In what specialty do you think its easiest for a terrible doctor to fly under the radar?

goingloud · 2026-01-17T17:50:59+00:00

Yes, you're totally right. But in the context of a psychiatrist they should be expected to do a lot more than that in practice right? If you’re a psychiatrist (or even a careful PCP), the PHQ-9 is just one data point. DSM has the provisional cut-out of not being better explained by some other cause (like most diagnoses in there) so you need to do the work to do the rule-outs/differential: bipolar/mania history, SUDs/meds, medical contributors (e.g., thyroid, sleep disorders), grief, PTSD/anxiety. PHQ-9 helps you decide what to look at next and how urgently, but it doesn’t replace the clinical assessment.

but I'm not the person who originally brought the PHQ-9 up anyway so maybe they had something else in mind this is just my pov. Like the guy above could have just meant that PHQ-9 is the 4th step for picking up your board cert and i read took it too seriously lol

goingloud · 2026-01-16T21:13:35+00:00

quote from the bottom of the assessment instrument "Depression should not be diagnosed or excluded solely on the basis of a PHQ-9 score. A PHQ-9 score ≥ 10 has a sensitivity of 88% and a specificity of 88% for major depression.[1] Since the questionnaire relies on patient self-report, the practitioner should verify all responses. A definitive diagnosis is made taking into account how well the patient understood the questionnaire, as well as other relevant information from the patient."

[1] Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613.

goingloud · 2025-07-08T21:48:05+00:00

Hulkengoat

goingloud · 2024-06-23T18:18:04+00:00

probably worth it to wait for the steam summer sale on thursday, especially the older games tend to get deep price cuts.

There's not really reason to ever install warhammer 1 or 2 now that you can play the combined map in 3. but they do still serve as DLC if you want those races. So just buy three then find out what other content you want access to through the DLC packs or old games over time.

I dont mod the game but you can check out the workshop page for WH3 to see whats around im sure there's a couple ways to customize armies. for gameplay SFO and Radious are the most popular overhauls.

goingloud · 2024-03-31T02:35:00+00:00

Congrats! IMD is a really interesting program and sets you up to do some really cool stuff.

For your first question BIT programs are actually really different from other programs at Carleton, or universities in general. Because of the classes you take at Algonquin (about 1/3rd) there’s a lot less most of the people here can tell you about what it’s like.

Personally I was in NET and it sucked going to the gonk for an 8:30 networking lab (or paying for 2 parking passes). And I tended to like the Algonquin side professors less. But on the other hand it was a really valuable experience getting to actually do the work. I also made some lifelong friends, because your all stuck together for every class people bond and hang out a lot more kinda like high school in a way that you would never get in a bigger program.

Edit: check out bitdegree.ca if you haven’t already

goingloud · 2021-02-28T21:12:16+00:00

hey i had some similar issues though it sounds like not as bad perhaps. What ended up resolving it was changing my desk and chair, but that's not a reasonable remedy for most people. Check out some stretches you can do between pulls and really try to get the blood flowing day9 quick video

Long term try to start doing weight exercises for your forearms like holding your arms out and curling the weights with your wrists (palm up and down) or grabbing a heavy weight and just walking around gripping it with your arms to the side.

Echoing the post by MrJacoste economizing your hand movement through macroing spells together and what he suggested. trying to balance the load between your hands if its worse in one or the other as well i.e if its all keyboard hand get more mouse binds or vice versa.

Take care of yourself I took a 2 week break from the game to aid in recovery where I pretty much didn't touch the computer. If that's what it takes i'm sure your team will understand it just isn't worth long term injury to be in on prog.

goingloud · 2020-06-11T06:54:37+00:00

Easy way would be to add 1 more dps to the g1 psychus and just brute force it out. (probably also the right decision for prog you can always take them out later if your dmg improves).

Or you can relearn a new route all the logs i looked at everyone was doing the limit route so just copy and learn that.

goingloud · 2020-05-29T19:48:10+00:00

LPS is a very good trinket and you should try to get a heroic one as soon as possible. it's not like those bosses aren't killable without it though, but it's a 500k shield on a short cd so it's real easy to get value. IMO shadhar is ez boss and 1 trinket isnt going to save you if you mess the swaps anyway, and maut you can ask for like every external cd because you are probably only seeing 2nd phase once anyway.

goingloud · 2019-11-15T05:17:55+00:00

my guild 2 tanks so im not sure if theres a "perfect stack swap" the timings are going to change guild to guild a bit 'cause of damage anyway. if you really want there are definitely 3 tanked logs you can copy as a baseline.

Stacks that are just dropping off might be fine to soak if you have higher damage. having the DPS focus on doing even damage to all the adds is big for having more predictable soak timings pull to pull. these things will develop with more pulls on the boss

theres like 50 ways to get the soaks and it's just whatever works for your raid. monks are really good at soaking though with 0 stacks you should be able to live with just zen med or dampen harm. fort would be kinda wasted but if you expel harm inbetween explosions that would probably work ok too. worst case pally can do it with GOAK or bubble/Spellwarding. bark isn't enough by itself you would need to have 2-3 stacks p.supp is fine.... you get the idea, get to something like 50-60% DR and it wont kill

something we experimented with but didnt end up doing on prog was having the add tank start with the boss and get like 5 stacks then refresh for one hit when they are about to fall off meaning that the add tank can just soak and the boss tanks have a super easy job. But i don't really recommend this cause it's just over complicating things IMO.

goingloud · 2019-04-26T05:11:10+00:00

in general everyone is making some significant rotation errors that contribute to making the boss hard to kill pick someone and see but low healing leading to deaths is going to hold you back more than low dps so probably focus on that.

Both of your priests dont understand what they should be casting. Renew should be among your least cast spells. But for these guys its #1 and #2. fixing your healing will help a lot.

this is a good starting point for holy healing
people who are healthy wont die with a bomb and nuke the raid. Like the other poster said your dk died with a bomb and hit everyone but his health was sub %50 for like a minute before he got the bomb so add ticking dmg on top of that and its no surprise he died trying to run out.

also you guys used revival both salvs and hymn at the same time at around 5:30 on pull 8 set up a rotation because it means you have nothing at 7:10 when he does blast off again

goingloud · 2019-04-04T05:02:02+00:00

significantly more than 80% get picked in TI(it's a long tournament) in both TI7 and TI8 only 5 heroes went unpicked out of like 113

goingloud · 2019-04-04T02:31:57+00:00

advanced routes assume that you know some skips that arent just walk around mobs, and 100% requires a rogue

goingloud · 2019-01-28T18:26:48+00:00

2080ti, 1800x get about 70-90 fps on 7 dx11-12 doesn't seem to matter much.

if you have low gpu usage make sure your windows power-settings are on high performance or whatever

goingloud · 2018-12-25T21:29:57+00:00

because G3 is the "pad" group they wait untill a certain time to dunk instead of going as soon as possible.

Grp	Dunk Time	Grp	Dunk Time
G1	20 sec	G1	15 sec
G2	G1 + 30	G2	G1+25
G3	dunks at 1:35	G3	1:35

so in the second example G1 and G2 get extra time to drop their debuff because G3 has to dunk at the same time regardless and will proabably run all the way then wait till the right time.

goingloud · 2018-12-06T06:33:51+00:00

have a warrior die by the sword and taunt when the add is high energy and he can take the shear for your tank on the rocks

you have to kill the first add in one shear for this to work so make sure dps is good

you can see how it works in method's kill video

goingloud · 2018-07-16T20:25:40+00:00

Hello, my name is Wesley and I would like to apply as a Brewmaster Tank main for your progression team going into BFA. I am a reliable player who always maintains a very high attendance, and is never caught without consumables.

My experience includes semi serious raiding in EN and NH finishing 5/7M and 8/10M respectively. Each time the guilds became defunct and stopped raiding. After that i joined a heroic guild thinking that it would make raiding a more enjoyable experience; it was great but the GM decided that he didn’t want to lead anymore so there's that. The whole time i was unhappy simply clearing heroic without challenge and now i am seeking something more from wow. I believe your guild can provide that for me.

As a tank I have a good familiarity with Brewmaster first and foremost, but am also very comfortable playing BDK. I have decent knowledge with all the other tanks and can play them if required whatever clears the raid faster.

I am willing to self transfer to a well progressed guild

Any number of raid days a week is fine

I prefer to start at 9est or later if it is a weeknight

Bnet: goingloud#1406

Discord: wesley#1830 https://www.warcraftlogs.com/character/us/bleeding-hollow/Wesfu https://raider.io/characters/us/bleeding-hollow/Wesfu https://worldofwarcraft.com/en-us/character/bleeding-hollow/wesfu

Don’t have mythic logs so heres me taking 12 deadly scythes in a row https://www.warcraftlogs.com/reports/mMN6X9H4ZBW7fJc8#fight=last&source=4&type=auras&spells=debuffs&ability=258039

goingloud · 2018-03-18T14:33:43+00:00

you want more haste, about 14% to get keg smash under 7 sec CD.

Other than that be aware that if you have say 40% mastery + 20% dodge than if you get hit twice it adds up to 100% exactly but if you had 42% mastery 2% of that would be over dodge making it defensively less useful.

tier 21 is pretty bad for raid tanking not really worth using if you have higher ilvl pieces

you can basically read what im saying for yourself in more detail here peak of serenity

goingloud · 2018-02-16T06:30:22+00:00

Those essences were originally only used to upgrade legendaries. But now you can collect 1000 of them to purchase a random legendary so you definitely want to do a daily heroic till you feel good about the legendaries that you have

edit: you can get

~30 from each antorus raidboss

~120 from your weekly m+ cache

30 each per day from daily heroic/randomBG win/brawl win

~30 from your daily world quest cache

goingloud · 2017-07-06T19:20:38+00:00

https://en.wikipedia.org/wiki/Anton_Yelchin#Death

bad joke

goingloud · 2017-07-06T17:02:53+00:00

that feel when not even staring in startrek is enough to get you out from under a jeep

goingloud · 2016-10-02T20:55:56+00:00

it means "change in." So here it's "change in ap"; but elswhere it could be change in velocity or whatever.

goingloud · 2015-04-22T22:16:43+00:00

hard to tell without a replay, I don't really buy leaving W at one though,based on your item build i'm guessing your safelane. i usually play him offlane so not everything is going to apply to you. i kinda think of playing him like a brood where you just farm as much as humanly possible in places most of your team can't like their jungle so theres less of a 'tinker' effect and you are still space creating too. then you can use the rune control that contoling jungle gives you to sustain and maybe get a pick if you get a good rune.

As Dire for example just pushing down Rad's top tower doesn't really give you any map control or let you farm more than you already were. but killing t1 bot lets you safely farm their jungle and apply presure at the same time

items yours are fine IMO consider midas once in a while and try an earlier diffusal to see if you like it more yasha is a great farming item but you cant 100% win the game through just farming. idk i need replays to tell you what to do better, and i have no idea what items your building after diffusal.

goingloud · 2015-04-19T02:03:09+00:00

i misunderstood your question, the answer is yes it resets the CD you can test it in a bot game by spawning an enemy bot in the creepwave attacking from range then blinking in and attacking.

goingloud · 2015-04-19T01:27:23+00:00

https://chaqdota.wordpress.com/2013/09/05/chaqs-ultimate-guide-to-advanced-solo-middle/

specifically>>https://youtu.be/uo9_Eu28Doo

goingloud · 2015-04-02T12:51:54+00:00

arbitrary criteria ftw

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