This is a game where you're constantly presented with a legion of things to do, numbers to increase, boxes to tick, things to collect, factions to impress, points to earn, monsters air-dropped in to battle without warning and/or preferably all of the above simultaneously.
So this is the most job-like game on the internet?? Awesome! Sign me up.
Less facetiously, I didn't think the answer to the common complaint of, "We're sick of killing 10 generic monsters to collect 5 generic trophies to advance a quest" was, "Here's more stuff to grind!"
There have been some successes along the way, like genetic tests for warfarin dosage, but for the most part our gains in understanding of basic biology haven't been matched by clinical advances.
If you're spending thousands of dollars for genetic testing for a $4 a month drug like warfarin, you're doing it way wrong. It's like the proverbial million dollar cure for the common cold. You could either use one of the newer warfarin alternatives with more consistent pharmacokinetic profiles at a higher price or use the old tried-and-true trial and error dosing.
Either way, you're still doing weekly to monthly lab testing for warfarin dosing. And your warfarin effectiveness (or bleeding risk) is still going to be thrown way off if you vary your diet significantly or start new medications.
You realize the Scientific American article that you point to backs up the OP's point? Let me quote the article summary directly:
"whereas female brains are more connected between hemispheres to combine analytical and intuitive thinking"
So, women are supposedly more wired to perform analytical and intuitive thinking? And what is coding and software engineering, exactly? It's certainly not a showcase for men's supposedly superior motor skills!
I don't believe many parents (there are a few) who directly point their children away from STEM. But I know a lot of parents and family and friends who indulge all day in Disney Princesses and makeover parties and introduce their peers to the wonders of staying connected all day to social media.
It's not malignant, but there is a social bias present. It may not have been in your immediate family, but taken as an aggregate, social pressure does steer little girls' interests away from STEM. And interests often turn into exploration for careers.
No one told him there was an issue and he'd been doing it for months. I would have at least expected a manager to ask him politely at first. What makes his glasses any different from a regular cell phone? Aside from the fact that he also requires them to see and they're actually on his face instead of in his hand.
Hey, guess what? Just because you get away with going 100 mph on the highway for the first few months doesn't mean you get to avoid the speeding ticket when the cop does pull you over later.
"Well, gee, officer, I've been doing this for months now, and no one's bothered to stop me before!! It must be OK then, right?"
As an object lesson in expected social etiquette, you should hold up your cell phone the next time you're in a movie theater (preferably on opening night), leave it pointed at the screen with the camera/camcorder app on without actually taking pictures, and see what happens.
You guys need to get over the word "apologists", frankly it makes you sound like your parroting some right and/or left wing extremest political view. I've mostly gotten in the habit of as soon as I read that word I shutdown and ignore everything else as been completely off base and out side of normal reality. Actually I just had a good laugh because after typing all that I read your user name (reality impaired).
Fine, how about this? I'm not the original poster, but I'll amend what he said. It boggles the mind that an idiot wore a wearable videocamera to a movie theater and pointed it at the screen, and some people are beyond themselves that the idiot got into trouble for it. There, no need for the word "apologist".
Because of the legalities, the automated cars will drive like grandmas.
Quite possibly true...but it's also quite possible that they would still reduce average trip time. perfect merges at all on-ramps.
I rarely encounter an on-ramp slow-down that wasn't due to multiple lanes of busy traffic converging into a single lane, as opposed to panicky driver hitting the brakes too much. 2 flows merging into a single flow of the same size will result in a slowdown, no matter how perfect the computers are at scheduling.
No need for stop lights / signs.
Yes, because nothing else, like pedestrians, needs a traffic break to cross the street, ever.
Automatic routing of traffic to use the most optimal routes based on current volumes.
I don't think "optimal" means what you think it means. If every car can read the traffic and select routes, there will be no "optimal" route, since traffic will be evenly congested everywhere. It may be faster than taking Highway 555 now at rush hour, but all your shortcuts of taking little traveled street X or trying to save on time by using a more roundabout route will disappear.
Laws and pledges will inevitably be broken inversely proportional to the enforcement and proportional to the benefits of breaking your word and how many people are involved. So Bitcoin is good, no one involved is trying to make money for nothing.
And yet, the doctor seems to have determined that it had nothing to do with the current stuff and moved on:
There, on MugShots.com, was a younger version of my patient's face, with details about how she had been detained for cocaine possession more than three decades earlier. I looked away from the screen, feeling like I had violated my patient's privacy. I resumed our medical exam, without bringing up the finding on the Internet, and her subsequent hospital course was uneventful.
So, depending on the kinds of tests he was doing, he apparently concluded it was a red herring.
Let me give you some insight as a doctor.
Patient comes in, lies, is actually abusing cocaine. Cocaine is a stimulant, and can cause overexertion of the heart through either chronic use or acute overdose, leading to shortness of breath and weakness, which the patient came in with. Additionally, smoking cocaine and all its impurities can damage the lungs.
It had everything to do with the "current stuff", as the patient lying and abusing cocaine as an elderly person ties everything together logically. Medical mystery solved, the doctor goes about his day. Seeing gramps come into the hospital after shooting up or smoking some dope is uncommon, but not unheard of.
Now, elderly person comes in, unknown care situation at home or what passes for home. Tests positive for drugs in their system. This explains why they came in with their symptoms, but not how it got there. That possibility requires further investigation, and may be cause for a call to adult protective services.
TL,DR: Not a red herring. The doctor reacting as they did was because they got the answers they needed, not because it wasn't relevant.
The problem is that they didn't get any answers at all -- just because she used Cocaine 30 years ago doesn't mean she still does. I used a number of drugs 20 years ago that I literally haven't touched in decades.
If he suspects abuse, then he shouldn't dismiss that suspicion just because she once used the drugs. If she associated with people 30 years ago that had access to cocaine, there's a good chance that she still comes into contact with people today that have access to cocaine, so if anything, the fact that she once used the drug makes it more likely that someone may be giving it to her now.
Which is a valid point, too. But the response to that is complicated. It may have been an incomplete story given to us - when I ask a social history on substance use, I usually ask a variation of, "Are you using any illegal or street drugs? Have you done so in the past?"
Most people who are steadfastly lying about current use will say no to both. People who have fallen off the wagon may lie about the first question in the beginning and tell the truth on the second, but if you come around again the patient will usually admit to it when directly asked and they know it's pertinent to treatment. If this patient had lied to the doctor about using before, I wouldn't blame them for thinking they're lying about both the past and now.
So, what then? Usually it comes down to conversations with the patient and his/her family or caretakers, and talking with adult protective services. If you aren't satisfied with the patient's safety at home, you tell them you're locking them in the hospital as a matter of patient safety until you're done investigating. The drug abusers will usually confess after this, because they want to get out of the hospital, after they're feeling better, to go back to using.
Further examples of HIPAA violations and nonviolations and why.
Doctor X discusses Patient Y's case with Doctor Z, also involved in the case, at the supermarket. This is a HIPAA violation, as long as there are bystanders and he used specific identifying information. The Doctor intended to have the conversation in a place where he could have reasonably assumed there were unrelated people overhearing.
Now, Doctor X discussing Patient Y as a generic stroke case in public that could be one of a million just like it, with no identifying information, and debating the best ways to treat it? Not a HIPAA violation. Happens all the time during teaching rounds and medical conferences.
Doctor X leaving Patient Y's information up on a public console in a hospital? HIPAA violation. Doctor X could reasonably know that other people are going to walk by and either incidentally or purposefully look at the information he left up.
Doctor X looking up Patient Y's information on a public console in the hospital, and then taking it down before leaving. If an investigator or spy comes by with a USB drive of cracking tools and reconstructs Patient Y's information? Not a HIPAA violation. Doctor X took reasonable precautions with intent to protect Patient Y's privacy.
Doctor X opening Patient Y's chart to write a note and orders, and unrelated person sneaking behind him and sneaking a quick peek over the shoulder at Patient Y's information without anyone seeing? Not a HIPAA violation on the Doctor's part. No intent to share. Reasonable protection. Doctors shouldn't have to hire armed security guards to watch their back while they're focusing on treating patients.
Wouldn't doctors googling their patients essentially violate HIPAA rules?
No.
Because you've now let the fact that you are a doctor treating a specific patient bleed out around the corners, and since Google is keeping track of who you are and what you searched for, they know it too.
Unless you are doing this in such a way that you can guarantee you're not causing patient confidentiality to be breached (which Google sure as hell isn't), I'm of the opinion you've demonstrated a lapse in ethics, and a breech of the law.
Violating HIPAA takes intent. And you're taking the doctor's responsibility to protect patient information way too far.
For example, Doctor X discusses Patient Y's case with Friend Z, with specific identifying information. HIPAA violation.
Doctor X discusses Patient Y's case with consulting Doctor A in a suitably private conversation over the telephone. Unknown to the parties, the NSA / and/or the phone company is wiretapping the line, and just learned all about Patient Y. Not a HIPAA violation on either Doctor's part. Doctors have to take reasonable precautions to protect their patient's privacy. Guarding against every possible outlet that snooping intelligence agencies and snooping internet companies could use is too much, and we'd never get anything productive done.
And, even if you search in a manner you know was anonymous, if those searches come from something which is identifiable as being the anonymous search of doctors, the content of those searches can still leak information out.
Because when Google see that Dr. Joe Quack has searched for Bob Skippy Smith followed by a quick refresher on the symptoms of herpes.... Google knows (or can infer) that Bob Smith has Herpes.
Doctors are not information theorists, and quite possibly not well educated enough about this technology to be using it in conjunction with their medical practice. Because clearly, if they understood this a little better, they'd realize they've more or less violated their ethics (and possibly the law) by doing this.
Doctors Googling their patients is a terrible idea, and has every possibility of violating the privacy of the patient, as well as the laws meant to protect it.
This would be an incredibly bad idea on Google's part to try to gather accurate information this way on patients. Because I assure you, doctors are neither linear nor subject related in their internet searching. Just because I google "gstoddart" and then a few minutes later "UpToDate: complications of inserting foreign objects in anus" does not mean the two are anywhere related, despite what you're thinking. I may have 20 different patients on my service at any given time, and I frequently have to be thinking about multiple cases at any given time during a workday. Hell, just to make things more confusing for google, maybe I googled "best place to order roses nearby" in between those two google searches, because I'm taking my girlfriend out to dinner after work.
Sorry, while I hate it, no one, not me, not you, has privacy anymore online or electronically. While we can fight against it, get used to it.
And that is a major failing on the doctor's part. Old people can be addicts too.
I replied about this above this thread, too.
The doctor responded the way that they did, because the rest of the medical picture falls into place once it becomes known that the patient is still abusing cocaine. The doctor didn't dismiss the possibility, treating cocaine addicts for their health issues is commonplace.
The question that was nagging the doctor was, how did the drugs get into the patient's system in the first place? Elder abuse takes many different forms.
And yet, the doctor seems to have determined that it had nothing to do with the current stuff and moved on:
There, on MugShots.com, was a younger version of my patient's face, with details about how she had been detained for cocaine possession more than three decades earlier. I looked away from the screen, feeling like I had violated my patient's privacy. I resumed our medical exam, without bringing up the finding on the Internet, and her subsequent hospital course was uneventful.
So, depending on the kinds of tests he was doing, he apparently concluded it was a red herring.
Let me give you some insight as a doctor.
Patient comes in, lies, is actually abusing cocaine. Cocaine is a stimulant, and can cause overexertion of the heart through either chronic use or acute overdose, leading to shortness of breath and weakness, which the patient came in with. Additionally, smoking cocaine and all its impurities can damage the lungs.
It had everything to do with the "current stuff", as the patient lying and abusing cocaine as an elderly person ties everything together logically. Medical mystery solved, the doctor goes about his day. Seeing gramps come into the hospital after shooting up or smoking some dope is uncommon, but not unheard of.
Now, elderly person comes in, unknown care situation at home or what passes for home. Tests positive for drugs in their system. This explains why they came in with their symptoms, but not how it got there. That possibility requires further investigation, and may be cause for a call to adult protective services.
TL,DR: Not a red herring. The doctor reacting as they did was because they got the answers they needed, not because it wasn't relevant.
Which kind of proves the point: If the material is any good, it will succeed and wont need artificial state support.
The same could be said of American sports franchises, which receive billions of tax dollars, mostly as stadium subsidies. What the French are doing is stupid, but America is no better.
Not exactly the right analogy.
What the Americans are doing with state and local government and sports franchises comes down to scarcity of supply. There are only a finite number sports franchises within any given professional sports league, and beyond a certain point the talent level is diluted and the overall entertainment value and ticket sales goes down. There are any number of American cities and states that would love to host X sports franchise. A successful pro sports team can bring millions of dollars tax revenue or more to a locale directly, and provide a much bigger indirect boost to the city in business growth and prestige. (See: Oklahoma City after they wooed the NBA SuperSonics / now the Thunder away from Seattle.)
The sports teams realize the benefits they provide just by being there. And they trade those benefits for sports arenas, tax breaks, and other concessions from the locale. If a city gets bitter or bored of supporting the team, they can and will pack up and move elsewhere.
You mirror my thoughts. At times I also most wish that republicans would take and hold all three branches. It will hasten the fall of this country and perhaps, maybe, possibly out of the upheaval, a better system can come to pass. Right now I feel democrats (or maybe better to say caring politicians) try to slow the fall, give hope to the hopeless and serve only to make this country suffer more. Gangrene slowly pervades our system, our society and the caring politician, a minority today, only allows the infection to spread, albeit slowly.
It's hard to do any sort of study of large groups of people if you can't at some point collect and aggregate data about all the individuals involved.
I disagree. There is no need for information which identifies specific individuals when determining the effectiveness of a drug or medical procedure in a large group of people. There is no need for information which identifies specific individuals for market research or television ratings. Those are just a few examples. Data can be made anonymous without losing its usefulness.
Data can be made anonymous without losing its usefulness; however, data cannot be made anonymous without losing the ability to check its veracity.
If there is no real person connected to data in aggregate in a scientific study, then there is no way to prevent a scientist from making up data wholesale and padding the results to favor one outcome or another. Conversely, if a skeptical competitor levels charges of this against you, being unable to point to the real people that you derived the results from looks bad.
It's a good question. All I see in this paper is fresh discovery of the same facts that were well known among skeptics like the Perth group back in 1990s. Is it really such a bizarre virus that acts like no other virus, kills like no other virus, and manages to hide the way it works so well that decades of research still leave us guessing? Or is it just a weak virus that cannot survive inside an uncompromised immune system and thus serves as a great diagnostic for immune problems that it does not actually cause?
It's a horrible question. Treating the HIV infection with anti-HIV medications can for the most part prevent or regress the syndrome of AIDS. If it was just a "great diagnostic for immune problems that it does not actually cause", treating and suppressing the HIV infection should be 100% ineffective in helping the patient.
HIV only kills ~5% of the T-cells. Newly discovered pyroptosis pathway kills the other 95% This is a radical departure from the accepted mechanisms of how HIV works. Pyroptosis can be triggered by a boatload of different inflammatory processes, I'll be looking forward to their smoking gun that HIV is the cause. With all the research money poured into HIV research, it's taken them 20 years to notice this?
Hi! Your comments are a sterling example of the dangers that having just a little knowledge in a certain field poses. As a doctor who has worked in an HIV clinic, let me give you the best practical proof for your reinventing of the wheel. Take an AIDS patient who is sick with an opportunistic infection. Cure the infection, and start the patient on a good regimen of anti-HIV medications. In most patients who aren't too far gone, their immune systems will rebound, and as long as they're compliant with taking their meds, the odds are they will never reexperience the practical consequences of an AIDS diagnosis.
Testing positive for HIV used to be a death sentence. Now with current anti-HIV meds, HIV can be relegated to a chronic illness less burdensome, and less deadly, than type 2 diabetes mellitus. Do you understand that? Treatment of an HIV infection can prevent the onset of AIDS, a clinical syndrome.
If you want a better proof, have a scientist inject you with HIV virus. Make a journal, and see what happens in 5 years.
Cancer gets cured about once a decade, sometimes by real doctors, sometimes by "quacks." I could show stats from real doctors with similar results to this one, which never saw the light of day once it was discovered (or rediscovered).
Please, do show us the stats. I get tired of the false meme that "oh, we would have cured disease X already if the results weren't being suppressed in a big conspiracy"! Medical research is hard work, and frustrating. Not only do you have to cure the disease in the test tube, but then you have to cure the disease in a living patient, and make sure it doesn't do something equally or more horrible to the patient in the process.
On top of that, the public has been oblivious to the fact that real progress in cancer treatment, and yes, even cures, are being made. Many leukemias and lymphomas are now curable through chemotherapy and radiation. This boy in the article is in the small minority that standard treatment did not work. Solid tumor cancers are getting better early detection and treatment. Mortality from many cancers has been dropping over the last 2 decades. What was once usually a consistent death sentence doesn't have to be.
People don't actually like creativity, even in medicine:
Staw says most people are risk-averse. He refers to them as satisfiers. “As much as we celebrate independence in Western cultures, there is an awful lot of pressure to conform,” he says. Satisfiers avoid stirring things up, even if it means forsaking the truth or rejecting a good idea.
In medicine, innovative things happen all the time. When *you* go to the doctor, you get the same ol' thing that has been done since 1952.
Most of us physicians try to live up to our creed: "First, do no harm." This includes not jumping to try every crazy-ass, untested treatment that some would-be genius cooked up and put in a syringe on the patients under our charge, if there are other treatment options that are still available. And here's a crazy thought: some diseases are better off untreated. I have an 85 year-old with dementia that was recently diagnosed with a lung tumor, likely malignant cancer but slow growing. Am I going to recommend putting her under general anesthesia, the knife, follow-up chemotherapy and possible radiation? Hell no.
If you truly think the standard of care in medicine is the same as 1952, I invite you, when you get sick, to turn down any or all recommendations for an MRI or a CAT scan. No heart catheterizations. No minimally invasive or laparoscopic surgery. No joint replacements. Very few blood pressure, cardiac, or autoimmune treatments. None of the advances for asthma and other lung diseases. If you're infected and allergic to penicillins and sulfa medications, good luck! I certainly wouldn't want the alternatives: veritable bleach in the veins or antibiotics toxic to the kidneys and ears.
Infinite computing power to apply analytics to hiring practices, and they end up with nepotism. Truly garbage in, garbage out. I bet the friends of the HR VP are all top candidates...
"...To a frustrated game developer who feels the software conglomerates are stifling his creativity..."
Are we talking about the same person here? Notch takes Infiniminer, adds some new features and extensibility to the basic gameplay, which becomes his one and only claim to creative success. And it's the software conglomerates' fault that he doesn't have an original idea out yet?
Lucking into the Angry Birds/FarmVille style sweepstakes does not a gamer genius / tycoon make. He wants to build a Valve? Good luck.
My family owns Apple shares and I think it's wrong.
Just curious. Do YOU pay more taxes than you're legally obligated to?
If not, why not?
You've just stated that you "think it's wrong" that Apple pays no more taxes than they're legally liable for. Which would make YOU wrong for not paying extra taxes.
Whoa. You're confusing "It's wrong because ethically it stinks" with "It's wrong because it's against the law".
It IS wrong that multibillion dollar corporations are unfairly paying cellar-level taxation for large profits made from consumers. Just because corporations own governments around the world and have enshrined that unfairness in taxation law to benefit themselves does not suddenly make that right.
Stop shipping a browser with Do Not Track defaulted to off.
Some web servers have had a policy of disregarding DNT headers from browsers known to default it to on. Case in point: pre-release versions of IE 10. If Google were to "Stop shipping a browser with Do Not Track defaulted to off" as you suggest, what would that do other than get Chrome added to the list of browsers from which to disregard DNT?
Is this a damnation of Internet Explorer, or a damnation of a weak-ass privacy flag labeled "Do Not Track" that corporations can apparently ignore at will?
Newsflash: this is not a indication that Google is doing things the right way. This means Do Not Track needs to be fixed.
Not the original poster, but yet again, the propensity of any given person (you, me, this guy in Brooklyn) to act dumb and do really stupid things should be proportionally inverse to their ability or desire to engage in activities that can hurt themselves and/or others.
Hairyfeet is 100% correct, and what I am most thankful for out of this completely avoidable tragedy is that no innocent bystanders got hurt with this guy.
Yes, we can all die in the next minute, but if a person dies while doing something completely forseeable and avoidable such as driving drunk, juggling running chainsaws, or doing stunts with remote control helicopters right over your own head, there is no guilt on anyone else's part, and there is very little sympathy, except for the people that person left behind that have to deal with the aftermath.
Slashdot Mirror
This is a game where you're constantly presented with a legion of things to do, numbers to increase, boxes to tick, things to collect, factions to impress, points to earn, monsters air-dropped in to battle without warning and/or preferably all of the above simultaneously.
So this is the most job-like game on the internet?? Awesome! Sign me up.
Less facetiously, I didn't think the answer to the common complaint of, "We're sick of killing 10 generic monsters to collect 5 generic trophies to advance a quest" was, "Here's more stuff to grind!"
There have been some successes along the way, like genetic tests for warfarin dosage, but for the most part our gains in understanding of basic biology haven't been matched by clinical advances.
If you're spending thousands of dollars for genetic testing for a $4 a month drug like warfarin, you're doing it way wrong. It's like the proverbial million dollar cure for the common cold. You could either use one of the newer warfarin alternatives with more consistent pharmacokinetic profiles at a higher price or use the old tried-and-true trial and error dosing.
Either way, you're still doing weekly to monthly lab testing for warfarin dosing. And your warfarin effectiveness (or bleeding risk) is still going to be thrown way off if you vary your diet significantly or start new medications.
A much better example of genomic medicine payoff would be targeting therapies to specific cancer types, like the EGFR receptor mutations in some varieties of lung cancer.
You realize the Scientific American article that you point to backs up the OP's point? Let me quote the article summary directly:
"whereas female brains are more connected between hemispheres to combine analytical and intuitive thinking"
So, women are supposedly more wired to perform analytical and intuitive thinking? And what is coding and software engineering, exactly? It's certainly not a showcase for men's supposedly superior motor skills!
I don't believe many parents (there are a few) who directly point their children away from STEM. But I know a lot of parents and family and friends who indulge all day in Disney Princesses and makeover parties and introduce their peers to the wonders of staying connected all day to social media.
It's not malignant, but there is a social bias present. It may not have been in your immediate family, but taken as an aggregate, social pressure does steer little girls' interests away from STEM. And interests often turn into exploration for careers.
No one told him there was an issue and he'd been doing it for months. I would have at least expected a manager to ask him politely at first. What makes his glasses any different from a regular cell phone? Aside from the fact that he also requires them to see and they're actually on his face instead of in his hand.
Hey, guess what? Just because you get away with going 100 mph on the highway for the first few months doesn't mean you get to avoid the speeding ticket when the cop does pull you over later.
"Well, gee, officer, I've been doing this for months now, and no one's bothered to stop me before!! It must be OK then, right?"
As an object lesson in expected social etiquette, you should hold up your cell phone the next time you're in a movie theater (preferably on opening night), leave it pointed at the screen with the camera/camcorder app on without actually taking pictures, and see what happens.
You guys need to get over the word "apologists", frankly it makes you sound like your parroting some right and/or left wing extremest political view. I've mostly gotten in the habit of as soon as I read that word I shutdown and ignore everything else as been completely off base and out side of normal reality. Actually I just had a good laugh because after typing all that I read your user name (reality impaired).
Fine, how about this? I'm not the original poster, but I'll amend what he said. It boggles the mind that an idiot wore a wearable videocamera to a movie theater and pointed it at the screen, and some people are beyond themselves that the idiot got into trouble for it. There, no need for the word "apologist".
Is there anything more arbitrary than the line drawn between "human" and "animal"?
Is there anything more arbitrary than the line drawn between "animal" and "plant"?
See, I can do this too!
Drawing a line between humans and everything else is easy. Are you a member of homo sapiens, or not?
Quite possibly true...but it's also quite possible that they would still reduce average trip time.
perfect merges at all on-ramps.
I rarely encounter an on-ramp slow-down that wasn't due to multiple lanes of busy traffic converging into a single lane, as opposed to panicky driver hitting the brakes too much. 2 flows merging into a single flow of the same size will result in a slowdown, no matter how perfect the computers are at scheduling.
No need for stop lights / signs.
Yes, because nothing else, like pedestrians, needs a traffic break to cross the street, ever.
Automatic routing of traffic to use the most optimal routes based on current volumes.
I don't think "optimal" means what you think it means. If every car can read the traffic and select routes, there will be no "optimal" route, since traffic will be evenly congested everywhere. It may be faster than taking Highway 555 now at rush hour, but all your shortcuts of taking little traveled street X or trying to save on time by using a more roundabout route will disappear.
...I will Do No Evil(tm).
Laws and pledges will inevitably be broken inversely proportional to the enforcement and proportional to the benefits of breaking your word and how many people are involved. So Bitcoin is good, no one involved is trying to make money for nothing.
And yet, the doctor seems to have determined that it had nothing to do with the current stuff and moved on:
So, depending on the kinds of tests he was doing, he apparently concluded it was a red herring.
Let me give you some insight as a doctor.
Patient comes in, lies, is actually abusing cocaine. Cocaine is a stimulant, and can cause overexertion of the heart through either chronic use or acute overdose, leading to shortness of breath and weakness, which the patient came in with. Additionally, smoking cocaine and all its impurities can damage the lungs.
It had everything to do with the "current stuff", as the patient lying and abusing cocaine as an elderly person ties everything together logically. Medical mystery solved, the doctor goes about his day. Seeing gramps come into the hospital after shooting up or smoking some dope is uncommon, but not unheard of.
Now, elderly person comes in, unknown care situation at home or what passes for home. Tests positive for drugs in their system. This explains why they came in with their symptoms, but not how it got there. That possibility requires further investigation, and may be cause for a call to adult protective services.
TL,DR: Not a red herring. The doctor reacting as they did was because they got the answers they needed, not because it wasn't relevant.
The problem is that they didn't get any answers at all -- just because she used Cocaine 30 years ago doesn't mean she still does. I used a number of drugs 20 years ago that I literally haven't touched in decades.
If he suspects abuse, then he shouldn't dismiss that suspicion just because she once used the drugs. If she associated with people 30 years ago that had access to cocaine, there's a good chance that she still comes into contact with people today that have access to cocaine, so if anything, the fact that she once used the drug makes it more likely that someone may be giving it to her now.
Which is a valid point, too. But the response to that is complicated. It may have been an incomplete story given to us - when I ask a social history on substance use, I usually ask a variation of, "Are you using any illegal or street drugs? Have you done so in the past?"
Most people who are steadfastly lying about current use will say no to both. People who have fallen off the wagon may lie about the first question in the beginning and tell the truth on the second, but if you come around again the patient will usually admit to it when directly asked and they know it's pertinent to treatment. If this patient had lied to the doctor about using before, I wouldn't blame them for thinking they're lying about both the past and now.
So, what then? Usually it comes down to conversations with the patient and his/her family or caretakers, and talking with adult protective services. If you aren't satisfied with the patient's safety at home, you tell them you're locking them in the hospital as a matter of patient safety until you're done investigating. The drug abusers will usually confess after this, because they want to get out of the hospital, after they're feeling better, to go back to using.
Further examples of HIPAA violations and nonviolations and why.
Doctor X discusses Patient Y's case with Doctor Z, also involved in the case, at the supermarket. This is a HIPAA violation, as long as there are bystanders and he used specific identifying information. The Doctor intended to have the conversation in a place where he could have reasonably assumed there were unrelated people overhearing.
Now, Doctor X discussing Patient Y as a generic stroke case in public that could be one of a million just like it, with no identifying information, and debating the best ways to treat it? Not a HIPAA violation. Happens all the time during teaching rounds and medical conferences.
Doctor X leaving Patient Y's information up on a public console in a hospital? HIPAA violation. Doctor X could reasonably know that other people are going to walk by and either incidentally or purposefully look at the information he left up.
Doctor X looking up Patient Y's information on a public console in the hospital, and then taking it down before leaving. If an investigator or spy comes by with a USB drive of cracking tools and reconstructs Patient Y's information? Not a HIPAA violation. Doctor X took reasonable precautions with intent to protect Patient Y's privacy.
Doctor X opening Patient Y's chart to write a note and orders, and unrelated person sneaking behind him and sneaking a quick peek over the shoulder at Patient Y's information without anyone seeing? Not a HIPAA violation on the Doctor's part. No intent to share. Reasonable protection. Doctors shouldn't have to hire armed security guards to watch their back while they're focusing on treating patients.
I am a doctor.
Wouldn't doctors googling their patients essentially violate HIPAA rules?
No.
Because you've now let the fact that you are a doctor treating a specific patient bleed out around the corners, and since Google is keeping track of who you are and what you searched for, they know it too.
Unless you are doing this in such a way that you can guarantee you're not causing patient confidentiality to be breached (which Google sure as hell isn't), I'm of the opinion you've demonstrated a lapse in ethics, and a breech of the law.
Violating HIPAA takes intent. And you're taking the doctor's responsibility to protect patient information way too far.
For example, Doctor X discusses Patient Y's case with Friend Z, with specific identifying information. HIPAA violation.
Doctor X discusses Patient Y's case with consulting Doctor A in a suitably private conversation over the telephone. Unknown to the parties, the NSA / and/or the phone company is wiretapping the line, and just learned all about Patient Y. Not a HIPAA violation on either Doctor's part. Doctors have to take reasonable precautions to protect their patient's privacy. Guarding against every possible outlet that snooping intelligence agencies and snooping internet companies could use is too much, and we'd never get anything productive done.
And, even if you search in a manner you know was anonymous, if those searches come from something which is identifiable as being the anonymous search of doctors, the content of those searches can still leak information out.
Because when Google see that Dr. Joe Quack has searched for Bob Skippy Smith followed by a quick refresher on the symptoms of herpes .... Google knows (or can infer) that Bob Smith has Herpes.
Doctors are not information theorists, and quite possibly not well educated enough about this technology to be using it in conjunction with their medical practice. Because clearly, if they understood this a little better, they'd realize they've more or less violated their ethics (and possibly the law) by doing this.
Doctors Googling their patients is a terrible idea, and has every possibility of violating the privacy of the patient, as well as the laws meant to protect it.
This would be an incredibly bad idea on Google's part to try to gather accurate information this way on patients. Because I assure you, doctors are neither linear nor subject related in their internet searching. Just because I google "gstoddart" and then a few minutes later "UpToDate: complications of inserting foreign objects in anus" does not mean the two are anywhere related, despite what you're thinking. I may have 20 different patients on my service at any given time, and I frequently have to be thinking about multiple cases at any given time during a workday. Hell, just to make things more confusing for google, maybe I googled "best place to order roses nearby" in between those two google searches, because I'm taking my girlfriend out to dinner after work.
Sorry, while I hate it, no one, not me, not you, has privacy anymore online or electronically. While we can fight against it, get used to it.
And that is a major failing on the doctor's part. Old people can be addicts too.
I replied about this above this thread, too.
The doctor responded the way that they did, because the rest of the medical picture falls into place once it becomes known that the patient is still abusing cocaine. The doctor didn't dismiss the possibility, treating cocaine addicts for their health issues is commonplace.
The question that was nagging the doctor was, how did the drugs get into the patient's system in the first place? Elder abuse takes many different forms.
And yet, the doctor seems to have determined that it had nothing to do with the current stuff and moved on:
So, depending on the kinds of tests he was doing, he apparently concluded it was a red herring.
Let me give you some insight as a doctor.
Patient comes in, lies, is actually abusing cocaine. Cocaine is a stimulant, and can cause overexertion of the heart through either chronic use or acute overdose, leading to shortness of breath and weakness, which the patient came in with. Additionally, smoking cocaine and all its impurities can damage the lungs.
It had everything to do with the "current stuff", as the patient lying and abusing cocaine as an elderly person ties everything together logically. Medical mystery solved, the doctor goes about his day. Seeing gramps come into the hospital after shooting up or smoking some dope is uncommon, but not unheard of.
Now, elderly person comes in, unknown care situation at home or what passes for home. Tests positive for drugs in their system. This explains why they came in with their symptoms, but not how it got there. That possibility requires further investigation, and may be cause for a call to adult protective services.
TL,DR: Not a red herring. The doctor reacting as they did was because they got the answers they needed, not because it wasn't relevant.
Which kind of proves the point: If the material is any good, it will succeed and wont need artificial state support.
The same could be said of American sports franchises, which receive billions of tax dollars, mostly as stadium subsidies. What the French are doing is stupid, but America is no better.
Not exactly the right analogy.
What the Americans are doing with state and local government and sports franchises comes down to scarcity of supply. There are only a finite number sports franchises within any given professional sports league, and beyond a certain point the talent level is diluted and the overall entertainment value and ticket sales goes down. There are any number of American cities and states that would love to host X sports franchise. A successful pro sports team can bring millions of dollars tax revenue or more to a locale directly, and provide a much bigger indirect boost to the city in business growth and prestige. (See: Oklahoma City after they wooed the NBA SuperSonics / now the Thunder away from Seattle.)
The sports teams realize the benefits they provide just by being there. And they trade those benefits for sports arenas, tax breaks, and other concessions from the locale. If a city gets bitter or bored of supporting the team, they can and will pack up and move elsewhere.
You mirror my thoughts. At times I also most wish that republicans would take and hold all three branches. It will hasten the fall of this country and perhaps, maybe, possibly out of the upheaval, a better system can come to pass. Right now I feel democrats (or maybe better to say caring politicians) try to slow the fall, give hope to the hopeless and serve only to make this country suffer more. Gangrene slowly pervades our system, our society and the caring politician, a minority today, only allows the infection to spread, albeit slowly.
We live in a time of a heartless society.
Thank you, Ra's al Ghul!
I disagree. There is no need for information which identifies specific individuals when determining the effectiveness of a drug or medical procedure in a large group of people. There is no need for information which identifies specific individuals for market research or television ratings. Those are just a few examples. Data can be made anonymous without losing its usefulness.
Data can be made anonymous without losing its usefulness; however, data cannot be made anonymous without losing the ability to check its veracity.
If there is no real person connected to data in aggregate in a scientific study, then there is no way to prevent a scientist from making up data wholesale and padding the results to favor one outcome or another. Conversely, if a skeptical competitor levels charges of this against you, being unable to point to the real people that you derived the results from looks bad.
It's a good question. All I see in this paper is fresh discovery of the same facts that were well known among skeptics like the Perth group back in 1990s. Is it really such a bizarre virus that acts like no other virus, kills like no other virus, and manages to hide the way it works so well that decades of research still leave us guessing? Or is it just a weak virus that cannot survive inside an uncompromised immune system and thus serves as a great diagnostic for immune problems that it does not actually cause?
It's a horrible question. Treating the HIV infection with anti-HIV medications can for the most part prevent or regress the syndrome of AIDS. If it was just a "great diagnostic for immune problems that it does not actually cause", treating and suppressing the HIV infection should be 100% ineffective in helping the patient.
HIV only kills ~5% of the T-cells.
Newly discovered pyroptosis pathway kills the other 95%
This is a radical departure from the accepted mechanisms of how HIV works. Pyroptosis can be triggered by a boatload of different inflammatory processes, I'll be looking forward to their smoking gun that HIV is the cause.
With all the research money poured into HIV research, it's taken them 20 years to notice this?
Hi! Your comments are a sterling example of the dangers that having just a little knowledge in a certain field poses. As a doctor who has worked in an HIV clinic, let me give you the best practical proof for your reinventing of the wheel. Take an AIDS patient who is sick with an opportunistic infection. Cure the infection, and start the patient on a good regimen of anti-HIV medications. In most patients who aren't too far gone, their immune systems will rebound, and as long as they're compliant with taking their meds, the odds are they will never reexperience the practical consequences of an AIDS diagnosis.
Testing positive for HIV used to be a death sentence. Now with current anti-HIV meds, HIV can be relegated to a chronic illness less burdensome, and less deadly, than type 2 diabetes mellitus. Do you understand that? Treatment of an HIV infection can prevent the onset of AIDS, a clinical syndrome.
If you want a better proof, have a scientist inject you with HIV virus. Make a journal, and see what happens in 5 years.
Why do I even bother responding to this nonsense.
Cancer gets cured about once a decade, sometimes by real doctors, sometimes by "quacks." I could show stats from real doctors with similar results to this one, which never saw the light of day once it was discovered (or rediscovered).
Please, do show us the stats. I get tired of the false meme that "oh, we would have cured disease X already if the results weren't being suppressed in a big conspiracy"! Medical research is hard work, and frustrating. Not only do you have to cure the disease in the test tube, but then you have to cure the disease in a living patient, and make sure it doesn't do something equally or more horrible to the patient in the process.
On top of that, the public has been oblivious to the fact that real progress in cancer treatment, and yes, even cures, are being made. Many leukemias and lymphomas are now curable through chemotherapy and radiation. This boy in the article is in the small minority that standard treatment did not work. Solid tumor cancers are getting better early detection and treatment. Mortality from many cancers has been dropping over the last 2 decades. What was once usually a consistent death sentence doesn't have to be.
People don't actually like creativity, even in medicine:
http://www.slate.com/articles/health_and_science/science/2013/12/creativity_is_rejected_teachers_and_bosses_don_t_value_out_of_the_box_thinking.html
In medicine, innovative things happen all the time. When *you* go to the doctor, you get the same ol' thing that has been done since 1952.
Most of us physicians try to live up to our creed: "First, do no harm." This includes not jumping to try every crazy-ass, untested treatment that some would-be genius cooked up and put in a syringe on the patients under our charge, if there are other treatment options that are still available. And here's a crazy thought: some diseases are better off untreated. I have an 85 year-old with dementia that was recently diagnosed with a lung tumor, likely malignant cancer but slow growing. Am I going to recommend putting her under general anesthesia, the knife, follow-up chemotherapy and possible radiation? Hell no.
If you truly think the standard of care in medicine is the same as 1952, I invite you, when you get sick, to turn down any or all recommendations for an MRI or a CAT scan. No heart catheterizations. No minimally invasive or laparoscopic surgery. No joint replacements. Very few blood pressure, cardiac, or autoimmune treatments. None of the advances for asthma and other lung diseases. If you're infected and allergic to penicillins and sulfa medications, good luck! I certainly wouldn't want the alternatives: veritable bleach in the veins or antibiotics toxic to the kidneys and ears.
tl,dr: You're full of it.
Infinite computing power to apply analytics to hiring practices, and they end up with nepotism. Truly garbage in, garbage out. I bet the friends of the HR VP are all top candidates...
"...To a frustrated game developer who feels the software conglomerates are stifling his creativity..."
Are we talking about the same person here? Notch takes Infiniminer, adds some new features and extensibility to the basic gameplay, which becomes his one and only claim to creative success. And it's the software conglomerates' fault that he doesn't have an original idea out yet?
Lucking into the Angry Birds /FarmVille style sweepstakes does not a gamer genius / tycoon make. He wants to build a Valve? Good luck.
They obviously need more employee lock-ins. Servants! Work harder! You are failing management!
Just curious. Do YOU pay more taxes than you're legally obligated to?
If not, why not?
You've just stated that you "think it's wrong" that Apple pays no more taxes than they're legally liable for. Which would make YOU wrong for not paying extra taxes.
Whoa. You're confusing "It's wrong because ethically it stinks" with "It's wrong because it's against the law".
It IS wrong that multibillion dollar corporations are unfairly paying cellar-level taxation for large profits made from consumers. Just because corporations own governments around the world and have enshrined that unfairness in taxation law to benefit themselves does not suddenly make that right.
Yay! It's got prettier particle effects than BF3! Glad that's $60 that would be well spent. "The blood spatter will be even cooler now!"
Stop shipping a browser with Do Not Track defaulted to off.
Some web servers have had a policy of disregarding DNT headers from browsers known to default it to on. Case in point: pre-release versions of IE 10. If Google were to "Stop shipping a browser with Do Not Track defaulted to off" as you suggest, what would that do other than get Chrome added to the list of browsers from which to disregard DNT?
Is this a damnation of Internet Explorer, or a damnation of a weak-ass privacy flag labeled "Do Not Track" that corporations can apparently ignore at will?
Newsflash: this is not a indication that Google is doing things the right way. This means Do Not Track needs to be fixed.
Lots of people act dumb and don't die.
Not the original poster, but yet again, the propensity of any given person (you, me, this guy in Brooklyn) to act dumb and do really stupid things should be proportionally inverse to their ability or desire to engage in activities that can hurt themselves and/or others.
Hairyfeet is 100% correct, and what I am most thankful for out of this completely avoidable tragedy is that no innocent bystanders got hurt with this guy.
Yes, we can all die in the next minute, but if a person dies while doing something completely forseeable and avoidable such as driving drunk, juggling running chainsaws, or doing stunts with remote control helicopters right over your own head, there is no guilt on anyone else's part, and there is very little sympathy, except for the people that person left behind that have to deal with the aftermath.