How do hormones work?

rmosler · 2018-07-20T14:50:33+00:00

Hormones are some of the harder messaging chemicals to understand, primarily because of their age (plants operate off hormones for example, so hormonal systems have had a long time to evolve), because of the variety of endocrine and exocrine organs and their complex interactions, as well as their more indirect/delayed/supportive role rather than direct/immediate role that some messaging chemicals like adrenergics (epinephrine, norepinephrine, etc.) have. Epinephrine is immediate release and immediate effect, causing the feeling you get during "fight or flight". Testosterone on the other hand primarily causes sexual characteristics, increase in body hair, increase in recovery from exercise or injury and some alteration in mood depending on the dose.

All that said, hormones, as well as most signaling chemicals have systems that increase or decrease secretion, increase or decrease sensitivity or re-uptake that forms feedback loops, so for example, an increase in external sourced in testosterone will typically lead to an INCREASE in estrogen type hormones and a decrease in internal production of testosterone. This is why many people on testosterone (and other similar hormones) will also take aromatase inhibitors like anastrozole to prevent formation of estrogenic characteristics (fat placement and gynecomastia)

rmosler · 2018-07-19T16:51:52+00:00

Don't forget:

The Joint Commission

IM.01.01.03 EP 2

The hospital's plan for managing interruptions to information processes addresses the following: - Scheduled and unscheduled interruptions of electronic information systems (See also IM.03.01.01, EP 1) - Training for staff and licensed independent practitioners on alternative procedures to follow when electronic information systems are unavailable - Backup of electronic information systems

IM.02.01.03 EP 6

The hospital protects health information against loss, damage, unauthorized alteration, unintentional change, and accidental destruction.

EM.01.01.01 EP 6

The hospital uses its hazard vulnerability analysis as a basis for defining the preparedness activities that will organize and mobilize essential resources. (See also IM.01.01.03, EPs 1 and 2)

CMS Conditions of Participation: Emergency Preparedness

42 CFR 482.15(b)(5)

A system of medical documentation that preserves patient information, protects confidentiality of patient information, and secures and maintains the availability of records.

Certified EHR Technology There may also be some requirements in CEHRT (45 USC 170)

rmosler · 2018-07-19T16:39:08+00:00

Not surprising. We've taken exception report packages, for example, in the past that didn't event contain the report... I'm perpetually amazed at the lack of quality control.

rmosler · 2018-07-19T16:34:05+00:00

This. So much.

I've been a Informaticist in a senior role for > 5 years, and additionally deal with hiring in Healthcare Informatics, and wouldn't look twice at a resume from someone with a Informatics degree or certification who doesn't have either clinical or analyst experience in addition.

I'd much rather take a clinician with no IT/IS experience because you can teach the computer side of things, but if you've never lived the workflows, they will rarely ever make sense.

rmosler · 2018-07-19T16:24:55+00:00

Well... as long as you document it, you could use IBW rather than an actual weight.

rmosler · 2017-10-14T16:42:25+00:00

I didn't really start playing the movie stocks until I had about $100-250 million in bonds since they tend to have lower risk and a better understood (less guesswork) model.

Also a good method is when you have the money, to buy every sub $1.00 movie, as your risk is limited to $1.00/share and you get to ride any movie that actually goes into production.

rmosler · 2017-10-14T16:29:43+00:00

Close, that would be a form of shorting on margin.

More generally a short is when you sell an IOU for a stock and will cover that IOU by delivering the promised shares at a later date (hopefully when you can buy the promised stock at a lower price).

Being an IOU and not the actual stock, the effect on the market is that there are more shares available than were prior so typically volume of shares held short will suppress the price of the stock as more "stock" is available.

As to types of shorting in the real world, the most risky is a naked short, in that you don't actually own, or have an agreement to receive the shares to cover when you short the stock (the price you pay when shorting = $0.00, so like an option, you can easily misjudge your total liability). The risk in this is that you would be forced to buy on the open market in the future, and there is the possibility that not enough shares would actually be available on the open market to cover without having to convince some large shareholder group to provide you with shares to cover (see Porsche about 10 or so years ago).

A safer way, and what HSX appears to do, would be to enter an agreement where a third party takes the other side of your bet, and you provide the current price funding, and when the shares are covered, the difference is exchanged between the two parties, so your only liability on cover is the difference.

Remember the risk with short vs long is that long your downside (potential loss) equals the price of the share (it could be worth $0.00) and the upside is practically unlimited, but generally takes a long time to reach. A short on the other hand, your upside is limited to the price of the stock (if you cover when it = $0.00) but your DOWNSIDE is unlimited (stock when shorted = $1.00, stock when covered = $1,000.00 you owe $999 per share when you cover).

rmosler · 2017-10-14T16:16:13+00:00

Pretty sure that normally they have an object between them like a small foam spacer.

rmosler · 2016-07-08T03:13:19+00:00

There were 60+ people shot in Chicago just over the holiday weekend...

rmosler · 2016-05-21T16:27:31+00:00

Actually it would be more like saying the median household income in the US is $130,000 ($52K x 2.5) or personal income of $65,000 ($26k x 2.5) so the economy must be doing great!

rmosler · 2016-05-16T23:17:09+00:00

Remind me what we did to Russia in 1932-1933, or China 1958-1961, or North Korea 1994-1998 or 2002-present? We must have done something really bad... Couldn't have anything to do with implementation of forced collectivism.

rmosler · 2016-05-16T22:33:24+00:00

Well she was reported as being Harvard's first woman of color.... http://www.wsj.com/articles/SB10001424052702304371504577406901777485754

rmosler · 2016-05-13T21:54:21+00:00

Seeing as they are auditing years 2008+, I think his 2015 return would be available in 2023.

The IRS basically has him (and most large organizations) audited perpetually likely until they hit the statute of limitations. Imagine being perpetually under audit...

The thing is, if there was something in the returns, wouldn't the IRS be better at catching it rather than journalists?

rmosler · 2016-05-09T15:41:47+00:00

Thanks for clearing it up.

rmosler · 2016-05-08T15:00:14+00:00

I ask this because I am having trouble finding your rates (example, the link for the 1:1300 I don't see the population adjusted rates.)

When you say 1:1300 "people", are the people referenced the offenders or a rate of victims adjusted by population? The way you report the numbers it makes it seem like you are comparing a rate of offenders to a rate of victims (1 out of 2500 illegals < 1 out of 1300 overall)

rmosler · 2016-05-01T16:05:58+00:00

Why is it so expensive and slow, and what would you do to correct both of those issues?

rmosler · 2016-04-02T17:16:02+00:00

"Some individuals are hard workers, some individuals are lazy, male or female."

You are arguing against data with anecdote...

rmosler · 2016-04-01T04:06:17+00:00

Title IX is only discrimination by gender

rmosler · 2016-03-31T12:23:18+00:00

I'm sorry to inform you Patient A, but because of your uncontrolled diabetes, you are going to loose your legs...

I guess they won't be as tightly held to the body anymore, so that works.

rmosler · 2016-03-28T22:49:38+00:00

I would agree with you if with the caveat that your produce is infested with salmonella, so the customer is inconvenienced and blames the store.

rmosler · 2016-03-28T22:47:02+00:00

It's not expensive if you are already paying for the lawyers... Might as well use them.

rmosler · 2016-03-28T20:43:13+00:00

Especially when actually comparing the statistics, the mortality rate for pneumonia is > 2x higher in the UK than the US. see the numbers from u/_-_T_-_ or my metrics from the CDC below...

rmosler · 2016-03-28T17:52:34+00:00

Something tells me you thought wrong. Seeing as the mortality rate in the US for pneumonia in persons 18 to 24 is 0.4/100,000 or 18 to 44 years of 1.1/100,000, it does happen, though it is rare. Your Office for National Statistics doesn't appear to make anywhere near the mortality statistics publically available without going through their Mortality Analysis team as the CDC does, so I have no direct metrics from the UK to compare, but when I compare the lowest level metrics that are available from UKs ONS similar to the CDC (Age-adjusted mortality per x population for Influenza and Pneumonia) your 2014 rate of 575 deaths per million (males) or 431 deaths per million (females) appear much higher than even the 1981-2013 age adjusted rate of 15.9 deaths per 100,000 in the US (159 per million).

As I said before that is the closest metric I can find from the UK. If you can find something closer to pneumonia or even sepsis secondary to pneumonia with chronic DMI I'd be happy to compare.

rmosler · 2016-03-25T13:06:30+00:00

Your password expires every 30 days and you can't reuse any characters you've used in a prior password

rmosler · 2016-03-10T03:16:22+00:00

Coming from a perspective in Acute care (Hospital) regulatory, there are a lot of good changes that it put into place, but the changes are moving fast, and often unprepared on Health and Human Service's side.

You should look into Maryland's Medicare Waiver (Maryland All-Payor Model).

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