The best waterparks in Tucson, AZ were on the outskirts of the city and worked great as a place to "travel" to for the parents as the kids would be wiped out on the way back. Breakers....Justins....how i miss those days of running around on hot pavement or gravel in bare feat only to also step on some cactus...
The biggest hurdle i face with interoperability is getting people to buy into the standard. working with (https://www.hl7.org/fhir/R4/)[FHIR] it seems like 90% of the objection is that the standard is to use unstructured json to request/respond. To many out there it feels like this is a completely foregin concept. I even have some staff engineers balk at the idea of using FHIR because its not going to conform to any ORM package. As this article says with standards comes maintenance and this is why the FHIR spec is constantly evovling with new versions and updates and even the ability to create your own implementation guide.
It is the standard in healthcare though. The world is using it to exchange data for both payor and clinical. The US has mandated the use of it for healthcare. Its built into Apple and Samsung Health apps. You can get your entire FHIR chart via mychart (epic) instances (along with many other EHR systems). And yet I'm having to prove out why we shouldnt use custom structured ORM models to translate in/back because many have grown so accustomed to it.
I had a relative who setup a kinda "blockbuster" type service recording things and offering them out for rental. It really took off for VHS when he got HBO and recorded movies and then rented those. It wasnt a very lucrative hustle but it was an instance of what they didnt want to have happen
If school busses can look both ways before crossing train tracks you'd think a firetruck would look both ways for airplanes coming down a runway. Don't want to blame the firemen though - this was a series of extrmeemly unfortuante scenarios and people trying to keep the airport running safely. For years people have been on soap boxes saying the FAA/NTSB needs to do better, and yet year after year they are poorly run and poorly funded.
its the only path to go to be able to continue to support their pricing models - they've priced the consumer/pro-sumer out of the market prettymuch and so B2B is the more sustainable paying population.
Living in Portland I meet SOOOO many tech people that live across the river in Vancouver just because of the income tax - WA has none - OR has a healthily number of them (5 lines worth of various taxes show up on my paystub).
Bigger impact im sure will be Seattle but the impact to Portland is not insignificant. I'm sure the WA tax would be less than the OR one though so I don't see the moves stopping, but probably akin to whats happened in CA where people moved to NV or AZ to escape some of the taxes (not a significant number but ive met enough to wonder). As people retire, they moved away to those places as they think they will be taxed less
They are lifelong drugs though - you go off it and the weight and “food noise” come back. If you grow to used to them you have to switch from ozempic to moniourno to whatever diff thing then circle around again.
Not saying the effort is the same just that its def not a decision to take lightly and just start doing thinking its a few shots and bam your down 50 lbs forever - still have to do the mental reprogramming to not eat the bad stuff and exercise regularly
The most noticeable jump has been at 10mg but i started noticing it from the beginning of 2.5 to 5 to 7.5 over a 6 month period but something about 10 just hit different but only on my 2nd month of it now. Less anxiety about things i was hit by before and mood improved overall
I can hear russia/iran now “darn they thwarted our plans to take out el paso and that mountain. There are absolutely zero other targets in the vicinity we can fly to. Zero in a 100 mile radius our drone has a capability to get to within 10 days. I mean if we had 11 days sure but how do they know 10 days???”
My psychiatrist is really interested in how it affects anxiety and depression as he has now seena number of improvements from a bunch of patients (including myself) who use the drug. Im on meds for both and only after i started on monjourno did i feel a signifigant change. The food cravings gone due to the nuerological effects but the stress levels lower as it seems to be impacting seratonin levels in ways as you increase dose.
Was my glucose under control without glp-1's? Yeah I could manage an a1c of 5.4-5.6 with metformin but I was still hovering near 300 lbs.
With glp-1's I'm down over 50 lbs, my a1c is a much more manageable around 4.0-4.5 and it makes it much easier to exercise and portion control is a huge benefit. Not to mention a buncha other things like triglicerides and blood pressure have come down due to exercise and eating better. it sucks i have to take it forever, but at the same time i feel a ton better physically, and if i loose 50 more lbs, and labs continue to show improvement, i can reduce the cocktail of other meds I'm on my doc says.
Cigna denied me at first until my doc appealed twice. Cigna wouldnt cover because i wasnt a full diabetic so wasnt on insulin. I would've had to pay close to $1k a month to take it otherwise. Thank goodness for a tenacious doctor!
The constant back and forth between architecture and product and project management roles is the new norm for more senior/staff engineers it feels like. rarly do i get an opportunity to work on code during regular hours.
my days are spent in meetings discussion how to implement things or why do it certain ways - when most of that time spend asking inevitably turns into "when can this be ready?"....well if you didnt have me stuck discussing it for the last 6 months it would've been ready yesterday like you wanted.
I used the CIA factbook so much in college in the early 2000's when looking at so many things. When researching countries to support and travel to it made sense to vreview it beforehand. Its insane that this as a resource would be taken down.
this is something that also never made sense to me - it felt like star wars got it right - for repairs and remedial tasks a trash can (rs-d2) or all the little service droids are more appropriate, but c3p0 or other nurse and protocol droids makes sense to look more humanistic since they serve functions to facilitate human activitiy - but there is no way those functions are numerous enough to be priofitable.
That doesnt mean they are illegal right off the bat - there is no reasonable way to filter out the "illegal" members of the roles and essentially making it so the DOJ has a list of people who they can cross reference with expiring status and the moment the clock strikes midnight and their status changes they can get picked up. They should not have all those records for fishing expedititions.