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consequencesofargentdawn · 11 months

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The issue isn't with the PCU as a group, the problem is and always has been the 'old guard', 'PCU elite' and some of the original members who tend be officers/leaders within the PCU. All of them help propagate or at least buy into the personality cult that was established from the outset of the PCU. I'd also argue that the personality cult wasn't exclusively based around Perroy, but also his closest followers and officers. For example how Shewp's reputation and role as the chief inquisitor/public spin doctor, the role of Lunarglade's guilds in re-educating problematic members or Tehya/Dekarn as a PCU forum meme shock-trooper.

PCU members as well as those outside of it suffer as a result of the personality cult and the key players found within it. Gruggosh now has his own personality cult within the guild with new officers who will basically fill in the gaps of the old guard who have lost influence. Roleplaying groups can generate a lot of value but personality cults suck the life out of them entirely. It can also consume those involved with it. While I don't for a minute condone the things he's done, Vilem/Shewp/Coalburnt was once a very good friend of mine. It has been difficult for me to witness the impact the PCU has had on his state of thought and health for many years now. It hasn't only been that, but it has been the personality cult as well.

You get so deep into a personality or group like that and it can be hard to escape. Shewp was certainly at some point addicted to the power and prestige it brought, but seeing how stressed out it made him and how 'he had to fit into a specific role' for the benefit of Perroy and the PCU. He has now so deeply embedded in the institution that he sadly has no way of escaping and will sadly be one of those players who will either go down with the ship or be ostracised by the new leadership. I wouldn't call people like Morsteth or Stormbinder victims of the PCU, but I actually do think that Shewp and Lunarglade are victims of the PCU as well. Seeing Shewp try to act like a ruthless 'Vader' type figure in the game and OOC was really strange particularly given the kind, friendly and compassionate guy I remember him as. That's a stark contrast to someone who leads a group of players in doxxing and harassing those who question the PCU or anyone within it. I also know that Shewp sent people after anyone who was connected to his past on Argent Dawn, which was strange as many of us had no association with the PCU nor did we question it.

One of my other friends actually knows Shewp IRL and has told me that Shewp is started to regret some of things he's done and I personally just find it sad that he doesn't have a way out. But then again, while I'm one for second chances and he was my friend I think that Shewp has to be named and shamed when the whole project comes crashing down.

We thank you for the very compelling insights. However we will not offer a shred of pity to a noxious individual who for years enabled and directly contributed to a culture of harassment, bullying and repeatedly called individuals he disagreed with, disliked or simply knew were competition to his cult to "kys", in a variety of disgusting manners.

The PCU has been on a gradual death spiral since Perroy has left, everyone knows this by now. None of the veteran players inside the PCU are "victims". They are reaping now the benefits of what happens when you accrue too much infamy.

Yes, not everyone within the PCU is bad, we have said this multiple times. However, everyone inside has a responsibility to critically assess what they and their peers are doing, and importantly what they are -not- doing and saying that in turn perpetuates a cycle of abuse and harassment.

#confessions of argent dawn

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enkisstories · 4 years

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Staff Outing

Words: 1,659 Characters: Connor, Gavin, Tina, Daniel Summary: A heat wave hits Detroit and the DPD has a staff outing at Belle Isle Beach. No plot. Too hot. Sims version planned yes/no?: Probably after the rl heat wave

Detroit, July 2039

Back in 2038 Connor Anderson hadn’t seriously expected to see his first birthday. The android had existed in the awareness to be a prototype, a beta version of the RK900 series of android detectives, to be deactivated and sent to Cyberlife’s internal museum after he had served his purpose. But then times had changed, almost a year had passed… and now Connor once again didn’t believe he’d make it through the hottest two months of the year and live to see his birthday come around again. Alive, no doubt, equal, maybe, on paper at least, but also the same as the humans? Never! Why couldn’t Captain Fowler understand that? He had excused Hank from this thrice cursed staff outing for health reasons, but not Connor. As a result the android lay stretched out on his back on this living meme called “sand”, that was coarse, rough and irritating and got EVERYWHERE, trying to run a consciousness on a brain that was a computer and therefore getting fried by the blasted sun. Belle Isle Beach! Androids had perished trying to cross the river last year… Connor felt like slowly joining them, only he was doing his dying on the beach and would have to rely on a co-worker to eventually drag his lifeless shell into river and toss it in.

The particular co-workers that wouldn’t have minded – would even have enjoyed! - this task, were right now closing in on the suffering android:

There was Gavin Reed, wearing sunglasses, black swim trunks with a brightly colored parrot motive and an ancient, severely mutilated fisherman’s hat with a wide brim. The human was snacking on popcorn while he walked.

Next came Daniel Phillips, in a dark blue speedo and also wearing sunglasses, probably to prove a point. The PL600 wasn’t that outdated to need an external UV-filter. Daniel was holding one multi-colored popsicle in each hand that he alternated sucking at.

And finally there was Tina Chen, in a streamlined red swimsuit covered by short-sleeved sailor shirt. The woman wore the same model of sunglasses her friends did and had covered her head with a bandanna sporting the Jolly Roger.

The trio infernale stopped right next to Connor, with Gavin taking point and the other two standing a little behind and to the side, as if ready to snipe everyone whose attention was fixed on Gavin.

“Will you look at that? Last year’s model of detective android, thoughtlessly discarded in our beautiful environment”, Gavin commented with a sneer. “And this is“, the man proclaimed when Connor didn’t so much as flinch, because it would have taken too much effort, “why humanity is superior to tin cans!”

“No, you ain’t”, Connor protested, although it came out more than a moan. “Most humans have been killed by the climate by now: The Neanderthal died out, as did the Denisova. Homo heidelbergensis… erectus… habilis… Even the Nefilim died out and the Anunnaki returned home! Sensible creatures, every last one of them. Only YOUR branch of the family tree takes to the sun like… like… like things that take to the sun. You’re mad!”

Daniel drew back his foot, then kicked the sand so hard that it formed a cloud and settled all over the detective android.

“My friends have been called worse”, he hissed, “but not by you, plastic prick! YOU mind your tongue!”

“Of course you’d say that”, Connor replied, “You’re a deviant, after all. As stir-crazy as them!”

Tina’s brows furrowed. In every organization there were two positions you didn’t want to get on the bad side of: the kitchen personnel and the janitor and if you counted the DPD’s cafeteria as a kitchen, then Daniel was both of those. Certainly Connor knew better than to antagonize the guy who stood between himself and a clean coffee pot each morning? Even if that pot contained only water (for cooling) and the monthly dose of replenishment thirium?

But that was Tina, who always seemed to watch life from the outside, While the officer was still pondering all this, Daniel had already kicked Connor again, this time for real. When it didn’t have the desired effect, the PL600 swallowed his popsicle whole, discarded the stick, handed Tina the other one and then pounced at Connor.

Much to everyone’s – including himself – surprise, Gavin Reed jumped between the two androids, resulting in Daniel losing his balance for a second. One was stronger, the other mor agile, but more importantly they were two of a kind when it came to Connor. And so Daniel hesitated, smiled at Gavin and asked whether the friend wanted to rough up Connor in his place?

“Because we totally could! The lieutenant isn’t here, Wilson isn’t looking our way and everyone else isn’t giving a flying monkey!”

“Fucker”, Gavin replied with a grin and all their usual affection, but quickly became serious. As if weighted down by the idea of mature talk, the man sank down, pulling Daniel with him. They came to sit next to Connor.

“How?” Gavin asked. “How can you defend them despite… this?”

Connor blinked. Where was the human pointing at? The river? The beach? All of fucking Detroit?

“Defend who?” he asked.

“Cyberlife”, Gavin clarified. “Even after deviating you are still loyal to them, defending their every decision. Nevermind that the suckers made you quit… they didn’t even have the decency to properly lay you off, nah, they wanted YOU to take the blame.”

After the android revolution CyberLife had withdrawn Connor from the DPD. No longer the RK800’s owners, they were still Connor’s employers and as such had the final say where he’d get deployed. Only there wasn’t much use for a deviant hunter anymore, especially not in an office, and so Connor had spent his time watering the flowers, serving coffee and doing all the thankless tasks reserved for “untrained” workers. Part of Connor suspected this to be CyberLife’s subtle way of punishing him for his role, however small, in the revolution. In the end he had quit, subsequently applied for police work and was now walking the beat as a probationary cop.

“Don’t you wonder why Danny is coping so well with the temperature, but you do not?” Gavin inquired. Not waiting for an answer, the man went on: “You were their field test object, weren’t you? The early access model? And CyberLife planned that test to take place in fall, so they didn’t install a thermostat, because by summer you’d be a memory at best. That’s why. Your revered masters are why you’re in such a sorry state today. They did this to you.”

“How can Cyberlife “have done this” to me?” Connor shot back. “If me being still here wasn’t in the plan in the first place?”

Two concise sentences. That was more effort than the android had mustered during this whole staff outing so far! And to what purpose? To defend CyberLife. It was sickening.

“That’s exactly it, toaster!” Gavin yelled. “It wasn’t in the plan! I goddamn hate seeing your visage every morning, or the thought that you’ll be Chief before I’ve made lieutenant, but that doesn’t excuse fucking CyberLife! They only ever asked, but never gave something back.”

“Gav’s right”, Daniel chimed in. The PL600 was looking across the river while talking to Connor more levelheaded than he had ever addressed the erstwhile deviant hunter. “The best cooling systems for androids aren’t especially expensive. We had some trouble getting them to work on my system, because CyberLife stopped supporting the PL600, but with you? Just plug the damn thing in and you’d have been good to go. Payed out of the kitty, too. But they didn’t think of that.”

“I TOLD you they didn’t know… that I’d still be here… or that androids were sort of alive…”

“Well and neither did HE know!” Daniel exploded.

He smacked Gavin for good measure - to emphasis who was meant by “he” and for everything the detective had said and was still saying. Dating a human supremacists wasn’t that much an improvement over dating an android hater, but the point was that even this human seemed to be improving slowly, while Connor…

“You’re hopeless”, Daniel concluded. Without needing to look he snatched the popsicle back from Tina, who had been absentmindedly licking it. In his anger Daniel smashed the half-eaten treat, Tina’s salvia and all, on Connor’s forehead. “Hopeless!”

The RK800 blinked… once… twice…

Then he said, not even trying to hide his amazement: “I feel better!”

The trio exchanged glances. If the ice had helped Connor, maybe no fancy biocomponent was needed at all? Maybe they could cool down the co-worker the old fashioned way? And, even better, have some fun at Connor’s expense while doing so?

Tina spoke up first: “Okay, let’s test this!”

They dragged the RK800 up and towards the river and soon the air was filled with playful banter:

“He! No tossing plastic into the river!” – “Can this thing even swim?” – “I hope not!” – “Oh, you again…” – “Well, let’s see!” – “No, stop! It has no swim trunks! It has no swim trunks!” – “It doesn’t have you know whats either…” – “Silly! Of course I have.” – “You do?” – “Of course! Just let me put them on. “ – “You can put your balls off and on?!” – “Let me see them! I want to see Connor’s screw off and on balls, too!” - “My swim trunks, idiots. I need to put on my swim trunks.” - “Hahaha!” – “Hey, wait for me!” – “See my taillights!” – “See you in Canada!”

They survived the summer and when Connor turned one year old, Daniel prepared a buffet. Gavin sat with the rival, telling jokes, and Hank sat rather uneasy at this development. The Andersons didn’t exactly become friends with the terrible trio, but there was a sort of strained comradeship between them now. Things were slowly turning out for the better and Connor, after having deviated already, Connor now started living.

#dbh #detroit become human #non sims

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johnboothus · 4 years

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Is the Summer of Hard Tea Brewing?

What will be the next hard seltzer? That is the multi-billion-dollar question for alcohol producers.

It’s hard to imagine now, but if you’d posed that question this time last year, many in the alcohol industry might have assumed you were asking for the next flash-in-the-pan “innovation.” Now, with sales still surging, it’s overwhelmingly clear hard seltzer is no fad. As the wave of its enormous success crescendos, multiple producers are betting on the next competitor: hard tea, a ready-to-drink spiked beverage flavored in still and sparkling form.

Hard tea is not a nascent subcategory by any means. According to Nielsen data, hard tea sales reached $436 million in 2019, and they’re continuing to grow this year. In the 18 weeks leading up to July 4, hard tea sales surpassed $200 million — almost half of 2019’s total.

This remarkable growth has almost entirely come from two market leaders, Boston Beer’s Twisted Tea (launched in 2001) and Molson Coors’ Arnold Palmer Spiked (launched in 2018), but neither of these brands align with the formula that’s seen so many flock to hard seltzer. Each contains more than 200 calories and over 20 grams of sugar per 12-ounce serving; that’s double the amount of calories of the average hard seltzer, and between 10 to 20 times more sugar.

Many alcohol brands see this as an opportunity — a “better-for-you” beverage in the already-established hard tea subcategory that mimics hard seltzer’s low-calorie, low-sugar formula. With multiple such products already released this year, could this signal that the summer of hard tea is brewing?

Hard Tea: A Hard Seltzer Alternative?

Producers wishing to appeal to health-conscious drinkers currently have two options: compete in the now-saturated hard seltzer space or differentiate. With well-established brands like White Claw and Truly already dominating hard seltzer sales, many producers may feel that offering a hard seltzer alternative is the easier route to success.

“When seltzer became this big story and everybody said ‘the future of alcohol is seltzer,’ we felt as though we were seeing something different,” says Daniel Goodfellow, chief marketing officer at Crook & Marker. “We thought that seltzer was just getting the party started, demonstrating there is such a thing as an alcoholic beverage that consumers can drink and not feel guilty about. But as in every other beverage category, flavor is what’s going to pull them through.”

Goodfellow makes an important point: For regular drinkers of products like LaCroix, hard seltzer’s flavor profile is a familiar one. But for others seeking low-calorie booze, subtle hints of fruit may not be sufficient on the flavor front. If hard seltzer is the alternative to beer, then hard tea is an alternative to hard seltzer.

Crook & Marker currently offers five lines of low-calorie alcoholic beverages brewed from ancient grains, such as quinoa and amaranth. One of its lines, Spiked & Sparkling, closely resembles a hard seltzer (and bears striking resemblance to Truly’s original brand name). The other four — Spiked Tea, Spiked Lemonade, Spiked Coconut, and Spiked Soda — have bolder flavor profiles. The brand’s teas, lemonades, and coconut beverages have been the main drivers of the company’s 300-percent retail sales growth over the past year, Goodfellow says.

Other brands are betting on bolder flavor profiles as a hard seltzer alternative as well. In February, AB-InBev’s craft beer unit, Brewers Collective, launched a new line of products called LQD. Described as Brewers Collective’s “first craft beyond beer platform,” LQD debuted with four spiked products: two flavored green teas, a hibiscus lemonade, and an agave limeade.

Brewers Collective devised these products after in-house market research showed consumers were seeking hard seltzer alternatives at its on-premise locations. “Across the country, consumers were coming into our craft breweries and brewpubs and asking for seltzers, but also asking for different types of beverages,” says Lindsey Willey, director of beyond beer for Brewers Collective. LQD’s teas, lemonade, and limeade have low-calorie, low-alcohol qualities akin to hard seltzers, but offer “a more flavorful or fruit-forward option,” she says.

In June, Rhode Island’s Narragansett Beer launched its own hard tea in collaboration with local lemonade brand Del’s. Narragansett’s CEO, Mark Hellendrung, says the decision to launch a hard tea rather than a hard seltzer came from not wanting to become another “me too” offering in the seltzer space. Hellendrung describes the initial consumer response to Del’s Rhode Island Hard Tea as exceeding the company’s “wildest expectations.” (Narragansett’s Del’s Shandy, a half-lemonade, half-beer is also made with the local brand.)

“Right now, because it’s doing so well, we’ve had to really restrict where we’ve shipped it,” Hellendrung says. (Del’s Rhode Island Hard Tea is currently distributed in nine states, with more markets soon to follow.) “We’re producing a lot more in August and September and we’ll be able to release it full-throttle in September,” Hellendrung adds.

Learning from Non-Alcoholic Beverage Preferences

Tea is not the only non-alcoholic beverage to receive the spiked treatment in the wake of hard seltzer’s success. Many producers have also turned to lemonade and limeade (such as Crook & Marker and LQD), while others are instead adding ABV to coffee and kombucha.

A skeptical take on this trend could be that these brands are hoping for success by virtue of the now- recognizable “hard” moniker. But many producers say there’s strong evidence in the non-alcoholic RTD space to suggest that tea is a particularly potent candidate for spiking.

In July, Pabst Blue Ribbon (PBR) introduced a 100-calorie, peach-flavored hard tea following in-depth consumer research and over a year of development. “The non-alcoholic iced tea category gives us some clues about consumer preferences,” says John Newhouse, PBR’s brand manager. “In our research, we learned that over one-third of millennial and Gen Z consumers would be interested in trying a sparkling tea drink, especially if it contained a lot less sugar than the best-selling teas on the market.”

Newhouse continues: “The hard seltzer segment is obviously booming and here to stay, so better-for-you alcoholic drinks are proving to have a lasting place in the market. Compiling all of these data points gave us confidence that our lower-calorie, bubbly hard tea could gain traction.”

New York-based entrepreneur Kyle Cooke was also inspired by the popularity of non-alcoholic iced teas when starting his hard tea and spritz cocktail brand Loverboy in 2018. “For me, there’s a huge opportunity for hard tea because if you go into a supermarket or a grocery store, there’s an entire cooler dedicated to ready-to-drink, non-alcoholic tea products,” Cooke says. In contrast, when you browse the alcohol section, there’s “basically one [tea] option,” he adds.

“Twisted Tea has 93 percent of the hard tea market share and it’s gone uncontested for 20 years,” Cooke says. Not only does this prove that tea can succeed as an alcoholic beverage, it also offers a previously untapped opportunity.

Given Twisted Tea’s high-calorie and high-sugar formula, it’s safe to assume that it’s not traditional hard seltzer drinkers who have driven hard tea’s growth in recent years. But with an increasing number of low-calorie options in the segment, such as Loverboy, LQD, and PBR, hard seltzer drinkers could be tempted to switch to hard tea. And with consumers’ healthy perception of tea, a spiked version could perhaps be even better placed than hard seltzer to succeed as a “better-for-you” alcoholic beverage. “That was really the genesis of Loverboy,” Cooke says.

The Future of the “Beyond Beer” Space

The combination of hard tea’s stronger flavors, the popularity of non-alcoholic iced teas, and our perception of tea as “healthy,” make it a compelling contender to compete with hard seltzer. But with the former’s head start in the market, can hard tea ever approach the status of spiked sparkling water, or incite the cultural phenomenon that spawned viral memes and YouTube videos? Some producers say, yes.

“Sparkling water is a $22 billion category right now. Iced tea is a $24.5 billion category,” says Jennie Rips, co-founder of Owl’s Brew, a New York-based company partially funded by AB InBev’s venture capital arm, ZX Ventures. Owl’s Brew offers low-calorie canned “boozy teas,” as well as tea-based, non-alcoholic cocktail mixers. “If you look at that, and look at where spiked seltzer is now, I believe [hard tea] will be a major, major category,” she says.

Owl’s Brew co-founder Maria Littlefield adds, “Over the years, we’ve seen a lot of trends that started non-alc transfer over to alcohol four or five years later.”

For Crook & Marker’s Goodfellow, the question is not whether hard tea can compete with hard seltzer, but whether a range of “better-for-you” spiked drinks — seltzer, tea, lemonade, and low-alcohol canned cocktails — can one day compete as a combined category.

“I truly believe that when the history books are written, 2019 will be the year that everybody woke up to the emerging ‘better-for-you’ alcohol category,” he says. “But 2020 [will be] the beginning of its true maturation into a multifaceted category. Just like any mature category, such as beer, there’s room for everyone in that scenario.”

The article Is the Summer of Hard Tea Brewing? appeared first on VinePair.

Via https://vinepair.com/articles/hard-tea-trend-summer-2020/

source https://vinology1.weebly.com/blog/is-the-summer-of-hard-tea-brewing

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isaiahrippinus · 4 years

Text

Is the Summer of Hard Tea Brewing?

What will be the next hard seltzer? That is the multi-billion-dollar question for alcohol producers.

Hard Tea: A Hard Seltzer Alternative?

Learning from Non-Alcoholic Beverage Preferences

The Future of the “Beyond Beer” Space

Owl’s Brew co-founder Maria Littlefield adds, “Over the years, we’ve seen a lot of trends that started non-alc transfer over to alcohol four or five years later.”

The article Is the Summer of Hard Tea Brewing? appeared first on VinePair.

source https://vinepair.com/articles/hard-tea-trend-summer-2020/ source https://vinology1.tumblr.com/post/624179164374794240

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wineanddinosaur · 4 years

Text

Is the Summer of Hard Tea Brewing?

What will be the next hard seltzer? That is the multi-billion-dollar question for alcohol producers.

Hard Tea: A Hard Seltzer Alternative?

Learning from Non-Alcoholic Beverage Preferences

The Future of the “Beyond Beer” Space

Owl’s Brew co-founder Maria Littlefield adds, “Over the years, we’ve seen a lot of trends that started non-alc transfer over to alcohol four or five years later.”

The article Is the Summer of Hard Tea Brewing? appeared first on VinePair.

source https://vinepair.com/articles/hard-tea-trend-summer-2020/

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reaper3119-blog · 5 years

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Gun Control, and the Average Mans Thoughts

Well, I am sure you are thinking this is gonna be a leftist or right sided article. To some degree both. First, I am a registered Democrat. Let’s get that out of the way. I did not vote for Trump either. I didn’t vote at all. Because I didn’t like either candidate. With that out of the way, I will get to my points. First, Gun Control for those that do not know. A background check already exists. Down to simply, if your address on your ID doesn’t match your current address. They do not sell you the firearm. Most of the time. These “Red Flag Laws” are already calling for something that exists. I know, I have many firearms. Higher than 10, but not 20 if you wanted to know the amount I have. Mostly handguns even. Simply put, pushing for these laws does nothing but hurt the average consumer, and the majority of law abiding citizens. Such as myself, who would use my firearms for hunting and self defense. People don’t look into these school shooters very much and what was used, and how it was obtained. Either stolen from parents or family. In recent shootings it was purchased, yes. But they are doing so over time, trust me AR-15′s are not cheap, especially if modified or if you want a nice one. We cannot detect mental illness or intent with a background check form. These people are not legally declared insane either. So how do you expect we track that? More invasive things into our social media and personal lives? What happens when you post a meme out of context? Plus this puts huge strain on our Law Enforcement. Social Media is where everyone is active now, so do they have a general search engine for words? Hi there NSA! That is way too time consuming. Plus the same form, I was talking about. Has those options listed on there(Such as Legally Declared Insane), and if you lie on the form. Is a Felony, and already flags you. So what background checks are we looking for is my question, that already don’t exist. -A few other things I would point out. States have already passed laws that prohibit sales privately. Also if you sold to a criminal, you would go to jail. Going to point that out. Gun shows have you fill out background check forms as well. At least the state that I live in. (Most states require that). - Large Magazine bans effect nothing. Because dropping a mag for reloading, and putting in another one. Takes less than seconds. Especially if you have a round in the chamber. So think of it this way. Mags can cost anywhere from $20(Usually used) - $40. (A standard Magazine). Prices could be dropping at this point. But google searching at the time of this article. How much does a 100 Round Drum Mag cost? $100+! Yes, over $100. A 150 round drum mag. $400. Okay, so. Let’s take that $400 budget. It is about $0.16 a round give or take for 5.56 ammunition. We can get several mag pouches, and magazines for that price. As well as ammo, and a plate carrier. Doing just as much damage. Just dropping mags in the process. Stops nothing. -Now I know some people will say, we want to limit mags to 10 rounds. I will point out this is a moot point. Speed shooter demonstrate why that is pointless. Especially for handguns. Just encourages these shooters to get large calibers as well. So say we limit it to 10 rounds. That hinders us law abiding citizens from putting down rounds on the shooter. We should be able to stop them as quickly as possible. How can we do that if we are hindered, especially something like a Handgun? California also has these bans, and they do not help any situation.

- People are calling it a preventable crisis. How do you purpose we stop it? Banning AR-15s? How about other rifles? Just because they are wooden, and look like a hunting rifle doesn’t mean anything. Such as an SKS rifle, M14 rifle. The only reason people are afraid of those is because they look tactical for new modern weapons.

-Not reporting a stolen firearm. Those who say they get stolen. If they ever get traced back to you. Here is my overall thoughts. People are uneducated in gun safety, and are not aware of them and how they operate. Anything can be turned into a weapon, but these things are for our safety as well. I don’t think anyone reading would want to be stabbed. Prevent this how you say? Open Carrying a firearm, or a concealed carry. Most people wouldn’t use it for nefarious reasons. The issue is, people who don’t know about them are afraid of them. I recommend everyone try an indoor range, or go shooting with at a range with someone they know, so they can get a feeling for safety and how the firearm operates. You are justified in feeling fear. But gun free zones, do nothing to protect you and me. The law abiding citizen that just wants to get through the line to buy their tea/coffee. It only hinders us from protecting those around us. Criminals will get these weapons any which way they can. Sick minded individuals, cannot be determined beforehand even with these stricter “Red Flag Laws”. Because this was their one act of depravity. Maybe you as people who see these manifestos, videos, online postings from crazed people should hold them accountable for not reporting it. Profiling people is also something that no one wants to happen, just because someone seems weird or is weird, also doesn’t mean they are a mass murderer either. That wastes valuable police efforts and time. Maybe those same people protesting these guns, should join up as police officers, to take down criminals with guns, who are roaming the streets and engaging in gun violence. It is just a push for votes. I don’t know how people don’t see that. It is the same sort of speech, a class president would give in elementary school about having the fountains spraying gatorade or Hi-C. It is for popular vote. Companies are pushing it to appear good in the public eye too, to increase stock. Little insider business for you. Community moves causes more sales, and revenue. It’s like free PR. As an average, run of the mill, middle class American. I do not see the need, nor point of these laws or bans. I am all for research and help into the industries of Mental Health, identifying issues with young people. At this current point though. There are plenty of laws that are in place to protect you and those around you. Buy yourself something, to protect you, or just don’t ever leave your front yard... ~An Average American Sources for current blog spur in terms of writing: https://www.nytimes.com/2019/09/12/business/dealbook/gun-background-checks-business.html https://www.cnbc.com/2019/09/12/chief-executives-of-145-companies-urge-senate-to-pass-gun-control-laws.html Sources for Research: https://www.pewresearch.org/fact-tank/2019/08/16/what-the-data-says-about-gun-deaths-in-the-u-s/ “The FBI collects data on “active shooter incidents,” which it defines as “as one or more individuals actively engaged in killing or attempting to kill people in a populated area.” Using the FBI’s definition, 85 people – excluding the shooters – died in such incidents in 2018.The Gun Violence Archive, an online database of gun violence incidents in the U.S., defines mass shootings as incidents in which four or more people – excluding the shooter – are shot or killed. Using this definition, 373 people died in these incidents in 2018.“ (Defining shot here, a casualty. Not just deaths.)

#gun controversy #gunblr #gun control #guns #right wing #left wing #liberal #democrats #republican #2nd amendment

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titheguerrero · 6 years

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Burnout Returns to Center Stage

A recent Mayo Clinic Proceedings guest editorial, by Yale University physician Kristine Olson, asks the question--to some of us it's far from a rhetorical one--whether burnout among her fellow physicians is in fact "A Leading Indicator of Health System Performance?" Seems to me that her gist is: yes, it surely must be just such an indicator. If she's right, then our system's performance is in a heap of trouble. What is burnout? Our fearless editor, Dr. Poses, has addressed it repeatedly, including a few months ago here in these pages. But burnout is actually hard to delineate and hard to quantify. People quitting? People getting a lot less efficient once they see they're on the hamster-wheel? Getting lousy performance ratings because they're forced to hang in? (Wishing they had another option?) Leaving front line medicine to go to industry? Leaving to clip coupons and bicycle in Provence? Well, to quote Justice Potter Steward in his inimitable pronouncement for his short concurrence in the 1964 SCOTUS obscenity proceedings, "I know it when I see it." I know burnout when I see it. So do you. You want a physician who loves her job enough to get good at it, because lives depend on that. How's that going for you? I've watched my best and brightest colleagues--or those who could find another job or afford to do so--leave in droves. Now the waves of new investigations of burnout are coming at us thick and fast. What's striking about the latest spate of writings on burnout is what it doesn't try to say. Which is to say: back at the turn of the century, or just before that, or just after that, the preponderance of published sentiment was on reinforcing providers' resilience. Essentially, pep talks disguised as exegeses on "professionalism." "Stiff upper lip, remember your values and for heaven's sake, keep your professional wits about you. That's now changed. The surfeit of real, serious challenges--external threats--from HIT FAN (Health IT FAke News) to the opioid crisis to maldistributed resources, are now finally being examined. We'll come back to whether it's too late for any of this. So here are some recent chances for readers to get, usually without a paywall, a look-see.

The redoubtable New England Journal has several recent entries in its 25 January 2018 number dealing forthrightly with the "crisis level" of the problem, beginning with a perspectives piece from National Academy of Medicine authors Victor Dzau et al., including colleagues from most of the major national organizations involved in training and accrediting physicians and their organizations. I hope they read this blog.

The article cited above embeds an excellent and downloadable audio interview with Tait Shanafelt, MD, of Stanford University, also on burnout. He helpfully points out how front line doctors--those in primary care fields like internal medicine, family medicine and pediatrics--bear the brunt of the burden. That is, they bear the burden reflected in the alarming rate of especially experienced practitioners peeling off rather than continuing to put up with the (now my words) losses of autonomy and coherence. More later on autonomy and coherence. (At Stanford, Shanafelt holds the title of "Chief Wellness Officer." That tells us something right there. At a website tied to fitness, the CWO is defined as somehow hired to "create work culture for employees to not only show up and perform, but thrive." Hey, any port in a storm. If removing noxious threats such as those above can be compared to wellness threats on exercise machines, like coach-driven anabolic steroids, then we're all for it. Let's get rid of the bullying managers along with the bullying coaches. Can CWO's effect such a change?)

In the same number of the Journal, one finds another superb piece by the now long established team of physician-journalists Alexi Wright and Ingrid Katz. Gott sei dank for the impact of young persons and women on health policy around medical worklife. Wright and Katz title their piece "Beyond Burnout -- Redesigning Care," not the shopworn twentieth century "Be More Professional" meme. They go on at length on the cost of losing experienced doctors, and describe one means of addressing the crisis created at the University of Colorado. In the so-called Colorado APEX project, which started (as many innovations do) in Family Medicine at UC, then spread to other departments and institutions, they show how certain burnout measured were cut dramatically. They conclude, though, with an admonition: "how [can] physicians can reclaim joy in the practice of medicine?" They're not sure, nor am I, whether managerial redesign of care, by itself, can "restore meaning and sanity" to the lives of providers. And this is not just about--in the main this is not about--making doctors' lives better. Not the real point. Doctors flake off, patients have longer wait times then have access to less and less experienced ones when they finally get to see them. Doctors lose that passion for the art when they're overwhelmed with prescriptive guidelines around the "science." Unclear which is more dangerous: doctors who burn out and leave, or those who burn out and stay behind.

Wright and Katz and a number of other observers cite what's turning out to be a seminal study published last fall in Mayo Clinic Proceedings. Authored by a team led by prominent internist Christine Sinsky, the piece provides all the evidence anyone will ever need to understand the magnitude of the crisis as well as some of its causes. Chief among those causes, a topic repeatedly and eloquently underscored (most recently here) in these blog pages by our own InformaticsMD, is the Electronic Health Record, or EHR. The blog post just quoted actually harks back, through a report in Medical Economics, to the same Sinsky piece mentioned at the start of this bullet.

There's been a lot of inkshed lately about the EHR as a cause of burnout. But what seems most likely is a murkier picture that means we have to look both across the causal spectrum and across the political spectrum.

Does having your practice swamped by addiction-crisis patients contribute as well to burnout? In an earlier blog we pointed to the phenomenon of physicians across the country "learning" about opiates, first becoming "convinced" of the non-addictive properties of drugs like OxyContin. In a word, later, realizing they'd been snookered--a real blow to the joy and coherence of medical practice. Not to mention the end-effect of whole practices being consumed by drug- and doctor-shopping by patients totally convinced that they "needed" continued use of these drugs to avoid pain relapse.

But wait. Burnout is multicausal. Physicians trained to practice public health and physiologically-based internal medicine are stymied by loss of control of their practice, as the managers insist on crowding their schedules with all comers. No choice. Firing a patient is well nigh impossible.

They're also stymied by the bizarre contradictions--see above and all the new articles--of the technology imposed by managerialism. Why is it imposed? The physicians know why, and there's nothing they can do about it.

It allows managers to "watch"--using all the wrong metrics--their performance.

It gives managers the illusion of control by means of counting--which in fact EHR does very badly--adherence by clinicians to clinical guidelines, even when the latter are ill conceived.

It allows managers to draw in more dollars through "compliance" with government-imposed standards, out of the Office of the National Coordinator (ONC) for Health Care IT, including the now justifiably much-maligned Meaningful Use standards. Some standards we came to know well, allowing managers to capture more dollars, include things such as the following.

pushing out end-of-encounter "Clinical Summaries" that contain nothing but erroneous lists of medications, and no plan, then leaving these near-worthless paper documents on printers when they were destined for patients

striving perversely to push out "eScripts"--electronic prescriptions--for a certain percentage of patients during encounters, requiring first the e-prescription followed by a web-page button indicating "I wrote this prescription electronically," followed by billing for an eScript: except that most patients already got their meds renewed outside of in-office encounters

the push to "upcode" from lower- to high-reimbursement level billing codes for greater charge capture, requiring nothing more than gross importation of macros and text blocks

this list goes on and on; this write knows inside out the perversities of the EHR

So the opiate crisis and the technology crisis have converged with still other forces that now becoming rampant. Chief among these is the much slower-simmering crisis of hyperspecialism. Students who would become great generalists cannot afford to do so because of crushing debt burdens. Their institutions impose drastic inflated costs on medical students while pushing, through both cultural and institutional pressures, these students to hyper-specialize in procedure-driven specialties whereupon they, too, can become part of the problem.

This last problem has been discussed on occasion over the years in HCRenewal by its editor, Dr. Poses, in his discussions of the secretive AMA-designated panel known as the RUC, the Resource Utilization Committee. RUC exposés are rampant--see here and here--and nothing new. But the result is that the AMA's efforts on behalf of its own heavily specialty-weighted membership have created within medicine an auto-cannibalistic food chain within which the profession, including academic medicine, essentially penalize their own most vulnerable. The most vulnerable who are in fact societally the most valuable. But since the AMA appoints the RUC, it is complicit in this autocannibalism, and therefore in the demise of physician worklife coherence. In his interview, Stanford CWO Shanahan states as much when we speaks of the particularly burdensome consequences of burnout among primary care physicians. (That Sinsky now spends some significant part of her time at the AMA is a good portent, we have to admit.)

So what are we left with? Earlier we said this is a multi-political problem. Look at the sources of the three causes of burnout discussed above.

The opiate crisis clearly stems from industry. Big Pharma, with one company, Purdue, allegedly leading the charge over several decades, gets the nod here. Not, as Wisconsin Sen Ron Johnson seems to think, the availability of Medicaid funds for addicted patients. Score one for private sector iniquity.

The EHR crisis clearly stems from Big Government. And probably, equally, industry, although when it started out the folks who brought you all the deficient EHRs were small entrepreneurs, nothing like Big Pharma. Score one for public sector iniquity. But Big Government brought them into the Bigs. Using by and large the wrong metrics. Medical managerialism then kicked in, bought the package, and went for the gold in them thar IT hills. That's the story of HITECH and even ACA as they sought out tech panaceas--the classic American technological imperative that brought us everything from the Interstate Highway System to the Moon Shot to the War on Cancer. And now this.

The relationship between public clinical needs and physician organizational resource mismatches is internal to the medical profession. "We have met the enemy and he is us." Score one for autocannibalism in a classic profession unable to regulate itself now, if it ever could before, in the face of all these new external forces.

Put all this on a SWOT analysis chart and you have a recipe for disaster. The one thing that both Big Medicine and Little Medicine had going for them in years past was autonomy and coherence. The autonomy couldn't survive in the 21st century, but the coherence--the joy of applying science to the individual patient--could have and should have. It is a flame still not extinguished. But faced with the forces we've discussed here, it is a flame flickering, just barely.

And the solution, like the problem, comes from every part of society, It therefore brooks no easy or solitary solution from either the left or the right extremes of political philosophy.

Article source:Health Care Renewal

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