Body-bag ice cooling has actually been pretty common practice across emergency medicine for some time. Legit body bags (clean ones obviously) are purpose built to be watertight and hold an adult human, and they’re easily accessible to hospitals. It’s a very effective and affordable method for controlling hyperthermia
It’s so funny because it is criminal activity for regular non-corporation people. Transferring assets to family/hiding assets for the purposes of declaring bankruptcy but not losing the assets is illegal. Functionally identical to what is going on here, except they’re somehow transferring the liability instead of the assets.
Can’t tell if we’re agreeing or disagreeing. Companies should totally be able to hire on short-term contracts. But it should be clear that it is a temporary contract from the start, not a bait-and-switch from long-term employment to hire-and-fire.
I mean if the only way they’re gonna have jobs is through predatory hiring practices that could leave them fired and without severance, then yeah. Because if the company is planning on hiring these younger workers for the long-haul, then this shouldn’t be a significant change. I think overall national policy should discourage unnecessary high-turnover and predatory hiring. I’m sure there will be situations this is still unavoidable, but that doesn’t mean we have to endorse it by way of law/policy.
I’m going to digress from the economics a tad and focus on the ethics of this. I feel like companies should be on the hook for this. You should invest in capital (including human labor) based on your confidence in its expected return. Companies should not be able to hire a myriad of workers for funzies and not have to meaningfully consider if that person will be necessary in 6 months. If it is a legitimate business venture, then the cost of potential severance for new hires should be folded into the economics of the decision to pursue that venture. Larger severance pay/worker protections encourage employers to not utilize exploitative hiring practices.
It depends on the half life of the element in question. The most comparable concrete thing we can compare this to with real numbers because we know it works is an RTG. RTGs are solid-state generators, but people could colloquially refer to them as “batteries” and not be terribly wrong. They take a quantity of a radioactive material and allow it to decay, using the heat given off to establish a thermal gradient which is then converted to electricity via thermocouples. Most of these are “fueled” with Pu-238 (at least the ones for spacecraft), which has a half life of 87.7 years. That means in 87.7 years, if you started with 4kg of Pu when you built it, you’d have only 2kg of Plutonium left. If the Pu decayed only into stable isotopes (it doesn’t) then your radioactive emissions/decay would also be exactly halved at this time. If the electrical system is perfectly efficient this would also halve the electrical power produced.
I provide this all as background because to answer your question you have to know three key factors about the device to determine the lifetime of the battery. The half-life of the isotope used, the minimum electrical requirements of the device you’re powering, and the amount of radioactive material in the initial battery. The battery’s lifetime is determined by when decay will decrease the ongoing energy output below the minimum current and voltage requirements needed by the battery. The longer the half life of the isotope, the slower this decrease is and the less initial overpowering that is required.
Ex. If you use an isotope with a 12.5 year half life for a “50-year” battery, you would need to start with 8 times the material needed for your minimum power output requirements. If you use an isotope with a 200 year half life, you only need 19% more starting mass than you minimum requirement. The first battery will produce 8x the power at the very beginning, while the second will only produce 18% more.
I know, which is why my example was about providing the patient’s name over the radio.
EMS communication over unencrypted channels is limited by HIPAA, patient information must be kept vague to protect patient privacy. In the event that, say, an individuals name needs to be given to the receiving facility to facilitate review of records prior to arrival by the ER physician, some other method of communication has to be used.
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A lot of the really prestigious medical schools/residency programs have a reputation for a toxic culture, and this means by and large they attract a larger share of toxic applicants. Their programs are really focused not on training great bedside clinicians, but on training people who will attempt to change fields through research and public policy. Unfortunately, the toxic nature of these programs, and their immense emphasis on publishable output and reputation, likely attract a larger fraction of narcissists with the skills necessary to mask their inappropriate behaviors when needed in comparison to other programs. That is not to say that all Harvard trained physicians are horrible people, I’m sure the vast majority of them are fantastic, but I would be money that Harvard attracts a greater fraction of the kookes than your average midtier medical school.
I’d love to know what she was taking. As far as I’m aware there have been no approved medications that have demonstrated reliable anti-disease activity in Alzheimer’s. We do have some medication that can help mask symptoms for a while, but the handful of drugs that have been approved reportedly targeting the actual disease sit on really shaky scientific evidence and likely don’t actually work.
As I said previously, the process needed to get insurance under these programs can be too complicated for individuals with low literacy or for whom English is a second language, limiting their access to these resources. And believe it or not, there are individuals for whom $15 a month is still not affordable for something they may or may not use that month, like medical insurance.
I’m aware that those costs do not magically disappear and are absorbed into other billing/passed on to society. However that is not why healthcare is so ludicrously expensive in the United States. It is the substantial and unnecessary administrative costs, predominantly driven by for-profit insurance companies, for-profit hospital systems, and pharmacy benefits managers. The continued exploitation of the ill for shareholder benefit is a uniquely American take on health care, and coupled with our incredibly individualistic tendencies bring about a huge fraction of the poor health outcomes we have in comparison to other developed nations, despite spending generally more than double per person.
Some of this is certainly driven by system inefficiencies such as forcing people into a situation where they have to use the ER for primary care. Or where they cannot afford their blood pressure or cholesterol medicine, and instead of our society helping provide these very affordable interventions, we pass the buck. So when those individuals inevitably have a heart attack, we then pay many times more for care that they may not have needed had they simply gotten good preventative care.
I will happily stand up and bash the current US healthcare system. I despise its insistence that human lives and suffering are secondary to wealth-extraction. But as much as I hate it I can’t change it, and while I will advocate for policy to change things, for now all I can do is continue to provide care to the patients presenting as a symptom of an ill society.
I hope others can see that these patients presenting to the ER are simply doing the best they can to take care of themselves and their families, and that the real blame and consternation should be placed on the government, hospital, insurance, and pharmaceutical officials and lobbyists who continue to exploit their illness for profits.
Let’s see if I can add something to this conversation. I’m a fourth year medical student in the United States, who in a few short months will hopefully begin training to be an emergency medicine physician. You are absolutely correct, that the government subsidizes health insurance, and that in a decent number of cases, individuals without insurance or the means to pay for healthcare are eligible for Medicaid. You are also correct that the ideal use of the emergency room is to evaluate for medical emergencies, I say this as someone soon to be an emergency room doctor. Lastly, there are certainly physician groups which are capable of providing cash pay based care.
However, the process to apply for Medicaid can be quite complicated, particularly amongst those with low medical or even just general literacy levels. This disproportionately impacts individuals for whom English is a second language. As I said above, in a perfect world, the emergency department is only for true medical emergencies. However, patients as a whole are notoriously bad at knowing if their symptoms are from an actual emergency or not. Secondarily, in many communities, the emergency department is the only reliable access some individuals have to the health system due to difficult difficulties with transportation and scheduling. With regards to your last point, while there are certainly clinics that can provide cash based care, the majority of individuals who cannot afford insurance are also likely the patient who cannot afford a cash pay clinic.
The fact is also that a large number of uninsured patients will simply have their ER bills written off by the hospital, and/or social workers within the ED will help sign the patients up for Medicaid if they qualify so they become insured can then have the visit billed for, as opposed to the individuals giving fake names.
Unfortunately, the current state of the US Healthcare system is that for many disadvantaged populations, the ER is their primary care physician. This is not ideal, but I will not admonish my patients for doing what they can to seek care in a system that otherwise leaves them abandoned and uncared for
I self host a lot of shit, but after almost a year of using Obsidian I finally paid for their sync feature for one reason: iCloud sync to iOS is painfully slow.
I was sometimes waiting 30-45 seconds to jot down a note just waiting on the app to open with iCloud sync as my backend. Now, with Obsidian sync, the app is ready-to-go in seconds.
Now if you’re only going to be using on desktop, I would definitely consider a git-repository based sync, but if you’re gonna use mobile I’d recommend you at least consider Obsidian Sync
Except these physicians are often completing something called a “peer-to-peer” on behalf of the insurance companies, not just making broad treatment decisions. This is a process by which an ordering physician is required to call a physician employed by the insurance company to justify a testing or treatment course to their “peer”. Unfortunately these “peers” are often composed of physicians who did not complete residency and/or who do not currently practice, let alone in the specialty of the physician who is required to call for the peer-to-peer.
This leads to rather absurd results in which a board certified, practicing sub specialist (cardiologist, neurosurgeon, oncologist, etc) with 5+ years of specialized training after medical school has to convince a physician who may never have even practiced that they know what they’re doing. I personally think if you’re not a neurosurgeon, neuroradiologist, or neurologist then you aren’t really qualified to cancel a neurosurgeons MRI, but hey, I don’t get a bonus for denying claims.
Yes, but most DRM has been circumvented in one way or another. DRM primarily continues to keep law-abiding citizens from easily acquiring a copy of media they rightfully own as opposed to preventing piracy.
Though if institutions insist on utilizing DRM for prevention of privacy, I do think that DRM should be built to fail after a meaningful timeframe, at worst the expiry of the copyright for the material. Unfortunately many pieces of media, particularly video games, are abandoned and unsupported long before their copywriter expires. Abandonware in general is not well handled by modern copywrite law.
I think the point is more so why are digital purchased DRM’ed and prohibited from local storage in so many ways. The historical argument is “well you’re not buying it, you’re buying a license to use it for as long as we wish to provide it”, but why does it necessarily need to be that way. And more generally, from the standpoint of artistic/media preservation, as BluRay releases continue to decrease and console video game releases become continually more digital-only, these non-archivable or locked-without-server-license-validation media results in IP that at some point in time, this media could be permanently lost.
Personally, I feel this is unacceptable. The media we consume forms a huge portion of our culture, and is just as much an example of artistic expression as painting. While I thoroughly believe artists/companies should be able to charge for these properties, I do not believe that when it is no longer profitable for them to support the system, that these pieces of media should simply be discarded with no method for future recovery and preservation.
That’s not true. HIPAA covers anyone handling protected health information in a professional manner. If some office clerk at the VA is mailing out copies of HIPAA-protected information, they’re bound by HIPAA. If a consulting IT firm has access to a hospital’s servers as they’re changing something about the EHR, they’re bound by HIPAA. Protected information cannot make its way from a “covered entity” to a non-covered entity like a totally unrelated bakery who would not have an obligation to protect your information without either: 1) violating the law, 2) you personally disclosing the information to the non-protected party, or 3) you or someone authorized on your behalf signing a disclosure waiver permitting the covered entity to disclose
Cellular insulin resistance is the definition of Type II diabetes