
Measuring Your Clinic's Performance with CROWNWeb Deepblue Lib Umich


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How does it feel to get off heroin?
Really really shitty.First, you have the withdrawal. Withdrawal is like having a cold and the flu and vertigo and food poisoning and also you're too hot and too cold and your skin tries to crawl off of your body.The reason this happens is because taking heroin on a regular basis causes your nerve endings to shrivel up and die. This is also the reason why heroin addicts often can't get erections or lose their sex drive: sexual stimulation is nothing compared to the euphoria of heroin.Anyway, when you stop doing heroin, your nerve endings start to come back. The opioid receptors in your brain start throwing a tantrum, shrieking at you to fill them up again.There are medications that remove the symptoms of withdrawal. However, the catch is that you have to start withdrawal in order for them to be effective.Here's how works: a strip of (which most commonly comes in the form of an orange sublingual film that tastes like orange-flavored cat shit) contains and naloxone. The naloxone (also knows as the anti-overdose drug) prevents people from trying to inject the . If you take while the heroin is still in your system, you will go into precipitated withdrawal and the won't be effective.There's a scale, called COWS (Clinical Opiate Withdrawal Scale), that measures the progress of withdrawal. It is an 11-item test that clinicians use to determine whether a patient can be given yet. It is important that the patient be in moderate withdrawal (>10 points) before they receive the Subs. If you are curious about withdrawal and would like a more thorough explanation of the symptoms, I highly recommend looking at the link I provided. works by preventing the user from getting high off of heroin while they are taking the Subs. This is important because is effective at managing cravings for two reasons: 1) it prevents the heroin from working and 2) even if you stop taking it, you have to wait at least a few days before the heroin will affect you.This helps with cravings because most cravings only last a few minutes. As long as you can ride out those 20 or so minutes without picking up, you're usually ok for at least the next few hours. If you know that you won't get high even if you do pick up, it effectively stops you from bothering to waste money.Cravings are even worse than withdrawal. At least with physical pain, you know that there is an end in sight. With the psychological pain of cravings, you know that it will be years, even decades, before you can feel “normal” again.The only good thing about stopping heroin is that your finances immediately and signNowly improve. You can spend money on fun things and try to distract yourself from the fact that you can never, ever experience the intense euphoria of heroin ever again.I do enjoy volunteering at the needle exchange and my Smart Recovery meetings. But I will always know, in the back of my mind, that I have experienced the chemical equivalent of a hundred simultaneous orgasms and I can never ever touch opiates again or I will slide back into addiction.Sliding back into addiction is incredibly dangerous. Because your tolerance has been lowered signNowly, you are at a much higher risk for overdosing. This is how many people end up overdosing after doing only one shot following a clean period: they do the same amount they are used to doing and it is far too much for them.Withdrawal sucks. Cravings suck. Track marks suck. Being in debt sucks. People not trusting you sucks.Heroin sucks.
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What is the most painful thing about money and medicine today?
This is an interesting question and funnily enough a topic I’ve just discussed with 2 medical physicians in as many days.I’m not a medical professional just someone that’s spent a lot of time surrounded by them as a patient. They’ve provided treatment and care in what has been some complex medical conditions and I’ve honestly been so incredibly blessed to have such amazing people providing that care.I live in Australia and we are one of the most heavily regulated countries in the world - and not only in medicine. There are policies, procedures, laws, regulations etc…. in place for the welfare and protection of individuals and I totally understand that. But sometimes these laws, procedures, regulations are beaurocracy gone mad!I refer to medicine (or health and welfare) and all the elements surrounding them which makes it more challenging for not just those working within these constraints to ethically and morally make decisions and provide guidance but to people who have sought treatment or signNowed out for help. How is it fair that these highly skilled professionals are confined by regulations that are almost dark ageGoing back to the original question, what is the most painful thing about money and medicine today? - it’s the pain itself, be that physical, emotional or mental. The pain patients suffer physically, emotionally, mentally as a result of a heavily regulated country. The pain professionals are suffering morally and ethically as they work within the constraints of a system with limited scope to operate outside the box.It is the weight of a heavily regulated country that is our biggest source of pain. People indirectly hurting people - it’s irony at its best with a cost that’s insurmountable
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If you left a survey for burglars to fill out the next time they ransacked your home, how would they rate the experience?
How did you learn about us?Rumors about rural houses having little Security.Location: 5/10Location was alright. Around 500 meters to the nearest neighbor. But unfortunately an hour away from any sizable population (20,000 plus being a sizable population.)Transportation: 10/10Transportation was top notch. The owners of the property never lock their Minivan or Pick-up truck. The keys are always left in the vehicles. Both are moderately new and somewhat non-descriptive so a perfect getaway vehicle. Not only did they provide vehicles they also kept trailers in a easily accessible unlocked shed.Security: 9/10Security was lax. There is a gate but it isn’t locked. Doors aren’t locked unless the house is left unoccupied for more than 2 weeks. No cameras made it really easy. They did have a dog which made it a bit of a pain. He was easily disposed of as he was just a Labrador Retriever puppy. Owners are very light sleepers don’t rob if they’re around.Products: 10/10No place has better selection. The place had 3 DSLR cameras, 3 Workstation class desktops, 3 tablets, 4 drones, 6 Smartphones, 9 external monitors and 11 laptops. All of the items were of premium design and value (aka Apples or equivalent). The freezers and shelves were well stocked the rest of the property was much more appealing though.They also had a shop on the property with many tools ranging from mechanics to carpentry to fabrication. The tools were of medium quality. The shop also stored 2 ATV for added convenience. The shop wasn’t the jackpot though.The shed was the real treasure trove. This drive in shed held heavy equipment all with the keys in the ignition for easy accessibility. The average equipment’s value was around $100,000, with a combined value of around $1.5 Million. Unfortunately the heavy equipment is hard to transport and the market is too small to get away with it.The products all seemed gift wrapped for the taking. Everything was easy to find as it looked organized.Laws in the area: 10/10Owners aren’t allowed to use lethal force or even have a premeditated weapon for self defense. A robber in the area once accidentally locked himself into the garage place he was robbing. As the owners did not come home for a couple days he resorted to eating dog food. The end result was the owners were charged for negligence of the robber. Laws almost protect us. Owners are not supposed to attack us in any way or they may be charged.Would you recommend to your friends?If everybody is gone a resounding yes. Unfortunately that’s not very often as the house is occupied by Home-schooling kids, a Writer and the owner is a farmer who mostly works on property. Also if you intend to use brute force, bring a weapon. All the occupants are big. The average height is around 6 feet.BTW bring friends to help loot. It really requires a team of people to loot the place.
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What are the best strategies and tips for filling out your March Madness bracket?
If your goal is to win:Rely on advanced models like KenPom [1], Sagarin [2], and Nate Silver's rankings [3] to compare teams. Everyone has their pet heuristic (always pick experience, defense wins championships, mid-majors are underrated, Duke will always win/choke--the list goes on), but the best data-driven methods consistently outperform everything else. Sometimes actual basketball knowledge like matchups or tendencies is useful, but I only use this information for games that the models tell me are toss ups.Understand the ramifications of your scoring system. If you use a standard 1-2-4-8-16-32 scoring system, correctly picking the national champion gets you 63 out of a possible 192 points, and an entirely correct national championship is worth 94. Get these picks right and you're assured a finish near the top. Get them right with non-top seeds and you have a really good chance of winning most small to moderately sized pools. For example, I'm considering picking Florida (a 3 seed) over Louisville as my national championship. I'll probably be the only person to pick Florida in my pool of around 15 people (except my dad, since he uses the same strategies I do), so if Florida wins, everything else I do is irrelevant. Know where you can separate yourself. Congratulations on getting your point for picking that 1-16 game correctly, but everyone else got it too so you haven't actually made any progress. You'll gain or lose ground based on your picks that go against conventional wisdom and toss up picks, so choose carefully. It's tempting to pick the sexy mid-major double-digit seed to make a Sweet 16 run, but ask yourself if you can really defend that pick or if you're just trying to show how smart you are (guilty right here). On the flip side, if you find a game where the selection committee has blatantly mis-seeded the teams (UCLA-Minnesota and Memphis-St. Mary's this year), relish in the glory of the points you just gained with a probability greater than 0.5. Tailor your picks to the size of your pool. If you're in a large competition, you need more picks that might separate you from everyone else and can justify picking upsets more aggressively. On the other hand, if you're in a small pool, you can probably stick with your "maximum likelihood" bracket and still have plenty of places to build a lead. Determine your goal (winner, top 3, in the money, etc.) and the size of your pool and adjust your picks accordingly.If your goal is to have fun:UPSET CITY BAY-BEEE! Every year I pick a few wild upsets and obnoxiously talk them up to anyone who will listen. When they actually work out, I look like a genius and get to brag about it for years, and when they don't, I just stay quiet. Last year I picked St. Louis to knock of Michigan St (lost by 4) and Belmont to take down Georgetown (not close). This year Davidson is upsetting Marquette and Pittsburgh is headed to the Final Four. Remember, you heard it here first from the Bracket Whisperer.Pick the teams you want to root for. Are you a proud graduate of Florida Gulf Coast University? Send them to the Sweet Sixteen! Your obnoxious ex went to Duke? First round upset special! It's fun to have some picks where you ignore all the analysis and go with the team you like better. My mom always picks North Carolina to make a run. Is it because of their run-and-gun offense or consistently high talent level? No, it's because my sister is named Caroline and she likes picking a team that reminds her of her daughter. She also picks teams with bird mascots because of her birdwatching hobby. Of course, the risk in this strategy is if your team loses, you've lost both as a fan and in your bracket. But hey, that's all part of the Madness![1] 2014 Pomeroy College Basketball Ratings[2] Jeff Sagarin Ratings[3] FiveThirtyEight's NCAA Tournament Predictions
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