least (u/least) - Readit News

least commented on ADHD drug treatment and risk of negative events and outcomes bmj.com/content/390/bmj-2... · Posted by u/bookofjoe

2c2c2c · 19 days ago

Curious if anyone has gone through the process of an adult adhd diagnosis at Kaiser SF.

Through my attempts, I've been told they don't really do adult adhd diagnoses without documentation of issues as a kid. I was recommended Wellbutrin to deal with symptoms in 2017. Got onto adderall when I moved health insurance in 2021. Back to Kaiser in 2024, I was routed to the same psychiatrist who once again wouldn't budge on adderall and once again recommended Welbutrin.

I used an online clinic to get my assessment (which I understand isn't taken seriously) which is what she cited. I asked what aspect of the assessment documentation did she think left me unqualified and she cited marijuana use in 2016. I asked her how she squares the fact that I'm an adult professional that makes comparable money to her, I have experience using both wellbutrin and adderall and see the former doing nothing and the latter helping, there's hundreds of times more evidence for adderall efficacy vs the flakey data on wellbutrin... She responded with something like: "I believe in my heart of hearts that what I am doing is right".

I thought the entire situation was kind of insane. Further research into the person makes me think they're a bit of a loon.

least · 19 days ago

When I was on Kaiser, it was an absolute nightmare trying to get any traction. They had me do a computer test and, I guess because the results of it (which aren't disclosed to you) did not indicate ADHD, they would not consider the wealth of documentation I had ready to take a look at my old school records. I asked for a second opinion and the next psychiatrist they assigned to me was aloof and refused to consider anything, either. They did give prescribe me bupoprion which did absolutely nothing for me (though I have heard it works for others).

I'm now on a PPO plan and have been using Vyvanse for over a year now. It's lead to a dramatic improvement in my quality of life. I grieved for the time and opportunities I had lost due to not having been diagnosed and treated in childhood.

HMOs have a lot of upsides, but Kaiser's behavioral healthcare is awful (at least in the DC Metro area) and there's not much recourse unless you want to/can afford to pay out of pocket.

There's so much cynicism about ADHD even existing, even among healthcare professionals. Any time on HN any mention of ADHD seems to invite a lot of cynicism as well. That, compounded with that one of the most effective treatments for it is something that pretty much everyone can see a positive effect from (stimulant medication), makes it really difficult to navigate.

I hope that you can find a better option because it seems like Kaiser is just very antagonistic towards ADHD.

least commented on A South Korean grand master on the art of the perfect soy sauce theguardian.com/world/202... · Posted by u/n1b0m

jihadjihad · 3 months ago

So is it like tamari? Seems to be made from fermented soybean paste, which is how tamari is made too (byproduct of miso paste).

Most of the soy sauce you encounter in the US has wheat, while in Japan (and seemingly South Korea) there's no wheat added.

Personally once I switched to tamari I never went back to "regular" soy sauce, the flavor is quite a bit richer and more versatile in cooking, in my opinion.

least · 3 months ago

> Most of the soy sauce you encounter in the US has wheat, while in Japan (and seemingly South Korea) there's no wheat added.

This is incorrect with regards to Japan. Shoyu is made with wheat. Tamari is not. Their production process is different.

Kikkoman is the most popular brand in the West AND in Japan, which is a koikuchi shoyu, which is the "standard" shoyu type in Japan. It is made with wheat.

least commented on Plain Vanilla Web plainvanillaweb.com/index... · Posted by u/andrewrn

bob1029 · 4 months ago

> In short, while letting customers send Excel files "and then load+merge their results directly into the same SQL tables" might sound nice, this does not scale and will certainly result in a failure state at some point.

Much of US banking operates almost entirely on this premise and has done so forever.

> error detection/reporting, business workflows, and/or role-based access control.

I'd take a look at the Nacha (ACH) operating rules if you have any doubt that sophisticated business workflows can be built on top of flat files and asynchronous transmission.

https://www.nacha.org/newrules

least · 4 months ago

That the system works does not mean that individual components of it are advisable. It works because it must and that is with great development effort to keep these interfaces working.

least commented on How each pillar of the First Amendment is under attack krebsonsecurity.com/2025/... · Posted by u/todsacerdoti

_emacsomancer_ · 5 months ago

[0]: https://en.wikipedia.org/wiki/Paradox_of_tolerance

least · 5 months ago

The Paradox of tolerance almost never means what the person invoking it as a rebuttal to free speech thinks it means. It's not some moral axiom that demands action to shut down problematic speech whenever it happens. It's a concept that has varied views on to what extent should tolerance of intolerance be extended and to what response is appropriate when it extends beyonds that threshold.

The most frequently quoted text I've seen is Karl Popper's writing, where he states that we must reserve the right to suppress intolerant philosophies, not that we should always suppress them.

Now, some people might have the opinion that we should be completely intolerant to intolerance and that might be a defendable position in its own right, but the paradox of tolerance is not intrinsically condoning that sort of response.

least commented on How each pillar of the First Amendment is under attack krebsonsecurity.com/2025/... · Posted by u/todsacerdoti

slibhb · 5 months ago

> Freedom of speech is just the easiest way to have plausible deniability when directly or indirectly defending otherwise indefensible positions.

The idea that it's somehow suspicious to be in favor of free speech has got to be one of the worst developments in American politics.

And, for whatever it's worth, every vocal "free speech person" I know doesn't like the current administation. Some people actually just have principles!

least · 5 months ago

> The idea that it's somehow suspicious to be in favor of free speech has got to be one of the worst developments in American politics.

This isn't really a recent development but I think I understand what you mean. Authoritarians, regardless of their political leanings, try and sow distrust in free speech in order to garner support for advancing their agenda.

Currently, the "right" is using "free speech" as a tool to push back against the "woke agenda." So now "free speech" is becoming faux pas, at least in certain circles. Mentioning it as something you value without some long preface to explain yourself now associates you with a certain group of people, whether that group actually values free speech or not.

least commented on Apple M3 Ultra apple.com/newsroom/2025/0... · Posted by u/ksec

dwedge · 6 months ago

Something like the brightness buttons not working, or sleep being a little erratic is ok. No released wifi drivers, bluetooth issues, and audio and the keyboard not working are not ok. Apple going backwards in terms of supporting Linux is not something I'm ok with.

least · 6 months ago

There are wifi drivers; you just have to install them separately because they use broadcom chips. It's a proprietary blob. The other things do work, but it requires special packages and you'll need an external keyboard while installing. It's a pain to install, for sure, but it's not insurmountably difficult to get it installed.

Apple Silicon chips are arguably more compatible with Asahi Linux [1], but that's largely in thanks to the hard work of Marcan, who's stepped down as project lead from the project [2].

Overall I still think the right choice is to find a laptop better suited for the purpose of running linux on it, just something that requires more careful consideration than people think. Framework laptops, which seem well suited since ideologically it meshes well with linux users, can be a pain to set up as well.

[1] https://asahilinux.org/

[2] https://marcan.st/2025/02/resigning-as-asahi-linux-project-l...

least commented on Apple M3 Ultra apple.com/newsroom/2025/0... · Posted by u/ksec

dwedge · 6 months ago

I've been buying and using MBP for 6 or 7 years now, and just assumed I could run Linux on one if I wanted to. I just spent a couple of days trying to get a 2018 MBP working with Linux and found out [edit to clarify] that my other ARM MBP basically won't work.

I just want a break from MacOS, I'll be buying a Thinkpad and will probably never come back. This isn't my moaning, I understand it's their market, but if their hardware supported Linux (especially dual booting) or Docker native, I'd probably be buying Apple for the next decade and now I just won't be.

least · 6 months ago

I think the only laptops you won't find weird issues with linux are from smaller manufacturers dedicated to shipping them like the kde laptop or system76. Every other hardware manufacturer, including those that ship laptops with linux preinstalled, probably have weird hardware incompatibilities because they don't fully customize their SKUs with linux support in mind.

Not that I'm discouraging you from switching or anything. If Linux is what you want/need, there's definitely better laptops to be had than a Macbook for that purpose. It's just that weird incompatibilities and having to fight with the operating system on random issues is, at least in my experience, normal when using a linux laptop. Even my T480 which has overall excellent compatibility isn't trouble-free.

least commented on Hyperspace hypercritical.co/2025/02/... · Posted by u/tobr

cxr · 6 months ago

> An issue tracker, on the other hand, requires active engagement from the developer. Every issue, even low quality ones, require some form of processing

Nope.

least · 6 months ago

Yes, it does. The only way it doesn't is by not looking at the issue tracker at all. How do you figure it doesn't?

least commented on Hyperspace hypercritical.co/2025/02/... · Posted by u/tobr

cxr · 6 months ago

At any given time when I'm at a restaurant or grocery store, there's more food around and on the menu than the threshold for how much food that I as a single person can eat.

least · 6 months ago

At a grocery store or restaurant, there’s no expectation that I examine every item individually, nor am I responsible for organizing the options categorically. Those are already handled for me by the establishment. My only responsibility is to navigate the choices and make a selection, and even then, there’s no 'wrong' choice, per se.

An issue tracker, on the other hand, requires active engagement from the developer. Every issue, even low quality ones, require some form of processing, be that responding, closing, or categorizing. While tools can assist a person in these tasks, the developer is ultimately still responsible for it.

I'm not saying people should only create closed-sourced paid software, but I strongly disagree with the idea that it's negatively affecting the quality of the software because there's no open issue tracker for people to post to.

It's not just github. It's every single issue tracker where users can submit feedback, some of which are almost entirely opaque, like Apple's feedback system. Look at Mozilla's issue tracker, or look at the mailing lists for linux. It's a lot of effort which simply is not worth it for a lot of people in a lot of cases.

least commented on Hyperspace hypercritical.co/2025/02/... · Posted by u/tobr

cxr · 6 months ago

You're vastly overestimating how the norms of GitHub are able to account for how things have to be. Recognizing that GitHub's userbase has a certain type of problem is no different than realizing that HN, Reddit, Tumblr, etc. all have their own respective userbases and each tends to behave in certain ways (desirable or not) that are characteristic to that group.

least · 6 months ago

It's not about the meta-characteristics of a user base. By allowing anyone to create issues, you are creating additional noise. Even if the signal to noise ratio were to be higher, you're still increasing total noise.

There are limits to how practical it is to allow for more and more feedback and that threshold for a solo developer is quite low. Restricting your user base by charging for your work means that there is less noise because the only people sending bug reports are paid users.

The quality of these reports are probably lower than if you had an open issue tracker, but you are substantially reducing the mental overhead and you know the people that are sending feedback are doing so with their own interests in mind.