Honestly I would love to hire a statistician to do the analysis on any clinical research I do. I just wanna collect the broset scores every shift and request and assign staff to best balance them then let somebody else count how many (hopefully less) people got punched by patients vs not doing that.

And there’s a lot of right to repair fights. If you think a Honda trying to lock you out for not taking it to the dealership for an oil change is bad, just imagine how bad it is for somebody with a combine that costs most of that million.

Connections Puzzle #920
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those last two…

This is why I opted for the keep messenger option when I deactivated my account. I have so many people even just from old jobs and while I can get a job pretty much anywhere I apply (that offers my specialty) and be working within a month, that comes with having to vet employers / weed out sketchy facilities.

So I need to be able to message old coworkers and be like “hey do you know anyone who’s worked at ___? That 10k sign on bonus is SUS” and have them be like “yeah 5 people got fired and 15 bailed after the state inspection. They were reusing paper iso gowns and billing for surgeries their sister hospital in the city was doing to get the Medicaid incentive for providing rural care.” Like WUT. Honestly me having a low social media presence is a plus for most employers especially in psychiatry, but I need to be able to get the tea on these people before I sign up for REAL shitshow instead of the lowkey kind I’m used to.

Fun fact: the FDA regulates most supplements (including melatonin) as food, not drugs. That means there are standards for what’s in them, but it’s mostly that they can’t just outright lie about the ingredients. There are nowhere near the same standards of testing for efficacy / safety, and they don’t even have to be the exact chemical structure (which makes sense for something like powdered ginger root that might vary slightly between batches / growers). Supplements can be super helpful but you really need to do your own research or get advice from a doctor experienced in holistic medicine (a lot of primary care / general practitioners / family medicine doctors are picking up on this but it’s definitely not universal).

Also pair with behavioral cues! Pick a stimulus for each sense that you only use while trying to sleep! Examples:

• Sight: dark obvs but you might try an orange night light if you need low light for mobility / safety or PTSD / night terror related reasons.

• Sound: I use a thunderstorm but other white noise mixes are also great.

• Touch: heavy blanket

• Smell: detergent, or a different air freshener than you use in the rest of the house.

• Taste: cup of chamomile before bed.

Avoid phone / TV while in bed unless the TV / YouTube is your sound cue in which case turn down the brightness / red shift it and play something boring / familiar like a sitcom you watched a lot of as a kid or a steamer you’ve seen a lot of.

Avoid most activities in general in bed except sleeping and fucking and possibly one mindless repetitive task like knitting or an easy untimed puzzle game. If you need an activity to wind down, learn to be mindful of your physiological sleepiness symptoms (mine is eyelid heaviness) and the second you feel it put your activity down immediately and lay your head on your pillow with your eyes closed.

It is very important that if you use medication to sleep you do. not. get in the habit of fighting them. If you let them make you sleep instead of using them to compliment a full behavioral sleep plan, you are going to wind up on ridiculous doses of medications that doctors are gonna get shitty with you about prescribing. Save yourself the trouble and make yourself a sleep plan. And if you have little kids that can’t regulate their sleep this is a great time to enforce (and model!) healthy sleep habits.

This will likely take about two weeks to kick in but once it does you are gonna have some of the best sleep of your life.

And to back this commenter up I have a lot of patients say melatonin gives them nightmares. Most of them have tried taking >10mg. That is waaay too much and melatonin is well known to do that in high doses. Buy the lowest strength melatonin you can and like this person says maybe even get a pill cutter and split them.

This is my gripe with tankies. One of the most salient points of 1984:

“It was now impossible for any human being to prove by documentary evidence that the war with Eurasia had ever happened.”

“Oceania was at war with Eurasia: therefore Oceania had always been at war with Eurasia.”

All war is fake except the class war.

Those are actually completely different developmentally. There’s a reason they often count those first few years in months. There’s a buuunch of milestones the kid is supposed to be hitting and if they’re not but they’re intervened with quickly there’s often few overall deficits in the end. We had to learn the Denver 2 test in school and do a test on a friend or family members kid.

It was a kid from church and the parents were super proud that the kid had never been sick due to avoiding daycare, and the kid was fine and even ahead in most skills, except language and a few of the social skills. You could see dad’s brain cogs start turning while he watched that. Idk what they wound up doing but I know some families do send the kid to daycare like once a week just to make sure their language and social skills are still hitting milestones.

For instance if they’re not talking it might be autism or deafness and if they get the right supports quickly they can start learning to sign instead and/or the caregivers can get educated better on the kids needs, instead of them just never learning to communicate well and having trouble advocating for themselves later in life. If they’re having trouble walking or starting to feed themselves they can get treated for a musculoskeletal problem or get physical or occupational therapy to make sure their motor skills develop properly.

I’m child free and wouldn’t touch pediatrics as a specialty with a ten foot pole but even I know that.

Honestly I wonder if some of it isn’t people in super remote areas or otherwise disconnected from conventional communities. If you live on a mountain with no internet or TV and drive into town once a month for groceries or live in an underground mole people tunnel system it’s probably easier to not give a fuck. Like obviously these things will still affect you, but not in any immediate way that’s gonna slap you in the face tomorrow.

If somebody catches that guy at the grocery store at the end of the month and gets him to fill out a survey he’s probably just like “…who? Oh a coupon though!” And the mole person will do it for a $5 subway card. That’s still at least a cookie these days. And they’ll both just check “meh” for everything and hand the survey back and take their coupon. I talked to a dude at the bus stop for a while that said getting his phone stolen had actually turned out to be really great for his mental health aside from needing to ask me when the next one was coming. Like I get that this is important stuff but sometimes ignorance looks pretty damn blissful.

Or a Presbyterian church service. I gotta give it to the Pentecostals, they might be a cult but at least they know how to party.

Honestly I would settle for people just recognizing the infinite complexity of the universe but apparently that’s just my high openness in the OCEAN assessment.

Used to work with the criminally insane. I’ve also met a LOT of pedophiles. Not many because they actually were crazy but because they were trying to get declared as such to not get fucked up in prison. Most of them aren’t even actually attracted to children they just wanna victimize someone and children are smaller / weaker and less able to advocate for themselves. The one thing pretty much all of them have in common is a pitiful combination of sadism and cowardice.

And also interestingly, most mammals have the same electrolyte needs as humans. Some need more or less water (esp desert animals), but the balance of the electrolytes themselves (sodium vs potassium vs magnesium etc) are a lot more similar than you would think. The safe water ratio for oral intake is pretty wide too because the 90% of the kidneys job is to rebalance that, so as long as the electrolytes are balanced in relation to each other you’re fine. So for Gatorade the optimal electrolyte level is actually about half (I usually dilute it 1:1 with water) but most healthy humans can easily tolerate it as-is (but it’s still only better than water if you’re losing a lot of water to illness or exercise).

When I looked up the normal range for the metabolic panel of a dog, the electrolytes were almost identical to a humans. I remember there being a theory that it relates strongly to when in the evolutionary chain we left the oceans, which is pretty similar for most mammals. Assuming this is true of horses, I wouldn’t think this would be any more harmful than Gatorade or pedialyte, and even beneficial in some cases (significant fluid loss to illness or exercise).

I have an agendered one but I’m also legit considering changing it.

I mean yes, but not in a way that’s likely to result in significant harm, even in the long term. It’s the kind of thing that being white myself (and having IBS on top), I would feel comfortable laughing at.

Never played actually.

Connections Puzzle #918
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Had to work my way back around

Connections Puzzle #917
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Still not tired of the term “rainbow herring!”

I think you need a line break after the second spoiler and I think you are missing a space after the :::

Wait lemme check:

Apparently a hospital in my network is trialing a tool to generate assessment flowsheets based on an audio recording of a nurse talking aloud while doing a head to toe assessment. So if they say, you’ve got a little swelling in your legs it’ll mark down bilateral edema under the peripheral vascular section. You have to review before submitting but it seems nice.