domain:npr.org?page=1?page=0
orthoxerox
If you can read this, you're using a custom theme
2hr ago
Xiaomi something something, 6 liters, mechanical controls (Alec Watson convinced me I didn't need a fancier one).
hooser
2hr ago
Thanks for sharing the study, it is really very good! Reading it was a Sunday well-spent.
The conclusions that the authors reach have a lot of nuance, and help explain both why so many people have negative impressions of NPs while others have positive impressions: the variability of the productivity[1] within each profession dwarfs the difference between the average NP and the average doctor.
The other useful estimate from the study: randomly pick an NP and a Doctor working for VA emergency department; 6 out of 10 times, the Doctor is more productive, 4 out of 10 times, the NP is.
I understand that VA hospitals have trouble attracting talented doctors, though I assume that they have similar problems attracting talent in other professions, NPs in particular.
If I were in charge of VA, I would make a rule that any doctor who got their license in any OECD country can work unsupervised (provisional on training on HIPPA or whatever other US-specific medical laws). Then get a whole bunch of H1 Visas for any doctor who wants to come work for VA for five years.
[1] "productivity" was operationalized as the total cost of care (negatively coded), including the cost for any avoidable hospitalization due to screwing up, which makes sense in the VA emergency department.
FormerPothead
2hr ago
I just blew through 1,000 page Exodus by Peter F Hamilton. I’m pretty mixed on PFH. I loved Commonweath but I’ve tried and fail to get into his others. I’m taking a stab at Nights Dawn but that’s besides the point
I thought Exodus was great. His best work in quite some time. The universe, pacing, major plot lines - all great. Good characters. The dude is really really imaginative.
The book is actually contract work where it’s and in-universe tie in novel with a new sci fi RPG that’s in development but some legit ex-BioWare guys. I’m very skeptical that the game won’t be woke slop since it’s being published by WOTC.
All this is to say that I hope more people read this book and it has some success. PFH is legit and doesn’t seem to have gone performatively woke even if he has been bullied into no longer including sex scenes in his stories.
George_E_Hale
insufferable blowhard
3hr ago
men grow cold as girls grow old / and we all lose our charms in the end
The trade-off of being a very beautiful woman is the extremely brief shelf-life. Female beauty, at least in terms of "hotness," is very ephemeral.
pigeonburger
3hr ago
My friends and I were speculating the other day how this could be improved within the current constraints of our public health system, we landed on a mix of telehealth and licensed practitionners (could be NPs) who specialise in making observations (and auscultations, etc...) for doctors to extend the amount of ailments that can diagnosed by a remote doctor.
My work insurance has as one of its perks free access to a telehealth service and it's shocking how convenient it is compared to going through the public health pipeline, when it is able to help. I'm sure it's convenient to the doctors who work through that system too.
Lazuli
3hr ago
Invest. Make your money work for you. Start by putting your money in a high-yield savings account.
MollieTheMare
3hr ago
Low-calorie does limit your options. Not necessarily for dipping and in no particular order:
- Malt Vinegar, possibly with some amount of "brown sauce." If it works for fish and chips, it probably works with just chips
- Tomato Chutney or salsa, especially with larger home fries
- Mustard, stone ground or whole grain. According to the totally unbiased National Mustard Museum, superior in every way to using ketchup. Particularly for the calorie conscious.
- Nutritional yeast. I guess a topping not a sauce, but still another option to complement fries. IMO, needs salt too. Low calorie and low sodium sounds very miserable. Kind of a funky cheesy flavor with way fewer calories than cheese sauce.
- Hot sauce. Frank's RedHot reminds me the most of using ketchup. Melinda's is available pretty broadly, and has a bunch of flavors of varying spiciness.
- Gochujang. Depending on what you're having the fries with, but surprisingly versatile as a sauce for something so strongly associated with Korian food.
- Crema. Can be lower calorie if made with yogurt or fat free sour cream, less tasty that way of course.
Personally, I don't worry too much about the calories from a table spoon of sauce. I typically go for Ketchup, BBQ, or 1:1 fry sauce (as apposed to 2:1 of Mayochup, as a concession that mayo does have appreciable calories, even at the table spoon level). If squeezed from a fine tip condiment food service bottle, you can "cover" a pretty large area with relatively little sauce.
ulyssessword
3hr ago
I think I want to build self contained mini factories.
Take a look at this: https://www.themotte.org/images/17324829035101736.webp
I'm making red/green research from ore, coal, and water. It's moderately impractical, but still cool.
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bonsaii
3hr ago
Even for something that happens every week at an average hospital, if you go from 10 residents to 40 you're going from residents who have trained on it 25 times to residents who may have only done it 6 times.
ChickenOverlord
3hr ago
The fact that the YouTube comments for Kirby's Air Ride: Item Bounce haven't been closed yet is proof that YouTube doesn't have complete control over ideology on their platform.
MadMonzer
Temporarily embarrassed liberal elite
3hr ago
The pro-life movement is funded and staffed by fundamentalists, and they wrote the legislation. By and large, the pro-life movement do support an exception for sufficiently dangerous-to-the-mother pregnancies . They don't support an exception for non-viable fetuses, which forms part of a pattern where pro-life Christians (particularly Catholics) support heroic intervention to keep non-viable babies like Charlie Gard alive for as long as possible, as well as their opposition to withdrawing treatment from effectively non-viable adults like Terri Schiavo. I think pro-life Christians are consistent in their attitude to these cases and that it reflects their religious beliefs, but I profoundly disagree with them.
I don't know why Ken Paxton chose to noisily go after a mother who wanted to abort a non-viable fetus, but he did. I hope the median general election voter applies condign punishment, but given the nature of Texas politics I doubt it. My best guess is that Paxton is positioning himself to run for governor, and the main obstacle is a Texas Republican primary in which the median voter is well to the right of Donald Trump. One weakness of the American electoral system is that in a 60-40 state like Texas it tends to elect a government that represents the median Republican, not the median voter. And given that almost 40% of Americans claim to be young-earth creationists when polled, I don't think that fundamentalists are going to be a small minority of Texas Republicans.
HB3058 doesn't cover non-viable fetuses, it clarifies two particular cases where there is a genuine threat to the life of the mother (as opposed to the fake threat to the mother's continued fertility that Cox's lawyers tried to use to work around the lack of an exception for non-viable fetuses). Unlike danger-to-mother cases where there is clearly a desire to produce workable rules that allow a reasonable margin of discretion to the doctor treating an emergency case without opening a loophole the size of a barn door, I see no movement from the pro-life right in the US on this point.
Throwaway05
3hr ago
It's called the art and science of medicine for a reason, in psych it can be pretty evident to the lay man, in other specialties it's less but still present. This means experience, heuristics, gestalts, they lead doctors astray yes, but for a lot of things we don't have good guidelines or understanding.
Importantly, doctors can be sued - this causes all kinds of problems but it does serve as a feedback mechanism that assess for problems and gives patients recourse.
Let me give a specific example of how this happens, sticking with psych because it's more interesting than me mumbling about open vs lap vs conservative appendix management.
Most people are aware of Bipolar disorder, at least superficially. Lots of people say "I have mood swings" and tell that to healthcare workers with less training, these people dutifully write down Bipolar in the chart. Or they say "you ever like have mood swings and be unable to sleep?" Gets the diagnosis. Someone who actually has Bipolar 1 with a manic episode barely sleeps for a week of more, does illegal things, or spends ALL of their money in the bank account and all kinds of other stuff. The diagnosis is serious and life limiting without treatment. The medications are also serious - most patients get antipsychotics these days which increase all cause mortality. They are worth it if you actually have the disease. Put undertrained staff give the dx to people who don't have it and then suddenly...
NPs also do things like mix benzos and stimulants, put people with depression or anxiety on antipsychotics which will result in an early death....just all kinds of ridiculous stuff.
The skill ceiling in psych (and medicine) is very high, but if you don't work in healthcare you'll (hopefully) never see it come into play. Most medical work isn't your quick annual physical with your doctor but for many patients (especially young ones) that's all you see.
As for the second point, no the issue is that physician salaries are less than 10 percent of healthcare spending, and it's been decreasing every year. Cutting doctor salaries does not solve the problem and introduces all kinds of new problems.
Likewise NPs don't save money because they do more unnecessary testing and over consult, which drains the specialists and slows down care.
urquan
3hr ago
I'm sure there have been some converts, but I don't doubt that there have been enough progressive young tech workers joining the field to more than balance them.
There are not official gradations of lawyers, but it's widely understood that there are (specialties aside) bad, okay, good and fantastic lawyers, and the public has a good idea where specific levels of quality are found. They know that is all you can get is a mall lawyer, your chances are much lower (for the same quality of case) than if you could hire a prestigious law firm. Doctors associations cling to the idea that (specialties aside) doctors are essentially fungible, and this is even more explicit in countries where a public system assigns doctors to the public. Of course, this is preposterous to the public, you don't have to be a doctor yourself to spot when one is particularly good or not. Anyone with a bit of life experience has seen lazy doctors, doctors who don't listen to them and give them an obviously bad diagnosis because of it, and on the other side doctors who spotted something from hard to read symptoms. My wife recently got assigned by our healthcare system to a shifty clinic in a bad neighborhood where the clinic also advertises "natural remedy treatments" alongside having actual licensed doctors, and to our system that's good enough: to them she needed to be assigned to a clinic, any clinic, they're all as good as one another, and if she wants to switch she gets shoved to the back of the line and likely will be without an assigned clinic for 5 years. And on the opposite side, an optometrist going above and beyond speculating about the reason for me having an uveitis led to me having an auto-immune disease diagnosed and my quality of life improved dramatically.
Throwaway05
4hr ago
For anyone wondering
Laparoscopic surgery is the other main issue on this front, but you'll have more of that available in Africa.
EdgeCityRed
4hr ago
Precisely. That's a tomorrow problem when you're in that state.
Lizzardspawn
4hr ago
New media isn't conventionally left or right, but the most popular versions tend to lean republican.
The more you tighten your grip, Tarkin, the more star systems will slip through your fingers
The total media dominance in print, tv and web news and the monoculture turned everyone even mildly dissenting to alternative pastures. And there was demand for right wing content and the market delivered.
George_E_Hale
insufferable blowhard
4hr ago
A Da Vinci is a robotic surgical setup meant to be less invasive. I had thought they were relatively new but that Wiki link says they were introduced in 2000.
Loquat
4hr ago
My immediate neighborhood had very few signs, but there were absolutely places within a 15-20 minute drive where loads of houses had signs for one or the other. Roughly speaking, the places with quaint, walkable mini-downtown shopping area had mostly Harris signs, the people who seemed like they frequently used their pickup trucks to actually haul stuff had mostly Trump signs, and nice suburban houses with big lawns could go either way. (Location: Pennsylvania)
hydroacetylene
4hr ago
Know what you want to do, and figure out an actionable plan to get there.
Now is the beginning of the rest of your life whether you want it to be or not. Make use of it.
Quantumfreakonomics
4hr ago
Youtube comments sections have gotten signifigantly further right over the last 3 years. That's basically social media.
hydroacetylene
4hr ago
Umm, are dual culture kids consistently WEIRD?
hydroacetylene
4hr ago
I'm not middle aged or a woman and I think carrying on a purely sexual relationship with a high schooler while a man in his thirties is pretty cringe.
One house on my street had a single sign that just said "Kamela". Every single one of the others had multiple signs, banners, and flags. One at the intersection had a big banner of trump snarling with some slogan about the face of stupidity, racism, and fascism. Most others also got updated What This House Believes signs with the new firmware.
They all popped up within a week of the Kamelanomicon being opened.
Suspect I'm on a list for not having one. With the neighborhood going 80D-15R it's pretty easy to spot the dissidents.
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