BC HEALTH
Saved by @Alex1Powell

@janethooton_ @ErinInTheMorn @fifi_EY 1/ The 🏴󠁧󠁢󠁥󠁮󠁧󠁿 government decided pediatric gender care in England would be a monopoly contract (a Labour minister, in 2008), despite all other NHS patients officially being entitled to a choice of providers, & second opinions on diagnoses & treatment, & gave it to GIDS, which has…

 @73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 2/…always advocated that trans minors & their families must have no alternative source of care, & subsequent Tory ministers have personally put their signature on renewals of it, and even personally rejected proposals for improvement that have been put forward by NHS England…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 3/…as a result of wider & public consultation. They & their civil servants listen only to GIDS on trans minors - it was GIDS advised against <18s being allowed #GenderRecognition in 2004, & since, on the basis that no one under 18 can be certain of their gender identity, just…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 4/…as many other staff at their trust wrote⬇️ to the press in 2002 (when the first instigator of this case, psychoanalyst Susan Evans was on staff too) that no trans people should be allowed that recognition but needed therapy…
https://t.co/JFD5efyEoq
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 5/…to "cure" us instead. Yet GIDS proved incapable of defending its super-conservative protocol in court - no doubt because GIDS has always expected challenges to be from patients seeking care more like that elsewhere, arrogantly ignoring that services in countries where the…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 6/…challengers in this case have been operating in the past knew that only their approach was defensible from that direction, & worked with their patients rather than attempting conversion therapy by delay & frustration & ignoring #UNCRC, children's rights, not least to…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 7/…bodily autonomy. It is also on the English government that NHS England, despite being a co-defendant, wasn't in court, leaving no one there to speak for other vital services that rely upon the Gillick principles (which GIDS misuse since they deny parents the right to…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 8/…consent whereas Gillick is only supposed to be used when an <16yo refuses to involve their parents or parents disagree with the patient) in order to care for some of their patients. Could they not see the potential threat despite the lawyer acting for the claimants having…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 9/…a long history of anti-abortion & birth control cases & those backing his cases trying very publicly to use trans minors' care as a wedge issue in the US & elsewhere, or is the current English government - whose ideological backing largely comes from US think-tanks that…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 10/…are strongly anti-LGBT, anti-abortion, anti-birth control, anti-women's bodily autonomy generally, anti-NHS & anti-EU - secretly intending to travel in that direction too, after trans minors' care has been used as a wedge issue to open the way.

And was it down to 🏴󠁧󠁢󠁥󠁮󠁧󠁿…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 11/…government pressure that the 🏴󠁧󠁢󠁥󠁮󠁧󠁿 Children's Commissioner, legally responsible for protecting UNCRC rights, wasn't in court to speak up? Why does that government-appointed official choose to never speak up on the rights of trans minors under that UN convention, & under…
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 12/… EA2010, even when a threat to them is a clear threat to other minors too, & the UN oversight committee for that convention has been specific that trans minors are included in its protections, if anyone ever had any doubt?

Yes, the 🏴󠁧󠁢󠁥󠁮󠁧󠁿 government is very much guilty on this.
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 13/ And of course this ruling is oddly identical to the threat made by the Equalities Minister shortly after she'd met with The Heritage Foundation, whose ex-staffer serving in the Trump Dept HHS was attempting in court to have all protection for US trans healthcare removed 🤔
@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY cc @threadreaderapp unroll SVP

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James Salazar
James Salazar
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In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:

Does race/ethnicity belong in the first line of the patient

Some background: I’ve struggled with this question since early in medical school

Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan

2/

From preclinical lectures to Qbank questions to clerkship rotations, race/ethnicity was often prioritized in the same sentence as age + gender.

I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.

3/

However, when it came time for me to use race/ethnicity, there was always tension. Race/ethnicity are self/socially-ascribed identities that in clinical practice are almost always assumed by providers based on appearance. I was also concerned about the potential for bias

4/

I wondered how my own care would be impacted or not impacted by my ethnicity (Hispanic) – I have light skin so I’m not sure if my doctors would even identify me as such – but how would my care be different if I was presented as a 30-year-old Hispanic male?

5/
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mf.
@redwineclouds
After therapy sessions, it is occurring to me how my parents and maybe most desi parents don't really grow as parents. For example, a person would be a very different to a baby and to a teenager because the needs and vulnerabilities are so different.

But here, I feel that growth for parents stagnants sometime around when a child is 12-13. None of our parents really talk to us about puberty and growing up. None of us are taught or can talk about relationships because of moral reasons. So what do you have?

You have parents who are still parenting their adult children like kids, not apologising to us but asking us to eat, reminding us to wear jackets, locking up cars. They care. But they are coming from a care where the parent is always concerned about keeping the kid safe and alive

which imo really reduces the kind of parental advice and care one needs as an adult. Because adults know enough about the world to no longer be infantilized but we still have parents who expect us to be the same children because they're still the same kind of parents.

This is why so many of our parental relationships are strained or just based on civilities. We're forced to hide a lot from them because parents refuse to grow as parents and acknowledge us as adults. How many of us are still lectured, have curfews, other restrictions?
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Anosognosiogenesis
Anosognosiogenesis
@pookleblinky
Fun fact: the standard advice for if a dog, cat, or human bites your hand, is to feed the bite. Push your hand further into their mouth, forcing the jaw open.

Nurses, EMTs, veterinarians, etc are taught to respond this

The advice for a human biting you is to jam your hand or arm deeper into their mouth, and rub the spot under their nose back and forth.

If you attempt to remove your hand, or forearm, the teeth do what they're supposed to and gouge out a chunk.

This vicious wolf attack illustrates proper technique.


So: every EMT and nurse who gets bitten by a human, is trained to jam their hand or forearm deeper into the mouth, feeding the bite so the jaw widens enough to remove the limb

Also, every redneck learns this along with the advice of "never run from an angry dog"
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Gilles Demaneuf
Gilles Demaneuf
@gdemaneuf
This is the $1mln question still without an answer: why were these workers cleaning bat guano from that abandoned mine?

Surprisingly we simply don't know.

China would have all interest in clarifying that point if for instance they were prospecting or selling guano. It did not.


What we know is that EcoHealth + WIV were sampling bat sites in the vicinity at the exact time of the workers being in that mine.

#DRASTIC wrote about this and about other oddities in the official story:

Maybe it's just one of these coincidences.

Then it gets interesting: about a year after the miners death, Olival & Epstein from EcoHealth Alliance co-authored a paper about the coronavirus risk infection from bat guano collection.

No mention of the

That paper oddly used some old bat samples collected by DARPA in 2006/7 at the famous Thai bat cave.

It never mentioned that the Thai monks have been doing this every Sunday for many many years without infection.

But most interestingly it never mentioned the Mojiang mine accident, even if the perfect timing and recycling of old DARPA bat samples seem to point to a likely knowledge of it.

Anyway, the idea was to ask for more money, as you correctly
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Dan Go
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@FitFounder
If you want to get in the best shape of your life by 2023 read this:

1. Get 80-90% of your calories from single ingredient nutrient dense foods.

2. Avoid processed foods as much as possible because they're addictive, devoid of nutrients & leave you feeling empty.

3. Eating similar meals every day is an underrated way to get lean.

4. Lift weights 2-4x a week. Use progressive overload to build muscle.

5. Progressive overload is simply doing more through reps, weight or frequency,

6. Eat .8 to 1 gram of protein per pound of body weight. This helps you build & retain muscle. Eat protein with every meal.

7. Avoid trying to lose weight. Focus on creating good habits. The first is focused on an outcome the latter is focused on your lifestyle.

8. Your aim is to become the type of person who stays in shape. In order to change your body your identity must come along for the journey.

9. Eat your meals on a schedule. This will help train your hunger & circadian rhythms.

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I've spoken to 1,500+ people about remote work in the last 9 months

A few predictions of what is likely to emerge before 2030

[ a thread ] 💻🏠🌍

🚜 Rural Living: World-class people will move to smaller cities, have a lower cost of living & higher quality of life

These regions must innovate quickly to attract that wealth. Better schools, faster internet connections are a must

⏰Asynchronous Work: Offices are instantaneous gratification distraction factories where synchronous work makes it impossible to get stuff done

Tools that enable asynchronous work are the most important thing globally remote teams need. A lot of startups will try to tackle this

⚽️Hobbie Renaissance: Remote working will lead to a rise in people participating in hobbies and activities which link them to people in their local community

This will lead to deeper, more meaningful relationships which overcome societal issues of loneliness and issolation

🌍Diversity & Inclusion: The most diverse and inclusive teams in history will emerge rapidly

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Will Buxton
Will Buxton
@wbuxtonofficial
The Haas / Force India argument is fascinating, and the decision of the stewards may still have consequences. The first key finding is that the stewards ruled Racing Point Force India to be a valid constructor. That means that it builds its own cars.

Haas had argued that the cars had been designed by Force India, but as Haas knows only too well, "outsourcing" is legal. The stewards decided that "there is no regulatory support for the argument that Outsourcing of Listed Parts cannot come from a former or excluded team."

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This will have a big knock on effect for Haas in its continued arguments over the rights of RPFI as relates to its eligibility and rights under the complex payments structure. Haas has argued all along that RPFI should be treated as a new team and tread the same path that it did.

TLDR? Haas lost the fight but may have won the war. In having its argument that Racing Point hadn't designed their own car thrown out, they gained clarification that RPFI was a new team.
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@ShaanVP
If you're a college student who wants to pay off all your loans... here's an idea for you:

It takes ~$5k to start and will make ~$30k a year of profit

It won't get you rich, it'll pay for college.

(..and will teach them more about business than they’ll learn in school)

The idea isn’t sexy. But it works:

**Plastic Moving Bin Rentals**

Everyone knows moving sucks. The worst part is being stuck with 400 cardboard boxes at the end of your move.

Instead - @benmlevy told me about Gorilla Bins. They dropoff plastic moving bins, & pickem up later.


Let’s break it down. Our goal is to pay for college (~$30k profit per year).

To do that, I think we’ll need $50k in revenue.

The avg move (a 2 bedroom apartment) is $180

To hit our goal, we need do ~5.5 moves per week

COSTS?

How many bins do we need to buy up front?

5.5 moves a week x 50 bins = you need 275 bins. Let’s round up to 300 to be safe.

Ok let’s hop over to @uline to see how much these bins cost

Bingo. Bins cost about $15 a piece.

$15 x 300 bins = $4,500 initial startup costs.

Time to beg your parents or a rich aunt to lend you money to get the biz rolling (...or just take $5k of student loan money and invest it here…)
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Pran Katariya
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The Straddle is my favorite trade these days. But more often than not, one needs to adjust to make a good return from it. There are many ways to do this depending on your view, psychology and imagination. Will discuss a few that I use

The Straddle is a delta neutral strategy and it is important to keep deltas in check during the course of the Trade and not let them run away from you. Of course Volatility is the elephant in the room- but not going there as that will require a separate discussion

The first and most common method is to go 'inverted.' That is to say to shift the untested side to generate additional Premium and increase the runway to Breakeven. So if you start with a Straddle at 700 and price goes to 740, you can move the PE up to say 720.

How much should you move the untested side? While again this is a matter of skill, experience and artistry, the rule of thumb is to cut deltas by half. Remember, prices will move and you have to allow sufficient room for them to fluctuate

The second method is to shift the entire Straddle in the direction of the move. So if you have a 700 Straddle and Price goes to 740, you can shift the Straddle to 720. If you time this right, it can generally be done at virtually no cost or minimal cost.
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Jaya_Upadhyaya
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@Jayalko1
ANTARVEDI LAKSHMI NARASIMHA SWAMY, EAST GODAVARI DIST.(AP)

Located where Vasistha Godavari joins Bay of Bengal.

Present structure was built by Kapanati Krishnamma of Agnikula Kshatriya clan in 1823.

It is one of the oldest among 32 Narasimha Kshetras in AP.
@LostTemple7


Legend says that here Maharishi Vasishta prayed to Narasimha to end the demon Rakta Vilochana.

Narasimha created Maha Maya, also called Ashwaroodambika or Gurralakka to suck his blood as he got a boon from Brahma that blood falling from his body would produce another demon.


After his death, the stream of blood was let out by Maya to form a pond called Rakta Kulya.

Narasimha,then,washed Sudarshan Chakra at a place called Chakra Tirtha.

Brahma is said to have performed Yagna and installed Shiva Linga here. Hence the place was called Antarvedi.


Later Sri Rama prayed here and Arjun also visited here.

Panchamrita Abhishekam is done every day.
One can have Nijarupa Darshanam (main murti without any decorative shield) between 6.00 a.m. and 8.00 a.m.

Anna Prasadam is very famous and distributed daily from 10:30 to 2 pm.
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