philpo @ philpo @feddit.org

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597

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1 yr. ago

Holy shit, what kind of system do you use?

On this side of the pond most H0 engines are still well below 200$. Sure,there are some that are more expensive, but I could only find sets or special editions in that range here.

Pellagra usually comes from eating a high corn/sorghum diet without proper nixtamaliziation (I really hope I spelt that correctly), the alkalisation of the food before cooking. While some chronic digestive diseases, alcoholism and a few other causes can also lead to it, malnutrition is the main cause and neither of these causes come upon an otherwise healthy looking child overnight. While I might not rule out that someone is idiotic enough to feed their kid only corn and sorghum it is rather unlikely and diarrhoea is one of the rather late symptoms.

(I transferred a five year old with major liver and some cerebral damage after the parents kept the poor kiddo on a "barley, corn, yeast, self produced apple juice and full grain" only diet for a year....one can imagine what that leads to)

The bad parents as in "not caring" aren't the worst ones, at least for me (not a doctor, paramedic with former leadership/admin roles including in a hospital like environment)- the ones who think they care but really don't are the ones that get most of my colleagues and me far more. Because for "simply not caring" parents you can at least inform the proper authorities and at least here they are actually fairly good at dealing with them.

But there are so many "bad faith" parents out there meanwhile - intentionally withholding Information from both the healthcare providers as well as the children, withholding care, working against the best interest of their child.

Just to put themselves and their beliefs first. It's a huge crowd these days:

• The alt-righters who think that their children will get nanobot vaccines and that that modern medicine is against them anyway.
• The alternative medicine idiots who believe in homeopathy and crystals
• The religious numbnuts who think that their God gave them a prayer as universal treatment - and not modern medicine.
• The instagramers. The ones who either need their sick child as a way to gain sympathy or even money in social media, to exclude themselves from other obligations of adult life (that borders on Münchhausen by proxy often). And the ones who blindly follow some influencer and their "new nutrition supplements" that helps against everything.
• The know it all's. The ones who think a quick google search can actually replace a multi year medical training and specialisation and the four buzzwords they just googled in the elevator make them the new noble price winner. There are actually two types of these people: The diagnosers and the undiagnosers. The first ones have already diagnosed themselves and will jump from hospital to hospital,from doctor to doctor until they finally find someone who gives them the diagnosis they already had in mind four years ago. The undiagnosers are always three steps ahead of you and you can always count in them to bring in another rare disease that needs to be checked out.

People can belong to multiple of these categories. And parents are especially bad at it - I get it, it's your child - but after working in healthcare on 4 continents for 20 years now it feels like these people spin faster and faster down their rabbit holes today.

Just to give you a few examples(not all directly from me,some from colleagues I know):

• The mother who replaced the "Chemo" for her deadly sick child with saline in an unobserved moment. The twist: It wasn't even a chemotherapy drug,it was an immunoglobulin, 10k per session. Kid nearly died as a result and will be disabled for life.
• Parents who withhold cancer care for their daughter, daughter suffers immensely and dies. They thought prayer would be enough.
• A mother faking vacation certificate so her kid could attend kindergarden. A few months later the kid showed measles symptoms in the kindergarden and was sent home. The mother faked a doctor's certificate that the kid was well and non-contagious so the kid could attend an event there. The event was also attended by other parents and the younger siblings. Multiple kids still too young to vaccinate got infected and one kid died.

And a few more recent ones:

• Parents brought their lawyer to the ED when they attended it for a broken arm.
• Parents demand a hymen-repair surgery at 4am on a Sunday for their 17 year old daughter.
• Parent told me the 6 year old kid with diarrhoea and fatigue (at 2am at night) surely had pellagra. Dumbfounded I asked how much corn or sorghum they eat. None,the children don't like either.

sighs Oh god. No, it wouldn't. Here we go.

The name pressure headaches come from the feeling of pressure,not from actual pressure - actually most pressure headaches are not caused by a process within the cerebral cavity at all. Most are related to sinuses, especially the frontal sinuses, teeth, the middle ear/auris media, tension headaches(which are usually cervical/muscular). Only migraines as a cause for pressure headaches are actually within the cerebral cavity but have nothing to do with actual pressure. (Okay, actually we don't really know how they start - but we are really sure it's not the pressure)

As the brain matter itself has no pain receptors it does not actually feel pain - but the root of nerves like the Trigeminus, Occipitalis and the layers of tissue covering the brain (Meninges) as well as the vessels can absolutely feel pain. A lot of pain.

Cerebral bleeds, post aneurysm or trauma, usually happen in a very acute form or very slowly - with patients suffering from minutes to month from occasional headaches,often rather mild and not "pressure" headaches. Often after an initial knockout punch. (And at that point I must remind people that someone who has been knocked out needs a brain scan urgently. It's NOT something to joke about and feel ultra manly,eh, toxic masculinity, about)

The acute form is totally different though - it's one of the nastiest ways to go. Patients have a sudden onset of massive,life-changing pain, described by survivors as a catastrophic, sharp(*), pain associated with a fast onset of other neurological symptoms.

Another misconception is the fact that the cerebral cavity has no openings - it has quite a few and when the pressure within the skull is increased by a pathologic event like a cerebral bleed or the swelling of the brain the brain gets pushed in these holes - mainly the hole connecting to the spinal column. Which is why cerebral bleeds are so deadly - because the brain goes "stem first" through there - and it's too small even for the brain stem. And the stem is what regulates breathing,etc.
Other nerves get simply sheered off/cut by the pressure. (This is part of the pain mentioned above - Large nerves being cut by your own blood pressure)

Nevertheless even in these cases the removal of large parts of the skull as it is done by neurosurgeons does not alleviate the pain - the damage to tissue, nerves, etc. is done. The goal is to give the brain room and stop the bleeding. But thankfully we have good options for pain relief these days and these patients are in a very deep sedation/coma for a good reason.

(There are of course rare special cases like hydrocephalus cases, but that's a bit far fetched here)

So no, it would not help a bit painwise ,even in the most extreme situations.

So as a healthcare professional I generally would advise against drilling into one's head. It will make a lot my colleagues very angry.

And if you really feel you must do that please consult the nearest psychiatrist first. And if you then still feel like you must do that, make sure to do it during business hours, make also sure you livestream a video of it for the loolz of a lot of HCPs around the world, get a testimony recorded so your next of kin can sue the earlier mentioned shrink that he did not admit you to a closed ward and most importantly get a organ donor registration.

And due to a call a decade back I might also add: DO NOT drill into your own Sinuses as well,even if they are clogged up. Even if you are a doctor. You might accidentally (almost) lobotomize yourself.

Source: Am a paramedic. Seen shit. Seen people do shit that started as an internet hoax.

A Chinese low cost manufacturer from Shenzhen. Their parent company is actually one of the Top 5 manufacturers - but none in the North/West has heard of them.

They were specifically founded to provide smartphones for low and medium income markets like Africa, India, etc. Meanwhile they also manufacture phones there.

Their parent company holds almost 50% of the African market share.

They are actually producing decent phones by now - had the chance to take a look of one of their most recent phones a few weeks back. 5G, dual SIM, dedicated microSD slot, headphones jack (yes Lemmy!) and a big battery - but the camera and display were mediocre. Overall still a decent phone for a good price, even though they don't sell them everywhere and I would be weary of the updates issue.

It depends very much on the legislation - in many legislations it is absolutely illegal to retain it.

Anyway, there are more than enough non-evidence class materials that need to be removed asap.

In theory a good idea, but there is lots of content that needs to be gone serverside asap - either because it's CP, otherwise illegal, spam that clogs down the Fediverse/can even be used to DoS a server,etc.

Clear vote for Matrix.

Easily works with basically every system from iOS, Android, Windows, Linux,Mac and there are Web-Clients as well. And everyone can find their own client of choice.

You can use one of the huge federated instances like matrix.org or set one up yourself.(Which is much easier than setting up an Activity pub instance,btw.)

There are rooms/channels that can be open or semi-open just like in Telegram, and bots are absolutely not problem (Not Like in signal). Registration is not bound to a phone number like it was in signal for a long time (but is no longer) and (unlike still needed in signal) a phone does not need to be used for sign up&transfer between devices works seamlessly.

If you selfhost or use beeper you can even bridge to different services (signal,WhatsApp, telegram) etc. so you only use one app for everything.

I had my fair share of health problems,from a major motor vehicle accident with a broken spine,burns,ruptured nerves, etc. to a stroke, a dislocated shoulder and knee, etc.

But the worst one? By far?

A fucking kidney stone. It literally redefined my 10/10 pain level.

Indeed is major trauma (which getting run over by a bus is a euphemism for) a much overlooked concern for older people (especially "the younger" old people, which are between 60-75).

Sorry, it would be easy to identify the customer then, so sadly I can't.

Yeah. Came here to write exactly this.

What OP misunderstood is the old tale of mortality vs. lethality.

In a simplified explanation: Mortality defines the percentage of deaths in a population by a cause.

Lethality is the percentage of deaths of people suffering from a cause.

In our case:

• Smokers might only get hit by a bus slightly less often or slightly more often(1) (Mortality)
• But they have a far greater chance of dying from it when they get hit. The same can be said for being shot,etc. Being a smoker always reduces your statistical chances.

(1:Actually quite fascinating - there is conflicting evidence on that one, as smoking is often statistically associated with substance abuse and bad health - which increases the likelihood of major trauma events, but on the other hand smokers die earlier,leaving more old people to walk in front of vehicles due to reduced cognitive abilities)

You know when a scientist/expert warns people about a disaster and they don't believe him and a short time later they actually suffer from that disaster?

Well. I was that expert. I do disaster response planning for a living.Told a large public company that they are at risk of a certain scenario. They told me that they don't believe it would apply to them and basically kicked me out.

Two weeks later they were on national news for it.

Not that it would have changed a thing - projects we do take months and do not prevent a disaster, just deal with the risk much better.

But still. Felt surreal.

Learn ondsel (which is basically a freecad fork) first and then transfer to FreeCAD later. It's easier to learn at first but for true woodworking FreeCAD is better - but only after you know the basics.

Sadly neither of them is remotely efficient at all when it comes to woodworking. But if you don't care for the time it takes too much it is something to work with.

No biggie.

Hopefully the mother is insured with a proper assistance company,for them that's actually daily business. I had multiple calls when we were tasked with flying home a mom and preterm babies or two. One with neither mom and dad knowing beforehand a pregnancy existed.(that was kind of funny, though,as both had a medical background and were pretty cool about it)

From the document side of things for the industrial nations and the more developed destinations it is usually also no problem - first a local certificate of the birth is required,the closest embassy/consulate is contacted and emergency travel documents are created. As the old children's passport have been phased out by virtually all countries are regular provisionary passport is granted (that is not printed abroad but filled out by the embassy/consulate) and you are ready to go.

Only intermittent stops/layovers can be a problem sometimes, especially in some countries (US....) so with a professional assistance company one takes care to avoid these. Furthermore some countries do not trust birth certificates from some countries (e.g. due to a high number of surrogate motherhoods) and may demand further proof of the motherhood - e.g. medical records from antenatal care back home or a medical certificate of a recent birth by one of the embassies trusted doctors. But these problems can usually be solved easily.

As someone doing systemic healthcare management for a living (and for research purposes) I might be a bit biased, but basically there is no other way than socialized healthcare. Healthcare is not a market that is open - a patient that needs healthcare is in almost all cases not able to shop freely - unlike a regular economic market you are unable to hold back your healthcare needs (normally).

Additionally society pays massively when healthcare needs are not met - crime goes up, long term healthcare costs rise, the pressure on emergency services increases.

(And if it's not DNS it's NTP oh yeeh) (But that kills the Haiku)

Got myself a cheap Chinese programmable foot switch with three switches that enables me to do exactly that without fucking up my normal layout. And it can be switched to other things depending on the application as well. Very useful.

Yes and no. I generally don't care what consenting adults do between each other no matter if there is money involved.

BUT: I have also seen the ugly side of sex work due to working as paramedic in some not so nice areas. Very often sex work is not really consensual and very often people are forced into it one way or another. We have to definitely handle this situation as a society. This includes more accessible social welfare (and yet we are miles ahead of the US here), very rigid surveillance of the situation and prosecution of people exploiting sex workers.

Funnily enough I think porn by now is far worse than sex work - while someone can get past sex work somewhat easily (I know a consultant doctor who is a former sex worker) by simply changing the environment it is almost impossible with porn. The internet does not forget and while you can always deny doing sex work for porn there is physical evidence that people did that. Add the upcoming AI fakes and it becomes even more of a problem.

Tbh,I have no idea how we should tackle that problem.

You don't give your friend a thing, you give his poor wife something. A bidet goes so long and pregnancy itself is hard.

Seriously: Offer her to do some chores like shopping, gift them some take-away gift cards,etc. The situation will put a serious strain on their relationship,