Discounts at Amazon.co.uk

Jun. 28th, 2017 10:34 am
[syndicated profile] brickset_amazon_feed
Latest >= 25% discounts
41180 Ragana's Magic Shadow Castle£52.99 (£79.99)Marketplace-34%
75091 Flash Speeder£25.40 (£34.99)Marketplace-27%
60129 Police Patrol Boat£29.25 (£39.99)-27%
42066 Air Race Jet£80.99 (£109.99)Marketplace-26%
>= 33% discounts on this year's sets
75524 Chirrut Îmwe£9.99 (£19.99)-50%
75525 Baze Malbus£9.99 (£19.99)-50%
41149 Moana's Island Adventure£15.00 (£24.99)-40%
71348 Hermione Granger£8.99 (£14.99)Marketplace-40%
41182 The Capture of Sophie Jones£11.18 (£17.99)-38%
71266 Chase McCain£9.49 (£14.99)Marketplace-37%
70351 Clay's Falcon Fighter Blaster£28.79 (£44.99)-36%
42061 Telehandler£15.98 (£24.99)-36%
41185 Magic Rescue from the Goblin Village£34.97 (£54.99)-36%
10834 Pizzeria£15.99 (£24.99)-36%
10823 Batwing Adventure£15.99 (£24.99)-36%
42062 Container Yard£35.98 (£54.99)-35%
41232 Super Hero High School£48.99 (£74.99)Marketplace-35%
70352 Jestro's Headquarters£55.18 (£84.99)-35%
70626 Dawn of Iron Doom£39.18 (£59.99)-35%
70627 Dragon's Forge£48.97 (£74.99)-35%
41313 Heartlake Summer Pool£35.98 (£54.99)-35%
71344 Excalibur Batman£9.79 (£14.99)Marketplace-35%
75523 Scarif Stormtrooper£12.99 (£19.99)-35%
21033 Chicago£29.58 (£44.99)-34%
21034 London£29.58 (£44.99)-34%
41150 Moana's Ocean Voyage£26.50 (£39.99)-34%
41147 Anna's Snow Adventure£13.33 (£19.99)-33%
41148 Elsa's Magical Ice Palace£43.50 (£64.99)-33%
42058 Stunt Bike£12.00 (£17.99)-33%
10832 Birthday Party£8.00 (£11.99)-33%
21032 Sydney£19.98 (£29.99)-33%

QotD

Jun. 28th, 2017 05:24 am
dglenn: Me in kilt and poofy shirt, facing away, playing acoustic guitar behind head (Default)
[personal profile] dglenn

"Why not be oneself? That is the whole secret of a successful appearance. If one is a greyhound, why try to look like a Pekingese?" -- Edith Sitwell (b. 1887-09-07, d. 1964-12-09)

siderea: (Default)
[personal profile] siderea
Constant readers will recall that I wrote a three-part post titled, "Why You Can't Find A Therapist, No, Really". I posted Part 1 on Sept 1st and Part 2 and Part 3 on Sept 30th of last year.

The clinic I work for as a contractor recently paid me, for my last pay period, an amount of money that was four times my typical earnings. Admittedly, how much I actually get paid fluctuates pretty wildly, but I figured I would have noticed having either 4x in arrears or having seen 4x as many patients as usual. But I'm paid via direct deposit, and the corresponding statement saying what I was getting paid for is put in my mail box at the clinic, so I had to wait till I was back in the clinic – today – to pick it up and find up why I was getting all this money.

The statement mystified me when I got it. It was two whole pages of pairs of canceled previous payments and replacement payments and at first I couldn't make heads or tails of it, and then I realized that I was looking at a statement where almost all the patient sessions listed had happened in 2016.

As I mentioned, last month, for the first time in decades, we got a raise. A big raise. Not big enough to be adequate, but big enough to be astounding. It was, we thought, effective starting May 1.

No. Turns out the raise was retroactive. To – apparently – Oct 1, 2016...

...The day after I posted the final sections of "Why You Can't Find A Therapist, No, Really".

Rumor has it that the raise – more properly, the increase in rate paid by at least two of the Medicaid providers – happened because MassHealth (Massachusetts Medicaid) leaned on them to do so, to fix the emergent strike.

Um.

MassHealth? Are... are you there? Are you reading my journal?

If so, thank you! (If not, still thank you!)

I have a few other suggestions for things you could fix!

For instance: I'm currently doing an amazing job (or so my chart reviewer wrote) doing care coordination with a big medical team involving four clinics, three hospitals, and family all involved in the care for a patient with an emergent psychotic illness. I can do that because the patient has MBHP, and MBHP pays for case coordination if it's extramural. I'd like to point out that it's insane that if I have a 15 minute conversation about the diagnostic formulation for a challenging and high-risk case with an in-house psychiatrist, I don't get paid for it (and neither do they), but if I do the same thing with a psychiatrist at a different clinic, I do. How wack is it that I literally wouldn't be able to afford to spend the sort of time on this case that I did (and continue to!) if the patient hadn't coincidentally decided he didn't like my clinic's available psychiatrist and went and found himself another one through his PCP. Surely this can't be the incentive system you want me or the patient (or the psychiatrist) to be functioning under – one where patients are incented to get their psychiatric care from an entirely different facility from their therapist.

And thank goodness that he had MBHP, as pretty much an amazing fluke. No other MassHealth payers pay for care coordination at all. If this guy had been on NHP or Tufts/BMC when he came down with schizophrenia... I shudder to think. Do you realize how much I've been on the phone with MGH's ER and APS and social workers and psychiatrists at local mental hospitals in the last six months?

Don't you think there should be some sort of provision for what happens when someone presents with a psychotic disorder? Like, when a provider slams the big red "R/o Schizophrenia" button, the payer has to start paying for some case coordination? (I'd also recommend that for substance abuse cases, where patients can manipulate providers around meds; and in mandated reporter cases, where you should probably have payers pay therapists for their time filling in DCF/DPPC/DES or whatever.)

I have to think that the time demands of handling such a high-risk case are part of why some – maybe many – therapist are leary of working with psychotic or other high-risk patients. I've been there. I've twice spent four hours – half a work day – keeping a patient in crisis calm and coordinating with the BEST team and then the hospital, and never saw a dime for any of it. Who wants to bring a patient onto their caseload, for whom the total compensation divided across the total hours of work for that one patient come to less than minimum wage?

And I'm just talking about care coordination – I'm not even talking about CPT 90839 and 90840 which last I checked were still universally unfunded. Funding that would be way cool.

I have many other fine suggestions – I swear many of them even aren't just suggestions you pay me more money! I'm happy to talk more about reforms in mental health care.

Discounts at Amazon.co.uk

Jun. 28th, 2017 08:34 am
[syndicated profile] brickset_amazon_feed
Latest >= 25% discounts
70322 Axl's Tower Carrier£39.98 (£59.99)-33%
>= 33% discounts on this year's sets
75524 Chirrut Îmwe£9.99 (£19.99)-50%
75525 Baze Malbus£9.99 (£19.99)-50%
41149 Moana's Island Adventure£15.00 (£24.99)-40%
71348 Hermione Granger£8.99 (£14.99)Marketplace-40%
71266 Chase McCain£9.49 (£14.99)Marketplace-37%
70351 Clay's Falcon Fighter Blaster£28.79 (£44.99)-36%
42061 Telehandler£15.98 (£24.99)-36%
10834 Pizzeria£15.99 (£24.99)-36%
10823 Batwing Adventure£15.99 (£24.99)-36%
41185 Magic Rescue from the Goblin Village£34.97 (£54.99)-36%
75523 Scarif Stormtrooper£12.99 (£19.99)-35%
42062 Container Yard£35.98 (£54.99)-35%
70352 Jestro's Headquarters£55.18 (£84.99)-35%
70626 Dawn of Iron Doom£39.18 (£59.99)-35%
71344 Excalibur Batman£9.79 (£14.99)Marketplace-35%
41313 Heartlake Summer Pool£35.98 (£54.99)-35%
41150 Moana's Ocean Voyage£26.50 (£39.99)-34%
21033 Chicago£29.58 (£44.99)-34%
21034 London£29.58 (£44.99)-34%
21032 Sydney£19.98 (£29.99)-33%
41147 Anna's Snow Adventure£13.33 (£19.99)-33%
41148 Elsa's Magical Ice Palace£43.50 (£64.99)-33%
42058 Stunt Bike£12.00 (£17.99)-33%
41232 Super Hero High School£49.99 (£74.99)-33%
10832 Birthday Party£8.00 (£11.99)-33%
conuly: (Default)
[personal profile] conuly
If you want to be intensely spoiled for next season, clicky clicky. I can't wait!

Edit: Yeah, the nod to a certain government official — we thought we were being cute, and now, I find myself longing for George Bush, wishing we could have George Bush back in the White House and remembering him fondly.

Yeah, Rob, you and me both. Never ever dreamed I'd be nostalgic for those days.

Discounts at Amazon.co.uk

Jun. 28th, 2017 06:34 am
[syndicated profile] brickset_amazon_feed
Latest >= 25% discounts
76058 Spider-Man: Ghost Rider Team-Up£13.97 (£19.99)Marketplace-30%
>= 33% discounts on this year's sets
75524 Chirrut Îmwe£9.99 (£19.99)-50%
75525 Baze Malbus£9.99 (£19.99)-50%
41149 Moana's Island Adventure£15.00 (£24.99)-40%
71348 Hermione Granger£8.99 (£14.99)Marketplace-40%
41182 The Capture of Sophie Jones£11.18 (£17.99)-38%
71266 Chase McCain£9.49 (£14.99)Marketplace-37%
41185 Magic Rescue from the Goblin Village£34.97 (£54.99)-36%
10823 Batwing Adventure£15.99 (£24.99)-36%
41313 Heartlake Summer Pool£35.98 (£54.99)-35%
70352 Jestro's Headquarters£55.18 (£84.99)-35%
71344 Excalibur Batman£9.79 (£14.99)Marketplace-35%
42062 Container Yard£35.98 (£54.99)-35%
75523 Scarif Stormtrooper£12.99 (£19.99)-35%
21033 Chicago£29.58 (£44.99)-34%
21034 London£29.58 (£44.99)-34%
21032 Sydney£19.98 (£29.99)-33%
10832 Birthday Party£8.00 (£11.99)-33%
41147 Anna's Snow Adventure£13.33 (£19.99)-33%
41148 Elsa's Magical Ice Palace£43.50 (£64.99)-33%
42058 Stunt Bike£12.00 (£17.99)-33%

(no subject)

Jun. 28th, 2017 01:43 am
alwaysbeenasmiler: (Madoka/Homura♥Every now and)
[personal profile] alwaysbeenasmiler
Brief update (amid everything that I have to do still!) - there will be a longer update eventually, or maybe not-- blame my ENFPness

1.) We are in our house, all moved in (but definitely not settled)
2.) INTERNET! (after a few weeks of roommate flaking out, which reminds me, NO MORE ROOMMATE)
3.) Cats are doing well, they fucked with Owen today and hid from him for a majority of the day-- so I kept getting texts from him going "Where is L.I.T.A-- idk)
4.) Oh yes, last but not least-- I am engaged! Owen proposed to me on sunday and now I have a pretty Claddagh ring (which is exactly what I wanted). So, homeowners and engaged in one fell swoop-- it's like so many life events at once (no, I am not pregnant)

Hopefully you guys are doing awesome! I missed y'all!

Now to download Stormblood and watch that eat up my life!

Happy birthday to me.

Jun. 28th, 2017 12:53 am
sineala: Detail of The Unicorn in Captivity, from The Hunt of the Unicorn Tapestry (Default)
[personal profile] sineala
It is now my birthday! Go me!

June Sundown Healing Arts Newsletter

Jun. 27th, 2017 09:35 pm
sonia: Presence After Trauma cover (Presence cover)
[personal profile] sonia
Even if we missed out on learning how to be calm as babies, it is not too late for our nervous systems to learn about rest and regulation as adults.
Find Calm: Practice Rest and Regulation

New book response at Curious, Healing. Have you read this? Comments welcome!
Video on co-regulation
Bonnie Badenoch, psychotherapist and professor of interpersonal neurobiology, warmly explains co-regulation and polyvagal theory in her video How to Feel Safe in Your Relationship. Thanks to Donna Norfolk for the link.

Curious, Healing is a blog, and you're welcome to comment there or here about the books. The articles don't have a comment section. You're welcome to comment here or send me email with any thoughts.

If you want the monthly newsletter in your inbox, along with news about my practice, you can subscribe here.

Wednesday's comic!

Jun. 28th, 2017 12:01 am
murgatroyd666: (von Zinzer Hmm)
[personal profile] murgatroyd666 posting in [community profile] girlgenius_lair
www.girlgeniusonline.com/comic.php?date=20170628

Hmmm. Where will that leave Tarvek?

Match Game Primed

Jun. 27th, 2017 09:02 pm
kevin_standlee: (Match Game SF)
[personal profile] kevin_standlee
I do wish that I didn't always have to leave so much show prep until the last couple of days, but it seems inevitable that a lot of the things on which I depend for a show don't come in until those last couple of days. Indeed, I expect that people will be contacting me about the show while we are traveling, and will be surprised to hear that we've already left home, since we leave tomorrow afternoon and get to Tempe sometime late Friday.

In any event, we have the question packs loaded, the commercials written, the prizes loaded (including a complimentary Worldcon 76 membership, which is a really nice prize!), all of the paperwork printed out, and I just helped Lisa carry the heaviest single piece of our kit out to the van. Lisa says she will take care of the rest of the packing of kit tonight after I go to bed, as her hours and mine are offset quite a bit right now. (But this does mean that she'll be able to drive during the first leg of the trip, which is Fernley to Tonopah.)

Work permitting, we'll leave after lunch tomorrow.

Fig and Ibid on their current home

Jun. 27th, 2017 11:31 pm
james_davis_nicoll: (Default)
[personal profile] james_davis_nicoll
Fig thinks everything is the best thing ever, especially the completely adorable orange cat. Who would like the stranger to stop gazing affectionately at him.

Ibid, on the other hand, won't come out from behind the toilet.

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corvi

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