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4inkjets coupon 20% cheap | Fashions and savings | Scoop.it

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4inkjets coupon 20% discounts

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Inn owners bowing out: Kilauea Lodge for sale

Inn owners bowing out: Kilauea Lodge for sale | Fashions and savings | Scoop.it
VOLCANO – A historic piece of Volcano Village is for sale.
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A Shortage of Juggling Doctors

A Shortage of Juggling Doctors | Fashions and savings | Scoop.it

A controversial statistic suggests that in the near future our country will be in desperate need of more doctors. The Association of American Medical Colleges has estimated that by 2025 we will be about 130,000 short, thanks primarily to an exploding older population. Ten thousand Americans now turn 65 every day, entering their golden years of disproportionate consumption of medical care.

Not all the experts agree with these calculations. A panel at the Institute of Medicine, for example, has countered that geographic variability always undermines these dire predictions, with a reliable glut of physicians persisting in some places and reliable shortages in others. The real problem, they say, is a profession top-heavy with specialists, leaving too few to provide primary care.

I have no particular professional expertise to inform an opinion on these matters. I do, however, have a pertinent personal perspective, having lived in a miniature version of our soon-to-be-geriatric nation for most of my adult life. Thanks to extremely long-lived parents who married late in life with a sizable age difference between them, it is now closing in on three decades that our nuclear family has contained an extremely old person to worry about.

So here’s the bottom line: We have had no doctor shortage. In fact, even with just the one permanently on-call house doctor (me), I would say we have actually had enough doctors. Maybe even a surplus.

My mother, ever the comic, used to drag out an annoying little routine at dinner parties to the effect that she and my father sent me to medical school specifically to supervise their old ages. After many years chewing that one over, I am forced to conclude that the joke is on her. Not the best choice, Mom.

It would have been better by far to send me to nursing school. Talk about shortages — how our little world could have used an in-house individual formally trained in patience and small acts of kindness, one whose knowledge of health care reflected the more practical, symptom-focused schematic that distinguishes nursing from medical education. Certainly, doctors are now making tentative forays into this territory: We have, for instance, added the concept of “comfort care” to our knowledge base, and we use the term freely. But most of us are not too clear on the actual techniques.

It would have been better to send me to physical therapy school. No surprise there: A doctor’s familiarity with obscure diagnoses — and the ingrained habit of reviewing them compulsively when something goes wrong — is considerably less helpful for the old than an understanding of some normal activities, like sitting, standing and tottering around. Unless you are a rare physician indeed, you know nothing about the process of rising from a chair except to politely conceal your impatience while it is accomplished.

It would have been better to send me to design school, given the fact that every single item marketed to help old people stay in their homes is uglier than ugly, making their reliable decision to have nothing to do with it (cane, walker, bathing aids, you name it) particularly difficult to countermand. Furthermore, nowhere in the universe does there exist a portable, slim, elegantly designed, mechanically sound, reasonably priced chair that a person with no strength or balance can spend a lot of time in and then actually get out of.

It would have been better, much better, to send me to clown school, to pick up some validated tools for amusing and distracting people. It turns out that when a lifelong worker no longer works, a reader no longer reads, a person who never took a vacation is on a long one, miserably elastic time stretches long and wide and heavy in every direction. The days may be running out, but there are still too many of them and they are all much too long. An on-call juggler would be just the ticket.

Best of all, I think, would have been the decision to send me to graduate school in philosophy, to observe wiser minds making sense of it all, possibly to absorb some rudimentary techniques for soaring high above the small, sad details to a serene understanding of the bigger picture. Or perhaps a few years in aviation school would have provided the same perspective.

You could certainly say that our family has experienced serious decadeslong shortages of various professionals. But doctors — those valiant but limited warriors schooled to think only about their own tiny little battles in an irreversibly lost war — were not among them. We probably had one too many of those.

 

 


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Christmas greetings 2014

Christmas greetings 2014 | Fashions and savings | Scoop.it
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4inkjets coupon 20% deals

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Christmas greetings 2014

Christmas greetings 2014 | Fashions and savings | Scoop.it

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4inkjets discount printers supplies

4inkjets discount printers supplies | Fashions and savings | Scoop.it

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Christmas greetings 2014

Christmas greetings 2014 | Fashions and savings | Scoop.it

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7 Tongue-in-Cheek Marketing Predictions for 2015

7 Tongue-in-Cheek Marketing Predictions for 2015 | Fashions and savings | Scoop.it
What will be the future of the Internet and online marketing in 2015? This is a question asked around this time every year. Most of the answers coming from the “experts” are often either vague or completely obvious. So what’s a marketer to do?

Because you have so much riding on your website, I wanted to do better for you this time around and give you some concrete ideas you can actually use and plan for in the coming year. And so, without any further preamble, here are my seven boldest online marketing predictions for 2015:

Via Brian Yanish - MarketingHits.com
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Women at Work: A Guide for Men

Women at Work: A Guide for Men | Fashions and savings | Scoop.it

The business case for this is compelling. Companies with more women in leadership posts simply perform better. Fortune 500 firms with the most female board members outperform those with the least by 26% on return on invested capital and 16% on return on sales, according to a 2011 Catalyst study. Yet the number of women at the top is barely budging: some 5% of Fortune 500 chief executive officers and 17% of board members. Numbers in law and finance are dismal too.


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Mike Allen's curator insight, December 17, 2014 5:48 PM

Women in top roles are vital as long as they are there on merit. They bring a range of good qualities and reduce macho management . This evidence is both compelling and ignored Why?

Prof. Hankell's curator insight, December 17, 2014 10:20 PM

I am convinced that women don’t need more advice. Men do...

FOXY Steph's curator insight, December 18, 2014 9:09 AM

It's a complex subject. It sounds as if women have to be more like men to succeed in business...  whereas all we need to do is be ourselves.

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How Boomers, Gen X and Gen Y Look for Work

How Boomers, Gen X and Gen Y Look for Work | Fashions and savings | Scoop.it

When it comes to using mobile technology in the job search, boomers are catching up to their kids; nearly half of boomer job seekers now use their smartphones to search for work.

That's one of the surprising findings in Three Generations of Talent: Who is Searching For Jobs Today, a report released today by Indeed Hiring Labs, the global research arm of the world's largest job site, Indeed.com.

"Overall, generational job search differences are far less striking than you might expect," says Tara Sinclair, the author of the report, who is an Associate Professor of Economics and International Affairs at George Washington University and Chief Economist at Indeed.


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The Learning Factor's curator insight, December 14, 2014 2:21 AM
A new report's surprising findings on how Boomers, Gen X and Gen Y look for work.
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2014 Retrospective On Marketing-to-Mom Research

2014 Retrospective On Marketing-to-Mom Research | Fashions and savings | Scoop.it
Did you know that 71% of modern mothers work outside the home? And we are in the midst of the rise of the Latina mom? Moms make 90% of their purchases online. The following is a year in review of 2014’s most interesting research and insights into today’s mom

Via Jeff Domansky
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Jeff Domansky's curator insight, December 16, 2014 11:57 PM

Excellent basket of insight into marketing to moms.

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The American hospital as we know it is in peril

The American hospital as we know it is in peril | Fashions and savings | Scoop.it

I appreciate the need for physicians and others to sleep.  I’ve spent a great deal of my career awake in the wee hours.  In some very real ways, emergency medicine as a specialty exists as a shield between patients and their sleeping (or otherwise engaged) physicians.  But I fear we’re all wearing a little thin.  Because the emergency room has become an all hours clinic, and increasing numbers of other physicians simply won’t be bothered at night.  Sometimes they take themselves off of the call rotation.  Other times, they simply make it obvious that the ER needs to deal with it.  My friend Doug is fond of saying “emergency medicine is the residency that never ends.”  That is, some other doctor is always telling us what to do for them.

 

Also, in an era of increased medicalization, a populace under-educated on health and the human body simply panics at the slightest event.  I’m sympathetic.  There are lots of unknowns in life, and if I weren’t educated I’d panic sometimes too.  (Heck, I still over-diagnose myself all the time and I’m wrong 98 percent of the time.)  My wife has said that she doesn’t know how moms do it when they aren’t married to physicians!  Nevertheless, better education in high school is certainly in order.  This “overmedicalization and undereducation” leaves us addressing life-issues more than medical emergencies.  But hospitals are fine with that, since administrations seem to view every customer as a bill about to be paid.  Which in fact is often untrue, but I digress.

Back to the point.  I’ve worked in Tiny Rural Hospital in several states.  I’m an advocate for the Tiny Rural Hospitals of the world.  But after hours it’s a strange time.  Patient’s physicians try their best not to see the patient 1) on admission, since the ER doctor already did and was compelled under by-laws to write orders, and 2) during the night because, well, it’s night.  In many locales, the ER doc is tasked with seeing, working-up and stabilizing the patient, then calling the admitting doctor to tell the story, getting approval for admission, then writing the admitting orders.  The admitting physician will pick it up from there. But not always. Often, the nurses still call the ER doctor for clarification.  Wouldn’t want to wake up the admitting doctor after all. “He get’s grumpy when we call,” I’m often told.  Obviously, this is different in facilities with active hospitalist programs, those workhorses of the modern hospital.  God bless ‘em.

In addition, most folks don’t realize that many services taken for granted in the past aren’t available at even large institutions at night.  But even less so in small ones.  Obtaining an after-hours ultrasound in a small hospital can be a nightmare.  The techs simply won’t come in.  Sometimes they will for select cases, ruling out tubal pregnancies or ovarian/testicular torsion (twisting) which can be surgical emergencies.  But in a few locales, it’s simply “transfer the patient.”  I worked in a charming little hospital where the ultrasound tech was a very nice, very competent man who simply never learned to do any OB/GYN studies.  “I just never was trained to do it.”  And he remains so.  Thus, women in need of formal obstetric or gynecologic ultrasounds at night had to be transferred.

Frequently, simple radiology interpretation services are not performed after 5 or 6 p.m. unless specifically requested.  CT and MR images are read remotely, of course.  But plain x-rays?  Not so much.  Of course, and it’s a pet peeve of mine, they still bill an emergency reading fee in the morning. By then I’ve already acted on what I saw.  It’s just how things are.

The American populace doesn’t realize that many hospitals don’t have much specialty access.  General surgeons are usually available, but not always.  Orthopedic surgeons are sometimes available, but frequently are not.  (Just transfer him!)  ENT surgeons are a rarity.  Gastroenterologists and cardiologists are luxuries.  Ophthalmologists, neurologists and psychiatrists?  A miracle.  In fact, I worked in a very busy hospital that had no pediatricians on call most nights.  (Pediatricians!)

The American hospital as we know it is in peril.  Some of these folks made themselves unavailable for good reasons.  They were overworked, underpaid and reacted to changes in billing and by-laws by voting with their feet.  Others, I don’t get.  Sometimes I think it’s simply sloth, or a lack of genuine concern for the community.  Other times I understand that it’s sheer exhaustion.

The sum total, though, is that specialist or not, ancillary services or not, the ER is open and the physicians and nurses who work there have to deal with the same complex situations, but without much back up.  Even when back-up exists, doctors don’t come in like they did in years past.  If there’s no procedure to be done, the specialist says “call the hospitalist to admit them.”  Or says, “I don’t admit.”  I remember telling a cardiologist, “I’m concerned about this patient.  You want to swing by and see him?”  “No, not really,” was the reply.  End of discussion.

The hospital after hours is increasingly a barren, lonely place, offering less and less care for more and more money.

I don’t know the answer.  But I know that my colleagues and I, emergency physicians and hospitalists and hard-working nurses, will still be stuck holding the check at the end of the night.

And in the morning, will always be held accountable when things didn’t end well in the lonely watches of the still dangerous night.

 

 


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Christmas greetings 2014

Christmas greetings 2014 | Fashions and savings | Scoop.it
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4inkjets coupon 20% exclusive

4inkjets coupon 20% exclusive | Fashions and savings | Scoop.it

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Sony Hack Reveals Health Details on Employees and Their Children | The Health Care Blog

Sony Hack Reveals Health Details on Employees and Their Children | The Health Care Blog | Fashions and savings | Scoop.it

On top of everything else, the Sony data breach revealed employees’ sensitive health information:  Top Sony executives saw lists of named employees who had costly medical treatments and saw detailed psychiatric treatment records of one employee’s son.

Like last year’s revelation by AOL’s CEO, it shows US corporations look at employees’ health information and costs. By ‘outing’ the fact that 2 of AOL’s 5,000 employees had premature infants whose treatment cost over $1 million each, the CEO violated the employees’ rights to health information privacy.

Trusted relationships simply cannot exist if individuals have no right to decide who to let in and who to keep out of pii. Current US technology systems make it impossible for us to control personal health data, inside or outside of the healthcare system.

Do you trust your employer not to snoop in your personal health information?  How can you trust your employer without a ‘chain of custody’ for  your health data? There is no transparency or accountability for the sale or use of our health data, even though Congress gave us the right to obtain an “Accounting for Disclosures (A4D)” for disclosures of protected health data from EHRs in the 2009 stimulus bill (the regulations have yet to be written).  And we have no complete map that tracks the millions of places US citizens’ health data flows. See: TheDataMap.

There is no way to know who sees, sells, or snoops in our health data unless whistleblowers or hackers expose what’s going on.  Our personal, identifiable health data is in millions of data bases unknown and inaccessible to us.  Both the Bush and Obama Administrations support this privacy-destructive business model on the Internet and in the US health care system.

The US health data broker industry consists of over 100,000 health data suppliers covering 780,000 live daily health data feeds. 

THE GREATEST DAMAGE CAUSED BY THE LACK OF CONTROL OVER PII IS THE LOSS OF TRUST— TRUSTED RELATIONSHIPS BETWEEN PEOPLE, COMPANIES, AND GOVERNMENTS ARE IMPOSSIBLE WITHOUT PERSONAL CONTROL OVER PII.

Both Angela Merkel and Jennifer Lawrence spelled out the deep and persistent effects of violating personal boundaries:

Both spoke of the deep emotional pain and costs of betrayal, and of being unable to trust or feel safe following such serious boundary violations. Trust is truly impossible unless individuals can set boundaries. People, companies, and governments must respect and honor individuals’ rights to control access to personal information to be trusted. Violating boundaries destroys trust and relationships between people and between nations.

Sadly, even though the  modern world’s concept of ‘privacy’ comes from our nation, from US Supreme Court Justice Louis D. Brandeis’ concept of privacy, and later in the computer age from Wallis Ware’s concept of Fair Information Practices, the US has lost its way and is destroying both freedom and the right to be let alone.

Among the Western Democracies, has the United States become the world’s most intrusive surveillance state?

Do we have control over any information about ourselves?  Or is every bit or byte of data about us collected, held, and sold by millions of hidden data bases?


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Afghanistan: Little Progress on Rights | Human Rights Watch

Afghanistan: Little Progress on Rights | Human Rights Watch | Fashions and savings | Scoop.it
(New York) – The dire human rights situation in Afghanistan showed few signs of progress in the past year, raising serious concerns about the future, Human Right Watch said today in its World Report 2012.

Via Caroline Wellford
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Why Self-Managed Teams Are the Future of Business

Why Self-Managed Teams Are the Future of Business | Fashions and savings | Scoop.it
Could you build a business around teams of people who have no manager and who report to no one up a food chain? If you want your business to thrive going forward, you just might want to

Via Mika Auramo, Aki Puustinen
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Mika Auramo's curator insight, December 17, 2014 1:48 AM

New culture should be taught in school. 

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The Making of Lady Vader | MakerED | MakerSpace

The Making of Lady Vader | MakerED | MakerSpace | Fashions and savings | Scoop.it

 

I knew the minute I saw this anime Lady Vader art that I wanted to cosplay the costume. However, when I started to show my friends, I got a few concerned "Wow, that's ambitious!" comments. I mean, ...

 

 

 

 


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Heatmaps Reveal Where Humans Feel Certain Emotions On The Body

Heatmaps Reveal Where Humans Feel Certain Emotions On The Body | Fashions and savings | Scoop.it
It’s well known that attitudes, emotions and feelings affect our body in a variety of ways. For example, feelings of hopelessness affect the body’s hormone system and change the chemical flows within our brains. Different emotional states act as triggers that impact our biology in a variety of ways. Brain activity changes during different emotional […]

Via Edwin Rutsch
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Michael Dunn's curator insight, December 14, 2014 1:43 AM

Emotions, natural sciences: Where do we feel different emotions?

Jakarta Web Developer's curator insight, December 14, 2014 1:11 PM

be Social:  
https://www.facebook.com/JakartaWebDeveloper

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4inkjets discount printer supplies kits | Fashions and savings | Scoop.it

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Christmas wishes 2014

Christmas wishes 2014 | Fashions and savings | Scoop.it

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4inkjets discount printer supplies

4inkjets discount printer supplies | Fashions and savings | Scoop.it
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Christmas wishes 2014

Christmas wishes 2014 | Fashions and savings | Scoop.it

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