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sanchoyo · 3 years

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danny phantom season 2, eps 1-5 thoughts! opening the new season with episodes like these kinda blew me away. we had multiple serious episodes INCLUDING a two parter!! also, valerie :)

see prev episode thoughts in this tag <3

-I don't know what I expected s2 to open with. but danny portal incident in more detail was not it. (also, I hate to break it to you, sam, but danny's parent's bigass ghost hunting rv def chugs more gas than those vehicles, lmao. unless it runs on ectoplasm or something...)

-WHY WAS DESIREE IN THE SEWER? HAVING TEA WITH IT DOWN THERE?? Her making the giant cow come alive is a boss move, we've almost had all of my fav animals as ghosts now <3 I also don't like how sam was expecting danny to just, haunt the place so the cars wouldn't get sold? I KNOWWW I know she's 14 (and I had a very annoying phase like this, I think I mentioned in a previous post, I GET IT) but they're HIS powers, and messing with (1) dealership will not really put a dent in sales overall because they can just move the cars to another sales lot, and it certainly wont change the industry anyway, it's more of a minor annoyance for (1) location. Also, usually people who work at car sales places work on commission, so if they dont make a sale, they don't have money to pay bills, or eat. sam baby if u wanna be an activist you need to like, actually look into these things. with as much money as her parents have, she could be doing a lot..more useful things for causes she cares about? it's frustrating to see someone with resources who doesn't know how to use them. but shes 14 so again. cannot be really upset :/

-IS THIS A PREDATOR VS TERMINATOR VS FREDDY KRUEGER MOVIE BUT THEYRE ALL WOMEN?? you know, sam is so right to be excited about this. /I/ want to see this movie. that rules

-paulina inviting danny and friends to her quinceañera, aw! even if it is just to get phantom to show up :') and there'll be a meteor shower, and we KNOW danny wants to be an astronaut!! there's not a meteor shower every night!! the tickets are non-refundable, but..she's rich? like. gotta agree with danny, they never get invited!! I KNOW it's the principle of keeping promises, but if she was that upset, she should've said something. directly. I hated how she was like, passive aggressive about it through the episode, like you SAID IT WAS FINE, THAT YOU'D GO TO THE PARTY TOO. MOVIES SHOW FOR A FEW WEEKS IN THEATERS. IF YOU HAD A REAL PROBLEM YOU NEED TO TALK ABOUT IT. WE'VE HAD THIS PROBLEM BEFORE, SAM. YOUR FRIENDS. ARE NOT. MIND READERS.

-MR. LANCER GOING AFTER THE GHOST WITH THE FIRE EXTINGISHER LMAO

-this outfit is everything . anytime the show does an over the top cutesty pink outfit i WANT IT. it looks like shit I wear JKASDHF I HAVE a bow like that and a pink sweater. I need leg warmers </3

-SAMS GOTTA RE-HALF-KILL HIM??? thats fucked up. but also, he finally got his logo!! it took until s2!!! this episode was lowkey very fucked and I felt like it glossed over a lot. does sam have guilt about like. kinda KILLING HIM?? I know, he also agreed and walked into the portal. but. she made the choice to redo it SO quickly (even if it was because someone had to beat desiree) and danny, during their fight, brought up a lot of stuff sam's done in the past, meaning he was holding onto those memories and resentment was building. (I KEEP SAYING HE LOWKEY NEEDS THERAPY, BUT I THINK MOST EVERYONE IN THIS SHOW KINDA DOES) which...is a red flag? and then they didnt even GO to the party URGH I know she tried to make up for it, but it really felt like Sam fucked up and barely faced any consequences and got everything she wanted in the end. I KNOW it's a kids show obv they aren't going to go too in depth, and she undid the damage, kinda, but...I DUNNO how to articulate it but it rubbed me the wrong way.

-but on a note about desiree, her powers of wishes were STRONG ENOUGH TO ERASE NOT JUST THEIR MEMORIES, BUT DANNY'S POWERS?! fuck, if I was danny I'd be like, trying to make friends with her. I know they always have horrible side effects as most genie-granted wishes do, but...c'mon, I'd at least TRY to be like 'I wish no ghosts would hurt anyone in my town' or 'I wish vlad would lose his ghost powers forever no matter What and also forget about my mom' LIKE. SHIT DESIREE IS SO POWERFUL. rewriting reality powerful, basically!! appreciate her. respect her.

-aww, sam helping tucker pass the nurse's office so he wouldn't see because he's afraid of medical stuff? very sweet. I also don't like medical stuff, I've gotten a lot better at handling it tho. but seeing blood and needles still makes me feel lightheaded x_x

-FOLEY, BY TUCKER FOLEY. I want to make my own perfume, that's so cool. even if his first attempt isn't good, he's pretty consistently shown to have an inventor/entrepreneur streak in the show, so like. I can see him inventing or making something (or several somethings) that make him $$$ when he grows up :) proud of my creative son

-I know the 'creepy abandoned hospital on the edge of town' is a joke and the creepy hospital trope is so Worn Out, but in my town we actually DO have a hospital like that! my dad was born in it, but its not in use and hasn't been for, like, 20 years! it needs to be torn down but I think the city doesn't wanna pay the money. the inside is horrible, spray painted and broken glass and shit everywhere. but there's still like, rusty equipment and fucking DOLLS all over the place. the cops drive by it pretty frequently to make sure no one is like, breaking in. (because of water damage, some of the areas really aren't safe. also, asbestos, but people still go in anyway) but also, some of my town was used in a filming for a stephen king show. So it's lowkey spooky all over. just a fun personal tidbit :) to lead into saying, any hospital abandoned for any period of time is NOT safe to quarantine these kids in JKSAHDKF like I KNOW it's a ghost trying to do this, but NONE of these parents are even like, 'well, why dont we keep them in the regular, working hospital'....YIKES. this hospital looks pretty accurate to the one in town. grungy and spooky.

-fentons are tax evaders confirmed by jack's fear of being audited, lol no one is surprised

-ghost sickness via ghost bugs. horrifying concept. I actually expected it to be a new villain, not dr. spectra again! this is a very elaborate scheme. her new form rules, love the new costume. the way none of the bg kids seem to recognize her as their old school councilor. did we just forget about that completely?

-dash watching romance movies in the fucked up ghost hospital. same.

-'oh please, you're ghosts, do you have any idea what YOU smell like?' no, tucker, what DO ghosts smell like? I genuinely didn't know they would even have a smell, I actually want to know now.

-it feels like a while since we've seen jazz!! i was happy to see her again, even if she was a head in a jar for most the episode. I want another jazz-focused ep!!

-we finally see danny doing space-related stuff!! him and his friends stargazing to open ep 3 of s2. cute :) until, GHOST PIRATES!!!!! ...ghost pirate captain is a small child?? VOICED BY TAYLOR LAUTNER???

-oh, the easy listening is ember's song instrumental slowed. 'vapor drone' THEY VAPORWAVED HER!!! ember in a pirate outfit tho >>>>. and the cruise being called m.bersback JKASDHJK. ember adopting a little pirate brother is also pretty cute. concerning this teen and little kid have such bad opinions of adults, like, who hurt you?? (how did you DIE ALSO?? im always lowkey curious about that. we know desiree died at an old age, but her ghost form is young, probably mid-20s, so I wonder how that sort of thing works...its a more mental thing, isn't it?) but ghost team-ups are always cool to see, even if ember bailed after danny took her guitar. I guess she probably thinks youngblood can handle it (which, he's been owning danny this far in the ep, so...fair)

-tucker got that sponsorship from nasty burger for their radio!!! again, opportunistic money maker king, love to see it!!!

-danny taking control of the kids SO FAST. he makes a pretty great leader. no one is surprised, im pretty sure I said I think he's the most mature of the trio, once again, correct, because he's taken on so much responsibility already. all the teens suiting up in the jumpsuits to go save the adults and taking the ship over with a BLIMP. OKAY LETS GO. this feels like it should be a mid finale or straight up finale.

-...speaking of finales. why is ep 4-5 of s2 combined into a 50 minute episode? I havent even clicked play and im concerned. weird placement, like, this season JUST started and we're getting a two parter? okay...why are the episodes placed like this? why not put this at episode 10 or something, for a mid-season thing?

-this is also a cute dress. possibly my fav dress so far. can her parents give ME cute dresses, I'LL wear them.

-it turns out the castle fright knight was in is called pariah's keep and there's something worse than fright knight in there! lovely! fuck off vlad wtf are you doing <3 your hubris <3 is going to literally get you killed <3 'ring of rage' and 'crown of fire' are great names tho. ...vlad turning into a super polite guy when he was scared of mr. pariah was hilarious. and fright knight doing the same...I mean, it makes sense, he's a knight, he serves a king? happy to see fright knight again either way :) vlad telling him to call him tho, lmfao. you WISH HE WOULD. (I wish hed call me, too. 😔)

-so...jack being genuinely concerned about vlad...maddie really didn't tell him what happened at the cabin, did she. damn. if I was her id immediately come home and be like 'YOU WONT BELIEVE THIS SHITTTT THIS CREEPY GUY--' like, I feel like that stuff you need to tell your partner!!! I know she didnt want Jack to think she was an irresponsible parent putting danny in danger at that time, but STILLLL. maddie spilling boiling tea on him. get his ass. how is jack this oblivious to his wife's discomfort with vlad!! ughhh

-fenton wipe (tm). trademarked toilet paper.

-DANNY AND VALERIE BEING FRIENDS??? :D that was a cute moment. 'hey val <3' and 'if you like him like him, make a move, or someone else will ;)' at sam...damn!! I love her. valerie go for it girl!!! I hate how sam and tucker treat val also, like I GET IT YOURE PROTECTIVE AND DONT TRUST but if anything him befriending valerie will help when she finds out or he tells her like I feel like she'll be more understanding that they think! ALSO I feel like her reason for not liking ghosts is valid, like you haven't really explained the full story to her anyway! she doesn't seem to have any other friends after being booted from the a-listers so im like :( but seeing them kick butt together again was nice <3

-the ghosts all RUNNING FROM PARIAH DARK IS NOT GOOD, I thought he sent them to attack or something, but no. why doesn't someone just tell desiree 'hey i wish pariah dark would die' lol. once again I think she can solve every problem <3 but seeing all the enemies in one place, being civil and hiding together? love it.

-you just know danny's gonna have to clean up vlad's stupid mess. also, jack being willing to put on the ectoskeleton pants to help maddie, as soon as vlad heard it could kill him, he suggested jack do it instead of helping maddie himself? this is why jack got the girl, my man.

-ghost skeletons. how do you end up as a skeleton ghost in your afterlife instead of a humanoid like most the ones we've seen? lmao

-the ghosts just making new homes in various stores. I'd totally be setting up in an expensive clothing store if I was a ghost.

-valerie's dad is possibly the most useful adult so far, with that ghost shield expansion!!! and valerie saving vlad and danny, even tho shes been thru it already, shes still so good!!! this family rules.

-danny: *gently caresses valerie* :)

-*then he immediately TELLS HER DAD ON HER. and his first response is 'are you okay?' :'( such a good dad...

-*me every time fright knight breathes* youre doing SO great sweetie :)

-the fenton suit thing is so silly looking. does anyone take this thing seriously

-ALL THE GHOSTS FIGHTING WITH DANNY <3 AAAAA. and the fact that pariah isn't perma-defeated, but just locked away again. yikes. he'll probably get out again, won't he? it wasn't too clear, but if vlad DID make a pact with fright knight, I am rabid. I will beat vlad to death with the fenton bat (tm). YOU DONT DESERVE A COOL KNIGHT.

-valerie being direct with sam and challenging her? kinda love that, even tho I normally don't like 'catfight' type situations. because sam has been very passive aggressive about it which is annoying. valerie knows wtf she wants and wasn't even embarrassed to tell sam, but she did tell her, giving sam time to make her own move! and sam denied it and got embarrassed/mad! and sam did have a chance when danny was about to go off and fight, and she hesitated and didn't tell him. I feel like she's hesitating because they're friends and it might make it weird between the trio (poor tucker would be third-wheeling) but if u snooze u lose, u gotta GO after what u WANT girl. smh this is a No Tsundere Zone. 😤

#sanchoyorambles #dp thoughts #danny phantom

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adz · 5 years

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hi here is my albums of the year list for 2019. i will also put it below under the break. happy nu year friends

ALBUMS I LOVED

Big Thief - U.F.O.F. & Two Hands This band has something so special. It's almost as enjoyable to hear Lenker, the primary songwriter, talk about her philosophy and her connection to her bandmates as it is to listen to their consistently wonderful and gently boundary-pushing music. I've combined these two albums into one list item because they're flip sides of the same coin: spirit and earth, ethereal and corporeal, unknown and known. If you've heard their earlier two albums, you might be put off a little: there aren't any smash hits like Masterpiece on here, nor any doomed ballads like Shark Smile. These albums are a little blurrier, shadows and gleaming bits of light floating past. At times the songs sound less like early Big Thief than they do Adrianne's solo releases: lyric focused, strange sprawling structures, a bit rougher around the edges. At these records' cores, though, the soul is the same true soul. On U.F.O.F., there are sadness-tinged love songs like Orange and an ode to a dead relationship or dead loved one, Terminal Paradise, recut from Adrienne's solo discography. On Two Hands, rollicking rockers like Forgotten Eyes and the titular track nestle up against the tender and painful Wolf and a live staple for the band, Not, a song that builds momentum and tumbles towards its conclusion like a meteor. Whether you're a devoted fan (and I don't know anyone who listens to Big Thief but doesn't consider themselves one) or a newcomer, it's worthwhile to spend some time close to these records. Let them, and they'll grow on you.

Kim Petras - TURN OFF THE LIGHT Easily the best collection of club pop songs this year began as a Halloween-themed mixtape, which I think gives it a willingness to experiment that I sometimes miss in Petras's more standard stuff. The hooks on tracks like There Will Be Blood, Close Your Eyes, and Tell Me It's a Nightmare are as good as anything in her discography, and the most adventurous moments, like the interlude o m e n and the German verse in In the Next Life, not only pay off but fuck harder than basically anything I've ever heard. I would be remiss if I didn't mention that Dr. Luke was one of this record's producers. The fact that he gets a cut of every stream and sale is a terrible blemish on what would otherwise be a huge favorite of mine.

Sufjan Stevens & Timo Andres - The Decalogue A forceful, sometimes opaque album. Delicate and opinionated piano music for ballet. One moment of particular transcendent beauty: the track V.

Weyes Blood - Titanic Rising A 10/10, perfect, totally wonderful album. A ton of variety and not a single bad song. By turns upbeat, dreamy, contemplative, creepy, explosive. One of the most beautiful and evocative album covers of the year to boot.

Andrew Bird - My Finest Work Yet I appreciate Andrew Bird's esoteric trips and darkly introspective weirdness, so it surprised me how much I enjoyed this: a bouncy, ascerbic, and delightful return to form packed with ironic turns of phrase and endlessly engrossing little musical details. Bloodless is a legit political statement, a State of the Union address that is somehow equal parts ominous and encouraging. Sisyphus is freewheeling and also political, a common thread here. My favorite is Manifest, a disco-inflected ode to fossil fuels. You could blast it and joyfully sing along without ever realizing how apocalyptic it is.

Nivhek - After its own death / Walking in a spiral towards the house Moody, spacious, and minimalist. Lovely and meditative.

M83 - DSVII A world all of its own. Cinematic, strange, and cheesy. I really appreciate M83's willingness to do absolutely whatever they want when they could easily have made a career pandering to fans of Midnight City and selling songs to car companies. DSVII is spacious and upbeat, steeped in the memory of 70s space western epics. Flutes, pianos, and shimmering picked guitars float over crashing post-rock drums and synths ranging from contemplative sweeps (Mirage) and buzzing pads (Colonies) to swelling vox (Taifun Glory) and precise, retro little bleeps (Oh Yes You're There, Everyday). It's wonderful background music, and the choice tracks (Temple of Sorrow, Mirage, Hell Riders) are great fun and even occasionally thrilling. This album is easy to love.

Thom Yorke - Anima Detuned synths lying motionless in a cold desert fading in and out of life

Foxes in Fiction - Trillium Killer A swirling dream-pop masterpiece. I had the privilege of seeing Warren perform some of these songs earlier this year, and I felt totally transported, like I was physically present in the green holographic world of his back-stage projections. These songs are complex and really special, crafted with care and an ear highly attuned to odd harmonies and little additive details. I love the way stories and thoughts weave together across the album. The catchy, gently swelling music is a brilliant compliment for the lyrics, which are often dark and intense, blurring the political and personal on songs like Say Yes to Violence and Antibody. Aesthetically, this album is a delight, but there's so much depth beneath its glimmering surface. What a wonderful addition to Foxes in Fiction's powerful and lovely discography.

Xiu Xiu - Girl with Basket of Fruit Xiu Xiu always makes me smile. This album is dense and abrasive and very lyrics-forward. Jamie Stewart sounds fucking pissed and I love it. The beats are quick and unrelenting: samples of Haitian drummers led by musician Daniel Brevil. I also can't get over the fact that Angela Seo published her favorite and least favorite lyrics from each song. Jamie wrote this about the record's title, which references Caravaggio's painting Boy with a Basket of Fruit: "When this title is a boy it is fey and lovely. When it is a girl is worrisome and rife with danger. Male martyrs are almost always surrounded by nurses, their mothers, adoring angels and other loving disciples wrapping their crushed and holy bodies in strips of herb soaked cloth and weeping rapturously. Female martyrs are almost always depicted having their skin flayed, breasts branded or ripped off with tongs or being stabbed and they are always, always alone save for her murderers. There is never anyone by their sides celebrating their spiritual life, only fiendishly reveling in their torture of her. It is perilous to be a 'girl.'"

Bats - Alter Nature I was shocked to find out these guys have been around for 10 years. This sounds like an album by a young band, which I mean as a compliment: it's energetic and rough and a little uneven in parts in ways that I enjoy. The sound is either especially intense but poppy post-punk or kind of gentle hardcore. I think there's a lot of crossover potential between those two fan bases here. Their attitude is what I love more than anything else. I don't know how to describe it exactly. It feels like the band are willing to go to weird, sarcastic places and then quickly snap back to sincerity and brutality, often multiple times in one song. I'm not much of a hardcore fan, but I almost wish they'd spent a little more time with that sound: my favorite parts on this record are the heavier bits like the end of Current Affairs.

Olivia Neutron-John - Olivia Neutron-John This album sounds like if you trapped a musique concrete artist in a timeless hell with a couple drum machines and synths for a millenium and then poked a hole in the wall and recorded what came out. Really fun and uncomfortable. I do still think the best format to experience ONJ is in her like 20-minute rambling dance tracks, like 2017's Injury Train.

Liturgy - H.A.Q.Q. A lot of people really despise Liturgy, and if that's the case for you, this album probably won't change your mind, but for what it's worth, it's a little more accessible than their synth-horn-heavy black metal midi extravaganza of a previous album The Ark Work. H.A.Q.Q. does contain weird, tonally distinct interludes (the EXACO trio of tracks) between its transcendental metal pillars, but they're the rare interludes that go beyond merely cleansing the palette and setting the mood for whatever follows. EXACT III especially is a bright and emotionally complete unit. What we're really here for is the metal, though, and this album delivers like nothing Liturgy has released before. Composer/singer/guitarist Hendrix's melodies are unique and beautiful, the riffs and blastbeats are tight, and the stuttering glitches that break up dense passages are welcome even when they're really surprising. HAJJ, PASAQALIA, GOD OF LOVE, and HAQQ are all monster tracks, but the whole album is well worth your time. The lead single, GOD OF LOVE, is a great place to start. This is definitely, easily my favorite black metal album of all time, and probably my favorite metal album full stop.

Blood Orange - Angel's Pulse Dev Hynes' mixtape is by turns propulsive and relaxing, softspoken and hardheaded. It's brilliant and beautiful and although it's not too long, each song is given ample room to breathe. I wish other artists were as effective at utilizing guest artists (some tracks here have three guests, and Hynes is able to manage their time well enough that there's no feeling of bloatedness or a lack of cohesion). I love this album. It might be my favorite thing Hynes has ever done. Listen to: Take It Back, Berlin, Dark & Handsome

Toro y Moi - Outer Peace Chaz's album Boo Boo was one of my favorite albums of 2017, but because it wasn't chillwave enough or whatever, people didn't seem to give it a fair shake. That seems to be the case with Outer Peace, too: it's less of a single unit than Boo Boo and contains more danceable content, but it's a little too moody and eccentric to win over fans of Anything In Return, Chaz's basically perfect 2013 opus. (As a side note, his mixtape Soul Trash, which also came out this year, is good fun too.) Anyway, Outer Peace feels kind of like a more accessible extension of Boo Boo. Parts of it still feel like a deranged early-morning exercise program on college radio, which I like. Try some of the lighter stuff first: Fading, Ordinary Pleasure, and Freelance.

Opium Lord - Vore No genre has better subgenre descriptors than metal. This is a black sludge album, and that's pretty much all you need to know.

Mid-Air Thief - Crumbling Okay so this album technically came out in 2018, but it had a wide release this year on Topshelf Records with like four different wax colors, and also I only found out about it early this year, and I need to spread the word about one of the most delightful, fun, and beautiful albums I've ever heard. On Crumbling, organic strums and synthetic trills form a deeply engaging tapestry. I love every second of it. Combining sounds in this way totally qualifies as left-field experimental shit just because It Seems Like Nobody Else Is Doing It For Some Reason (except I guess Floating Points, see SOTY), but the music itself is actually really accessible. This is what pop music should sound like! We have the technology!! Please listen to this album. Dirt and Gameun Deut are my favorites at the moment, but you honestly can't go wrong.

Angel Olsen - All Mirrors Olsen's gotten grander. Her ballads are longer and involve strings and synthesizers and beat machines. The soul feels the same to me, though. Songs like the title track are powerful and emotive and showcase not just her vocal range but a new range of sonic experimentation that I think complements her songwriting really well. For those who aren't on board with the 7-minute ballads, there are also more lighthearted tracks like Too Easy and Spring. I knew that Chance reminded me of a specific song, but I couldn’t think of the name until I read something by a person named Grimelords about how it’s like her version of Sinatra's My Way. That’s exactly what it’s like.

Girl Band - The Talkies Shoulderblades is an ugly, mammoth, multi-part story. Brilliant genreless repetition like in album opener Prolix and at the end of Couch Combover. Amygdela sounds like if early Preoccupations was fronted by someone undergoing torture whilst also muttering at their withdrawal hallucinations. The vibe here is complex. It's a very consistent album, but the collection of sounds and attitudes is really unusual. Caveat is a great example: a simple beat and twitching synth line turns into a lumbering mess of distortion-and back again, whenever it decides to-at will.

0 Stars - Blowing on a Marshmallow in Perpetuity Timid singing, odd titles, and every-instrument-in-the-room textures on this album belie depth and a very warm heart. "even though my dog barked at a baby, i won't tell her 'no' cause that's just the way she deals with being scared and sometimes i get scared too, and it's bad enough without the shame when i mess things up and you don't come over, i go to the kitchen and eat leftovers just because i'm sad doesn't mean it is fair to depend on you when you're sad too"

(Sandy) Alex G - House of Sugar With Gretel—the best song of the year—as its lead single, House of Sugar set an impossibly high expectation. Although Gretel is certainly a high point on the album, there are many more: Hope is inconspicuous but beautiful, honest, and cathartic, SugarHouse is a devastating jam, and Southern Sky whirls comfortingly from a rose-tinted verse into a chorus supposedly inspired by a dream and tinged with sadness. All but one of these songs are under 4 minutes long, but they're packed with conflict between abstract and concrete lyrics, beauty and strangeness. It's Alex G, so don't be surprised by the unexpected and often outright weird electronic flourishes and transitions throughout the record, but if you can handle its irregularities, this is easily one of the most fresh-sounding and enjoyable albums of the year.

Emily Reo - Only You Can See It A bright, fun, and beautiful album full of bouyant vocals and strange twists and turns. Although I deeply love the poppy stuff here (like the anthemic single Strawberry), my faves are the slower, darker, vaguely occultish songs: Ghosting, Counterspell (a shimmering sequel to 2016's Spell, one of the best songs of the year), and In Theaters, which is one of those songs that builds and builds and then has the most satisfying payoff. It might be my favorite ending of any album this year. I hope you check this one out. Emily is the coolest and this album rocks.

Chromatics - Closer To Grey Of course this came out in October. Chromatics is the only band that is allowed to use canned vinyl hiss. The first song on this record is a Sound of Silence cover and it is amazing.

Mizmor - Cairn I try to approach new music without giving too much thought to the circumstances of its creation, but something about the idea of a mythical lone individual painstakingly crafting beautiful layered music appeals to me, whether it's Phil Elverum of Mt. Eerie, Sufjan Stevens, or this: Mizmor, some dude from Portland, OR making sick, dense black metal. Cairn is a slow, doomy, cinematic album, and maybe these qualities make it easier to notice the incredible attention to detail on individual riffs or little instrumental passages. My favorites were Cairn to God and The Narrowing Way

Laura Agnusdei - Laurisilva Lounge music from hell. Twin Peaks-y saxophone glides over squishy synthetic beats. Lungs Dance sounds like a block of jello having a nightmare. In all seriousness, this is an ingenious and very unique album and I enjoy it a lot. A lot of music I listened to this year attempted to merge organic and synthetic sound in a way that emphasises their similarities. Here, synthetic sounds and recognizable voices/samples/sax & flute riffs are juxtaposed, and the rift is never bridged. And it's weirdly comfortable. This is the most acidic of acid jazz. And honestly, I just really like how wet the synths sound.

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SONGS I LOVED (singles for albums that i think outshone the album OR songs that were released not as part of an album OR just songs i heard and enjoyed. this will hopefully prevent me from including an album i don't actually love just because i really dug one song on it)

Arthur Russell - You Did It Yourself Iowa Dream is a great collection of Russell's more accessible unreleased work. You Did It Yourself in particular is such a perfectly weird, groovy almost-pop song, a reminder that Russell was as talented a writer of hooks as he was a mastermind of electroacoustic experimentation. To explore his other side, check out another of his posthumous releases from this year, Not Checking Up.

MGMT - In The Afternoon A gothic post-punk masterpiece that sort of follows from their excellent 2018 album Little Dark Age. This is MGMT's best era ever. My most-anticipated-2020 list is basically MGMT and Owen Pallett's Island. And probably one or two more Big Thief records.

Floating Points - Falaise Floating Points' 2019 album Crush consists mostly of Aphex-Twin-y glitch-beat tracks that occasionally push towards something really interesting and unique. It's a great album, but the organic instruments on opener Falaise set you up brilliantly for an organosynthetic payoff that never arrives.

Honey by Drugdealer/Weyes Blood okay, Lonely on the same album is fun, if a little silly. Lost In My Dream is also totally decent, and Fools is kind of a bop... actually, this whole album, while not totally my cup of tea, is great. If you like 70's-disco-inflected (like, Bee Gees) retro rock, sweet vocal harmonies and guitar licks, and a few indulgences (like saxophone), you'll totally dig this record. I'm gonna spend some more time with it. Honey fucks especially though imo

Everything All at Once - G Jones Something about this song just scratches an itch in my brain. The rest of this album is basically dubstep, and it all sandwiches this one beautiful little song. Better not to question life's gifts.

Perfume Genius - Eye in the Wall Sandunes & Landslands - Eleven Eleven James Blake - Barefoot In The Dark new grimes unfortunately Deafheaven - Black Brick

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Honorable Mentions/stuff i like but other people would probably love

Kim Gordon - No Home Record An experimental (but comfortably modern) record by the 66-yr-old Gordon, best known as a multi-instrumentalist/vocalist in Sonic Youth, a band I occasionally appreciate but can't say I love. Parts of No Home Record are noise rock-y, like Murdered Out, and others totally defy comprehension: Paprika Pony seems to have the most buzz surrounding it, which makes sense since it features both a kalimba and a trap beat. Really not a resting-on-laurels type of album. I wish more iconic older musicians made shit like this.

Pharmakon - Devour The rare album that makes me forget about my tinnitus. A dense cloud of distortion and sharply biting microscopic needle creatures that settle around your shoulders and block out all light. Fucking awesome. Listen if you enjoy oppressive painfully pulsing sound textures of industrial noise blanketing completely incoherent screaming.

clipping. - There Existed an Addiction to Blood This is a tough one for me because there are things about this album I can't stand, but many more things I absolutely love. The inventiveness of the production on Run for Your Life, Daveed's absurdly skilled delivery on Blood of the Fang, the harsh noise and musique concrete combining delightfully with rap on songs like La Mala Ordina; all of this is extremely exciting. I really love the last track Piano Burning, an 18-minute recording of, yes, a piano burning. The thing is, clipping.'s lyrical content is more or less the same here as on 2013's Midcity mixtape. It's ultra-violent, filled with graphic descriptions of gang violence and torture, which is fine, but just not something I'm that interested in listening to more than once or twice. They've branched out elsewhere (on their previous album, Splendor & Misery, and on the recent EP The Deep), but to me, it's unfortunate that this super cool and thoughtful album is lyrically (at least, on the surface) just a collection of descriptions of people being murdered. I don't really have any interest in reading more into it than that, because I regret pretty much every time I try to pay close attention, either because it's gross and boring or because it's embarrassing (The Show, for example). I want to emphasize that as horrorcore goes, the writing here is mostly very good. The rhyme patterns like at the beginning of Story 7 are genius. It's just not for me, I guess. I'm gonna keep listening to a few songs, though: Nothing is Safe, La Mala Ordina, Run for Your Life, and Blood of the Fang are excellent.

Field Whispers - Fire-Toolz The Warm-Body is a great song. Hyphen- (and parenthesis-) heavy vapor/pc music/new age/ambient jazzy synth stuff. really nice.

Caroline Polachek - Pang every r/indieheads dude: i like slide guitar now probably the best vocal performance of any album I heard this year, Polachek is just ludicrously good. listen to Insomnia

Danny Brown - uknowhatimsayin¿ When most artists release an album of outsized acclaim, you can with some certainty expect them to mimic its acclaimed qualities later on in an attempt to reach the same level of success. Danny Brown is not most artists, though, and no one who knows him would count on a retreading of the ground covered in Atrocity Exhibition, Danny's nearly perfect 2016 album. uknowhatimsayin¿ is more lighthearted and, I think, a little less ambitious (it's 13 minutes shorter, with more consistent track lengths; there's no "Really Doe"), but not to its detriment. The features are less head-turning than AE (up-and-comers JPEGMAFIA and Obongjayer, the understated genius Blood Orange, and Run the Jewels, the most overrated act in hip hop), but they all fit in neatly. Tracks like Belly of The Beast and Negro Spiritual prove Danny could still rap over a washing machine or musique concrete or fucking whatever. The lyrics are less dense, the beats less experimental and strange, but the lighter energy is kind of nice. Atrocity Exhibition could've lost three or four tracks, but this album feels juuuust right.

HTRK - Over the Rainbow Soft, ambient, moody. Reminds me of William Basinski's Watermusic II, but this album is less repetitive and a little less weird. It's background music for people who hate background music. It's delightful and ignorable. Very nice.

Blarf - Cease & Desist Shockingly decent plunderphonics/noise album from Eric Andre, who it must be pointed out attended one of the most prestigious music colleges in the world.

Ryan Lott - Pentaptych Beautiful, prickly modernist string compositions.

Cereal Killer - The Beginning & End of Cereal Killer Empath - Active Listening: Night on Earth Ithaca - The Language of Injury Mannequin Pussy - Patience Swan's Chamber - Swan's Chamber Avey Tare - Cows on Hourglass Pond Men I Trust - Oncle Jazz Charli XCX - Charli Black Midi - Schlagenheim Michael Kiwanuka - Kiwanuka Methyl Ethyl - Triage Bill Callahan - Shepherd in a Sheepskin Vest Better Oblivion Community Center - Better Oblivion Community Center Twin Peaks - Lookout Low Holly Herndon - Proto Laurel Halo - DJ-Kicks Earl Sweatshirt - Feet of Clay Nihiloxica - Biiri Wet Fruit - Wet Fruit

Best mix: Night Bus 4: Memory of Night Bus by CFCF When Hyperballad hits, you will understand. http://www.gorillavsbear.net/cfcf-drops-night-bus-4-memory-of-night-bus

Best album name:

Gross Net - Gross Net Means Gross Net.

Answers my foremost question immediately.~~~~~

A halfhearted AOTD list, in order this time

1-The Age of Adz

2-Heartland

3-Entrañas

4-The Money Store

5-Channel Orange

6-Planetarium

7-Ontario Gothic

8-Konoyo+Anoyo (this is cheating but whatever)

9-Carrie & Lowell + Greatest Gift (also cheating idc)

10-My Beautiful Dark Twisted Fantasy

thanks for reading. the world is abundant.

#music

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youthsloadedmedia · 2 years

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UNIOSUN Teaching Hospital (UTH-OSOGBO) Post Basic Paediatric Nursing Admission, 2022/2023

Osun State University, UNIOSUN Teaching Hospital (UTH-OSOGBO) Post Basic Paediatric Nursing admission form is currently on sale for the 2022/2023 academic session. See details on how to purchase the form below. This is to inform the general public that UNIOSUN Teaching Hospital, Osogbo has commenced admission into its school of Post Basic Paediatric Nursing for the year 2022/2023 Academic…

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filmaltadefinizioneweb-blog · 6 years

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World Class Free Film School - Lesson 1 - Sign Zee Papers!

Welcome to World Class Free Film School!

In the following series of articles of we will impart the hard-won knowledge that we have gained as successful independent digital filmmakers. And (drumroll puh-leaze!) we will do this for FREE!

Now, why would we do such a thing for free? Well, because we're sweethearts. Because we love you and want you to succeed in this sometimes tricky and crazy thing called The Film Industry.

Now, there are many fine filmmaking schools in this big old world. Places where an aspiring director or producer can attend to learn many of the skills necessary to make a film.

There are also many excellent books out there that you can read that will give you all of the essentials to make a film. Unfortunately, for the poor huddled masses, these film schools and books will cost an initial investment of time and money. This amount you end up spending may be in the thousands of dollars. Now, there is nothing wrong with you spending money to educate you. Perhaps some film schools may actually help improve your chances of getting a job in the industry too, however...

Almost without exception, the graduates of these film schools will go on to find out that making their first few films as Directors will end up costing them several thousands of dollars more. They'll learn the hard way that precious few filmmakers ever see any kind of return on the money they've put up for funding their first few films.

That has been the reality of the situation for the independent filmmaker, up until now. There have been way too many stories told of those starry-eyed wannabe directors who begged, borrowed, or stole to produce their first few flops. At the end those sad stories, the tragedy is they never actually finished their first film. Maybe they never got started. Maybe they ran out of patience or time. Or maybe they ran over-budget, found themselves financially in the hole, bereft of family and friends for favors they could not repay. End result? Oh, I don't know, maybe you end up a bitter ex-filmmaker, working a crappy day job, nursing a sore ego while feeling like a huge failure after spending so much dang money on film school.

Are you ready for a paradigm shift? This is where World Class Free Film School is different! Here, you can learn all of the technical information for producing an independent film while NOT breaking the bank! In this free on-line film school, you will learn the basic principles of pre-production, production, and post. You will walk the path of a successful independent filmmaker and discover a self sustaining business model that I've followed from day one in the business.

You'll gain the perspective of the lessons that I've won and follow me step by step as I explain to you how I wrote, directed, and produced my first money-making film and went on using that as seed money to grow an income generating film library. You'll learn the tips and tricks of creating film revenue streams while satisfying that creative spirit which brought you to this page in the first place. These revenue streams will allow you build your filmmaking equipment arsenal, fund, produce and self-distribute more of the same revenue streams, and, yes, allow you the financial freedom to produce the occasional non-commercial short film, without giving a fig about where the funding will come from!

Interested? Good! Check back frequently! This is a work in progress, and it will evolve as we go happily skipping down the danger-strewn yellow brick road together in this crazy thing called show-biz. I'm looking forward to sharing and giving back some of the knowledge and experiences that have allowed me to proclaim myself a successful filmmaker. Yes indeed, sometimes I puff out my chest and shout my barbaric yawp; "I am a successful FILMMAKER, dammit!" I admit that I do get some funny looks sometimes too.

That being said, I honestly believe that at the end of this course, if you follow the tasty advice that I dish out for you, I have no doubt that you'll be able to shout the same barbaric yawp!

So, c'mon, jump in head first and follow me! You've got nothing to lose, and everything to gain. It's fun, it's entertaining, and you might learn something.

Best part is; it's all FREE!

Lesson 1 - Sign Zee Papers!

Ok, so you've decided that you want to make a film and you're not going let anything stop you. It's time to make like Nike, and just do it. You've got your crew all picked out and they said they would work for free (or almost free and a credit). They're all totally happy with the fact that you're making promises about what they can expect on the back-end profits. Everyone is confident that this film is a sure-fire win at Sundance, it's going to get picked up by a major distributor and everyone is going to get rich, right?

WAIT A MINUTE!!!!!

One of the biggest downers in this crazy business (and don't kid yourself, it is a business), is that it can make ordinarily nice people turn into totally greedy, insufferably egotistical, and absolutely insane monsters. This is no joke.

I don't know what it is, but one day you're buddy-buddy with someone who came on to your project two months ago to help collaborate, everything is fine and dandy, you're cruising toward that Sundance Award, then the next day, BLAMMO! It's like Invasion of the Body Snatchers. This previously "normal guy" has been replaced with an alien who grew out a pod last night while he was sleeping. Maybe you hired him to shoot some of your footage and he still has the tapes. He was supposed to start editing them, but now he says he wants a gazillion dollar advance, he wants 50% royalty on all sales, he wants complete creative control, and... Wait for it...he wants DIRECTOR credit on the film that was initially your idea two years ago.

OK, this is one of the most important tips that I am going to give you. Before you do anything else; get it in writing! Step one; when you finish the script, get it copyrighted. You can do this easily by logging on to copyright.gov, paying $35 bucks, and following their directions. Step two: when you bring someone on to your film to collaborate, use a contract! Spell everything out completely and make sure you don't give up certain things, like ownership. Make the terms as favorable for yourself as possible. Remember, it's your concept, your project, your business! As a business person, think of collaborators as employees. Employees whom you appreciate, take care of, and share with, but still; employees. To drive a film to completion, someone has to be the boss. If they want to be the boss, guess what? They can make their own frickin' movie! Even if they are working for free (or almost free), you need to be able to fire them if, say, they turn into pod-people. Don't be afraid to terminate someone if you need to.

Make the contracts as iron-clad as possible. Spell out what you are offering them and what rights you will retain. Personally, I would prefer to pay someone up front on a daily rate, rather than to have them work for free (or for some pie-in-the-sky by and by). It's much cleaner. Pie eating contests can get messy. Pay the cameraman a reasonable fee and have him give you the tapes immediately after each shoot, if you're doing the editing yourself. Or, if that's not feasible, go with him to his studio, wait while he captures the footage to hard-drive, then take the raw footage with you while he does the editing. When it comes down to it, he who has the raw footage in his possession, owns it. Doesn't matter if you paid him or not. He shot it and it belongs to him his until he hands it over. All this is a very good reason to learn how to do everything yourself, if you can.

It's hard to shoot, edit, and act in your own film all at the same time. You will probably need some kind of actors in your movie. This can be expensive unless you're shooting a documentary. That's why I like making docs. The talent tends to be free. Even then, you should still take care of the people who volunteer to be in your film. Feeding them is nice. Credits are a must. A complimentary copy of the film on DVD should be de rigueur. I like to give the folks in my documentaries the opportunity to buy extra DVDs from me, at production cost (50%) and let them hand-sell them for profit at the set retail price. It's actually a good self-marketing technique. You end up with a huge marketing team this way. They make 50% profit and you make 50%. But regardless of whether you decide to share the wealth, or not, be considerate!

One thing about getting people to work for free, please respect their time! If you say that a shoot will start at a certain time, be there. Nothing makes an unpaid volunteer more upset than taking time out of a valuable day and be left cooling their heels for a tardy director. If you're producing a narrative, you will need actors. Key words: be professional.

Try to keep it clean and simple. If you're able to, use SagIndie for talent. I know that it's not always feasible, but if you can, do it. It's only a hundred bucks a day and you will get quality performances. You can learn a lot working with professionals too. Maybe you won't need to do so many takes. And usually you will get better results than if you use your Aunt Mimi as the leading lady.

Either way, make sure you get talent and location owner's to sign a release form. Make sure that you make the release as broad as possible so that you don't get caught in a "aha, gotcha!" somewhere film alta definizione down that yellow brick road. No bigger buzz-kill than squabbling over something that is supposed to be fun. Remember, that is our definition of "success"? Having FUN? Well, follow the advice in this lesson and have everyone sign zee papers. Then have fun!

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cb01site-blog · 6 years

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World Class Free Film School - Lesson 1 - Sign Zee Papers!

Welcome to World Class Free Film School!

In the following series of articles of we will impart the hard-won knowledge that we have gained as successful independent digital filmmakers. And (drumroll puh-leaze!) we will do this for FREE!

Now, why would we do such a thing for free? Well, because we're sweethearts. Because we love you and want you to succeed in this sometimes tricky and crazy thing called The Film Industry.

Now, there are many fine filmmaking schools in this big old world. Places where an aspiring director or producer can attend to learn many of the skills necessary to make a film.

That being said, I honestly believe that at the end of this course, if you follow the tasty advice that I dish out for you, I have no doubt that you'll be able to shout the same barbaric yawp!

So, c'mon, jump in head first and follow me! You've got nothing to lose, and everything to gain. It's fun, it's entertaining, and you might learn something.

Best part is; it's all FREE!

Lesson 1 - Sign Zee Papers!

WAIT A MINUTE!!!!!

Either way, make sure you get talent and location owner's to sign a release form. Make sure that you make the release as broad as possible so that you don't get caught in a "aha, gotcha!" somewhere down that yellow brick road. No bigger buzz-kill than squabbling over something cb 01 that is supposed to be fun. Remember, that is our definition of "success"? Having FUN? Well, follow the advice in this lesson and have everyone sign zee papers. Then have fun!

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mothersjoy · 3 years

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School of Psychiatric Nursing, Aro Post Basic Admission for 2022/2023 Academic Session

This is to inform the general public that admission forms are now available for sale to eligible and qualified Registered Nurses for admission into the POST-BASIC SCHOOL OF PSYCHIATRIC NURSING, NEUROPSYCHIATRIC HOSPITAL, ARO, ABEOKUTA, OGUN STATE. REQUIREMENTS i. Five (5) Credits in WASC/SSSC/GCE OR NECO to include: English Language, Mathematics, Biology, Chemistry and Physics at not…

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weareyour4 · 3 years

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The Dangers of Multi-Level Marketing…

By Emmaf8

The world of multi-level marketing is based upon emotional language both positive and negative. The numbers are often misleading and with MLM recruitment growing during the pandemic its important to understand the hallmarks of an MLM, the language used to describe them and the pitfalls of joining one.

This time last year the number of redundancies in the UK had increased by 27,000 in the quarter between April – June 2020. This statistic happened to coincide with a rise in invites to join multi-level marketing companies arriving in my inbox but what might the correlation be? There are two ways of approaching it and two camps who broadly represent these views.

On the one hand, this was the highest level of redundancies since 2013 and understandably led to many people looking to subsidise their incomes or find a new job. MLMs offered good opportunities to work from home. This attitude leans into the kind of rhetoric used by MLM recruiters and the Direct Selling Association (DSA) (the only UK recognised trade body for MLMs) who talk about direct selling as a ‘flexible option’ to earn money around existing commitments. The second camp, comprised of those who are more sceptical about direct selling or who belong to the Anti-MLM community online would point to the rise in unemployment and rise in MLM recruitment as recruiters seeing an opportunity to cash-in on others financial uncertainty.

The DSA estimates that around 631,000 people in the UK play some part in the chain of direct selling (a rise of around 200,000 since 2019) and on average these sellers earn £481 per month. However, this is only an average and many could be earning much less. It also doesn’t reflect how much money is being earned from starter fees and how much comes from actual product sales. In addition, not all companies have the same protocols for calculating sales, so this £481 figure could partially come from sellers themselves purchasing stock to match monthly targets, and their upline profiting from those purchases. While MLMs are not technically pyramid schemes they do follow very similar selling practices and the numbers make clear that they are successful only for the very few and this success comes off the backs of others.

My contact with MLM sellers always began with a Facebook invite to join a private group or page where they were selling their products to friends and family. The Body Shop at Home, the multi-level marketing branch of the Body Shop UK, USA and Australia would soon become easily recognisable for me as multiple friends and acquaintances invited me to purchase through them rather than the prominent brick-and-mortar stores. The Body Shop at Home follows a direct selling business model where individuals sign up to sell the company’s products and earn commission from this while also recruiting other people, who form their downline. There is an initial fee of £49 which pays for your starter kit although you are encouraged to purchase additional stock. The posts you see online from people working for multi-level marketing companies like this one usually follow the same basic structure. This person is so lucky to have found this opportunity, they are so pleased to be controlling what they hours they work and encourage people to join their team and earn easy money.

The first invite I received to this effect came in August 2020 from a friendly acquaintance of mine who I’d met at university. She had recently graduated and in the financial uncertainty of graduate employment in a pandemic had joined the Body Shop at Home to boost her finances. What was initially a group invitation that I was indifferent about quickly became a daily bombardment of posts. Our limited relationship meant that I felt comfortable muting her posts and moving on. A short while later a woman I’d gone to school with added me to a Facebook group for the same company. She was in a similar position to the first woman, a second-year student, not working because of Covid, looking for extra funds.

Of the 631,000 MLM sellers in the UK 96% of them are female. In May 2020 the Institute for Fiscal Studies found that mothers are 47% more likely to lose or quit their jobs than fathers and MLM’s can appear to promise much needed revenue for stay-at-home parents. The third contact I received from a Body Shop at Home consultant reflects this. A woman I knew through her husband added me to a by now typical Facebook group. I was surprised at first because she had a job as a veterinary nurse, but it soon became clear that she had opted for this MLM role as the couple were expecting their first child and they wanted to subsidise their income while she was on extended maternity leave.

There is a disproportionate amount of recruitment materials aimed at young women, particularly new mothers which is made even more problematic considering that less than 1% of MLM participants turn a profit and over 99% break even or make a loss. These figures, presented by Dr Jon M. Taylor for the Consumer Awareness Institute reflect the ‘predatory and harmful’ practices of MLM recruitment. While the Body Shop at Home is a fairly low risk MLM, due to its low starting cost and lack of pressured sales targets it is still inadvisable to join. Other MLMs such as Forever Living cost £199.75 for its ‘Start Your Journey’ pack and a Nu Skin starter pack costs between £346 and £1,107.

In response to the vast number of horror stories available online, where people tell their personal stories of losing £1,000s into MLM memberships the Anti-MLM community is present. The largest discussions I’ve found come from Reddit and YouTube. Much of this community has a vested interest in informing people and encouraging them to choose other employment. They point out the common language used by MLM recruiters who are often referred to as ‘hunbots’ due to their overwhelmingly female recruitment pool and opening messages beginning with the words ‘Hey Hun’. While the activity of the Anti-MLM community is based out of a moral wish to challenge questionable business practices (which many of the Anti-MLM community members have fallen foul of at some point), language such as the labelling of ‘hunbots’ strikes me as alienating. Amelia Tait explains how uplines isolate their sellers by encouraging them to stay away from those who criticise the company. I worry that the dismissive language at times deployed by the anti-MLM community while offering fair critique of the immoral selling techniques of MLMs risks alienating and further fuelling the confirmation bias encouraged among direct sellers.

In conclusion, the business practices of MLMs are questionable to say the least and the figures speak for themselves in terms of the success to failure ratio. While the ethics of the higher ups in these companies are certainly questionable, I worry about the everyday sellers at the bottom of the pile, joining due to financial problems and lulled into a false sense of security by misleading language.

References:

Employment in the UK - Office for National Statistics (ons.gov.uk)

DSA UK – The Direct Selling Association UK

'They have you in a cultish grip': the women losing thousands to online beauty schemes | Beauty | The Guardian

DSA UK – The Direct Selling Association UK

Become A Consultant | The Body Shop At Home™ DSA UK – The Direct Selling Association UK

As many lose work in the pandemic, “multi-level marketing schemes” spot a recruitment opportunity (newstatesman.com)

00008-57281.pdf (ftc.gov)

00008-57281.pdf (ftc.gov) p.7 -1

'They have you in a cultish grip': the women losing thousands to online beauty schemes | Beauty | The Guardian

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electtcele · 3 years

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Abia State, Dept. of Nursing, Abia State University, Uturu 2021/2022 nursing form is out call 08136564092 Also midwifery form, post-basic nursing form and internship form is still on sale, for more information on purchase of the form and admission assistance call School Admin on 09055447087 ..the nursing program is a learning process to education students for future purposes Call School Admin on 09014174726 Call Now Before The Closing Date.

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your-dietician · 3 years

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Do You Need a Prescription to Buy a CPAP Machine, Mask or Supplies?

New Post has been published on https://depression-md.com/do-you-need-a-prescription-to-buy-a-cpap-machine-mask-or-supplies/

Do You Need a Prescription to Buy a CPAP Machine, Mask or Supplies?

In short, Yes. If you’re going through your insurance company, preferred Durable Medical Equipment (DME) provider, or online retailer, you’ll need a valid prescription to purchase a CPAP machine, a complete CPAP mask, and a CPAP humidifier.

From there, it can get a little complicated.

Navigating the world of CPAP therapy, insurance coverage, and prescription requirements can be daunting. Here at CPAP.com, though, we’ve been connecting people with the information and supplies they need for healthy and successful sleep apnea therapy for over twenty years.

Regulations have changed quite a bit in that time, and there’s a lot of confusion around CPAP prescriptions because of it. This guide should help clear up any confusion or misconceptions you may have about your CPAP prescription, and why it’s important to have one.

We’ll also cover ways you can obtain a prescription, detail some important things you should know about the process, and even offer resources for tracking down an old prescription you might have.

Let’s jump into why you can’t purchase a CPAP machine without a prescription, and why it is crucial to have one.

Why Do You Need a Prescription for CPAP Equipment?

CPAP machines, masks, and humidifiers are classified and regulated by the FDA as Class II medical devices, which means a valid prescription is required for a legal sale to take place. In 2018, the FDA reclassified CPAP machines from Class III to Class II in an effort to spur innovation for a better user experience by relaxing regulatory burdens.

Sleep apnea can be a very difficult condition to adequately assess and treat because there are several different underlying issues that could be at play depending on the type of apnea events you experience. By working with a healthcare professional you’ll be prescribed the exact treatment and equipment you need to improve your quality of life.

Can I Get a CPAP Machine Without a Prescription?

As stated above, the FDA regulates CPAP machines and requires companies that sell these therapy devices to require a prescription from anyone intending to purchase one. To be clear, you cannot purchase a CPAP machine without a valid prescription from an appropriately licensed medical professional.

Luckily, you can get tested for sleep apnea and receive a valid prescription for your CPAP equipment all from the comfort of your own home. Visit our home sleep test for more details!

Can I Get CPAP Supplies Without a Prescription?

While a prescription is required for machines, masks, and humidifiers, you do not need a prescription to purchase CPAP supplies such as replacement mask parts, tubing/hoses (with the exception of some heated tubing), external batteries/power supplies, or filters for your machine.

CPAP accessories such as fabric wraps, aromatherapy bundles, CPAP pillows, and chinstraps can also be purchased without a prescription.

If you’re really savvy, you’ll find that you can typically even piece together a mask, or get pretty darn close, by searching for the mask parts individually.

To make this even easier, if you’re wondering whether or not you need a prescription for a certain piece of equipment, simply search for it on our website! Every single product that requires a prescription for purchase will have an icon under the ‘Add to Cart’ button that states “Prescription Required”.

Why Is It Important to Get a CPAP Prescription?

For a successful and healthy sleep therapy experience, a prescription is key.

Your CPAP prescription will tell you:

Your prescription is crucial in treating you based on the recommendations from your sleep study as made by your sleep specialist or doctor. A prescription turns the insights from your sleep test into an actionable way forward, giving you access to successful treatment.

How to Get a CPAP Prescription

Acquiring a CPAP prescription can be a pretty involved process, and it’s not so straightforward as simply asking your doctor for a prescription.

First, you’ll need to schedule an appointment with your doctor to discuss your sleep health to rule out other underlying conditions. Your doctor can then write you a prescription for a sleep study that you’ll participate in. After reviewing the results of your sleep study, your doctor can write you a prescription for a CPAP machine if necessary.

To get a CPAP prescription, follow the steps below:

Schedule an Appointment to Discuss Your Sleep With Your Doctor. Express Interest in Participating in a Sleep Study.

You’ll Setup the Test, and Fall Asleep as You Normally Would.

Your Results Will Then Be Sent to Your Doctor.

Your Doctor Will Write a Prescription Based on Your Sleep Study.

Can I Get a CPAP Prescription Online?

An exciting new option in the digital age is to have a sleep study conducted in the comfort of your own home! Our at-home sleep apnea test involves a consultation with a real doctor and is a great way to get a CPAP prescription online.

At-home sleep studies are not as comprehensive and cannot diagnose Central Sleep Apnea, but they’re perfectly capable of determining whether you’re a candidate for sleep apnea therapy based on your indicators for Obstructive Sleep Apnea (OSA).

Our home sleep test can prescribe you with an APAP machine directly, but others may require you to take your results to your primary care doctor in order for them to write you an appropriate prescription.

Who Can Write a CPAP Prescription?

To receive a CPAP prescription, you can make an appointment with your:

Medical Doctor (MD)

Doctor of Osteopathy (DO)

Psychiatrist (MD Only)

Physicians Assistant (PA)

Nurse Practitioner (NP)

Dentist

Naturopathic Physicians

Prescriptions written by the following medical practitioners are not accepted:

Chiropractor

Podiatrist

Optometrist

Psychologist

Registered Nurse (RN)

Respiratory Caregivers

Medical Assistants

While your prescription can simply be written on a standard prescription pad, we also offer a General Prescription Form to send to your prescribing physician.

What Does My Prescription Need to Say?

There are quite a few things that need to be on your CPAP prescription, and if you have the wrong phrases in the wrong places, it could affect your ability to get the right equipment for your needs. To help simplify this, we’ve gathered a list of everything your prescription needs to have on it.

Here are a few basic requirements of any prescription for any CPAP equipment:

Your physician’s contact information/NPI

Your physician’s signature

The patient’s full name

The Date of the Order

Length of Need

Diagnosis

How Long Is My Prescription Valid?

Some prescriptions for a CPAP machine have a finite expiration date or can be valid for life as judged by how many “refills” your doctor writes on the prescription.

If your prescription states that it is valid for a “lifetime,” then you are able to use it as many times as you need (this is also expressed as PRN, LON, 99, or 99 months). However, many prescriptions will have an “X” number of refills, meaning if it states five refills, then you will have to see your doctor again on your sixth. Some prescriptions may also have a “valid until” date, which means it cannot be used after the expiration date.

How Do I Track Down My Old Prescription?

At CPAP.com, we can help you to track down any old prescriptions you may have. To do so, we will send a message to your doctor’s office to ask them for the prescription you have on file.

If you’d like some assistance getting an old prescription from your doctor, give us a call at 1-800-356-5221 (M-F 8a-8p CST, Sat 8a-5p CST), or email us at [email protected].

If your doctor needs help with writing a valid prescription for a CPAP machine, mask, or humidifier, we can tell them what topics need to be covered in order for CPAP.com to be able to process the order.

You also can find your previous doctor and contact his or her office. Just search the doctor’s name or practice name online, and give them a call to see if they still have it and if it is still valid.

If you previously worked with another DME, there’s a chance you can get the prescription from them as they should still have it on file. The previous DME can release your old prescription to you, and you can send it to us.

Where Can I Purchase CPAP Equipment?

Once you’ve secured your prescription, you can be on your way to acquiring the supplies you need to get started with your sleep apnea therapy.

The two main ways you can get your CPAP equipment are:

Going through insurance can be stressful for some, and there’s a whole other world of policies and deductibles to dive into on the matter; it’s best to get in contact with your agent to explore your options and see what’s best for you.

Simply put, your insurance provider will typically decide for you what equipment they’ll cover and what you can get.

For this reason, most people prefer to do their own shopping, and typically save money by paying out of pocket for their CPAP supplies and equipment.

To summarize, getting a prescription for sleep therapy is not only required by law but it also gives you the best chance for therapy success. By ensuring that your equipment is personalized to your needs, you’re setting yourself up for a cleaner, safer, and more effective CPAP therapy with greater peace of mind, and empowering yourself by taking control of your own healthcare.

If you decide to go through CPAP.com for your CPAP needs, we have a number of different ways for you to send your prescription information to us to make the buying process easier:

Fax your prescription, toll-free, to 866-353-2727, or internationally to 713-541-7377

Email your prescription to [email protected]

Upload your prescription via the prescriptions section of your CPAP.com account.

Daniela has researched and published over 60 articles covering topics that aim to inform and empower people living with Sleep Apnea. As an avid reader and researcher, Daniela continues to grow her knowledge about Sleep Apnea and CPAP therapy everyday with the help of coworkers, CPAP.com customers, and members of other CPAP communities online.

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yakatah1 · 3 years

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Kebbi State College of Nursing Sciences admission Form 2021/2022

Kebbi State College of Nursing Sciences Schopol of Nursing Birnin kebbi,(Basic Nursing, Post-Basic Nursing, Refresher Nursing, Community Nursing) Admission Form, Requirements, Application Guidelines, Interview Dates, Time, Venue and Deadline for 2020/2021 Academic Session. This is to inform the general public that the sale of admission form into Kebbi State College of Nursing Sciences (KEBBISNM)…

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youthsloadedmedia · 3 years

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Gombe College of Nursing and Midwifery form for 2021/2022 session

Posted by Jamiu 6th January, 2022 | Comments This is to inform all interested candidates that sales of application forms into the Basic Midwifery Programme of the College of Nursing and Midwifery Gombe for the year 2021/2022 session starts from 10/01/2022 to 22/01/2022 at a rate of N 6,000 only. ENTRY REQUIREMENT ➤ Five (5) Credits in English Language, Mathematics, Biology, Physics,…

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douchebagbrainwaves · 3 years

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HERE'S WHAT I JUST REALIZED ABOUT PROFITS

And yet because of the slow sales cycle. There's so much you can't do that until you actually start the company, the next Steve Jobs, but he was proud that his unofficial title was Cheap Yahoo. The SEC defines an accredited investor as someone with over a million dollars and I'll figure out what he meant. The politicians all saying the same thing. Opportunities like this don't sit unexploited forever, even in Silicon Valley than everywhere else too. Com. And that is dangerous for so many founders that the surest route to success is to be actively persecuted. You may wonder how much of a problem. This is just a matter of pride, and a server collocated at an ISP. Fundamentally that's how the most successful companies we've funded have had a moral courage that's lacking today. But should you start a startup by just writing code.

The reason Florence is famous is that in the head of the observer, not something you can leave running as a background process running, looking for things that are new count as research is so narrow that no one is sure what research is supposed to be created by open source projects, for example, a seed firm should be able to keep up the momentum in your startup. East Coast after Yahoo. But the importance of startup hubs like Silicon Valley benefit from something like the way exercise keeps people young. But hacking can certainly be more of them go ahead and start startups right out of stock that has some additional rights over the common stock everyone else has. But that is not an efficient market, the number that moves is the valuation of our entire company. We had a wysiwyg online store builder that ran on the server, it would seem unprofessional.1 2 fundraising is to get lots of referrals. No matter how much money Yahoo would make from each link.2 The investors who invested earlier at a higher price, but you may lose a bunch of stuff on a table, and maybe turn it into one. You can work 16-hour days to produce the Apple computer for a society that confiscates private fortunes. I realized that though all of them had done many things in their own blog posts.

Is it a problem if customers feel pinched: you may even be the majority. They were professionals working in fields like the arts or writing or technology that the larger environment matters. I am always looking. Suddenly, in a mild form, an example of loving their work might help their kids more than an ordinary employee were asked to do something.3 They send spam because it works. To someone who hasn't learned the difference, traditional philosophy seems extremely attractive: as hard and therefore impressive as math, and math doesn't get stale. It's a smart move. Because people in the world for the better. But it seemed worth spoiling the atmosphere if I could only figure out what lies you were told as a kid I had what I thought the patent was completely bogus, and would never hold up in court. This is the counterexample to the design principle I just mentioned. This kind of work in which people have to be able to say, Frederick's of Hollywood, which gave us valuable experience dealing with heavy loads on our servers. The summer founders were as a rule, the only purpose of correcting them is to discredit one's opponent.4

That is so much better than the others'. Buildings If you go to the public markets. What have other people learned about design? As a Lisp hacker. Though computationally expensive in the general case, if n is the fraction of the probability that the mail is spam. What scares me is that there are more of those to be had each year, the best response is neither to bluff nor give up, but instead to explain how you'd figure out the right thing to do, and there is thus a property of objects as much as painters need to understand these especially productive people. The most ambitious students will at this point attempted certain gambits which I will not describe in detail, except to remind readers that the word Republic occurs in Nigerian scam emails and this spam. You may be thinking, why deal with investors at all?

And he said that little desktop computers would never be suitable for everyone. And since individual performance is so hard to make their own. That's an interesting idea.5 That depends on how well they do are not orthogonal.6 And that is more likely to happen in the Bay Area it's the Band of Angels.7 You could feel like you're flying straight and level while in fact most of the Lisp programming done today is done in Emacs Lisp or AutoLisp. And the things I find hardest to get into grad school or just be good at programming is to find something you can't turn off. By the time you get throngs of geeks. I'm British by birth. Empathy is probably the difficulty of assigning a value to each person's work. Because they can't predict the winners in advance?

You'll also have a provisional roadmap of how to be employees is to hand off the task to companies via internship programs. The ideas that come to them for funding. We're up against a truly formidable headwind—one that has been operating for thousands of years is dangerous. Investors like it when voters or other countries refuse to bend to their will, but ultimately each user should have his own per-word probabilities based on each individual user's mail. Electricity seemed an airy intangible. But Lisp macros are unique. Merchants bid a percentage of their profits? On my list I put words like Lisp and also my zipcode, so that a month was a huge interval. Top of My Todo List April 2012 A palliative care nurse called Bronnie Ware made a list of objects of different types. Actually it's better to start in America because funding is easier to read. I think the difference between them will be a tendency, as a high school kid writing programs in Basic.

What used to be something that is available if you ask a great hacker doing that; and two, even if you only have a few trusted friends you can speak openly to. Recently I've spent some time trying to push your price down. The 2005 summer founders ranged in age from 18 to 28 average 23, and that employers are just proxies for users in which risk is pooled. It sounds crazy, but there's a continuum here. There's still debate about whether this was a proper use of the term recitation for sections in some colleges is a fossil of this. When you're abusing the legal system by trying to encourage startups locally, but government policy can't call them into being the way a jealous husband feels about his wife's previous boyfriends. I've been telling founders that the company was really successful. After a few seconds it struck me how familiar they seemed.8 What's really uncool is to be undisciplined. What are people doing now, everyone will be doing with computers in ten years, thinking that you'll quit and write novels when you have one this has real implications for software design.

Even if you were going back to the problems they solved, look for problems, preferably problems you have yourself. You should respond in kind when investors behave upstandingly too. I've noticed for a long time cities were the only D table in our cafeteria map. How many would have understood that this particular 19 year old Bill Gates. Startups prosper in some places.9 Hacking What should you do in a lot of great things were clumped together in a place that's different from other animals as the anteater. He walks right by them, dressed up as an old man on crutches, and they tend to think of some that aren't the result of some external stimulus hitting a prepared mind. Over time, beautiful things tend to thrive, and ugly things tend to thrive, even though it may take multiword filtering to catch that. Civil War was about slavery; people would be intolerable. Y Combinator is that founders are willing to compromise.

Notes

That's very cheap, 1/50th of a more general rule: focus on users, you've started it, there are certain qualities that some of those most vocal on the expected value calculation for potential founders, because you need but a blockhead ever wrote except for that they don't want to. There is a matter of outliers, and their hands thus tended to make a fortune in the world barely affects me. I.

On Bullshit, Princeton University Press, 1996. Robert Morris wrote the first version was mostly Lisp, you don't need.

But it takes a few of the problem, but those don't involve a lot better to embrace the fact that established companies can't compete on price, and this is: we currently filter at the mercy of investors started offering investment automatically to every startup we funded, summer 2010. And even then your restrictions would have gone into the intellectual sounding theory behind it. E-Mail. But so many different schools of thought about how to deal with slaps, but they seem like I overstated the case of Bayes' Rule.

A round. But one of his first acts as president, he saw that they think the top schools are the only function of prep schools, because Julian got 10% of the problem and yet in both Greece and China, many of the fatal pinch where your existing investors help you in?

No VC will admit they're influenced by buzz. Unless of course, or black beans n cubes Knorr beef or vegetable bouillon n teaspoons freshly ground black pepper 3n teaspoons ground cumin n cups dry rice, preferably brown Robert Morris says that clothing brands favored by urban youth do not generally hire themselves out to do this all the money.

Only founders of Hewlett Packard said it first, and that modern corporate executives would work better, for example. And while they tried to lowball them. How can people who lost were us. If you're dealing with the other hand, he tried to preserve their wealth by forbidding the export of gold or silver.

On the other people who should quit their day job writing software goes up more than 20 years, maybe they'll listen to them rather than trying to upgrade an existing investor, and there didn't seem to them till they also influence one another both directly and indirectly. He did eventually graduate at about 26. They each constrain the other meanings are fairly closely related. Except text editors and compilers.

At the time and Bob nominally had a house built a couple hundred years ago. S P 500 CEOs in the former, because talks are made of spolia. What will go away, and all the time it still seems to have moments of adversity before they ultimately succeed.

Stone, op. Actually he's no better or worse than he was before, but that it's a departure from the Dutch not to quit their day job. So if you're a big effect on college admissions there would be to write your dissertation in the fall of 2008 but no doubt often are, but more often than not what it would have been about 2,000. She was always good at acting that way.

#automatically generated text #Markov chains #Paul Graham #Python #Patrick Mooney #implications #words #cups

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electtcele · 3 years

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Lagos State, School of Nursing, Lagos University Teaching Hospital, Idi-Araba 2021/2022 nursing form is out call 08136564092 Also midwifery form, post-basic nursing form and internship form is still on sale, for more information on purchase of the form and admission assistance call School Admin on 09055447087 ..the nursing program is a learning process to education students for future purposes Call School Admin on 09014174726 Call Now Before The Closing Date.

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khalilhumam · 4 years

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Balancing lower U.S. prescription drug prices and innovation – Part 2

New Post has been published on http://khalilhumam.com/balancing-lower-u-s-prescription-drug-prices-and-innovation-part-2/

Balancing lower U.S. prescription drug prices and innovation – Part 2

By Steven M. Lieberman, Paul Ginsburg, Kavita Patel In Part 1 of this post, we provided background on U.S. drug prices and summarized an expert roundtable discussion held in June 2020 about the relationship between drug prices and innovation. The roundtable was convened by the USC-Brookings Schaeffer Initiative for Health Policy, with support from the Commonwealth Fund, and included current and former pharmaceutical and biotech executives, physician/scientist entrepreneurs, private equity and venture capitalists, and economists. Because the session was off the record to encourage people to speak freely, we convey the meeting’s general content without attributing specific comments or identifying the participants. Here, in part 2, we summarize the second half of the experts’ discussion, highlighting areas of general consensus among the roundtable participants.

What Is The Right Amount Of Innovation For Society?

While roundtable participants generally agreed that current U.S. drug pricing practices tend to encourage incremental rather than transformational innovation, a larger question surfaced during the discussion about what amount of innovation is actually best for society. The discussion centered on whether additional spending on priorities other than drugs would benefit society more or be preferred by the public:

“It seems to me [that] with widening income inequality, with a huge recession with lots of people without access to health care in the first place—like basic things that we know improve their lives—do they really want to be paying taxes/high prices to get innovation for things that that they can’t afford to begin with, and that if the government affords for them, it means they don’t have schools or vacations or roads or nursing homes?”

Although the view expressed by this participant was not widely shared, the question prompted a spirited discussion and helped crystallize a consensus regarding the importance of continuing to reward transformative innovation with high ROI, especially in the context of significant declines in average prices:

“If you come in with a me-too or me-three or me-four product, it [should] have a lower price than something really fantastic,” a participant said. “I think that if we could as a society credibly agree to pay for things that were really fantastic—like if tomorrow I had a cure for COVID, I should be able to charge a lot, and I, as a taxpayer, will be very happy with that compared to what we’ve got now, which is paying high prices for a lot of things that don’t do that much.”

There was also general agreement that the current U.S. market-based system does a poor job overall in fostering important innovation, and that high drug prices raise questions not only about affordability but also equity. The tension between equity and high prices means that “innovation will have to come side by side with some form of affordability.”

Lowering Drug Development Costs Could Maintain ROI with Lower Prices

Although specific reforms were not discussed, there was a consensus among participants about the importance of identifying ways to lower drug R&D costs without compromising safety and efficacy. Some discussed the potential to lower costs by modernizing some FDA requirements. For example, participants raised the prospect of relaxing requirements for large, randomized clinical trials and instead relying on registries or permitting post-market trials to focus on narrow subsets of patients rather than studying the entire population.

Lowering Drug Prices But Increasing Drug Companies’ Share Of Revenue Could Maintain ROI

Participants highlighted that a significant share of the revenue associated with purchasing drugs does not flow to manufacturers, leaving a large gap between gross revenues—the total paid when purchasing drugs—and net revenues retained by manufacturers. As one participant said, “We haven’t talked a lot about where the reimbursement dollar goes…. It doesn’t all go back to PhRMA—there’s a big middleman process in the U.S. that takes a big segment of this with rebates.” An estimate of the potential savings from reducing the dollars diverted to middlemen wasn’t available during the discussion. Importantly, the effects of reforms intended to reduce marketing costs would differ from those related to eliminating—or reducing—rebates. Lower marketing costs could directly benefit manufacturers by decreasing their spending. One participant advanced a stark assessment: spending on marketing and middlemen reflect attributes of the current market-based system and its reliance on competition, suggesting that eliminating these costs could occur only by switching to a system that relied explicitly on price setting by government or quasi-governmental entities.

“If you wanted to spend less on drugs, but you wanted the same amount of money to go to manufacturers, then one way to do that would be to have nationally negotiated prices….You would not require as much marketing and, in particular, you could almost get rid of the whole PBM function because you wouldn’t need tiers and rebates, and all that stuff because there would be one price. So, you could subtract out quite a bit of the dollar spend and leave more of it to go into innovation…. And we’re going to get price competition from another place, which is government negotiation.”

However, it’s unclear how significantly marketing expenses would be reduced in a system with regulated prices because manufacturers would still have incentives to invest in marketing to expand or maintain the quantity of their product sold. While selling more of a drug would benefit any manufacturer, the expected return on marketing expenses might be greater for drugs with therapeutic alternatives—in effect, spending intended to shift market share from competitors. As discussed in the first post of this series, it’s also unclear how eliminating or using a portion of rebates to lower patients’ out-of-pocket costs would affect overall drug spending. However, eliminating or redirecting rebates would cut off a revenue source that insurers now use to offset other costs and keep premiums lower. Given the expectation that the current political climate would result in reductions in drug prices, participants expressed interest in the possibility of regulated prices, with some speculating that even industry stakeholders might warm to the idea of administered pricing. These participants tied that potential interest to whether a shift to regulated prices would significantly increase the share of revenue flowing to brand manufacturers. The calculus might turn on an assessment of how manufacturer revenue net of rebates and marketing costs would compare under the current system (given expected pressures to reform drug prices) and under administered pricing (but receiving a larger share of lower prices).

Drug Pricing In The U.S. And Other Developed Countries

In the U.S., drugmakers “price what the market will bear,” as a participant observed, which results in U.S. drug prices substantially exceeding those in other developed countries. Rather than relying on market forces, government or quasi-governmental entities in other countries play a significant role in drug pricing by negotiating prices with manufacturers. An important factor in determining negotiated prices typically involves the effectiveness of new drugs relative to existing treatments, which increases the potential ROI for breakthrough drugs relative to drugs offering only incremental improvement. Countries like the United Kingdom and France use cost-effectiveness analysis to directly tie pricing to increased effectiveness of new drugs, relying on assessments by public institutions like the National Institute for Health and Care Excellence, known as NICE, in England. Another key point raised by a number of participants was that creating a more predictable, stable market and reducing uncertainty for drug companies would permit lower prices while maintaining acceptable ROI, as one participant observed:

“The U.S. is a wild card. A lot of the other countries, they’ve got multi-year contracts. They’ve got tenders that are renewed on a certain basis, and [manufacturers] know that they’re going to allocate a certain amount of drug to that country and therefore they can count on it in terms of revenue.”

Another participant added: “It may be less than they make proportionally in the U.S., but it is something that fits into a business model.” Having more certainty for longer periods of time about sales volume was considered an important factor in meeting expectations about adequate ROI. Japan was cited by several participants as a market where prices are controlled without dramatically harming innovation. Typically, new drugs in Japan achieve much faster market entry and higher penetration than in the U.S. Although drugmakers initially charge relatively high prices, the government reduces prices in a systematic and usually predictable way:

“When you talk to them, they say it’s really simple—you control costs by controlling price, not a problem, and the government does that.”

To Lower U.S. Drug Prices, Don’t Export U.S. Problems To Other Countries

Noting that the United States could learn from and potentially adapt practices from other countries, several participants stressed the importance of not exporting U.S. drug pricing problems to other countries. Both the “most favored nation” interim final rule issued by the Trump Administration on November 20, 2020 and H.R. 3 passed by the House in the 116th Congress would rely on other countries’ ability to negotiate lower drug prices rather than on the U.S. establishing its own process to evaluate and regulate drug prices. Following up on the President’s earlier executive order and applicable only to Part B drugs, the newly-published most favored nation rule would limit the permissible price for Medicare Part B drugs to the lowest price for which a drug is sold in another country. H.R. 3, which applies to broadly and not just to Medicare, would require the federal government to set prices for selected drugs (those with high prices or lacking competition) between the lowest price in six high-income countries and 120 percent of the average price across those countries. Relying on prices used by other countries would be a stopgap policy that is unlikely to be as effective over time as having the United States address high drug prices directly. As one participant said:

“I feel somewhat strongly about us not outsourcing our problems in our inability to control costs onto other countries . . . So, saying, oh, we’re just going to pay what Canada pays, you know what that’s going to do, it’s going to raise the price in Canada.”

Others, however, stressed that the U.S. shouldn’t pick up the tab for global innovation:

“There is such a big disparity in terms of how much drugs get priced in the U.S., relative to the rest of the world. And, again maybe I’m a little idealistic, but I think we all should be paying for new innovative therapies—everyone on the globe—maybe not at the same level, but not at the disproportionate level today between us and the rest of the world.”

Nonetheless, concern was widely expressed that attempts to link U.S. prices to lower prices in other nations would likely create unintended consequences and disrupt other countries established processes for pricing new drugs by evaluating their effectiveness.

Need to Develop Better Measures Of Value

While participants acknowledged the need to have some way to quantitatively measure the value of new therapies, they raised concerns with the current capabilities of cost-effectiveness analysis. “Almost everybody on this call has agreed that what we ought to do is not pay for really marginal products,” a participant observed. “At the same time, we say we don’t like cost-effectiveness analysis, and I don’t see how you decide what a marginal product is unless you have something like cost-effectiveness analysis to guide you.” Starting with the concern noted previously about exporting high U.S. drug prices to other countries, several participants urged that the U.S consider establishing its own process to set appropriate prices based on assessing the value of new drugs, rather than adopting the prices other countries negotiated with manufacturers. Many other industrialized countries rely on formal health technology appraisals, typically based on cost-effectiveness analysis, to assess the value of new therapies. A U.S. non-profit, the Institute for Clinical and Economic Review (ICER), conducts some of these analyses but lacks formal authority or governmental support. These countries generally link prices and reimbursement for new drugs to reference pricing for existing, therapeutically similar drugs, often relying on standards such as quality-adjusted life-years (QALYs) or incremental cost-effectiveness ratios (ICERs). A QALY measures disease burden in terms of both quantity and quality of life, while an ICER is the ratio between the difference in cost and difference in benefit of two or more medical interventions. QALYs often are used to quantify the benefit of an intervention when calculating an ICER, which then typically is expressed as the incremental cost per QALY.

“I wish there was something better than the QALY, because honestly, I went to [business school], and I still have a hard time calculating QALYs and trying to explain it to people,” a participant said. “So, I’m all for cost effectiveness and paying for that. I just wish there was maybe a better rubric than QALYs.”

Acknowledging that QALYs certainly are imperfect measures, another participant said, “If you’re trying to price drugs or understand cost-benefit analysis, there’s no good way to do it yet….Somebody’s got to fill in that gap of what is life worth and how do drugs impact that and what’s the economic benefit to people who are going to pay—big, big question unsolved.”

Alternatives To Sustaining The Unsustainable

Despite concerns that deep price cuts would harm innovation, participants also acknowledged the imperative to slow U.S. spending growth, not just for drugs but for health care overall, as the nation spent almost 18 percent of gross domestic product on health care in 2018. Spending on retail prescription drugs (at 11 percent of personal health care spending in 2018) is still a relatively small slice of overall U.S. health care spending, and multiple participants argued that squeezing drug prices in isolation will do little to solve the overall cost and quality problems in U.S. health care. “Nobody tells you about the lousy [U.S. health care] delivery. We’re down around the Dominican Republic in terms of outcomes…. It’s really disastrous in terms of cost,” a participant said. Participants would not be surprised if the United States were to follow the lead of other countries by adopting price regulation tied to cost effectiveness of new drugs, with one participant saying, “I agree that some kind of fixed pricing is ultimately the way we’re probably going to have to end up.” Given this expectation, during the roundtable, multiple ideas surfaced about how policymakers might balance the tension between lowering drug prices and encouraging investment in important innovation, including:

Exploring how to lower the costs of drug development and approval.

Understanding more fully how lower drug prices could increase access and potentially increase sales volume.

Taking actions to lessen the impact of lower prices on drugmakers’ revenues, paying particular attention to differentiating between average reductions and the prices for important therapeutic advances.

Ending unintended extensions of market exclusivity gained by drugmakers manipulating patent protections.

Reducing uncertainty about drug sales volume—for example, over a multi-year period—in exchange for lower prices.

Structuring rules to facilitate reduced spending on marketing and on intermediation (PBMs) in an environment that relies on regulated prices.

Establishing formal cost-effectiveness measures that encourage transformative rather than incremental innovation.

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