Hey y'all: Since we've talked about how this year's New Year's resolutions went, let's talk about the accomplishments that we didn't have written down but did anyway. 💪🏼 While I feel like I didn't accomplish most of my resolutions to a tee, I realized that I did more than I ever anticipated.
Hey everyone,
Just wanted to see what the process is in all of your clinics in the case of the 'unanticipated discharge'. I work in a small clinic in a low SES/low income area, and we have patients who fall off the schedule all the time because of things like lack of funds, lack of transportation, hospitalizations, other health conditions that they have that they need to manage, and probably a million other reasons as well. In the cases of these unanticipated discharges, are you guys typically still writing discharge notes or just not bothering with it anymore? Just because of lack of time I haven't been bothering with it so far but realized that if I did, between me and my PTA I would probably have 60+ of these notes to write and I really want to avoid doing that if it's not really that big of a deal. Just really seems like a huge hassle to be writing notes for patients who are not there and who aren't been seen in PT for that visit, especially when having to deal with a ton of other paperwork already.
This was not the market activity I was expecting today. Wasnt expecting a full moon either but I really didn't see a sell off like this in so many coins. Pretty sure we can lay blame squarely at the feet of America's guardians of the dollar. On a bright note, any bump tomorrow will look even better compared to this. 🐺 🚀 🌙
2nd year EM resident who’s had multiple recent unexpected bad patient outcomes (eg patient comes in for stubbed toe with normal vitals and no other complaints then codes randomly two hours later after delay in transportation leaving the ED, young person with low risk complaint and overly thorough workup comes back next day with new horrible findings not seen with initial studies, etc.). I know this stuff happens but I’m struggling now with not blaming myself and not becoming overly defensive/over the top with all other patient workups. Any advice for handling this part of EM?
Nice how they slide this into a Juneteenth rule change. What doin' SEC?
"Next, the Exchange proposes to add rule text within proposed General 3, Rule 1030(b), similar to CBOE BYX Rule 11.1(c), which states, “The Chief Executive Officer of the Exchange shall have the power to halt, suspend trading in any and all securities traded on the Exchange, to close some or all Exchange facilities, and to determine the duration of any such halt, suspension, or closing, when he or she deems such action necessary for the maintenance of fair and orderly markets, the protection of investors, or otherwise in the public interest including special circumstances such as (1) actual or threatened physical danger, severe climatic conditions, civil unrest, terrorism, acts of war, or loss or interruption of facilities utilized by the Exchange, (2) a request by a governmental agency or official, or (3) a period of mourning or recognition for a person or event. No such action shall continue longer than a period of two days, or as soon thereafter as a quorum of the Board of Directors can be assembled, unless the Board approves the continuation of such suspension.” While the Exchange would continue to submit a proposed rule change to the Commission to amend the annual holidays within General 3, Rule 1030(a), the Exchange proposes to give the Exchange the authority to halt or suspend trading or close Exchange facilities for certain unanticipated closures. Unanticipated closures are typically the result of natural disasters, ad hoc National Holidays, disruptions of infrastructure, and other unpredictable events that would cause the Exchange to close for business. The Exchange would not utilize this authority routinely, rather the authority is reserved for extraordinary circumstances where there would not be sufficient time for the Exchange to file to amend its rules. The Exchange notes that it would coordinate with the industry in determining closures for these events.[9] The Exchange believes that it is necessary to have such authority in the aforementioned cases as there may not be sufficient time to file a proposed rule change. Additionally, these unanticipated closures would not be recognized on an annual basis, rather these types of closures would be ad hoc closures. The Exchange would provide notic
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Some unanticipated foreshadowing from Laura about The Traveller using Sprinkle as his way to be there with Jester.
Jester is talking to Twiggy about The Traveller...
Jester mentions that The Traveller has always kept her company.
Twiggy: "Is he like Trixie?"
Jester: "He's not quite like Trixie."
Well, ummmmmm. Yes. Yes he is.
Me: 39M, SW 104kg, CW: 95kg, GW: 85kg
Current status: After years of yo-yo weight loss and generally mucking about with half-measures, about 18 months ago I started working with a nutritionist to get my diet under control. Since then I've gone through some controlled cuts (down to 90kg), and one big bulk over the summer. I'm now in the process of cutting again to lose the fat from the bulk. This is largely CICO, but with a mind towards keeping protein intake at an appropriate level.
Was at the gym yesterday and someone who is usually there around the same time as I am came up and mentioned that my body transformation in the last half year has been really inspirational to him. To be honest, while I recognize I have made progress, it's so easy to lose sight of how far I have come and only look to how far I still need to go. I remember seeing someone else in particular a few years ago and having similar thoughts to the person who spoke to me; how maybe if they could get into shape I could do the same. Never really expected to be that inspiration to someone else, but it feels really great!
Anyway, if you are still only partway to your goals, just remember you never know who you might be inspiring today! Goodness knows I have taken so much inspiration from this sub.
TRIT going to tank, good luck
This might not be the best place for this, but I need to vent to the universe.
In July I was told I had a very slim chance of ever becoming naturally pregnant again, after we had been TTC for 9 months. I cried for days about loosing our plan. But then I felt incredibly grateful for our happy healthy toddler, and fell nicely into a one-and-done mind set. We went on an expensive (for us) fishing trip, I drank with dinner, I stopped worrying about prenatal care, I lost a little weight and felt good about my body (I wasn't worried about my body image when planning a 2nd).
Well 2 days ago I took a pregnancy test and that bitch was positive . Like, it took all of 3 seconds to go dark blue and the control line had to catch up. I was shocked. My SO is excited, but honestly I was very happy in the one-and-done club. Family has asked if I'm excited and I just don't answer. Which is so foreign from my first pregnancy where it was all we wanted and we were both thrilled. I'm not sure what to do with all of this sudden unexpected change. Again.
Plus, to add to the stress, with my medical condition I have very irregular periods, so I don't know how far along I am. On top of that there is a 45% chance of miscarriage. I just need a cry and a nap. And maybe a therapy appointment.
I don't know what happened but for some reason I'm having trouble recording while having the other tracks play through my DAW.
When it won't record it says " Unanticipated host error" & "Error while opening sound device. Please check the recording device and project sample rate"
Not sure what to look for exactly but when it does record its when I put the playback device as my computer speakers. Could it be something I changed in FL Studio that's affecting it? Any help would be appreciated. Thanks
How have you seen "unanticipated problems involving risks to subjects or others" been defined in your experience? I'm asking from an academic sponsor perspective on a investigator-initiated multi-centered trial. But generally interested in people's experience as it seems difficult to define.
45 CRF 46 does not actually include a definition of "Unanticipated Problems" and while the OHRP guidance provides better a better definition it is still is difficult to determine when an incident/experience/outcome Mets the criteria of; unexpected, related and greater risk than previously know or recognized.
We invited 157 with our venue being a 120 minimum. We sent out invites knowing we’d get maybe 20-25 No’s. We’re sitting at 98 attending, 32 declines, and 27 no responses so far (11 of which we know are most likely declines). The more declines I get the more disappointed I get. They’re family members that will show up to just about any other family members wedding (even to ones they’re not close with) but are consistently saying no to mine. It’s more frustrating when a couple weeks ago one cousin responded attending but then his other siblings responded decline and so he went and changed his to decline.
I tell my husband I’m annoyed and he just goes off about how I should tell them I’m disappointed. I try to explain that would solve nothing, wouldn’t make them change their mind, and be a waste of time. To add on to the disappointment, my brother most likely won’t be able to attend either because he decided going to Canada to get married in December would be a good choice and is now stuck there pending his work visa.
Sadly this wedding is showing me how much of a loner I really am that even family can’t make an effort to show.
I am moderately confident and feel I do alright in social situations, but I feel boosted when I'm wearing a nice watch. I'd been hesitant to wearing any jewelry all my life, and couldn't really adapt to wearing a watch in previous years. Well I ended up buying a cheap $100 automatic Seiko about 6 months ago, and now I have about a dozen watches with one in the mail. While I have some really expensive watches now, even wearing a $50 watch feels good on me and gets compliments.
Men, go get an actual wristwatch. Not a quartz (battery) movement, but one with a real automatic movement inside of it. These things are like a cheat code for feeling awesome.
