#Motivational interviewing in healthcare

[embassyrowprojectonline]

“Revolutionizing Remote Care: A Comprehensive Field Manual for Launching Effective Medical and Telehealth Services in Tribal Communities” book is now available on Amazon

by Embassy Row Project

In the era of globalization, medical care should have no boundaries, yet tribal communities remain a significant challenge for healthcare providers. “Revolutionizing Remote Care: A Comprehensive Field Manual for Launching Effective Medical and Telehealth Services in Tribal Communities” by Embassy Row Project founder James Scott, illuminates the path to bridging this gap. With an ever-increasing need to extend quality healthcare to the most remote corners of the globe, this pioneering book offers practical solutions, culturally aware methodologies, and cutting-edge approaches to revolutionize medical services in under-served areas. Here’s what you’ll discover:

10 Key Insights:

-Understanding the Unique Needs of Tribal Communities: Grasp the intricacies of remote environments and tailor medical services to match the distinct needs of tribal populations. -Engaging with Cultural Sensitivity: Learn strategies to navigate cultural norms and traditions to form lasting connections with tribal communities. -Blueprint for Mobile Medical Care: Establish a flexible and responsive mobile clinic capable of delivering efficient care on the go. -Sustainable Impact through Local Partnerships: Understand how to forge powerful alliances with local entities to ensure a sustained impact on community health. -Diverse Medical Team Building: Discover techniques for recruiting and training a culturally diverse medical team capable of handling complex situations. -Navigating Complex Regulatory Frameworks: Acquire insights into the legal considerations vital for implementing healthcare services in developing nations. -Bridging Traditional and Modern Medicine: Integrate indigenous knowledge with modern medical practices to offer a holistic approach to healthcare. -Empowering Communities through Preventive Health: Invest in community education to create an empowered and health-conscious population. -Technological Advancements in Telehealth: Develop state-of-the-art telehealth infrastructure to overcome geographical barriers and offer timely care. -Implementing Ethical and Transparent Practices: Establish ethical guidelines and ensure transparent practices that build trust and promote community engagement.

“Revolutionizing Remote Care” is not just a book; it’s a movement towards a more inclusive and compassionate world where quality healthcare is not a privilege but a right for all, including those in remote tribal communities. With its groundbreaking approach, compelling success stories, and actionable strategies, this book is an indispensable guide for medical professionals, healthcare administrators, policy-makers, and anyone committed to breaking down barriers and making healthcare accessible to all. Dive into this enlightening field manual and take part in a global revolution that is shaping the future of healthcare delivery. Embrace the mission; be the change!

— — — — — — — — — — — — — — — — — — — — — — — — — — —

Get your copy now:

Kindle: https://www.amazon.com/dp/B0CFBG6FMX

Paperback: https://www.amazon.com/dp/B0CF4Q7GS5

[scrapsovereign]

OP is cooking, stepping away is a form of self-care.

Here’s a tool I made up in the throes of my personal despair and taught my coworkers that might help in a face to face interaction that catches you off guard and you can’t escape and you’re not fixing to get in a fight with someone who hasn’t yet realized the consequences of their actions:

Reflect, Validate, Shut It Down.

Example: “Aren’t you proud to be an American today? Because I sure am!” (Genuine)

Reflect: Paraphrase their words back at them.

Ex: “I see you’re feeling patriotic today.” Or “You seem excited about the election results.”

Validate: A generalized statement that makes whoever you’re talking to feel heard. It gives quick confirmation that you’re listening. Our person we’re talking to seems joyful, so we’ll just give them a polite, general affirmation without condoning it.

Ex: “It feels good to be on cloud nine.” Or “Bet it feels nice to cheer for the winning team, huh?

Shut It Down: Redirect the conversation to the task at hand, announce your exit, or say something so off the cuff they can’t help but follow (this is where I shine).

Ex: “Did you know that bestiality finally became illegal in the state of Washington on Feb 11, 2006?” Or “Did you know the last time Canada won a Stanley Cup was in 1993, and it was the Montreal Canadiens?”

I hope my motivational interviewing skills can be helpful during this time we are about to go through. I’m not excited, but I feel like if we band together in solidarity to help each other we’ll make it through 💕🫡

Hi. Things are bleak, I know that. I know that we paid for Trump's last term with blood and it is likely the price will be blood again.

But listen to me. LISTEN.

You do not have to force yourself to witness horrors as an act of activism. It is not a form of activism. You can put your phone down, you can block that horrific video. We cannot win if you cannot fight and you will not be able to fight if you are hopeless.

Do not let them guilt you into this. People who are exhausted are easier to walk over. Take care of yourself, find community where you find joy.

[ms-demeanor]

Knowledge Fight anon again - thank you for the list and recs! I look forwatd to checking them out. I was excited to see there's a West Wing podcast because I enjoyed that show, but yourself and the hosts hate it so maybe not for me lmao. Though I will still give the first episode a listen - very curious to understand why our feeligns about the show differ so vastly. And if you -want- to rant about why you hate TWW - feel free! I'm genuinely curious - I'm European, have never lived in the US, so for me it was one of the biggest tools of learning how US politics work, which made it absolutely fascinating to watch.

Anyways! I'll be looking at the other podcasts as well, they all seem very interesting, and the common-denominator format you describe them having does jive with me. Thanks again!

My very republican father and sister very much wish that all democrats would act like the democrats in the west wing. It's touted as a point of honor and a great example of compromise when Democrat Jed Bartlett appoints a republican justice to the Supreme court, any time there's an environmentalist or a union supporter on the show they're painted as extreme and uncompromising, in the later seasons the Jimmy Smitts character is running as a democrat on a pro-school-vouchers, anti-tenure/union (so anti-public school, basically) platform, the show as a whole is against entitlements (free college especially is something the ostensible dems in the show aren't even interested in enough to lament).

Idk at a certain point it gets frustrating to see anti-abortion, anti-gay marriage, anti-healthcare republicans being praised as the mature compromisers in the room with complicated motivations and good points when every time a leftist protest shows up it's a warehouse full of people without enough message discipline to talk to to cameras without erupting into a shouting match and getting brushed off as whiny babies by toby zigler.

"Oh, we need CJ to look a little loopy, let's have her agree with these cartographers who are pointing out that the mercator projection privileges the global north." "Oh we need to present something that's a ridiculous waste of money, how about a wildlife crossing that would prevent keystone species injuries in an area of urban incursion, that's bullshit that we shouldn't spend money on." "Oh, we want to explain why big pharma can't provide free HIV meds to african nations in 2003, let's suggest that it wouldn't matter even if they did because *Africans don't have clocks and can't take meds 12 hours apart.*" "this hollywood producer is pushing too hard for gay marriage in 2007, let's lecture him about how you need to slow down and respect the process instead of being an activist about it"

There's this interview with Aaron Sorkin where he's saying "America used to be the world's heroes, when my dad was a soldier people would say 'thank god, the Americans are here' and they don't say that anymore and it's because of Donald Trump" - Sorkin totally ignores US imperialism and the way that people in Vietnam and Iraq and Afghanistan wouldn't say 'thank god, the americans are here' to an extent that is genuinely startling, and that shows up in the show. At one point in the show president bartlett okays the assassination of a foreign leader and says 'today we enter the league of ordinary nations' as though the US hasn't backed coups or assassination around the world, as though the CIA isn't a thing, as though Henry Kissinger isn't a thing, and it's *bizarre* from a show that is supposed to be politically aware.

I'm actually super hesitant to recommend the west wing thing to general audiences because i don't always agree with the hosts or their guests but as an analysis of the surprisingly right-leaning politics of the show it's a worthwhile listen.

It's honestly something i could rant about for way too long because I had early warning signs about it. My sister *loves* this show and its politics. She's got a "my president is Jed Bartlett" sticker that she keeps next to her signed copy of one of Ann Coulter's books. If my sister thinks your liberal character is reasonable and level headed and has good policy positions, your liberal character isn't all that liberal.

The show is steeped in American exceptionalism and imperialist apologia but it's got a tearjerker soundtrack and maybe the best and most charming cast ever assembled so you ignore it when CJ wants to brush off constitutional protections against illegal search and seizure or cruel and unusual punishment (she's a huge fan of cops and intelligence agencies and not a fan of oversight) or when she shits on affirmative action (she believes her father lost his dream job to a less qualified candidate who was selected due to minority status, and that that job loss led to his mental decline - CJ Craig thinks that DEI hiring practices killed her father) because Allison Janney is an incredibly talented and charismatic actress who is elevating the hell out of her character.

But, you know, it would be kind of fucked up if a Democrat president's chief of staff was cheerfully on-record about the fact that she thinks intelligence agencies are more effective when nobody knows what they're doing so we should leave them to their own devices.

Thank you for the opportunity to rant i cannot fucking stand this show and i kind of want to do an episode-by-episode breakdown of various flavors of bullshit but there are much better things to do with my time so i don't but it's nice to have a chance to yell about the stuff that makes me crazy off the top of my head.

That said: if you want a podcast that is less vitriolic but does actually get into how parts of the US political system work, check out 5 to 4, which is a podcast by 3 lefty lawyers talking about Supreme Court decisions. It's great!

[justinspoliticalcorner]

Ryan Adamczeski at The Advocate:

JD Vance is not gay — and he really needs you to know that. The Republican nominee for vice president continued to spread lies about transgender youth and gender-affirming care in a recent interview with gay conservative podcaster Tim Dillon, during which Vance bizarrely felt the need to assure viewers that he isn't attracted to men. “I’m not a gay guy, but I’ve heard this from gay friends of mine…" Vance said, being interrupted by laughter from Dillon. He then went on to falsely say that gender-affirming care, a collection of practices that affirm LGBTQ+ identities, is "in some ways like the pharmaceutical answer to conversion therapy," a practice that attempts to erase LGBTQ+ identities. "I’ve talked to this about gay friends who feel very personally affronted [by gender-affirming care]," Vance said. "They feel like if they were 14 years old, and maybe they’re confused … Would somebody have had them transition?" The only LGBTQ+ friend of Vance's that has publicly spoken about gender-affirming care is Sofia Nelson, who rebuked him for supporting a ban against gender-affirming care for youth and accused him of targeting trans people to score political points even though Vance had previously supported Nelson's gender transition.

[...] On the other hand, "conversion therapy" is a universally-debunked practice that attempts to forcefully change the gender identity or sexual orientation of the patient, which has been compared to "torture" by its recipients and health care providers alike. It has been condemned by the American Academy of Child & Adolescent Psychiatry, American Psychological Association, American Medical Association, World Health Organization, and so on, which have called for conversion therapy to be banned. Vance then claimed, without evidence, that gender-affirming care is purely a “profit-motivated entity [that] tries to manipulate government policy,” and that "people who are getting rich off this are also lobbying the American Medical Association." He did not address the countless other organizations and medical practitioners that support the care, nor the fact that most health care in the U.S. is for-profit.

Dillon also claimed in the conversation that those supporting trans youth want to "allow an eight-year-old to fully transition" or to let "a seven-year-old consent to a life-altering medical surgery." This is false — the most common form of gender-affirming medical care for trans minors are puberty blockers and hormone treatment, which are reversible and used to treat other conditions such as early onset puberty and certain types of cancer, according to the National Institute of Health.

Grotesque JD tells lies about gender-affirming healthcare.

See Also:

LGBTQ Nation: JD Vance bizarrely stresses that he’s not gay while bashing transitioning as “conversion therapy”

[3t22]

I'm really glad that people are finally starting to figure out ways in which they can motivate themselves using their special interests or hyperfixations, such as someone imagining their favourite fictional character being with them to guide them along a very difficult task, but it does kinda break my heart whenever said people call themselves weird for it, because it really isn't all that weird.

In fact, any reputable healthcare professional who works with autistic children will tell you that using their patients' special interests as a means of motivating them can have wondrous effects on their functioning and overall well-being. It's a very popular coping mechanism to suggest to autistic people growing up because of how our brains' reward systems are wired to our special interests.

I'll let you in on a little secret; whenever I'm feeling less than motivated to do things like taking a shower, I'll sometimes bring my Littlest Pet Shops into the shower with me (somewhere where they can't get soaked, of course!) because sometimes the very act of seeing my favourite LPS from my collection is enough to get me through a task that I find very laborious.

I mean this in the nicest way possible: stop caring about how 'weird' your coping mechanisms look from the outside when they're truly benefiting you in healthy ways. Especially when it comes to autism and ADHD, we're quite literally wired differently in our brains and had abnormal development compared to our neurotypical peers. If you gotta imagine your favourite character being with you while getting a job interview, or bring a comfort item with you to an unfamiliar place to get you through a difficult task, then just do it! After all, you're not here to make ignorant people feel more comfortable.

Sometimes it's a matter of grabbing your special interests or hyperfixations by the balls and getting as much motivation out of it as you possibly can to make it through the day. Not only are they things that we're passionate about, but they're also tools for us to use while we navigate a world that isn't built for us, so use them at your disposal however you please.

[grison-in-space]

"that ability to just modify your perspective and step into the context someone else is wrestling with and listen, that's such an upsettingly rare skill for knowledge workers and healthcare workers... if you ask people why they're struggling, you can fix it and build a better process!"

You might be interested to know that when I was in pharmacy school, those patient interviewing skills mentioned by you and clockworkcrow in that reblog chain about provider burnout were taught to us as a set of techniques known as "motivational interviewing." It's not really in the scope of the personal vs systemic interventions that that reblog chain is about, but one of the revelational takeaways that I got from learning them was the idea that the healthcare provider cannot assume that their goals for care line up with the patient's; sometimes, the patient really doesn't care about the treatment or its outcomes because they have different goals of care in mind, and eliciting those goals during interviewing (because a lot of the time people are not at all articulate about what they want out of life) is a kind of ongoing step one.

I'm also curious if you or the MDs in this discussion have ever encountered ambulatory care pharmacists practicing the approaches that clockworkcrow talks about? I ask because listening to patients, identifying patient-specific blocks to care, and addressing them was something we were taught to do in pharmacy school (because our program pushed us toward ambulatory care). But since I didn't go into ambcare after graduating, I'm unsure both how much of an impact it has/how widespread such practices actually are, and whether ambcare practitioners actually, on the whole, put their money where the educators' mouths are. Can ambcare clinics actually make a systemic difference?

Oh! I had no idea they taught y'all those skills, but then I don't actually think I've ever had a conversation with a pharmacist about meds beyond a perfunctory question about whether I know what side effects there are. In general I am not used to pharmacists, doctors, or other medical professionals like psychiatrists taking a lot of time to really listen to me. Some of that is probably that all my main health complaints are things that feel normal to me and some is probably that I am a chronic minimizer--like I said in that discussion, it's a coping method.

I have never heard the term "ambulatory care" -- oh, it's outpatient care. Yeah, okay, let's use a specific physical issue: I can't run for more than about two to three without finding myself unable to breathe. This has been a thing for essentially my entire life, and in middle school we did running with heart monitors, so even apart from the physical experience of not being able to breathe and having to stop and take great heaving breaths of air, I was aware that objectively my heart rate was going up very fast no matter how hard I tried.

(We are talking "run until you start getting black spots in your vision, then walk until you can just barely breathe again, and then run, rinse and repeat. Literally the only kid slower than me was excused entirely from running because one leg was an inch shorter than the other.) No one around me seemed to think there was anything unusual about this or that I was anything besides just physically lazy, so I kind of wrote it off until my mid twenties. I mean, I'd been visibly struggling with extended physical exercise my whole life, and no one had called it remarkable yet, but friends were telling me it wasn't normal to experience those kinds of breathing issues, so...

I presented myself with this complaint to a nurse practitioner who basically told me I was just fat and needed to exercise more. I pushed past this and was grudgingly scheduled for an ecg (normal) and a peak flow test (astoundingly poor). There was no explanation presented for the peak flow except that I was out of shape and needed (guess what?) more exercise. Tried a pulmonologist, who confirmed it was not exercise induced asthma (which I had been sort of hoping, because there are fixes for that) and told me I was basically fine.

I more or less gave up until a dentist idly mentioned that my airway was very, very small and told me that micrognathia was something I should look into: my airways might be occluded. So I went to an ENT, who also immediately tried to tell me I was basically fine but did grudgingly agree to scope my airways... and discovered major blockages from my tongue (insufficient room in my jaw, so it gets shoved backwards over the airway), my nasal turbinates (swollen almost completely shut), and I forget what else. It was incredibly exciting to have a reason.

Okay, I say, what do I do with this? Exercise more? But I want to do that, I just can't breathe. I was aware that there is a surgery to artificially extend the jaw; it involves breaking the jaw and encouraging it to heal while maintaining space between the halves. So I brought this up. He was very dubious about this. I asked for a referral anyway and was referred to a plastic surgeon. The surgeon was perplexed by what I wanted to talk about and had clearly expected me to have come in for a cosmetic procedure like a nose job. Eventually I got too exhausted to follow up further; I've been meaning to resume this thing for like six years now.

Generally, my experience of doctors is that they have been trained to be suspicious of patient accounts that don't fit a very specific narrative, and that they are impatient to get on to the next thing unless you are very proactive about your own care. If you don't have a condition in mind that you can point them at without making them decide you're med seeking, they are quick to tell you that you are just making things up in your head. There are a few exceptions but I cannot underscore enough how rare I have found them to be.

And they will all tell you to exercise and lose weight as a first line of response. Not that I'm bitter.

Now, actually working in healthcare, @scientia-rex or @clockworkcrow might have more relevant commentaries than I do. But my experience in this field has not been, to put it mildly, great. Let's not even talk about my history of psychiatric care.

[religion-is-a-mental-illness]

By: Paul Garcia-Ryan

Published: Apr 18, 2024

Paul Garcia-Ryan is the board president of Therapy First.

A comprehensive review commissioned by England’s National Health Service, released last week, found that gender transition medical treatment for children and young people has been built on “shaky foundations,” with “remarkably weak” evidence. The independent study — led by physician Hilary Cass, the former president of the Royal College of Paediatrics and Child Health — incorporates multiple systematic reviews “to provide the best available collation of published evidence,” as well as interviews with clinicians, parents and young people, in reaching its conclusions.

Referring to young people who have already been treated under these dubious circumstances, such as those at the Tavistock Centre’s now-closed Gender Identity Development Service, Cass wrote, “They deserve very much better.”

In the wake of the Cass Review’s release — which has rocked the British medical and media establishment, and might soon reverberate in the United States — many are asking how we got here. How did clinicians come to recommend the use of puberty blockers and cross-sex hormones to thousands of children and adolescents when there was insufficient evidence that these treatments were safe and effective?

Part of the reason is that “the toxicity of the debate is exceptional,” as Cass notes in her foreword: “There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop.”

I know all too well how the absence of good-faith, healthy debate on this subject can affect clinicians and patients. When I was 15, a therapist affirmed my conviction that I was born in the wrong body. After more than a decade of hormonal and surgical interventions, I detransitioned at age 30. I had come to realize that my transition was motivated by my difficulty reconciling with being gay. Today, I am a licensed clinical social worker and board president of Therapy First, formerly the Gender Exploratory Therapy Association, a nonprofit organization that advocates psychotherapy as a first-line treatment for youth gender dysphoria.

Usually in psychotherapy, treatment approaches are refined and improved by vigorous discussion, research and dissemination of new information. When it comes to youth gender treatments, though, professionals who raise concerns have been censored and subjected to reputational damage, threats to their license and doxing. As a result, countless gender nonconforming young people have been badly served.

Therapy First has been the target of silencing and intimidation efforts. Now with a professional membership of more than 300 clinicians based in 36 states and 14 countries, we are joined in our concern regarding the quality of mental health care provided to gender dysphoric youth. Even though the organization is apolitical and non-religious, with many of our members being LGBT, we have been falsely linked to the religious right. Despite being strongly opposed to conversion therapy, or trying to change someone’s sexual orientation or gender identity, we have been accused of practicing it.

What I’ve learned is that therapists who cite the poor quality of evidence in support of medical interventions for youth gender dysphoria, or who advocate traditional principles of psychotherapy in this area, are likely to be vilified — sometimes by fellow clinicians. Last week alone, eight complaints were filed against one of our members’ licenses by other therapists for simply posting, on a professional Listserv, the link to one of our organization’s webinars, on trauma-informed mind-body practices.

An activist website has labeled our therapists as part of the “global anti-transgender movement” and listed details from their personal lives, including the names of their children and other family members. Last month in London, the Telegraph reported, a medical conference that explored evidence and heard from seasoned therapists and doctors regarding the treatment of gender dysphoria was interrupted by masked protesters who set off a smoke bomb and attempted to force their way into the building.

In addition to worrying about activists outside the consulting room, therapists apparently must now also be concerned about whether their patients are wielding hidden cameras. This month, an undercover video recording of a therapy session was posted online, presenting the clinician as a practitioner of conversion therapy, yet the would-be video sting merely revealed a clinician engaged in normal therapeutic exploration. In the current climate, any therapeutic response other than immediate affirmation is considered transphobic.

It isn’t right that professionals must risk their livelihood and reputation to help young people struggling with gender dysphoria. If the culture of bullying persists, I fear that fewer clinicians with a developmental approach will be inclined to keep working with this population. These young people will be left with clinicians who aren’t following the science, many with good intentions, but others who might behave more like activists than mental health professionals.

The Cass Review made clear that the evidence supporting medical interventions in youth gender dysphoria is utterly insufficient, and that alternative approaches, such as psychotherapy, need to be encouraged. Only then will gender-questioning youth be able to get the help they need to navigate their distress.

[ Via: https://archive.today/83ZJa ]

[prosewithpurpose]

Ozempic: Dying To Be Thin

I have recently been following a few stories and commentators as they have reported on the side effects of Ozempic. My typical literary niche is mental health, inspiration and motivation for self-development. While I don’t follow the latest trends in any area I had followed the Ozempic one for some reason.

I think the part that interested me the most was many of the people who interviewed were willing to buy the drug on the black market, unverified websites and the like. Don’t read what I’m not writing I think it’s important not to point fingers but to have a holistic view of the Ozempic side effects issue.

As I researched the stories I found most of the cases were in the United States and the UK. In the ever-evolving landscape of healthcare, understanding the implications of medications is paramount. Most people are aware who follow Ozempic know it’s used for type 2 diabetes.

It gained prominence for weight loss in the last few years. I reviewed some history and current lawsuits due to the side effects. I was not aware that the side effects can affect vital organs and cause other unsettling concerns. Some may not be aware that drugs can be researched and more information can be reviewed on the FDA’s website.

Another thing that consumers can do is explore if there are current lawsuits or recalls on drugs before they start taking them. I know most people trust their health care professional but we should do our due diligence as well.

Ozempic, a member of the glucagon-like peptide-1 (GLP-1) receptor agonist class, plays a pivotal role in regulating blood sugar levels. However, like many pharmaceutical interventions, its therapeutic benefits are accompanied by a spectrum of potential side effects. These side effects vary in intensity and occurrence, impacting individuals in diverse ways.

I’m a therapist, not a physician or a nurse. I have treated many clients who struggle with weight loss or menopausal weight gain. Most of the clients I have served have found it difficult to lose weight as they have gotten older.

I have referred them to their primary care doctor. With that said some people want a quick fix for whatever reason and I can see the frustration and all the concerns that go with trying to lose weight and obtain wellness.

My concern with the latest trend of those on Ozempic is the side effects and the those that may not be informed enough on those who are dying as a result of using Ozempic or the generic form of it.

Commonly reported side effects of Ozempic encompass gastrointestinal disturbances, with nausea and diarrhea being prevalent among users. These effects are often transient, diminishing over time as the body adjusts to the medication. Concurrently, injection site reactions, another common occurrence, may manifest as redness, swelling, or itching.

While these side effects are generally considered mild, their prevalence underscores the importance of patient awareness and proactive management. As I listened to story after story most of the people had other chronic illnesses as well.

Beyond the scope of common side effects lie more serious complications that demand heightened attention. Instances of pancreatitis, though rare, have been associated with the use of Ozempic. Pancreatitis, characterized by inflammation of the pancreas, necessitates immediate medical intervention and underscores the need for vigilant monitoring during Ozempic therapy.

Additionally, concerns have been raised regarding the potential association between Ozempic and thyroid tumors. Though the risk is deemed low, healthcare practitioners and users alike must remain vigilant, emphasizing the importance of regular health check-ups and communication between patients and their healthcare providers.

It is essential to recognize the symbiotic relationship between healthcare education and the communication of potential side effects. In the digital age, individuals often turn to search engines for health-related information.

I will say most of what I found were researchers on YouTube and science journals that are talking about the side effects of Ozempic a little more now. Thus, effective communication becomes a conduit for informed decision-making. Utilizing search engine optimization (SEO) strategies ensures that information about Ozempic’s side effects is readily accessible to those seeking it.

I’m a news buff and enjoy all things science and this story was disturbing because people were and are dying from one thing but the root cause was from taking Ozempic. I hope people will do their due diligence so not one more person has to die to be thin.

For those who may be interested in strategic keyword integration, such as “Ozempic side effects” or “Ozempic complications,” the dissemination of valuable information becomes more efficient and widespread.

Thank you for reading

Be Well!

[defiantbird]

No leads on jobs and I worry I've lost my ability to pretend to care about this stuff. Every job application wants you to jump through like five hoops for them, too. It's like that one class in high school that always gave you a shitton of homework as if you didn't have any other classes giving you homework.

The longer I live, the less motivated I feel to write a cover letter or try to impress anybody. I just want to get paid and not lose my entire savings to get healthcare. I wish applications could just be a test and an interview so you can objectively prove your abitility and show that you're not insane. I hate having to dig through each job description to use their preferred keywords just to even have a chance to maybe get seen.

Ugghhh.

[brainhunters]

Unlocking Opportunities: Job Hiring Services in Malaysia

In the dynamic and competitive job market of Malaysia, finding the right talent for your organization can be a challenging task. This is where job hiring services Malaysia play a pivotal role, connecting employers with qualified candidates and streamlining the recruitment process.

One of the key players in this arena is the rise of specialized Recruitment Agencies in Malaysia. These agencies act as intermediaries, bridging the gap between companies seeking skilled professionals and individuals searching for the right career opportunities. Their expertise lies in understanding the specific needs of businesses and aligning them with the talents of potential candidates.

Job hiring services in Malaysia are designed to cater to a diverse range of industries, including IT, finance, healthcare, engineering, and more. These services offer a comprehensive approach to recruitment, from sourcing and screening candidates to conducting interviews and facilitating the hiring process. By outsourcing the hiring process to a reliable agency, companies can focus on their core operations, trusting that their staffing needs are in capable hands.

Recruitment agencies maintain extensive databases of qualified candidates, allowing them to match the right talent with the right job quickly. This efficiency is especially valuable in a fast-paced business environment where time is of the essence. Employers benefit from a curated pool of candidates, while job seekers gain access to a wide array of career opportunities that align with their skills and aspirations.

The job hiring services Malaysia landscape is marked by its commitment to understanding the local job market intricacies. Recruitment agencies often have a deep understanding of the cultural and professional nuances unique to Malaysia. This localized knowledge ensures that both employers and candidates are well-matched, fostering long-term and mutually beneficial employment relationships.

Furthermore, Recruitment Agencies in Malaysia often provide additional services beyond traditional hiring. These can include talent management, workforce planning, and even training programs. Such comprehensive solutions contribute to the overall success of businesses by nurturing a skilled and motivated workforce.

In conclusion, the role of job hiring services in Malaysia cannot be overstated in today's competitive business landscape. As businesses strive to stay ahead, partnering with a reputable Recruitment Agency in Malaysia becomes a strategic move. It not only simplifies the hiring process but also ensures that the right talent is brought on board, contributing to the growth and success of both employers and job seekers alike.

[beardedmrbean]

Newspaper Karjalainen features an Uutissuomalainen news group interview with Chancellor of Justice Tuomas Pöysti, who said that he expects the government to be prepared, if necessary, to reopen the country's eastern border earlier than planned.

On Tuesday, the government decided to close the entire eastern border for two weeks starting midnight on Wednesday in order to stop entry by undocumented migrants. The decision does not, however, apply to rail freight traffic via the Vainikkala crossing.

"The government has an obligation to monitor the situation at all times. If it turns out that the threat is lessening, the government must take measures to cancel or mitigate the decision even before the two-week deadline expires," Pöysti told the news group.

If the government wants to extend the closure of the entire eastern border after two weeks, the Chancellor of Justice will assess whether this would be justified.

According to Pöysti, both Finnish and EU immigration legislation needs to be reformed. The current legislation does not take into account situations like the hybrid operation recently seen on Finland's eastern border.

Pöysti added that he hopes that preparations for the introduction of revised border procedures and accelerated processing of asylum applications will move ahead quickly.

"Regardless of the situation at the eastern border is prolonged, or if it eases, the risk of this kind of instrumentalisation of international protection is high, so there is a need to make procedures more effective," he said.

"We must be able to ensure that those who really need international protection could be separated out and given protection. And such persons who are not in danger of being persecuted in our neighbouring country could be quickly returned, or they could be denied entry," Pöysti stated.

The Chancellor of Justice pointed out that EU regulations were drawn up at a time when the world situation was much more optimistic. EU legislation is not sufficiently prepared, he said, for situations in which a state uses people and their desire for a better life as a tool for aggressive hybrid influence.

"If asylum processes are driven into chaos by other motives, then the central idea of refugee agreements is watered down," Pöysti summed up.

In an earlier article, Karjalainen reported that the final border crossing to be closed, Raja-Jooseppi in Inari, was quiet on Wednesday, with no new asylum seekers by the time the gates were shut.

The border post will continue to be staffed and the Finnish Red Cross has announced it is ready to provide assistance at the border if needed.

Health sector retirements

Savon Sanomat is among the morning papers reporting figures from the occupational pension insurer Keva showing that one in three employees of Finland's welfare counties, which provide public healthcare services, will retire within the next decade.

In relative terms, the largest number of retirees will be seen in the regions of Lapland, Kainuu and South Savo, where about 35 percent of current staff will be transitioning to old-age or disability pensions during the years 2024–2033.

At just under 30 percent, projected retirement levels are lower than average in Vantaa and Kerava, Central Ostrobothnia and in Helsinki.

Numerically, the largest number of retirees are community nurses and ward nurses in welfare areas. In relative terms, the largest number of retirees over the next 10 years will be home service workers, reception personnel, healthcare centre nurses and mental health nurses.

13 detained at university demo

Thirteen demonstrators were detained by police Wednesday evening at a pro-Palestinian demonstration at the University of Helsinki, reports Iltalehti.

According to the police, a peaceful demonstration started at the university's main building at 3 pm. Notice of the demonstration was not given to the police before it started.

University authorities, who wanted to close the building at 8 pm, requested police assistance to clear the facility. A number of protesters moved to the university's nearby Porthania building to continue the demonstration. University officials also asked for police help in clearing that building.

Some of the protesters refused an order to leave and were carried out by police. Those detained may face charges of resisting the police and obstructing police in the execution of their duties.

Looking good for a white Christmas

Ilta-Sanomat tells readers that Finland may well see a white Christmas – at least most of the country.

Citing the Finnish Meteorological Institute, the paper announced that Tuesday was the first day that snow was officially registered at all of its weather stations nationwide.

This is unusual. The only earlier observation of snow cover at all measuring stations was on 25 November in 2010.

According to FMI meteorologist Jani Parviainen, with more cold temperatures in the forecast for December, the snow is not going anywhere anytime soon.

Current forecasts do, however, show a change in the weather during Christmas week may bring milder temperatures to the southern coast. According to Parviainen, central parts of the country and Lapland are better set to see a white Christmas than southern areas.

But those living in the south should not lose hope yet, writes Ilta-Sanomat - it all depends on how much snow will fall over the next few weeks.

[mouseratz]

this was shared elsewhere and rightfully talked about Andrew Bailey's (the man behind the Missouri ban) extreme religious beliefs but I also wanted to point out another interesting bit:

"...Bailey accused healthcare professionals of financial motives in offering gender affirming care. He claimed patients would 'get addicted' to 'mental health procedures and mental health treatments'. "

so yeah, I would say the way they use mental illness to bar trans care in the ban is more than incidental.

also of note, apparently this has been going on since mid-March, but is now getting closer to being in action (April 27th), so I figure that's why it's more widely circulating and most people are just now hearing about it.

[justinspoliticalcorner]

Andy Craig at The UnPopulist:

While running for the U.S. senate from Ohio three years ago, JD Vance inveighed against “childless cat ladies” during a broadcast of Fox News’ Tucker Carlson Tonight, a comment that went viral after he was named Donald Trump’s running mate on the 2024 Republican presidential ticket. These women, who Vance argued have been running the country alongside “corporate oligarchs” and the rest of the Democratic Party, are “miserable at their own lives and the choices that they've made and so they want to make the rest of the country miserable, too.” Expanding the critique to include childless men, Vance went on: “It's just a basic fact—you look at Kamala Harris, Pete Buttigieg, AOC—the entire future of the Democrats is controlled by people without children.” (Kamala Harris is a stepmom of two, Pete Buttigieg and his husband adopted twins shortly after Vance’s interview aired, and Alexandria Ocasio-Cortez was still years younger than Vance was at the birth of his first child.)

That’s not the only occasion that Vance has exhibited an odd and explicit hostility toward childless Americans. In another resurfaced clip from 2021, this time as a guest on far-right influencer Charlie Kirk’s podcast, Vance pushed the idea that we need to “punish the things we think are bad,” before offering his proposal to tax Americans who don’t have kids at a higher rate than Americans who do. As UnPopulist contributor and law professor Ilya Somin has pointed out, the problem wasn’t necessarily with the underlying policy—the child tax credit—but the needlessly punitive framing Vance gave to it, singling out a particular constituency for a social penalty rather than playing up the pro-family outcomes the provision is supposed to incentivize. But one of the strangest policy proposals motivated by Vance’s contempt for the childless is his contention that parents ought to receive an additional vote for each of their minor children during elections.

Vance isn’t the only one who has endorsed this policy. Notable leftist and independent presidential candidate Cornel West also thinks it’s a good idea (though his professed interest in helping children does not appear to extend to the tens of thousands of dollars he owes in unpaid child support). In a new paper, two law professors, Northwestern University’s Joshua Kleinfeld and Harvard’s Stephen E. Sachs, flesh out the idea in more detail. As they see it, parents “should be able to cast proxy ballots on behalf of their minor children.” Although there’s always some merit to thinking outside the box on structural reforms to our democracy, giving extra votes to parents fundamentally misunderstands the purpose and principles of free elections.

Parents Aren’t the Only Voters Who Care About Kids

The assumption underlying the proposals to give parents extra votes on behalf of their children is that, in American politics, the interests of children are underrepresented. But that’s a dubious premise. Governments at all levels in the United States spend huge sums on education, healthcare, benefits, and tax breaks for children, not to mention on laws and regulations to protect the health and safety of children. In total, these policies amount to public spending well into the six figures for every child from birth until adulthood. If children were indeed an electorally inert constituency, parties and politicians wouldn’t bother devoting so many resources to them. In other words, none of this spending would make sense if politicians and policymakers could ignore children simply because they can’t vote, the supposed problem extra votes for parents is intended to remedy.

The “Proxy” Pretense

More importantly, this proposal is not about giving votes to children. It is about giving extra votes to parents. To say these extra votes are “proxy votes,” as proponents tend to frame the idea, is a fig leaf. The extra votes allocated would be cast by parents or other guardians, however they see fit, as an expression of their own political views. Parents who receive extra votes to cast “for their children” would be under no obligation to cast those votes any differently than they do their own. That’s true even if they’re party-line Republicans and their 17-year old is already a staunch progressive, or—less commonly—vice versa.

One adult person, one vote is not an arbitrary standard—it is a manifestation of legal equality, the core principle from which everything else flows. The franchise represents the equal interest we have as autonomous, equal members of society with an equal interest in the protection of our rights. That construct is only applicable to adults who actually are free agents; adults are free to read what they want, believe what they want, associate with whomever they want, form their own opinions, and freely express them. By aggregating the expression of these freely formed views, we have a kind of collective freedom in deciding how our self-governing society should function.

A genuine proxy vote, such as we sometimes see in legislative bodies, is a consensual arrangement. Individuals who have a vote in their own right delegate that vote to somebody else they have authorized to cast it. No such process plays out under the extra-votes-for-parents plan. That’s because minors do not have a vote in the first place. That means they cannot freely allocate their vote to anybody. It would be absurd to say children could revoke these extra votes if they disapprove of how their parents will use them, in the way actual proxy votes can be revoked. That inherent lack of consent makes it nonsensical to say this is really the child’s vote. The proposed extra votes instead belong to the adults, just as exclusively and absolutely as their own regular individual vote. Rather than proxy voting, the system proposed is more analogous to a number of discredited historical schemes for skewing the electorate by super-powering some class of voters and—as a corollary—either partially or fully disenfranchising others.

[...]

Why Stop At Extra Votes for Parents?

Once you open the door to picking and choosing which voters get more say than others, parenthood is hardly the only possible attribute you could choose to reward. Why not an extra vote for people with college degrees, since we want more educated people to have greater say? How about taxes paid—isn’t that a relevant interest we should accord extra weight to? Land ownership? Number of employees? Or how about age? Should 70-year olds who have a shorter amount of time to live with the consequences only have a fraction of a vote compared to 20-year olds with their whole life ahead of them? If we value religiosity, as many including Vance say they do, should churchgoers get an electoral boost over the irreligious? If you’re skeptical of immigration, as Vance is to a weirdly historical degree, should votes be weighted by the number of generations your ancestors have been in the United States? If these arguments sound familiar, it’s because many of them were once common, alongside the more notorious disenfranchisements based on race and sex. Property requirements, poll taxes, university constituencies, class-based plural voting, and various other efforts to skew the electorate have all been relegated to the dustbin of history for good reason.

JD Vance’s proposal to disenfranchise single women is more proof that he is a weirdo unfit to be the nation’s #2 in charge.

[mindfulmentalandbehavioralhe]

How Anxiety Disorder Specialists Can Help You Manage and Overcome Anxiety?

Anxiety disorders are a common mental health condition that affects millions of people worldwide. It can cause significant distress and impact daily functioning. However, with the right support and treatment, it is possible to manage and overcome anxiety. If you’re looking for a mental healthcare provider then you may contact Mindful Mental and Behavioral Health PLLC.

Anxiety disorder specialists play a crucial role in helping individuals navigate their anxiety and develop effective coping strategies. In this article, we will explore the ways in which anxiety disorder specialists can assist you in managing and overcoming anxiety.

Understanding Anxiety Disorders

Anxiety disorders are characterized by persistent and excessive worry, fear, or apprehension. These feelings are often accompanied by physical symptoms such as increased heart rate, sweating, and restlessness. Common anxiety disorders include generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias.

The Role of Anxiety Disorder Specialists

Anxiety disorder specialists, such as psychologists, psychiatrists, and therapists, are trained professionals who specialize in diagnosing and treating anxiety disorders. They have in-depth knowledge and expertise in understanding the complexities of anxiety and its impact on individuals' lives.

1. Accurate Diagnosis

Anxiety disorder specialists are skilled in conducting thorough assessments to accurately diagnose anxiety disorders. They use various diagnostic tools, such as interviews and questionnaires, to gather information about your symptoms and experiences. A precise diagnosis is essential as it guides the treatment plan and ensures that you receive the appropriate interventions.

2. Individualized Treatment Plans

Once diagnosed, anxiety disorder specialists develop personalized treatment plans tailored to your specific needs. Treatment may involve a combination of therapy, medication, and lifestyle changes. Specialists work collaboratively with you to set achievable goals and establish a roadmap for your recovery.

3. Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is an evidence-based approach commonly used by anxiety disorder experts. CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to anxiety. Through CBT, you will learn practical strategies to challenge irrational thoughts, manage stress, and gradually confront feared situations.

4. Exposure Therapy

Exposure therapy is a specific type of CBT that is highly effective in treating phobias and panic disorder. Anxiety disorder specialists guide you through gradual exposure to feared stimuli or situations. Over time, this exposure helps to desensitize your anxiety response and reduce avoidance behaviors.

5. Medication Management

Anxiety disorder specialists who are psychiatrists can prescribe and manage medications to help alleviate anxiety symptoms. Medications commonly prescribed for anxiety disorders include selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and beta-blockers. Specialists closely monitor your medication regimen and make adjustments as necessary.

6. Supportive Counseling

Anxiety disorder specialists provide a safe and supportive space for you to express your fears, concerns, and emotions. They offer empathy, validation, and non-judgmental guidance throughout your treatment journey. This therapeutic relationship can be instrumental in building trust and fostering your motivation to overcome anxiety.

Conclusion Anxiety disorder specialists are essential in helping individuals manage and overcome anxiety. You can navigate to this link if you want to know more about anxiety disorder. Through accurate diagnosis, individualized treatment plans, evidence-based therapies, medication management, and ongoing support, anxiety disorder specialists provide the necessary tools and guidance for a successful recovery. If you are struggling with anxiety, seeking help from a specialist can be a crucial step towards regaining control of your life and achieving mental well-being.

[angstbotfic]

so this is what is called a "push poll," where you try to change people's opinions about things, not measure them, by framing them in misleading ways.

here's the fact check:

Harris said in the June radio interview the movement “rightly” called out the amount of money spent on police departments instead of community services such as education, housing, and healthcare, emphasizing that more police did not equate to more public safety.

At a January 2019 CNN town hall, Harris appeared to fully embrace the system, telling a questioner from the audience she would be willing to cut out private insurers as part of the transition. She argued that insurers are motivated by profit, dump paperwork on patients and delay care, saying, “Let’s eliminate all of that. Let’s move on.”

Vice President Harris as a senator representing California backed legislation in 2019 that would have established a federal commission to study proposals for slavery reparations

Harris was among candidates who have pushed for a repeal of the criminal statute for entering the country without permission.

Harris said: “I think there’s no question that we’ve got to critically re-examine ICE and its role and the way that it is being administered and the work it is doing,” she told MSNBC. “And we need to probably think about starting from scratch.”

Harris said: If you’re able to, chip in now to the @MNFreedomFund to help post bail for those protesting on the ground in Minnesota.

decide for yourself: are those bad things?

Dude. I'm already voting for her. You don't have to convince me.

[joyfulcareercenter121]

Flexible Learning: How Joyful Career Center Supports Working Students

For many people, pursuing a career in healthcare can seem challenging when they’re already managing work, family, or other commitments. At Joyful Career Center, flexibility is a priority, allowing students to complete essential training while balancing their personal lives. Programs like PCA training in Lake Ronkonkoma make it easier for aspiring healthcare professionals to fit their studies into a busy schedule. Here’s how flexible learning options support students in reaching their career goals.

Adaptable Scheduling for Busy Lives Joyful Career Center offers various scheduling options to accommodate students' needs, including evening and weekend classes. This flexibility enables students to pursue training without sacrificing their existing obligations. For example, PCA training in Farmingville is designed with part-time students in mind, allowing them to work toward certification at a manageable pace.

Online and Hybrid Learning Options With advancements in technology, Joyful Career Center incorporates online and hybrid learning into its curriculum, where possible, for some components of the training. This allows students to study at their own convenience and minimizes the need for travel. Blending online theory with practical, in-person experience is a great way for students to gain the required skills in a flexible format.

Supportive Instructors and Resources Joyful Career Center is committed to student success by providing access to experienced instructors and support resources. Instructors understand the unique challenges of balancing education with other commitments and are available to offer guidance. For students enrolled in programs like HHA training in Terryville, this support is crucial, helping them stay motivated and engaged throughout their training journey.

Career Services and Job Placement Assistance Flexible learning also means being prepared for the next step after completing training. Joyful Career Center offers career services, including resume workshops and interview preparation, to help students transition into the workforce. Job placement assistance is available to graduates, making it easier to find employment in healthcare settings that align with their goals and schedules.

A Pathway to Career Advancement Many students who complete training at Joyful Career Center are looking to advance their careers over time. Starting with roles like PCA or HHA, graduates have opportunities for career growth. The center’s flexible programs allow working students to gain initial certification while exploring further studies that could lead to advanced roles in healthcare. Conclusion Flexible learning options at Joyful Career Center enable students to achieve their healthcare career goals without compromising their current responsibilities. With adaptable schedules, supportive instructors, and comprehensive career services, students can pursue meaningful work in healthcare on their own terms.