domain:npr.org?q=domain:npr.org?page=0
George_E_Hale
insufferable blowhard
9m 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
16m 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
17m ago
Invest. Make your money work for you. Start by putting your money in a high-yield savings account.
MollieTheMare
19m 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
42m 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
46m 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
49m 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
50m 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
1hr 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
1hr 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
1hr 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
1hr ago
Precisely. That's a tomorrow problem when you're in that state.
Lizzardspawn
1hr 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
1hr 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
1hr 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
1hr 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
1hr ago
Youtube comments sections have gotten signifigantly further right over the last 3 years. That's basically social media.
hydroacetylene
1hr ago
Umm, are dual culture kids consistently WEIRD?
hydroacetylene
1hr 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.
Jiro
1hr ago
New media isn't conventionally left or right, but the most popular versions tend to lean republican.
They do? Social media, except X, is all on the left too.
Certainly themotte didn't leave Reddit because Reddit was censoring Democrats.
EdenicFaithful
Dark Wizard of Ravenclaw
1hr ago
So, what are you reading?
Still on Future Shock, 12 Commandments, Crystallizing Public Opinion and Galactic Patrol.
Terracotta
1hr ago
However the bad outcomes are mostly increased lifetime mortality and risk of side effects 20 years down the line when the patient is seeing someone else. This becomes effectively impossible to study so we don't... Psychiatry is a better example - psychiatric interviews and pharmacology are the most complicated in medicine. Mental health care NPs are terrible at both of these things, give people unnecessary medications and incorrect diagnoses and are legible experienced as lower quality by patients and staff with some regularity.
I should emphasize that I have a lot of respect for psychiatrists, who seem to hurl themselves into the breach of various social ills in a way I certainly wouldn't want to do. But if we're searching for a test field where rigorous evidence makes it very legible which are the "necessary medications" and "correct diagnoses," so that MDs' highly effective healing practice contrasts clearly with NPs' useless flailing, then I'm not sure psychiatry is the obvious pick. We're talking about the same psychiatry that regularly diagnoses from subjective surveys and patient self-reports, correct? Where almost none of the biological mechanisms are thoroughly understood, either for the ailments being treated or the medications that treat them? Where exercise, healthy diet and getting plenty of sun/fresh air seem to work as well as the best drugs a lot of the time? Where official medical conditions pop in and out of the DSM with every passing political wind?
Would you say that psychiatry does a good job of monitoring its physicians' contribution to patients' lifetime mortality and/or risk of third-order side effects 20 years out, either across different levels of physician talent/conscientiousness, or versus not receiving psychiatric care at all?
Also, since this is why people normally bring it up - if you magically paid all doctors NPs salaries and didn't really change anything else......healthcare costs wouldn't go down at all in any substantive way.
I don't quite get the reasoning here. Is the idea that receiving NP salaries would cause physicians to practice as badly as you believe NPs practice, because all the competent MDs would decamp for higher-paid professions (notwithstanding the additional benefits of prestige, flexibility, autonomy and meaning in medicine)? Doctors in Canada, the UK and Germany earn about 1/3 to 1/2 what they earn in the US; is the contention that they must practice incompetently and waste a ton of money doing so?
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.
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