"A Better Way to Look at Most Every Political Issue"

[Lestat]

Just stop and think about that for a moment.

You'd be eating old fart sloppy seconds. After its gone through a gopher on a stick (well not on a stick at the time, that comes after the fattening obviously; for when you want to roast one on a stick )

[Calandale]

It's best not to know what goes into making food anyway.


I'm fine, just so long as I get to tear into delicate, tick infested, gopher meat!

[renaeden]

I don't know as you'd have a very large consumer market for old people sandwiches. The sense of taste, excluding fundamental tastes like salt, sweet, sour, umami, bitter and hot/spicy is based on olfaction, and old people smell iffy as fuck.

They've already gone off. They'd have to be the only food put on the market with a sell-by and use-by date in negative numbers

[Lestat]

Its one of the isomers of nonenal, formally speaking, the conjugated unsaturated aldehyde, non-2-ene-1-al that stems from a 9-carbon straight chain hydrocarbon. Although I doubt very much it is produced in-vivo from nonane. Not dissimilar entirely from the likes of fatty acids that make rancid feet or sweat smell, well, rancid. Or that give vomit its distinctively puke-like stink, like propanoic, isovaleric/valeric acids and in the case of barf, butyric acid. I've never worked with pure non-2-ene-1-al, but propionic acid as a side product I've experienced and its so much nastier than acetic acid as from vinegar, GAA etc. And butyric acid, which gives throwup its nasty smell, I once accidentally had some n-butyric anhydride get into the oil in my vacuum pump whilst distilling off unreacted anhydride from something and it STANK the place up something terrible, belching a stinking miasma from the air vents that smelled exactly like vomit. Oh and once had to remove it from something by means of a homespun negative pressure chamber, and during pumping it down it smelled  absolutely filthy, and so did the chamber when I was finished. Stank like a city full of already pretty rancid football fans had used the place as somewhere to stagger to in order to empty their stomachs of really cheap and nasty super strength lager.

And it doesn't take much either, one drop of butyric anhydride, although it doesn't hydrolyze completely, immediately, is instantly enough in a large room to make the entire space smell like the inside of somebody's stomach complete with a semidigested last meal. And I'd imagine that if it were the acid rather than the acid anhydride, it'd smell even worse even faster, although I've never handled neat butyric acid (nor, for that matter do I ever want to, since that is pure, distilled, undiluted essence-of-sick.)

[Gopher Gary]

Rodents are food.

Does that mean I get front row season tickets? 

[Calandale]

Rodents are food.

Does that mean I get front row season tickets? 

You get your own little warm cart. And eventually a soft bed of bread, and some kraut on top.

[El]

It's complete crap to say the vast majority of a country can live a life of leisure. There's no way a society can just sit around, without every public need falling to pieces; healthcare, education, transportation, utilities, the whole infrastructure. It might work in the short term, but a society requires a sizable workforce to function or otherwise will decay.

Most people with jobs work in service, in the more modern countries. The infrastructure is still going to shit, even with fairly high employment percentages, in the US. The vast majority of jobs being done are really not necessary. Those that are don't get
adequately funded. And nearly all of it could be done without large numbers of humans performing the 'work'.


Of course, in a consumerist economy, it's necessary to keep the engine running, even if what it stands on is falling apart.
How to move out of that cycle is the problem. The gentle path - creeping socialism - seems to have proven to be incapable,
imposing its own redundant bureaucracy. Too, there is backlash against anything threatening the value system which
underlies the consumerism. Something which shouldn't be necessary if people actually enjoyed the work they did, instead
of lying about it.

The vast majority simply isn't true; the medical industry employs a tenth of the population alone.

Medicine is a service industry. Much is bureaucratic paper pushing. Diagnostics have been shown to be better
handled by expert systems. Surgery will likely soon be better done with robotics (even if, like diagnostics, insurance
issues keep it from ever happening). Care that was once provided in the home, by family with less disposable time
mind you, is now hired out to low wage butt wipers, many of whom hate their work, and care little for their charges.

Don't understand how you can acknowledge the vast majority of people work to keep the gears of social infrastructure moving, yet say it's unnecessary.

Because the system is designed that way. Jobs which people are unnecessary for due to automation are kept
in inefficient human hands precisely because we demand people must work to be valuable - but, of course, we
give them an income which is lower than the price of the automation. There is something sick about this. The
developing world is different, of course.

The reality is, if people sit and do nothing then nothing will be achieved, and a society which the vast majority cant or don't work is a one that craps in holes and potentially eats old people sandwiches.

We could vastly reduce the number of people working, perhaps at some cost to the wealthiest, and still keep the elderly alive.
And THIS is the great opportunity: if we acted on it, we could (maybe?) get our over expanding population under control. Worse
health care, and old people sandwiches would help too.

As someone who works in healthcare and experiences the things we *currently* try to normalize and automate and give over to computers, the robots aren't taking over anytime soon.  Even with diagnostics- computers will always be more *reliable,* because they're computers.  But (at least with mental health, and this is probably true in medicine in general), people are shitty at expressing what's happening to them and shitty at cause -> effect.  Some of the information you most need, you only get by building a relationship with people.  Much more can and perhaps should be automated, but not all of it.

As for the paperwork, don't get me started.  Attempts at automating that, when done wrong, only make things worse.  And implementation is a bitch.  And I say that as someone who has literally made a tool for automating paperwork at my company.

[El]

relevant: 

[Calandale]

As someone who works in healthcare and experiences the things we *currently* try to normalize and automate and give over to computers, the robots aren't taking over anytime soon.  Even with diagnostics- computers will always be more *reliable,* because they're computers.  But (at least with mental health, and this is probably true in medicine in general), people are shitty at expressing what's happening to them and shitty at cause -> effect.  Some of the information you most need, you only get by building a relationship with people.  Much more can and perhaps should be automated, but not all of it.

People can be more comfortable expressing to a computer. And it can certainly be learned. It's not like probing questions are all that
accurate when asked by humans. The big problem for diagnostics, and why a human is always involved, is liability. Get rid of
such artificial constructs which are designed to employ others, and just try to meet the actual needs.

As for the paperwork, don't get me started.  Attempts at automating that, when done wrong, only make things worse.  And implementation is a bitch.  And I say that as someone who has literally made a tool for automating paperwork at my company.

Paperwork is the problem. It's not something which needs automation, it needs removal. A doctor can set a bone just
fine without filling out all kinds of paperwork. Someone can take drugs without it. Once the delivery system is freed
of burdens which require human effort, they can be added in a fully automated design later. But, it's ridiculous to try
and cobble together the reporting and record keeping PRIOR to building the actual system.


There are certainly things we'd have to give up. Stuff like insurance, and paying, and preventing folk from obtaining
illicit drugs maybe. At least during the design phase. Further iterations can refine the process to add in any desired
features. Like, if we want money back in the system (why?).

[El]

Also relevant:

Synergy Between Nurses And Automation Could Be Key To Finding Sepsis Early
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February 22, 201812:40 PM ET
Heard on All Things Considered
 Richard Harris 2010
RICHARD HARRIS

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Rosemary Grant is a registered nurse and helps coordinate sepsis care at Harborview Medical Center in Seattle. The center's goal, she says, is to get a patient who might be developing sepsis antibiotics within three hours.
Ian C. Bates for NPR
A quarter of a million Americans die every year from sepsis, which is the body's reaction to overwhelming infection. This cascade of organ failure can be nipped in the bud if health care workers know it's ramping up, but that's often not easy to do.

"Sepsis is a really frustrating disease," says Dr. David Carlbom, a critical care pulmonologist, and medical director of the sepsis program at the Harborview Medical Center in Seattle. "There's no blood test for sepsis," he says. "There's nothing you can look at under the microscope and say 'this is sepsis.' "

So a few years ago, Carlbom set out to devise a system that uses more subtle clues from a patient's day-to-day electronic health records to send up warning flags of impending sepsis.

Did An IV Cocktail Of Vitamins And Drugs Save This Lumberjack From Sepsis?
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Did An IV Cocktail Of Vitamins And Drugs Save This Lumberjack From Sepsis?
The automated system looks for patterns in symptoms like high temperature, low temperature, low blood pressure, fast breathing and high white-blood-cell counts. No single symptom signals sepsis, but certain patterns suggest this condition could be emerging.

Rosemary Grant, a registered nurse who coordinates sepsis care at Harborview, explains how it works as we stand at a nursing station in the hospital.

The previous day, a red box appeared on a computer screen next to the name of a patient who had been hospitalized for several weeks following a motorcycle accident. The computer prompted the nurse responsible for that patient to assess whether his constellation of symptoms was an early sign of sepsis.

"If the nurse says yes, then the provider is automatically paged, out of the computer system," Grant says.

The doctor is supposed to respond within half an hour, she says, and the overall goal is to get a patient who might be developing sepsis antibiotics within three hours.

But faster breathing might also be due to a walk down the corridor, and having an elevated number of white blood cells is not a reliable sepsis indicator in someone with cancer. Given the general nature of these symptoms, most of the time the nurse will report that the alert is just a false alarm.

Once one alarm is triggered, nurses aren't notified again for 12 hours, Grant adds — and that helps reduce the number of annoying false alarms the hospital staff must handle.

If the nurse says it's not sepsis, Grant says, "then the computer system just asks 'why do you think the patient has these abnormal vital signs?' "

The nurse may type in that the patient's heart rate was up because he was exercising, or has a high pulse because she's in pain. It's a partnership between the automation and the human being. And while systems like this are increasingly common in hospitals, the synergy between nurses and computers is a hallmark of the Seattle program.

"Just having the nurses really being in tune with their patients is really what makes the system work," Grant says. And it is working, she says. Since the system was installed in 2011 — and updated in 2017 — hospital mortality has fallen.

We head over to the room of the injured 34-year-old motorcyclist to see how he's doing. Matthew Clark says his world changed on Jan. 15, when he had an unfortunate encounter with a car.

"I was just on the way to make some chicken chili for my girlfriend," he says, "and a young distracted driver who wasn't looking kind of plowed into me." Two big bones in his left leg were broken, requiring a series of operations to set right.

But nine days after the accident, Clark got a clue his recovery was taking a turn for the worse when a friend came into his hospital room and he had trouble waving to her.

"I noticed my hands were shaking," he says, "and my blood started to leave my hands and feet. I just looked at her and said 'I need some help.' "

The hospital's internal 911 system responded with a team that, among other things, provided intravenous antibiotics to prevent his apparent infection from raging out of control and becoming septic shock.

"My temperature dropped incredibly," he says. "I'd never been so cold or shook so hard in my life."

And 24 hours later, he says, he was back to his old self.

In this case, the patient's alert actually popped up on the computer screen long after the medical team had stepped in.


Dr. David Carlbom, a critical care pulmonologist at UW Medicine's Harborview Medical Center, says sepsis has long frustrated clinicians. "There's no blood test," he says. "There's nothing you can look at under the microscope and say 'this is sepsis.' "
Ian C. Bates for NPR
"I think his case is a great example of action happening before the computer catches up," Carlbom says. "The vital signs are measured and dealt with at the bedside before they're entered into the computer."

In fact, that need to enter vital signs manually into the electronic medical record is a shortcoming of this system. The computer may be ever vigilant for signs of infection, but it only gets new data to crunch a few times a day.

Are State Rules For Treating Sepsis Really Saving Lives?
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Are State Rules For Treating Sepsis Really Saving Lives?
This isn't simply an issue for the system at Harborview — it's a shortcoming for automated sepsis-detection programs elsewhere. Medical researchers are actively working to close that gap, says Dr. Matthew Churpek at the University of Chicago.

"We're partnering now with a company that has a device that goes under a patient's mattress and can continuously calculate their heart rate and respiratory rate in real time," Churpek says.

His team and others are also working on more accurate computer algorithms, to reduce the number of false alarms that are a problem both in Seattle and in similar systems around the country.

Doctors have struggled to find a good treatment for sepsis. For example, last year Dr. Paul Marik announced that a protocol involving intravenous vitamin C, thiamine and steroids dramatically reduced the number of sepsis deaths in his hospital's intensive care unit in Norfolk, Va. That unproven treatment has just begun to be studied in a series of careful clinical trials.

Carlbom uses that experimental therapy sometimes, but says it would be much better to prevent the condition.

"We use all these therapies in the ICU as a rescue tool when people are very sick dying of septic shock," he says, "but I think early discovery will probably affect mortality more."

[Lestat]

I think thats a great idea Elle.

Although I think it could be improved for anyone that has an IV line, or even using regular finger-prick tests as with diabetes, for those patients who are at severely elevated risks of sepsis. I'm sure it would be possible to design microscale or nanotechnology bases sensors to monitor circulating levels of proinflammatory cytokines, which is the important bit in sepsis, it isn't so much the infection itself that causes it, but its the body's own defenses going into hyperdrive and releasing huge quantities of proinflammatory cytokines that does the damage and causes sepsis and septic shock.