How To Make Money With Ebates 75 In One Hour

How To Make Money With Ebates - $75 In One Hour 

This Website When You Signup You Will Get  $5.00 Automatically.! 
SIGNUP HERE NOW!!!

AS YOU CAN SEE THERE , I HAVE MADE ONLY $15.08 IN JUST 20 MINUTES.

After i explain to you what is this AMAZING website you will be blown away , please SIGNUP HERE if you havent YET! 

Hello guys as you know my name is Audrey and i am here to explain to you how you can make $75 dollars in just ONE HOUR!!! yes you read that right , $75 IN JUST ONE HOUR!! 

Let me introduce to you eBates it is a website that pays you when you buy whatever online, like an example if you go to ebay or amazon or walmart and you buy whatever you will get money back. Guarantee i have proof !! But that is not all.......

You will also make money only by bringing people!!! and guess what? I have ways to bring those people do not worry i will teach you guys exactly how i did it, i will explain step by step next week so please keep checking out THIS BLOG because this blog it is also to tell you everything about adfly and also money!!!

It is really simple this is how this amazing website works okay, you will bring a person and you already made $20 dollars, the next person will be $25 and the next $35 and it keeps going up up and up !! So you do the math imagine if you bring 12 people or even more i mean...............that is money for you in just one hour.!

But like i said and i told you guys i will explain step by step maybe tomorrow or next week because i am doing it right now and if it works i will tell you guys how i did it.! 

But for now SIGNUP NOW!!! to get your free bonus!!!

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Adfly Bot 2014 Download READ MORE!

Adfly Bot 2014 Download - READ MORE!

If you think i am giving away a BOT for ADFLY you are WRONG!!!!! 

I made this simple post because you guys need to understand one thing , okay so what is the thing that you need to understand? 

Well , adfly dont like BOTS ! so why would you download an adfly bot and risking your account, i have over 200 referrals , and make about $30 to $80  a day for me to even risk my account. Now why would someone do this??

Well , the reason is i wouldnt even trust these bot because a programmer made this and he can easily put his adfly number and get also comission from your clicks , also adfly will find out that you are using a BOT and they will cancel your account. 

Now imagine you working hard for adfly and they canceling your account , that is what i call DUMB ! so for those people who asked me for this BOT 

Let me tell you , i do not have it and i do not want it because i make this money with adfly and i did it working hard and just doing all the tips and tricks i have on this blog!!! so think about it before you going to mess up your account , if you think adfly wont find out you are wrong they will find out easily.

Because adfly has a system that they track all the clicks and they also have a system to see if people are using bots or even cheating. So why cheat? Honestly just do this right and i know and guarantee you will make money here.

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What can be done about letters of recommendation

Many surgical educators feel that letters of recommendation are not particularly helpful in evaluating applicants or predicting eventual resident performance.

Among the issues are lack of uniformity of content, excessive use of superlatives, reliability—if the writer is not known to the recipient—and more.

Even if the writers are well-known academic surgeons, the degree of their personal knowledge of the applicants is not always clear.

During an extensive Twitter discussion over the weekend, someone mentioned that in an attempt to deal with this problem, emergency medicine had developed a standardized letter of recommendation.

A recent paper from the EM Standardized Letter of Recommendation Task Force shows that there is still work to be done. From the abstract:

For the question on "global assessment," students were scored in the top 10% in 234 of 583 of applications (40.1%), and 485 of 583 (83.2%) of the applicants were ranked above the level of their peers. Similarly, >95% of all applicants were ranked in the top third compared to peers, for all but one section under "qualifications for emergency medicine."

Ive written before that deans letters are more like public relations press releases than accurate assessments of a students performance. You will rarely find negative comments in them. But another recent paper by a group of psychiatrists found that The presence of any negative comments in the deans letter yielded significant correlations with future problems. Further, those applicants with future major problems had significantly more negative comments in the deans letter than did those with future minor problems. Other factors such as USMLE scores, failed courses, letters of recommendation, and interviewer ratings and comments did not predict future problems.

These problems are not new. A 1983 New England Journal opinion piece about recommendation letters entitled "Fantasy Land" is remarkable for its validity even today. Here are a few choice quotes.

Its a land where everyone is "a pleasure to work with," has "excellent initiative," is "enthusiastic and conscientious," and possesses and "above-average fund of knowledge."

No one is ever poor, fair, or average; they are all "very good" or "excellent."

The author, Dr. Richard B. Friedman, said letters of recommendation were useless and advocated doing away with them.

A brief JAMA essay by Dr. Henry Schneiderman in 1988 called for more openness in describing students but acknowledged that negative comments were often "the kiss of death."

He proposed a new system of categorizing medical student performance. Here are just a few examples.



@AmirGharferi suggested this:

"Dr.G, do you feel comfortable writing me a strong letter?"
"No."
"Ok, Ill find someone who is."

That works if the student is aware enough to ask, and the faculty member is honest enough to say no. In my experience, even the most marginal of students can find someone—in addition to the dean, of course—to write a good letter.

I am no longer involved in the process of selecting residents. I have no suggestions.

What is your solution to this problem?

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My blog cited in JAMA Surgery paper Progress for bloggers

About a year and a half ago, I blogged that a medical student on Twitter used a blog post of mine as evidence. In January, the Canadian Journal of Anesthesia published an article I wrote under my pseudonym called “Why I blog and tweet.”

Last month, medical blogging took another step toward legitimacy. A JAMA Surgery Viewpoint formally cited my post critiquing the Finnish randomized trial of antibiotics versus surgery for the treatment of acute appendicitis.

Here is the first page with the portion of the piece discussing what I had written in the blog post.

Click on figure to enlarge.

Here is how citation appears in the JAMA Surgery article.

If you havent read my entire post about the randomized trial, click here.

Last year I said this: “Journals may have to adapt and become more like blogs. In the future, medical information may be disseminated by blogs and comments rather than journal articles and letters to the editor.”

We have already seen prominent publications such as the New England Journal of Medicine starting online forums and the BMJ hosting blogs (at least 36 so far) and rapid responses to published papers.

The sea change in the way medical research is disseminated may be happening sooner than I thought.

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Bobby Browns sister reveals shocking details about Bobbi Kristina

Bobby Browns sister Leolah Brown has revealed shocking previously unknown details about Bobbi Kristinas condition when she was found in the bathtub in January 2015, days after it was revealed that she died of drugs, alcohol and drowning. Read what she wrote after the cut...

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From the trenches More about grit

The following was compiled from two comments on my recent post about grit written by a doctor who calls himself "Geronimo." It is reproduced with permission.

Grit cannot be assessed by a survey. I wholly agree. As a military physician, my firmly founded opinion is that grit is essential to the practice of medicine. Grit is the elusive characteristic that carries the clinician through the challenges that exceed ordinary capabilities. You cite a paper that argues for surgical training to borrow aspects of SEAL training. I applaud any measure that would allow senior faculty and program directors to unilaterally shape their residents’ training, whether or not it bears any resemblance to the rigors of BUD/S [Basic Underwater Demolition/SEAL training].

The 2011 loss of 30-hour call for medical students and interns was a fatal blow to residency training, in my estimation. I count myself fortunate for having a 30 hour call internship before embarking on my operational career. While downrange, it is not at all uncommon to be woken at inconvenient hours of the night to tend to the wounds of war. If you don’t know how you function cognitively, physically, psychologically, and emotionally while sleep deprived, exhausted, hungry, cold, and pissed off, you’re behind the curve. While it isn’t any fun to work in such a state, or to work with people so challenged, it is decidedly less fun to be a patient expiring for want of any medical provider, let alone a tired one. American medicine used to be in such a place in the not so recent past, to hear the story told by my forbearers.

How often does disaster visit that requires sleep be sacrificed? The headlines recount a few – Katrina, Boston Marathon, Tropical Storm Alison, 9/11. No doubt there were physicians stretched beyond their ordinary limits for each of those ordeals. How often does it occur that a physician or surgeon must work beyond their ordinary limits for a patient whose ill begot fate failed to generate the attention of the press? I’d be willing to bet it’s on a monthly basis at least.

You sir, are a senior practitioner, and physicians like you taught me the practice. You know better than I why long hours and challenging training are essential, sir. My only question, sir, is why residency training standards were diluted and degraded at the behest of nurses, OSHA, and likely other “powers that be”, when you knew it was the wrong way. Why don’t modern program directors, department chiefs, make a stand? If there exists widespread agreement that the current methods don’t meet the standard, why pretend that they do? If you are a retired PD, you have a privileged position as not having to fear retribution. Use your bully pulpit to build consensus, unify the opposition and mount the attack.

Your SEAL post had a comment from a Man’s Greatest Hospital surgery program director who lamented the demise of training standards in the same fashion. I find it demoralizing that PD’s have been rendered impotent in the face of these trends. Obviously this will require a near unanimous front of PD’s and department chiefs. If your generation matriculates from practice without this trend being reversed, I believe it will be too great a task for my generation to overcome.

And for what its worth, I enjoyed the comments of TheTracker…

The utter incompetence of your generation—killing tens of thousands of patients every year with preventable errors secondary to the irrational systems, sloppily maintained, that you and your colleagues built up and managed.

Not to be blunt, but maybe while were struggling to clean up your mess and catch up with the rest of the developed world, you could forgo your attempts to shift blame with anecdotes?

This is pure unadulterated nonsense. I really can’t figure out what he’s talking about, but would venture the guess that he is a fan of checklists, timeouts, shifts that don’t exceed 12 hours and bubble baths. I don’t live in his world, and don’t want to. I am a doctor.

All doctors faced an attrition rate that exceeded BUD/S trainees matriculation to operational SEALs. Among aspiring physicians, 80-90% or more, are weeded out through undergrad prereq’s, MCAT, and the like. It should be an arduous, stressful endeavor to become a physician, just the same as it should to become a SEAL. Lives depend on SEALs’ and physicians’ capacity to demonstrate grit. Bearing that in mind, we should demand the same high standards and control over how we bestow the privilege of practice on the next generation. As it has been said many times, it is harder to stay in Ranger Battalion/Special Forces Group/SEAL Teams than to become a Ranger/SF Soldier/SEAL. The same is doubtless true of surgery and medicine. Medical and surgical training programs should reflect that reality.

Is Geronimo right or wrong?

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Baltimore Comic Con 2014 Coverage

The Baltimore Comic-Con celebrated its 14th year in the state of Maryland with its first ever three day show.  Guests in attendance included Cliff Chiang, Mark Waid, Gail Simone, Adam Hughes, George Perez and many more. Exclusive variants were available for purchase such as George Perezs Sirens #1, Big Trouble In Little China #1 and Robocop #1. Many panels took place during the course of the three day event including the topics of Cosplay and Comics. The Kids Love Comics Program included several sketch sessions and even a how to make your own cape and superhero mask. Media Guest of Honor was Star Wars actor, Peter Mayhew. The Harvey Awards which honors artists, writers, creators and publishers in the industry was held on September 6th.

A complete guest list can currently still be viewed on the Official Baltimore Comic-Con website. Taking place on September 5th-7th, the show was located in the Pratt and Howard Street Lobby which was a different area from past shows. The Costume Contest took place on Sunday and featured a grand prize of $2,000.

My photographer of Green House Photography and I arrived in Baltimore Saturday. I was originally going to attend the show as Elsa from Frozen. I was decked out in an Elsa wig, gown and makeup for the car ride to Maryland. However by the time we arrived, I decided to take everything off. Many factors contributed to my decision. First and foremost I was still exhausted from my trip to Dragoncon just one week ago. The travel to the state of Georgia, photo shoots, multiple costume changes and socializing had taken a toll and I had not yet recovered. I had also not slept well the previous evening. I wanted to attend Saturdays Baltimore show as a civilian and not have to pose for photo requests or be bothered. Apparently my plan did not work out too well. Almost immediately after hitting the convention floor in a black lace halter dress, someone called out: "Are you Victoria Cosplay?" It wasnt the first time I was stopped out of costume.

We visited friend and artist Billy Tucci. We also stopped by Adam Hughes table to get a book signed. We did some shopping. I was overjoyed to find a DC Direct Zatanna figure marked at only $40. It was quite amusing carrying the box throughout the con. People kept stopping to tell me that I looked like the doll. We took pictures of some impressive costumers. I also got to catch up with some personal friends. I had planned on attending Saturdays Prop Your Cosplay panel but was overcome with a wave of exhaustion and retired to my hotel room where I slept for several hours. Brian of Green House Photography returned to the show to take photos. In the evening we had dinner with friends.

On Sunday I had scheduled a photo shoot based on the television series Once Upon A Time and Once Upon A Time In Wonderland.  I was dressed as Regina The Evil Queen. This was my second year organizing a shoot based the show. Before the shoot, my friends Cosplay Jesus (who was dressed as Jafar) and Kevin D Cosplay (Robin Hood) walked the convention floor and posed for photos for con goers and the photographer at the Comic Wow! booth. There was a total of six of my costuming friends and the addition of a new friend who was also dressed as Regina. Our Wonderland characters featured The Jabborwocky, Jafar and The Red Queen (Lucid Cosplay). Once characters were Robin Hood, Little John and Regina. The shoot lasted 2 hours.

After we departed, we stood in Gail Simones line so I could get my Batgirl trade signed. I got to thank her in person and expressed how well she understood Barbaras frame of mind after regaining the use of her legs. I told her a bit about my car accident and how I was once in a wheel chair.  After meeting Gail, we went to visit my friend George Perez which is always a delight. I purchased the exclusive issue of Sirens #1 which he graciously signed. After mingling a bit more with friends and a little more shopping, we decided to head back to our hotel and prepare for the car ride home.

The staff at the Baltimore Comic-Con, affectionately referred to as "minions", were very pleasant and helpful. A great deal of stress must be involved volunteering at shows and dealing with the massive crowds but you wouldnt know it from the staff. They were absolutely delightful. A large seating area was arranged on the show room floor to eat and rest up. The guest list is my favorite part of the Baltimore-Comic Con. Its one of the few shows left that celebrates all of the talented creators, writers and artists in the industry. This is why it remains a shining light amongst the over crowded and pricey  pop culture cons that have taken over the scene.

Thank you Baltimore Comic-Con for putting comics and their fans first!

All photos by Green House Photography. For a full gallery of the event, CLICK HERE. Images from our Once Upon A Time photo shoot can be seen HERE. 

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Please stop this There are more than Ebola victims in the US

I get it. Can we please stop comparing the number of Ebola victims in the United States to all sorts of irrelevant things? PS: Its not that funny either.

The following are directly copied from recent tweets. Links have been removed for your protection.

There are more Saudi Princes than Ebola victims

Kim Kardashian has had more husbands than Ebola victims in the US

More Americans have been dumped by Taylor Swift than have died from Ebola

Fun Fact: More #kids die annually due to #faith healing than #Ebola.

FACT: Katie Price has claimed more victims than Ebola.

NYC traffic. another thing thats much more dangerous than #Ebola, courtesy of @bobkolker via @intelligencer

There are more people in this tram than ebola victims in America.

Ive lost more followers than US Ebola victims [I didnt tweet this or any of these other tweets.]

@lbftaylor fewer #ebola victims in US than drunk Palins in a #PalinBrawl.

@pbolt @robertjbennett Also, there are more ex-wives of Larry King than there are ebola victims int he US.

Rush Limbaugh has more ex-wives than USA has Ebola victims!

@xeni Menudo has had more members than 3x the number of American Ebola victims...

Put #ebola in the context of vaccination preventable dz: 118,000 children < 5 yrs old die from measles per year

@Tiffuhkneexoxo @LeeTRBL more dc team quarterbacks have played this year than there are US ebola victims

Rest assured, there will always be more American guns in Africa than Ebola victims. Everything is fine. Relax

As #Enterovirus spreads faster x country & kills more than #Ebola, sure victims parents must b sad congress isnt demanding an ED68 czar.

We are all far more likely 2 be victims of identity theft than #Ebola. Obama has a plan to fix that

Americans spend more money on Halloween costumes for their pets than the UN spends on helping Ebola victims and fighting ISIS combined.

@mikebarnicle 9900 gunshot victims since Newtown, much scarier than Ebola.

So FYI... More people die from the #flu than #ebola .

Fear hospital infections not Ebola. 1 in 25 patients are infected. 75,000 die yearly.

Every day in America around 100 people lose their lives to mostly preventable car crashes. #Ebola

There are more experts on CNN right now talking about Ebola in America than people with ebola in America.

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OBGYN Practice for Sale Marc Charles Update

9:22 AM

Hey Gang:

I like the Merger Network. They offer businesses for sale without the hype, deception and games most brokerages play.

I prefer to buy businesses direct from sellers, and advise my consulting clients to do the same thing.

Plus, when you come into a deal youll have either "strong" or "weak" hands. That means you have the funds, business savvy and ability to close deals in your favor, or you have no funding, no business experience in the given field and therefore usually get taken.

Granted, I think the good deal is profitable for both parties. This is why most of the deals and business sales Ive put together do not come undone. I try to make sure everyone is happy.

Anyway.....heres a OBGYN practice for sale. This is a high demand market and service.

http://www.mergernetwork.com/clikthru/businesses-for-sale/369920

Post your thoughts.

Marc

PS Check out my two new programs for making money in 2015.

Importing Fortunes

MicroGig Riches

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Follow up Meaningful Use Stage 3 is coming

Yesterday, I posted "Meaningful Use Stage 3 Is Coming: Should Be Fun" which discussed some onerous new rules that Stage 3 will impose including this one:

More than 25% of patients seen by an eligible professional (EP) or discharged from a hospital or emergency department (ED) must "actively engage" with their electronic health records (EHRs).

I said that in my experience most of the patients I took care of would have been unlikely to engage their EHRs and expressed concern that physicians would be penalized for their patients not reaching the 25% threshold.

A reader commented that the VA has had a patient portal called the Blue Button since 2010. He pointed out that in May of 2012, more than 500,000 unique patients had accessed their EMR. He meant this as a rebuttal to my opinion about the potential level of engagement.

However, it turns out that in 2012 over 6.3 million patients were treated by the VA system.  [See page 4 of this link.] If you divide 1 million by 6.3 million, you get 15.9%.

It seems like they have quite a way to go to get to 25%

I rest my case.

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Do doctors charge too much

We all know that some doctors’ fees are excessive. I have blogged about this myself citing a neurosurgeon’s $117,000 charge for assisting on a case.

We also know that doctor bashing is a popular sport right now.

In an otherwise reasonable article about high-deductible health insurance on Vox.com, reporter Sarah Kliff’s second paragraph read as follows:

The bolded text was hyperlinked to a Washington Post piece about a study that showed wide variations in hospital charges for appendectomies in California. The study was not about physician fees. No matter how difficult the case was, no surgeon would ever have been paid $186,955 for performing an appendectomy.

Yesterday, I twice asked Ms. Kliff to please correct this grossly misleading paragraph. She acknowledged my request that evening, but as of 9 AM today, nothing had been changed.

Even if Ms. Kliff had correctly identified the hospitals as the culprits, using appendectomy as an example of why patients should shop for the lowest prices was a poor choice.

Nearly every patient with appendicitis does not know he has it until he has gone to an emergency room, seen an ED physician, and had some tests. I doubt most people in this situation would A) ask how much it’s going to cost to have an appendectomy and B) decide to go to another hospital for care. The fact is, hospitals are so secretive about their charges that a patient would be unable to comparison shop especially if the emergency department visit occurred outside of normal working hours.

Even trying to find out the charges for elective surgery remains difficult in 2015.

Physicians—particularly surgeons—have taken a lot of heat recently. We don’t need articles like this to inflame patients (and journalists) even more than they already are.

ADDENDUM 9:45 AM 10/15/15

The article was just changed. The bolded mistaken passage was corrected, but the next sentence (underlined in red) remains the same. Still blaming those "really expensive doctors."

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How To Get Referrals For Adfly Fast

How To Get Referrals For Adfly Fast

Hello again , today we will be learning how to get referrals for adfly real but real fast... I just hope you guys will enjoy this.

AND you guys know i hate writing alot so this is why i always jump on conclusion real fast also lol , but that is better than sitting here and wasting your time , dont you think?

So , what will i need to get referrals for adfly fast?

Only a COMPUTER!! and if you havent sign up yet , singup HERE to get an adfly account FAST! also it is very important for you to follow instruction. I dont want to hear you say this dont work and the only reason why dont work is because you didnt put it to work.! 

 You need to signup and create a free website HERE and you will create a splashpage that is SO SO simple that anybody could do it even my grandma HAHA on that page you will show them your proof of payments , proof of referrals and put some words for them.. Be creative ill give you an example here 

BEFORE:

AFTER:

After you make the splashpage this is what it will be looking for... (KEEP IN MIND I WILL UPGRADE THAT PICTURE AFTER THIS POST!!)

The point here is... Y ou want them to CLICK on that "CLICK HERE" banner and redirect them to your adfly but you have to create a blog and explain how you are making tons of money with adfly or if you not making money feel free to use my proofs but give me credit ( you dont want to get in trouble) but this works like a charm.

You saw the before and after there is no way this wont work, the thing is you will receive FREE TRAFFIC from this website , just click and SIGNUP now!! 

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Cute pic of Odion Ighalos daughter

Footballer Odion Ighalo shared this cute photo of his stylish daughter and called her his WCW

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Woman shows horrific injuries after bear ripped her face off says the movie Revenants depiction of a bare attack is absurd

An America woman who survived a real bear attack has called the depiction of a bear attack in movie, The Revenant as “risibly faked” and absurd. The 68 year old woman said she found the scenes laughable as a bear attack isnt that easy to deal with. She then revealed graphic photos from her own attack to prove that the scene didnt make sense .

Allena Hansen was mauled by a bear on her Californian ranch back in 2008 - losing her nose, ears and 14 teeth.

Comparing her horrific injuries to Leo’s superficial facial scratches, she laughed at the “absurdity” of the Oscar-nominated movie.

The survivor said she had to endure dozens of surgeries and years of rehab as a result of the attack.
When she was attacked, Allena managed to fight the bear off with the help of her two large dogs - and by poking the bear’s eye with her thumb nail.

Allena said that Leo’s scene struck her as “risibly faked” and was also amused by the scene where Leo’s character gallops off a cliff edge – killing his horse but not him.

She added:

“Having gone off a cliff or two on horseback, I can assure you that: 1. Leo can’t ride for s*** and 2. Appaloosas [the breed of horse he rode] are a lot smarter than that.”

Source - TheSunUK

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Narcotic addicts can sue doctors and pharmacies for enabling them

In a 3-2 decision, the Supreme Court of West Virginia ruled that narcotic addicts may sue pharmacies and physicians for facilitating their addictions.

A suit was brought on behalf of 29 pain center patients who had been treated with narcotics for various injuries and became addicted. One article quoted the Chief Justices explanation: "A plaintiff’s wrongful or immoral conduct does not prohibit them from seeking damages as the result of the actions of others."

The court recognized that most of the plaintiffs "admitted their abuse of controlled substances occurred before they sought help "at the pain clinic.

Another story said, "The justices paved the way for people to claim damages for allegedly causing or contributing to their addictions of controlled substances—even if they broke the law by doctor shopping."

In a dissenting opinion, one justice wrote that the decision “requires hardworking West Virginians to immerse themselves in the sordid details of the parties’ enterprise in an attempt to determine who is the least culpable—a drug addict or his dealer.”

In response to the ruling, the West Virginia Medical Association issued a statement: "It may cause some physicians to curb or stop treating pain altogether for fear of retribution should treatment lead to patient addiction and/or criminal behavior. It may create additional barriers for patients seeking treatment for legitimate chronic pain due to reduced access to physicians. It would allow criminals to potentially profit for their wrongful conduct by taking doctors and pharmacists to court."

A post on the American Pharmacists Association website explained that pharmacists were included in the ruling "because they were aware of the pill mill activities of the medical providers. The plaintiffs said these pharmacies refilled the controlled substances too early, refilled them for excessive periods of time, filled contraindicated controlled substances, and filled synergistic controlled substances."

One newspaper summarized the public reaction to the ruling in an editorial stating, "Those who are illegally abusing prescription narcotics should be prosecuted to the fullest extent of the law. The same goes for medical professionals who are found guilty of committing a criminal act. But telling a drug addict or someone who is illegally abusing prescription narcotics that it is OK to go to court and file what could very well be a frivolous lawsuit is both baffling and shameful. This ruling by the Supreme Court justices is a clear back eye for West Virginia. And it does nothing to help West Virginia’s rampant drug problem."

As I wrote last year, I think the prescription drug abuse epidemic all stems from a 15-year campaign that declared pain is the fifth vital sign—a concept which is both untrue and as we have come to learn, harmful.

I agree with the WVMA. If I were practicing in West Virginia, I would be very reluctant to prescribe narcotic pain medication to any patient.

What do you think?

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SaaS Property Management Software PMS for Sale Marc Charles Update

10:14 AM

Greetings:

Heres another software company for sale.

I think the price is kind of steep. But I think everything is steep :)

But I like SaaS services, property management and the fact this business is profitable right now.

Check it out:

http://www.mergernetwork.com/for-sale/saas-property-management-software-pms/368954.htm


Marc

PS Check out two new ways to make money in 2015

Importing Fortunes

MicroGig Riches

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Variation is not causation

I made a rookie mistake in statistics of the “correlation is causation” genre by confusing variation for causation in the recent JAMA Surgery paper referred to in my last post. I contacted Dr. Timothy M. Pawlik, the lead author of the Johns Hopkins study, who said the following:

"The model is explaining and attributing variation in readmission and not attributing readmission itself to the different domains. The model suggested that only 2.8% of the variation in readmissions was attributable to surgeons. This is different than saying that only 2.8% were the fault of surgeons. A more accurate interpretation would be that only 2.8% of the variation seen in readmissions was attributable to provider level factors. The majority of the variation in readmission was due to patient factors."

He added that some of the 82.8% variation in readmissions attributable (note: attributable doesn’t mean it’s the patient’s fault) to the patient could be modified by better medically managing patients comorbidities or not operating on some of these patients.

That readmissions can be explained by a single domain or a single person is simplistic. Dr. Pawliks clarification confirms my original concern that attributing differences in patient outcomes solely to differences in technical quality of surgeons is probably inaccurate, statistically speaking.

Variation is not causation but variation is still a call to action. Regardless of who is to blame for unfavorable outcomes, surgery is a team sport. The incision is just as important as the community care. In this regard, I am certain that ProPublica and I are on the same side. Let’s work together so that we see the whole story behind the numbers.

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Debunking the Xena Comparison

At this weekends 2014 San Diego Comic-Con, Warner Brothers released the first official photo of actress Gal Gadot as Wonder Woman from the upcoming  Batman vs Superman: Dawn of Justice film. Immediately fan boys took to the interwebs to compare Dianas outfit to that of Xena, played by Lucy Lawless  in 1995-2001. I suppose many of the so-called "fan boys" thought they were being cleaver in referencing a t.v. series thats been off the air for over 10 years. If any of them were true fans they would have known that Princess Diana of Themyscira has been rocking the warrior princess look in comics before Xena ever hit the small screen.

Throughout the years Wonder Woman has had many different costumes but she has been sporting the Warrior look since the 1980s, Thats right folks; the 80s which was long before the Xena television series was created. If you need proof, feel free to Google Warrior Wonder Woman by George Perez which was done in the 80s and you will see for yourself. Princess Diana has been kicking butt in it ever since. If anything, Xena was inspired by Wonder Woman not the other way around.  Perhaps you should stop calling yourselves fan boys when it seems like your only goal is to rip apart uncompleted films. You have demonstrated an obvious lack of knowledge on the history of the character in comics. 

For those of you who say the movie costume is a rip off of Xena; your argument is invalid.

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Why in hospital deaths are not a good quality measure

You may be tired of hearing about the Surgeon Scorecard—the surgeon rating system that was recently released by an organization called ProPublica. Like many others, I have pointed out some flaws in it. You can read my previous posts here and here.

I had decided to stop commenting about it because enough is enough, but a recent paper in the BMJ raises a question about one of the criteria ProPublica used to formulate its ratings.

ProPublica defined complications 1) as any patient readmission within 30 days and 2) "any patient deaths during the initial surgical stay."

The authors of the BMJ paper randomly selected 100 records of patients who died at each of 34 hospitals in the United Kingdom. The 3400 records were reviewed by experts to determine whether a death could have been avoided if the quality of care had been better.

The number of patient records in which a death was at least 50% likely to have been avoidable was 123 or 3.6%.

There was a very weak association between the number of preventable deaths and the overall number of deaths occurring at each hospital. By two measures of overall hospital deaths, the hospital standardized mortality ratio and the summary hospital level mortality indicator, the correlation coefficient between avoidable deaths and all deaths was 0.3, not statistically significant.

From the paper: "The absence of even a moderately strong association is a reflection of the small proportion of deaths (3.6%) judged likely to be avoidable and of the relatively small variation in avoidable death proportions between trusts [hospitals]. This confirms what others have demonstrated theoretically—that is, no matter how large the study the signal (avoidable deaths) to noise (all deaths) ratio means that detection of significant differences between trusts is unlikely."

The Surgeon Scorecard was derived from administrative data. No individual analysis of patient deaths was undertaken. According to a ProPublica article discussing some key questions about their methodology, "As for deaths, we took a conservative approach and only included those that occurred in the hospital within the initial stay."

Maybe that wasnt such a conservative approach after all.

And maybe we need to rethink that 2013 paper claiming that medical error caused up to 440,000 deaths per year.

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Cosplay Spotlight Margie and Ned Cox

On my recent visit to Georgia I had the pleasure of meeting and spending time with Margie and Ned Cox, the powerhouse cosplay couple.

I have longed admired Margie and her husband Ned for their incredible talent in costuming. Their costumes are flawless and their photos are nothing short of stunning. Theres also an element of romance to them; I have always found it romantic when couples cosplay together.  This husband and wife team are quite the dynamic duel in the world of cosplay and are highly respected and admired. They have inspired many, including myself and I was thrilled to have the chance to meet them on my recent trip to Georgia.

Victoria: How did the two of you meet?

Ned: We met in college--nothing too interesting. She had taken Army ROTC as an elective while I was in the midst of my four-year pre-commissioning training to become an officer. She didnt care for me at first, as she likes to recall, but I can be pretty bad with first impressions, admittedly.

Victoria: How long have you been married?

Margie: We’ll be married six years in May.

Victoria: When did you begin cosplaying together?

Ned: Toward the end of college, my love of comics hit a boiling point where I felt the need to LIVE in the fantasy world. Totally healthy of course. Im kind of a big kid at heart and running around as Batman as an adult in 2012 isnt much different than what I was doing in 1992 as a child after watching episodes of The Animated Series, I just tend to be better dressed for the occasion. When I told Margie that this was what I wanted to do, she was a bit apprehensive. She liked comics and superheroes, but this took it to another level. When I told her that I was interested in looking into doing this beyond conventions as a way to give back to the community and help charitable childrens causes, she became more interested.

Victoria: Whats your favorite couple to cosplay?

Margie: Oh, I don’t know what Ned’s going to say, but I honestly really like being Carol and Hal (Star Sapphire and Green Lantern). I think the reason is that we only have two couples costumes (Star Sapphire and Green Lantern, Batman and Catwoman) and Ned’s personality is a lot more of a Hal Jordan personality than Bruce Wayne (Batman) personality. Anyone who knows Ned will probably say that “That guy doesn’t break character for anything.” Ned is naturally a goof-ball and I love him for it. However, as a comic fan (and someone who doesn’t like to alienate new potential friends and bystanders), I appreciate that he keeps that part of his personality locked down in certain situations or wearing certain costumes.

Ned: Agreed. Its great that, after so many years of pretending to "just be friends" as some of our JLA characters, Margie and I finally got to be Green Lantern and Star Sapphire and really be a couple just
like Hal and Carol.

Victoria: You recently debuted your New 52 Wonder Woman at this years MegaCon. How long did it take to construct the costume?

Margie: I have a day job and mostly I work on costumes at night and on weekends, but it took me a few months. That was with the sanity breaks I took, where I would stare at a boot for a week and think “I wish I had briefs to go with those boots…” Four weeks later: “I guess I need armor to go with this corset….”. Five weeks later: “I’m going to get Velcro to hold up this armor since it’s not going to stay on with magic.” My overwhelming guilt at staring at hundreds of dollars of untouched costuming materials is how most of my costumes get finished. I’ve actually been staring at a creepy plaster hand that I’ve had in my basement for a few weeks knowing I need to get started sculpting my Huntress armor.

Victoria: What costumes do you have planned for in the future?

Margie: I’m working of the New Huntress costume and a Sith costume. I would also like to do the new Starfire costume, but I’m honestly waiting (and hoping) that DC caves and gives her a bit more coverage. I really like the new costume, except for that part.

Ned: Im going to work on classic Giant-Man (Hank Pym) from the Avengers. After costuming as Cyclops, I feel a sort of connection to the misunderstood and damaged characters in comics. Besides that, hes a classic Marvel character that gets no respect. And the Giant-Man costume looks REALLY cool. Margie and I are also hoping to join the Sith soon--our first costumes outside of superheroes as well as "good guys." It should be fun!

Victoria: You both do a lot of charity work for your community. Could you tell my readers more about that?

Margie: Heroes Alliance is a charity that I’ve been involved with in some way since I first got into costuming. Basically it’s collaboration of costumers, photographers, and general comic fans who
would like to use their art to reach out to their communities, to charities, and also to support local comic shops. I’m the coordinator for the Atlanta group and I have a soft spot for children’s charities, so the majority of events that we do here are for special needs children. Some of the groups I’ve worked with over the last year are FOCUS, Down Syndrome Society of Atlanta, Children’s Healthcare of Atlanta, Extra Special People, and CASA.

Ned: Margie and I joined at the same time, shortly after the Heroes Alliances founding in Tampa. Ive had the honor of being elected council chairman for the second year in a row and Im extremely proud of our teams across the nation (and world, with our UK partners). Weve built a great community of volunteers who have a very unique role among charity groups in bringing a real-life superhero experience to children with illnesses and disabilities. I love conventions and seeing my spandex-clad friends, but Ive found so much more fulfillment in the Heroes Alliance than I ever imagined.

Victoria: Margie, you are a very accomplished writer. What are you currently working on?

Margie: Thanks! I have a Bachelors from USF in English with a specialty in Creative Writing—my family thought I was insane for coming off the Pre-Med/Microbiology track, so I’m elated that I’ve been able to do a few dark, gritty, artistic pieces which have proven to them that I was more insane than they ever imagined.

A few years ago, I finished my novel, Southern Gothic Confidential, a dark regional comedy/tragedy that entwines the cultural evolution of a small town with the personal renaissances of some of it’s inhabitants. The backdrop of characters is very colorful. In the foreground of the Historic District is Ms. Jane Bradshaw, a very prim and proper Southern lady. She is President of the Red Hat Society and Secretary of the Garden Club. When her neighbor is decapitated in an auto accident, she finds herself living next to his estranged mother, Crazy Deb, and Crazy Deb’s very strange husband, Wild Ernest, who have been certified uncrazy due to the overload of patients in Chattahoochee Mental Institution. This state of affairs sets off a chain of events which will forever change the Historic District and the characters. Luckily, SGC got into the hands of someone in the industry via my husband’s boss who was nice enough to send it to a professional proofreader. After the proofread, they sent it to a publisher for me. It was super nice of them. We’ll see where it goes.

Currently, I found a pretty sweet gig writing a comic with Eugene Selassie called Rock, Paper, Scissors. It’s a 12-Issue story that deals with the super-powered crime underbelly of Chicago. It is morally gritty and I’d like to think that the characters are rather likable although they are in a very ethically challenged climate. It was great being able to work on a team of very talented, fresh artists and writers. It was like walking into a room that was bursting at the crown molding creative energy. We were like artistic vampires feeding off of each other’s talents and ideas. Issue One exceeded my expectations art and story wise. I’m a huge fan of Tarentino and Puzo. We all brought our love of crime noir, modern classical mafia literature, and comics to the table. I don’t know how much more I can say since we’re talking to a few publishers now, but we’re building a damn good story.

Victoria: Many people like myself, see you both as an
inspiration in the world of cosplay. How does it feel to be role
models?

Margie: I’m so honored and humbled that you feel that way. When I started out, I just had a few friends who costumed (I could count them on both hands) and we were just supportive of each other. We’d find a few photos of ourselves online from time to time, but other than that, I don’t think anyone was terribly well known. I don’t feel very far removed from that experience except I can’t count the people I know on my hands anymore. It’s really easy to treat people well when I’ve been so well treated. I feel pretty much the same, but I’m very grateful for any good vibes that I’ve been able to send to people. It feels great to know that maybe I’ve made a difference.

Ned: Im humbled, perplexed, and honored that you say that. Its something I didnt expect but Im always very happy to hear whenever Ive had any sort of positive impact in peoples lives in any way.

Ive found myself in leadership roles from time to time--in the Army, through the Heroes Alliance, and now at the company I work for. Those are all very different environments with different leadership

requirements but Ive found some common truths among them: be honest, be consistent, and take care of the people you care about. Its always served me right.

As for being an inspiration, Ive always been just an, "Im just happy to be here" kinda guy. If I bring positivity and joy to a situation or group then all the better. Ive met some of the most wonderful people doing this (another unexpected blessing) and they inspire me. Its easy to be positive when youre around great people.

Victoria: What is your personal favorite costume?

Margie: Wonder Woman.

Ned: Im going to say Green Lantern. Ive accepted that Ill probably die as Hal Jordan--a Green Lantern Corps emblem on my tombstone. Thats fine. Im very happy to be known for that and I absolutely love the character, the Corps, and all of my fellow Lanterns. Its a wonderful thing.


My thanks to Mr. and Mrs. Cox and be sure to check out Margies Facebook Fan Page to keep up with this Cosplay Goddess!

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