easily breaks his wrist
and he kinda just considers him for a moment like
…hm
how about i….. make his situation even worse…?
and then traps him in a genjutsu that forces him to relive their parents death for 24 hours like why the fuck this is literally all your fault
and also on a side note, fuck danzo. why the fuck did the 3rd not kill him when he was supposed to. why. all the wrong people lived for far too long.
anyways
but yeah no idk i just really don’t like sasuke after he defected and became a Vengeful Teen
AND ITACHI’S STORY MAKES ME CRY EVERY TIME HOLY SHIT IT MAKES ME SO SAD WHY DID THIS BOY HAVE TO SUFFER SO MUCH and then mess up his little brother’s psyche to the point in which he starts killing like everyone wtf
AHEM
another favorite moment arc of mine is the very beginning
like the first 15ish episodes
IRUKA SENSEI
he’s such a blessing. he’s literally one of those crucially important side characters and i appreciate him and i love him and it would’ve been nice to see more of him, but hey, that’s okay too.
(his part in the naruto road to ninja movie had me in tears. like at the end. fucking tears.)
like naruto and kakashi may be super close and stuff, but when he needs someone as a guardian, naruto turns to iruka and idk i feel that says a lot about their relationship and it makes me cry all the fucking time
um anyways yes i also love zabuza
he’s so strong and empowered
AND THAT WHOLE ARC MADE ME CRY A LOT TOO AND THE FACT THAT IT BECOMES SUCH AN IMPORTANT PART OF THE STORY MAKES ME SO FUCKING HAPPY
i have a lot more the say probably but it’s getting late and i need to take a shower and sleep and get up early in the morning to make food so i’ll just leave it at that
(i wrote a lot i know i’m sorry)
(hope i didn’t blow you away with any spoilers D:)
#my naruto gushing got a bit out of hand but i regret nothing#also when i say i cry#I ACTUALLY CRY#LIKE FULL ON CRYING#I NOW HAVE A BOX OF TISSUES ON MY DESK BECAUSE OF THIS#replies#love people#polarbearchan
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Practicing Medicine While Black
By KIP SULLIVAN, JD
The managed care movement thrives on misleading words and phrases. Perhaps the worst example is the incessant use of the word “quality” to characterize a problem that has multiple causes, only one of which might be inferior physician or hospital quality. [1] To illustrate with a non-medical analogy, no one would blame auto repair mechanics if 50 percent of their customers failed to bring their cars in for regular oil changes. We would attribute the underuse of mechanics’ services to forces far beyond the mechanic’s control and would not, therefore, refer to the problem as a “quality” problem.
But over the last three decades it has become acceptable among American health policy experts and policy-makers to characterize any measurement of under- or over-use of medical care, or any measurement of a medical outcome, no matter how poorly adjusted to reflect factors outside provider control, as an indication of “quality.” The widespread, inappropriate use of “quality” long ago set off a vicious cycle. It helped spread the folklore that the quality of America’s doctors and hospitals is awful, and that in turn was used to justify taking even more crude measurements of quality, and so on. [2]
In the early 1990s when the measurement craze was limited to a few “quality” report cards, and grades on those report cards were not used to punish or reward doctors and hospitals, the craze posed less risk to providers who treated a disproportionate share of the poor and the sick. But over the last 15 years, inaccurate “quality” grades on report cards have been linked with financial penalties and rewards. Payment schemes that link rewards and punishments to quality scores were dubbed “pay-for-performance” (P4P) circa 2003. Payment schemes that link rewards and punishments to both quality and cost scores, which began to materialize in the late 2000s, were dubbed “value-based purchasing” (VBP) schemes. (“Value” implies both quality and price have been taken into account). These VBP schemes go by various names, the most important being “accountable care organization” and “medical home.” MACRA is one big VBP scheme.
A growing body of research indicates P4P and VBP schemes (I will refer to both from now on as VBP schemes) pose a much greater threat to the health of poorer and sicker Americans than the old report cards did. They do so because they pose a much greater threat to the financial health of the providers who treat poorer and sicker Americans. Because minorities represent a disproportionate share of our nation’s sickest and poorest, and because the responsibility for treating minorities falls disproportionately on a few clinics and hospitals, many of them staffed by minority health care professionals, VBP schemes punish minority providers for no reason other than that they see more minority patients.
In this article I will document what I have just said by focusing on black doctors as well as hospitals and ACOs that serve a large number of black patients. I will argue that those who promote VBP are guilty of racial profiling – punishing black doctors and other providers who treat a high proportion of black patients and, ultimately, black patients. We will see that three intractable conditions guarantee that VBP penalizes black providers and their patients:
(1) Black physicians, and a small number of hospitals, treat a disproportionate share of black patients;
(2) black patients tend to be sicker and poorer than white patients, which means the clinics and hospitals that treat a disproportionate number of them have to spend more on them and yet have fewer resources to do that, and are therefore less likely to score well on cost and quality measures; and
(3) administrators of VBP schemes are incapable of adjusting quality and cost scores accurately to take into account factors outside provider control, including the lower health status, lower incomes, worse insurance, worse access to transportation, and greater exposure to stressors such as crime and food insecurity suffered by black Americans.
Note that I am not criticizing measurement per se. Measurement is essential to quality improvement in every field of human endeavor. I’m criticizing inaccurate measurement and the reckless use of inaccurate measurement.
Intractable problem 1: High concentrations of black patients
Let us begin with problem 1. It is well established that a minority of the nation’s clinics and hospitals treat a disproportionate share of black patients. Peter Bach et al. found that “22 percent of primary care physicians … account for 80 percent of all visits by black [Medicare] patients….” Moreover, Bach et al. found that those primary care physicians were likely to be black. As Bach et al. put it, “visits by black patients were markedly more likely than visits by white patients to be to black physicians (22.4 percent vs. 0.7 percent).” (p. 579)
The concentration of black patients at the hospital level is slightly higher than it is at the clinic level. Ashish Jha et al. reported : “The 5 percent of hospitals with the highest volume of black patients cared for nearly half of all elderly black patients, and the hospitals in the top quartile by volume of patients cared for nearly 90 percent of elderly black patients. Hospitals with a high volume of black patients were … more often teaching hospitals located in the southern United States …. Hospital care for black patients in the United States is remarkably concentrated in a small percentage of hospitals”
If concentration of black patients is high at the clinic and hospital level, it follows it should be high at the ACO level as well (because ACOs consist of hospitals and clinics). A recent paper by Valerie Lewis et al. found that among 306 Medicare Shared Savings Program ACOs, “a small number … had very high proportions of minority patients,” and that blacks constituted 60 percent of those minority patients. “Each ACO in the top 5 percent of ACOs in terms of proportion of minority patients had a patient population with more than 50 percent minority patients,” according to Lewis et al. (p. 60)
Intractable problem 2: Sicker and poorer patients, fewer resources
I’m sure every reader of this blog is well aware of the ocean of evidence indicating black Americans are in poorer health than the average American. Their morbidity and mortality rates are far above the American average. [3] Other conditions outside physician and hospital control that affect health, such as income and insurance status, are also worse among blacks.
Perhaps the worst of these other non-health factors is the low level of resources available to providers who treat a disproportionate share of black patients compared with other providers. Black physicians and other high-black-proportion providers must not only treat more difficult and expensive patients, but they must do so with less income and less support. The study I mentioned above by Bach and colleagues determined that black physicians are significantly less likely to say they have enough resources to provide high-quality care and yet they provide more charity care than other primary care doctors. [4] Similarly, Lewis et al. reported gigantic differences in resources available to “ACOs with a high proportion of minority patients and … other ACOs.” The former “were significantly less likely than other ACOs to offer … routine specialty care (57 percent versus 75 percent), outpatient rehabilitation (29 percent versus 50 percent), pediatric health care (40 percent versus 59 percent), and palliative and hospice care (30 percent versus 53 percent).” (p. 62)
The reason why clinics, hospitals and ACOs that treat a high proportion of black patients have fewer resources should be obvious. Black people are more likely to be uninsured, to be on Medicaid if they have insurance (Medicaid reimburses at very low rates compared even to Medicare), and to be unable to afford out-of-pocket payments. But as we shall see in my next comment in this two-part series, managed care advocates routinely ignore or soft-pedal the resource problem. Acknowledging the resource problem would rebut, or at least undermine, the argument that VBP will save money. Managed care advocates would much rather place the blame on doctors and hospitals because demonizing providers makes it easier to justify the managed care solution – shifting insurance risk onto providers and micromanaging them with various VBP schemes. God forbid we should admit the problem is a resource problem, not a “quality” problem. What reason would managed care advocates have to get out of bed in the morning if America didn’t suffer from rampant “quality” problems requiring the expertise of managed care advocates to solve?
Intractable problem 3: Lousy risk adjustment
If the science of risk-adjustment were advanced enough to adjust cost and quality scores accurately to take account of patient health status and other factors outside provider control, the presence of the first two problems I have just discussed wouldn’t matter. Risk-adjustment algorithms would adjust away both problem 1 (a small number of providers treat a large share of the black population) and problem 2 (black patients tend to be sicker and poorer).
But no one has produced a remotely accurate risk adjuster, and no one ever will. The best risk-adjustment system in America, and possibly the world, is the one CMS began using a decade ago to adjust capitation (aka premium) payments to Medicare Advantage plans. This method, known as the hierarchical condition category (HCC) method, can only explain 12 percent of the variation among Medicare beneficiaries (see Table 2-1 p. 6 here. This means that CMS overpays Humana et al. for healthier enrollees and underpays for sicker enrollees. Here’s how the Medicare Payment Advisory Commission (MedPAC) put it in its June 2014 report to Congress: “[T]he CMS–HCC model predicts costs that are higher than actual costs (over-predicts) for beneficiaries who have very low costs and lower than actual costs (under-predicts) for beneficiaries who have very high costs.”
MedPAC illustrated this statement with the data in the table below. The table indicates CMS’s risk-adjustment method results in overpayments equal to 62 percent for the healthiest quintile of enrollees and underpays by 21 percent for the sickest 1 percent. Mind you, MedPAC discovered this much inaccuracy when they applied CMS’s HCC method to a pool of 12 million Medicare beneficiaries (see the discussion of MedPAC’s methodology in the sidebar on pages 28 and 29 of their June 2014 report). How bad does it get when CMS and other VBP advocates apply their crude risk adjusters to pools of 20, 25 and 50 patients?
Gross inaccuracy plagues quality measurement as well. For evidence of the crudeness of one of the best risk-adjustment methods in the world for a quality report card, see my discussion in an earlier comment on THCB about the New York Department of Health’s annual report cards on heart surgery. That report card, considered to be the gold standard for quality measurement, cannot distinguish the vast majority of the 185 New York coronary artery bypass surgeons from one another, nor can it distinguish the vast majority of the 40 hospitals where this procedure is performed from one another. (This is true even though the NY Department of Health relies on rolling three-year periods of data, which of course makes the reports somewhat dated by the time they are released.) Nevertheless, New York’s report card has been shown to harm sicker patients in general and black patients in particular (see Rachel Werner et al., “Racial profiling: The unintended consequences of coronary artery bypass graft report cards,” Circulation, 2005;111:1257-63).
The gross inaccuracy of quality measurement plagues quality measurement in all of CMS’s VBP programs, including their ACO, medical home, and “excess readmission” programs. Unlike the old days when report cards were simply published in newspapers or online where patients would ignore them, these days, thanks to VBP advocates, CMS punishes ACOs, “homes” and hospitals that get inferior grades on CMS’s crude report cards.
Medicare ACOs, for example, lose a portion of the shared savings (assuming they achieve any) if they don’t score well on CMS’s “quality” measurements, the great majority of which are not risk adjusted at all [5]. But risk adjustment is so inaccurate that even when it is applied to CMS’s ACO “quality” measurements it makes little difference. In the paper by Valerie Lewis et al. I cited above, the authors reported that the patients in the high-minority-proportion ACOs were much sicker than patients in other ACOs and that CMS’s crude HCC risk-adjustment method made almost no difference in the “quality” scores CMS attributed to the ACOs. The authors reported that patients in the high-minority ACOs “were more likely to be … dually eligible for Medicare and Medicaid, disabled, and female and to have end-stage renal disease…. In addition, the HCC scores for patients ages 65 and older who were not dual eligibles and for disabled patients were higher in ACOs with a high proportion of minority patients….” (p. 60).
These differences cry out for accurate risk adjustment. But none is available. Lewis et al. reported that high-minority ACOs suffered lower “quality” scores almost across the board, and that risk adjustment via CMS’s HCC method (plus adjustments for the percent of ACOs doctors in primary care) made virtually no difference. “The proportion of minority patients was associated with score performance … on 29 of 36 measures unadjusted for patient and ACO characteristics,” they report, “and on 25 of 36 measures… adjusted for those characteristics.” Lewis et al. concluded, “[A] large array of other unmeasured patient characteristics – including education, income and wealth, social support, neighborhood resources, and health literacy – may explain some or all of the associations reported here.” (p. 59)
Similarly, the VBP craze punishes hospitals with sicker, poorer, and blacker patients. One of the VBP fads authorized by the Affordable Care Act, and now inflicted on hospitals that treat Medicare patients, is the Hospital Readmission Reduction Program (HRRP). This program punishes hospitals for “excess” readmissions (an alleged quality measure) of patients with specific diagnoses such as congestive heart failure. But CMS’s attempt at risk adjustment of readmission rates is pathetic, in part because CMS thinks it is useful and fair to use pools of patients as small as 25 to determine what constitutes “excessive” readmission rates (see MedPAC’s June 2013 report to Congress ) “The result,” according to MedPAC, “is a great deal of random variation in these condition-specific rates.” (p. 102)
According to a paper published by NEJM Catalyst hsponsored by the Missouri Hospital Association, the risk adjuster CMS uses to determine “excess” readmissions for congestive heart failure (CHF) explains only 18 percent of the variation in readmission rates. That leaves room for “a great deal of random variation,” as MedPAC put it, which means hospitals that treat sicker and poorer patients suffer a disproportionate share of the penalties CMS dishes out, and that in turn means hospitals that treat a disproportionate number of black people suffer a disproportionate share of the penalties.
Manipulative language facilitated this mess
Lives are at stake here! Research at the University of Michigan suggests the HRRP program is killing up to 5,000 CHF Medicare patients annually. A disproportionate percent of those deaths are probably suffered by black people.
The managed care movement’s penchant for manipulative language played a substantial role in creating this mess. The problems managed care advocates glibly call “quality” problems are often resource problems or other problems clinics and hospitals cannot fix – that only society can fix. I will discuss the role that manipulative language has played in downplaying the resource problem and vastly exaggerating the “quality” problem in my next comment.
[1] For example, in a 2003 paper entitled, “The quality of health care delivered to adults in the United States,” Elizabeth McGlynn and colleagues at the RAND Corporation found that patients received recommended care only during 55 percent of their encounters with doctors. For example, the authors found that doctors referred alcoholics for “further treatment” during just 5 percent of the visits by their alcoholic patients.
Although McGlynn et al. made no effort to determine the causes of so much underuse (nor of the far fewer examples of overuse), they made it clear they had already made up their minds the problem was primarily physician incompetence. They conveyed this message implicitly by using the word “quality” over and over to describe the problem they were studying, and explicitly by calling for supervision of “clinical decision making” via information technology. (p. 2644)
[2] An example of how measurement advocates rely on the widespread abuse of “quality” to justify more inaccurate measurement appeared in a comment by four representatives of employers posted here on THCB on October 6: “Given the widely acknowledged … quality-of-care issues produced by the fee-for-service system, the fact that there are rough spots on the road to value-based payment is hardly a justification for slowing down reform.”
[3] Here is an excerpt from a recent literature review on disparities in cardiovascular health:
Disproportionate rates of cardiovascular disease (CVD) are seen in the U.S. African American population. African American subgroups have a greater burden of myocardial infarction, heart failure, stroke, and other cardiovascular events. On a population level there is a higher overall prevalence of risk factors that are unrecognized and therefore not treated, which places these individuals at a greater likelihood of experiencing adverse outcomes and therefore potentially higher morbidity and mortality. Among the various minority population groups, African American men have the highest overall death rate from cardiovascular disease. This extends to African American females, whose death rates from CVD are higher than those of white females. Equally as concerning is the fact that deaths also occur much earlier in African Americans compared to whites.
African American adults have among the highest rates of hypertension in the world. They and Mexican Americans tend to have higher blood pressure and exhibit lower levels of blood pressure control than whites in the U.S., even after consideration of modifiable health behaviors, suggesting that other racial/ethnic differences underlie these disparities.
[4] Peter Bach et al. found that physicians treating black patients had fewer resources available to them and yet provided more charity care. “Physicians treating black patients provided more charity care, derived a higher percentage of their practice revenue from Medicaid, [and] more often practiced in low-income neighborhoods … than physicians treating white patients,” they reported. “When physicians were asked if they were able to provide access to high-quality care for all of their patients, 27.8 percent of physicians treating black patients responded that they could not do so …, as compared with 19.3 percent of physicians treating white patients. They were also more likely than physicians treating white patients to report that they could ‘not always’ provide access for their patients to subspecialists of high quality (24.0 percent vs. 17.9 percent), high-quality diagnostic imaging (24.4 percent vs. 16.6 percent), nonemergency hospital admissions (48.5 percent vs. 37.0 percent), and high-quality ancillary services (36.6 percent vs. 27.7 percent).”
[5] Valerie Lewis et al. (see link to this paper in the text) stated that MSSP ACOs are graded on “33 Medicare ACO quality metrics and two disease composite measures,” and these “quality measures are not risk adjusted – except for unplanned readmissions and the two measures of admissions, which are adjusted for case mix.” (p. 58)
Article source:The Health Care Blog
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