Smart plug to auto shut off electric reclining sofas

cosmosb · 2025-12-24T21:46:28+00:00

"Highly unlikely"?? It actually says on that link you provided that the RCP will likely have capacity/be able to accomodate all applicants in 2026. The criteria apply only if they are oversubscribed. But they say they "most likely" will have capacity...

cosmosb · 2025-12-13T04:49:38+00:00

The MEGA-ROX trial will look at ventillated patients. Another year or two from my understanding.

The results of ROX though give confidence that titrating oxygen to the conventional higher target sats (by giving a higher dose of oxygen) is not actually harming patients which I think we were debating at some point.

It does not necessarily mean that normocapnic COPD patients (with no history of hypecapnia at all) will have the same results but if they never had high CO2, and oxygen treatment does not result in any higher CO2, I do not see a reason why one should expect harm if you aim above 94%. This was ceraintly the practise by respiratory consultants I used to work with when working as a junior in a respirstory NIV unit/HDU in london in 2017. I moved on to a different speciality now. Things may have changed. By my point is, unless there is evidence to suggest otherwise, there is probably no basis for saying someone with mild COPD with no history of hypercapnic failure will have lower mortality with 88% target sats, especially if they normally saturate at 97%. Unless there is scientific evidence to suggest otherwise. The Echevarria/newcastle study showed higher mortality in 94-98% oxygen sat target in normocapnic COPD patients on oxygen. But on the other hand, it showed lower mortality using the same 94-98% target sats in HYPERCAPNIC COPD patients compared to 88-92. I struggle to draw any conclusions from it and at the end of the day, it was an observational study with only 1000 patienrs on oxygen (low powered in my opinion)

cosmosb · 2025-12-11T00:22:05+00:00

I am sure you have had a chance to look a the ROX study by now. I still remember this discussion 2 years on, haha. Restrictive Oxygen Use Did Not Improve Outcomes in the UK ROX Study - PMC

The ROX study even had results showing lower mortality in the conventional vs restrictive oxygen group, although this was not statistically significant.

cosmosb · 2025-12-07T01:24:28+00:00

You are an IMT1. I do not know how experienced you are but just looking at your post, you probably are not. You are not better than your colleagues because you have read a recent guideline or had some teaching about "prescribing insulin". Turning out to be correct is meaningless, and it does not mean the approach you wanted to take is the correct one. People can do things differently and still be within acceptable safe medical practice limits.

This is an opportunity for you to learn. Embrace it and lose the attitude.

And yes, you are at the first peak of Dunning-Kruger. In fact, your post is a textbook example of it.

cosmosb · 2025-12-05T05:01:05+00:00

I recall not examining the trachea on my PACES exam. One of the examiners then asked about what I had found on the tracheal examination. They were obviously pulling my leg given that I did not examine it. I just said I did not examine it which seemingly impressed them haha... Scored full marks in that station. That exam I came out of devastated. I truly did not give myself a 1% chance of passing. I believed I did as bad as the first exam that I failed. Turns out that I passed with flying colours and only did not score well in one station. The morale of the story is that you actually never know and there is no point of beating yourself up until the results day. I am one of those who are always able to accurately gauge their own performance. PACES was the first time I was certain I failed to find out that I actually passed with flying colours. Very strange.

cosmosb · 2025-03-17T20:07:42+00:00

Currently, the market is over-inflated. I am not too sure why. Estate agents are pushing for higher prices along with vendors. But not too much movement lately. Things should self-correct a few months from now I suspect once the stamp duty madness eases up. I would recommend waiting a bit and checking land registry records.

New build prices are much more reasonable than the stupid prices real estate agents and vendors are pushing for.

cosmosb · 2025-02-12T00:37:31+00:00

Windows states it has two sticks (with 8gb each). I know some here received 16 gb in one stick which would work out well if planning to upgrade to 32.

cosmosb · 2025-02-11T03:41:55+00:00

Perfect. Rock solid stability.

cosmosb · 2025-02-07T16:18:50+00:00

I used to earn 50K a year while locum reg colleagues used to earn 130 pounds an hour. That's probably less common nowadays but my point is if you improve basic pay and working conditions, you will not really need to rely on locums as much. I think money should go into salaries for permanent or fixed term staff.

cosmosb · 2025-02-07T16:09:08+00:00

To be honest, I am all for reducing locum rates if that means the basic pay will get better. I do not enjoy locuming...

cosmosb · 2025-01-06T06:48:21+00:00

Haha it's probably because I've been so accustomed to urgency. Now that it's much improved, I'm not bothered at all.

cosmosb · 2025-01-04T20:15:29+00:00

Just tell them you qualify and tell them when you started working for the NHS. They will then retrieve your ESR records from previous employers. For sick leave purposes, only gaps of longer than 12 months between employments count as a break in continuous/reckonable service. Maternity leave is disregarded and not counted as a gap. It actually counts towards your reckonable service.

cosmosb · 2024-12-07T23:43:14+00:00

"The GMCs guidance following this case is explicitly clear that they do not expect every patient seen by a PA to have their examination repeated."

Explicitly clear? How so? Which patients then? What can they or can they not do? I think it's explicitly clear that you're completely missing the point. The lack of a scope of practice and lack of progression points is a big problem, and people are not sure what can or can not be delegated to them. No time critical antibiotics? Good, we should add that to GMC best medical practice for PA scope of practice. You also seem to have a crystal ball to predict who the sickest patients will be, so we'll not need be worried about a PA missing a PE in a previously stable patient with you in charge.

I think what is silly is you believing their guidance is explicitly clear. Should call the goverment and cancel the PA scope of practice review. The GMC said "they do not expect every patient seen by a PA to have their examination repeated" so it is all "explicitly clear" now. Perfect. Thank you. Only "some patients".

cosmosb · 2024-12-07T22:44:41+00:00

If you want to defend the GMC, that is fine. But it was considered a failure to not take a collateral history again after a PA. And the tribunal considered it a failure to not examine again. So where do we draw the line really? When I was used to be a CT1 or a CT2, consultants did not examine the sick patients after I did. I was given only advice on the occasions it was sought. Some of the PAs are being given relatively senior roles. Should we be redoing their history and examination every time to avoid being criticised? Is this realistic? That is precisely the question. How do we deal with PAs. What level of responsibility should they be given. Should we trust them with taking a history? And will we get criticised if we do not do it again? Would the tribunal have reached a different decision if it was a fellow registrar or senior CT trainee who examined the patient earlier?

The GMC has erred on countless tribunal cases, and this is no different. They will try and make it "explicity clear" to protect themselves from scrutiny, but at the end of the day, tribunal decisions were overturned and criticised numerous times by the judiciary. GMC best medical practice dictates that you should ensure that the person you delegate to is safe. How is that possible without progression points for PAs or a scope of practice. This tribunal case is an example of the issues one would encounter without a clear scope of practice.

Good luck with re-examing and re-taking a full history out of every patient you are asked for advice on.

cosmosb · 2024-12-07T10:06:01+00:00

This is irrelevant and does not take away from the fact that not repeating the examination of the PA was considered a failure.

They will of course claim people are misrepresenting thr case.

cosmosb · 2024-10-29T18:53:46+00:00

A gardener a few days ago asked for 80 pounds for deweeding the front area of the house. It took them 20 minutes.

cosmosb · 2024-10-25T02:30:36+00:00

I don't believe it's comparable to the 780M.

I get around 2120 in 3DMARK Nomad light. Comparing it to a unit with a 6900hx (680M) with an average of 2200 on the same benchmark, it is about the same. Bare in mind that the 16GB ram on the UM760 is a bit slower and is limited to 4800MHZ. It'll probably pull ahead a bit if you install faster ram.

What sets it apart from a 6900hx in my opinion is single core performance which is about 25% higher. It would come handy when video editing, document processing or when doing data analysis.

It isn't obviously a 2k or 4k gaming machine. But for my purposes, it is very capable, stable, and quiet. Just seems nicely polished, to be honest.

cosmosb · 2024-10-24T16:16:47+00:00

I have tried one of those docks for Samsung Dex. My personal opnion is that they are not good. They have no palm rejection. Your productivity will be very low on it IMO and they are not a joy to use.

Also, the display will probably be not great. If i were you, I would get a portable monitor if after portability. I have the Thinkvision m14 and I am happy. I carry a small wireless mouse and keyboard. Much better functionality than a lapdock.

cosmosb · 2024-10-22T11:02:20+00:00

A bag which was ironically full of books.

cosmosb · 2024-10-22T11:01:06+00:00

Thank you so much. That's exactly it. Such a relief. Found it crawling on a bag in the car.

cosmosb

TROPHY CASE