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yesco commented on ADHD drug treatment and risk of negative events and outcomes   bmj.com/content/390/bmj-2... · Posted by u/bookofjoe
diob · 9 days ago
Yeah, the journey to stimulants for me was long and painful, with a lot of procrastination on my part. And now even having them prescribed it is a pain dealing with the bureaucratic / expensive nightmare of USA health insurance.
yesco · 9 days ago
I just go through GoodRx now, makes it like $20 per month for my prescription. You don't even need to make an account with them, it's like coupon you don't even need to print out. Just tell the pharmacist you are going to use GoodRx and you are done.

My work insurance seems to change all the time, and while going through GoodRx doesn't count towards my deductible, I prefer the price stability. Not fun when I'm randomly told it's $120 now at the pharmacy because my insurance doesn't cover it now for some fucking inane reason. A few phone calls can often resolve it, but it's the last thing I want to do when I'm a day away from withdrawals kicking in. Even more absurd is this is basically guaranteed to happen more than once a year, THERE IS ONLY 12 MONTHS IN A YEAR!

yesco commented on EHRs: The hidden distraction in your doctor's office   spectrum.ieee.org/electro... · Posted by u/pseudolus
ChrisMarshallNY · 21 days ago
This is where user-friendliness is a requirement, not a luxury.

Anyone who has ever looked at an EHR/EPIC screen, can tell you that the 1990s Web called, and wants its tables and frames back.

In fact, one doctor I went to, still ran Windows 95 (in 2009), because they didn't want to deal with new interfaces.

Engineers are notoriously unsympathetic to usability and simple GUIs, but I have found them to be an absolute gold mine, if you want people to actually use your product. Apple and Google are trillion-dollar companies, now, mainly because of their simple, usable UX.

yesco · 21 days ago
The problem is a bit more complex than just UX from my experience. It's not as if the people designing these portals are going out for their way to make it user unfriendly, it's that the underlying data model all these hospitals use for their EHR is usually completely insane.

Hospitals were among the first to get "computers", I'm talking the big mainframes and such that used to be popular in big institutions & universities. On these systems many hospitals each individually hired programmers to construct custom databases for their record keeping. While most have by now have transitioned into a more standardized structure, like HL7, the original sin has carried forward enormously bizarre data structures that make you wonder if the designers were deliberately trying to sabotage the possibility of good software in the industry. I can't think of a better example of why you should never design by committee.

Yet in parallel to all this, capturing medical data is already hard. Doctors are most comfortable just writing notes freehand, recording the patients current state, notable observations, treatments and so on. When modeling this it becomes very tricky because you basically need a proper medical background and be a good at data modeling / programming. This kind of person is basically a unicorn in the industry everyone wants but can never get.

Consider, just for a moment, all the complexities that come with dealing with the thousands of different units and their conversions within the industry. Some doctors don't even use the same units for certain measurements, entirely out of personal preference. Then remember that measurements are the easiest part of the system to model, even what should be the simplest part of the entire thing is hard. Also yes, you will have to re-write all this from scratch, there is no special library or open source software to help. Everytime someone makes tools for this they keep it proprietary.

But that's just the tip of the iceberg, to really get an idea of what I mean, just look at HL7. It's basically a data format that is like a cursed csv with about 5 layers of deliminators for nested entries, since all hospitals like to be super special, the specification tries to be "flexible", so what exactly these characters are is not actually standardized! It wasn't enough for HL7 to just be a data model, they needed to violate a few OSI layers and interlace it with the transport protocol too!

So in essence you must establish a bizarre handshake on top of tcp to learn what the hospitals super special configuration of the standard is, the very syntax itself! Worse, 90% of it is the same for all hospitals but the 10% that isn't is entirely unpredictable!

Then you have the actual data model itself, like demographics, lab records and so on. They change the specification every few years! You need to support it all since this committee of monsters don't seem to care much about the migration path! All the changes they make seem pretty arbitrary to me but what do I know?

I'm still only scraping the surface here but my exposure has been limited to what I do, which was processing all this from the perspective of a medical device that only needed to deal with a subset. When I imagine the struggle one would have with actually dealing with the entire thing holistically I feel empathy and a desire to never have their job.

It's like building a house on top of an active volcano. Any illusion I had that my medical records could be used for anything other than basic notes for another doctor to read have long since shattered, because clearly that's how all of this mess is actually being used in practice.

Oh and don't forget HIPPA! Even when you roll up your sleeves and try to fix the problem, you learn you aren't even allowed to thanks to the governments overbearing regulations against using medical data for things that could help society. Wish they just made it a crime for insurance companies to use instead of whatever this is.

The fact any of this works at all is a fucking miracle honestly.

yesco commented on JavaScript decided my day starts at 9am   senhongo.com/blog/when-ja... · Posted by u/SenHeng
hatthew · a month ago
My rule of thumb is: keep all business logic in UTC, and convert from/to local time as close to the UI as possible
yesco · a month ago
Adding to this, if you are dealing with dates in JavaScript specifically I recommend going further and doing all business logic with the UTC timestamp stored as a number / unix epoch, and only doing `new Date(timestamp)` when you need it in local time, like right before rendering on the page or something as you mentioned.

It obviously depends on your use case but I find most time operations are often easier to deal with as pure mathematical operations. I will reach for Date when I need to deal with weird stuff like the day of the week but having burned through so many footguns with what I consider the worst DateTime API I have ever dealt with in any language, I will do anything I can to avoid using it.

Some libraries like date-fns can help here, but can't always bring in new deps easily. I hope the new temporal API fixes things.

yesco commented on UK backing down on Apple encryption backdoor after pressure from US   arstechnica.com/tech-poli... · Posted by u/azalemeth
tolien · a month ago
> There ARE thousands.

And here you're getting in on the dishonesty.

How many of those were examples of "hurt feelings" and not "put a whole lot of foreigners at risk of their lives" or any of the other classes of "online posts"? We don't know because in their rush to say "the UK's arresting 30 people a day for posting things online", the Economist didn't bother breaking that down.

> NONE of these would meet Brandenburg's standard in the US.

None of them happened in the US so that's irrelevant. My misunderstanding of the precedent around incitement isn't central to my point.

yesco · a month ago
'We don't arrest people for speech, we arrest them for crimes we've defined as speech' is not the defense you think it is.
yesco commented on UK backing down on Apple encryption backdoor after pressure from US   arstechnica.com/tech-poli... · Posted by u/azalemeth
tolien · a month ago
Do expand on that point then.

Edit: If I remove the reference to Brandenburg, I'm not sure my point substantially changes:

Incitement is an offence in the UK and also in other countries. You can argue whether that should be the case or not but that's completely orthogonal.

Gathering a whole lot of offenses which happened to include online activity to produce a big number of people who you can claim were prosecuted for something that you can claim is as innocuous as "online posts" is dishonest.

yesco · a month ago
You're playing a shell game with definitions to justify authoritarian speech laws.

> lumping together arrests for stalking, incitement to violence and other forms of harassment to produce a big scary number

But that's exactly the problem - the UK defines "incitement" and "harassment" so broadly that ordinary political speech becomes criminal:

UK "Harassment" includes:

- Misgendering someone online

- Posting offensive jokes

- Retweeting protest footage

- Criticizing immigration policy "grossly"

UK "Incitement" includes:

- Lucy Connolly's Facebook post (31 months)

- Jordan Parlour's "every man and their dog should smash [hotel] up" (20 months)

- Tyler Kay's "set fire to all the hotels" retweet (38 months)

NONE of these would meet Brandenburg's standard in the US. They lack:

- Directed at specific individuals

- Imminent timeframe

- Likelihood of producing immediate action

> if the stated number is true, there should be thousands of examples every year

There ARE thousands. In 2023:

- 3,537 arrested for online speech

- 1,991 convicted under Section 127 Communications Act

- Hundreds more under Public Order Act

You don't hear about most because "UK citizen arrested for offensive tweet" stopped being newsworthy years ago.

You're using the word "incitement" to equate UK thought policing with legitimate US restrictions on speech that creates immediate danger. That's like defending China's censorship because "every country bans fraud."

The definitions matter. The UK criminalizes hurt feelings. The US criminalizes immediate threats to public safety.

yesco commented on UK backing down on Apple encryption backdoor after pressure from US   arstechnica.com/tech-poli... · Posted by u/azalemeth
tolien · a month ago
Point taken, but incitement is still an offence in other countries. That the US has specific, and particularly permissive, laws around what constitutes speech is neither here nor there.

> You want thousands of examples?

Of people people prosecuted for innocuous speech in the UK, the original claim in this thread. Brandenburg doesn't apply there.

yesco · a month ago
I misunderstood what you were trying to imply but still think your premise is mistaken. My reply is merely directed at anyone implying the US's free speech-laws are somehow comparable to the authoritarian anti-free-speech laws the UK has.
yesco commented on UK backing down on Apple encryption backdoor after pressure from US   arstechnica.com/tech-poli... · Posted by u/azalemeth
tolien · a month ago
I wasn't saying the context I gave was an exhaustive list, I was suggesting that having Googled her name and maybe skimmed a couple of news articles, you might need to do some more reading before forming too much of an opinion.

> She didn't throw rocks, she didn't set things on fire, she didn't stab anyone -- it was her speech that got her a multi-year jail term.

Your contention seems to be that incitement shouldn't be an offence?

That's at odds with legal systems all over the world, including the US, where Brandenburg v Ohio [0] holds that if inflammatory speech is "directed to inciting or producing imminent lawless action and is likely to incite or produce such action" that is an exception to the First Amendment and can be prosecuted, which seems to be at odds with "regardless of whether there were riots ongoing or not".

The original point of my first post in this thread was that lumping together arrests for stalking, incitement to violence and other forms of harassment to produce a big scary number makes the argument seem utterly dishonest. The fact that so many "free speech proponents" fixate on one example when, if the stated number is true, there should be thousands of examples every year is a good demonstration of that.

0: https://en.wikipedia.org/wiki/Brandenburg_v._Ohio

yesco · a month ago
> That's at odds with legal systems all over the world, including the US

Not true. The US has a much higher bar for prosecuting speech than the UK.

Brandenburg v. Ohio (1969) - 395 U.S. 444

- https://www.courtlistener.com/opinion/107965/brandenburg-v-o...

- Speech must be "directed to inciting or producing imminent lawless action"

- AND "likely to incite or produce such action"

- General statements like "burn them all" typically fail both prongs

The "imminent" requirement is key. Connolly's Facebook post lacked:

- Specific targets or locations

- Timeframe for action

- Direct instructions to specific individuals

- Any indication people were prepared to act on her words immediately

Here are cases with far more explicit threats that were protected:

United States v. Bagdasarian (2009)

- https://www.courtlistener.com/opinion/221261/united-states-v...

- Citation: 652 F.3d 1113 (9th Cir. 2011)

- Posted that Obama "will have a 50 cal in the head" with racial slurs

- Result: Conviction reversed as crude political statement, not true threat

United States v. Turner (2013)

- https://www.courtlistener.com/opinion/904120/united-states-v...

- Citation: 720 F.3d 411 (2d Cir. 2013)

- Posted that three federal judges "deserve to die" with their photos and addresses

- Result: Conviction overturned as protected political hyperbole

Connolly's "set fire to all the hotels" would likely be viewed as angry hyperbole in the United States, not meeting Brandenburg's strict standard.

The distinction: The US prosecutes actual incitement (directing a mob to attack a building RIGHT NOW). The UK prosecutes offensive speech that merely might inspire someone, somewhere, someday. Your Brandenburg citation actually proves this difference rather than refutes it.

You want thousands of examples? Check Twitter during any US political crisis - they're not prosecuted precisely because Brandenburg protects them.

yesco commented on Retro gaming YouTuber Once Were Nerd sued and raided by the Italian government   androidauthority.com/once... · Posted by u/BallsInIt
brookst · a month ago
Using “forced” in the passive voice is telling here. Wouldn’t it show more agency to say you chose to pirate them because your desire to play them outweighed your estimate of the moral / legal downsides?
yesco · a month ago
Wouldn't it show more agency to acknowledge you chose to focus on the word 'forced' because your desire to make a rhetorical critique outweighed your interest in engaging with the substantive issue of abandoned software preservation?
yesco commented on Random selection is necessary to create stable meritocratic institutions   assemblingamerica.substac... · Posted by u/namlem
didibus · a month ago
Yes, but the value system behind these matters to prevent the very thing you are talking about. What I am seeing is that the value system behind meritocracy is too close to my liking to self-appointed superiority. I am rich and powerful because I am the smartest, fastest, strongest, and worked the hardest. No one else deserves my position of power unless they too are rich, and if they are not rich, they are not smart and don't merit such position. The idea of merit I think can be subterfuged, old Egyptian leaders were thought to be Gods, so it was deemed they were the only ones that could merit to rule.

You get in a situation where no one questions the system that evaluated someone's merit, and that system becomes easy to control, so the criteria become that those that are already in power are the only ones that meets it.

> your country will start to fall behind the others, and your quality of life will start to rot

I think this idea also needs to be toned down, many countries have as good or better quality of life than the US and China, yet they are way down whatever competitive latter you want to look at, GDP, military power, land mass, etc. I think corruption as a metric correlates a lot more to QOL than any of those.

yesco · a month ago
> I think corruption as a metric correlates a lot more to QOL than any of those

I see Meritocracy as a deterring force against corruption so I'm sensing some semantic discord here. A nation that starts to rot will be taken advantage of by external entities which will result in a drop on QoL. While GDP and such can somewhat approximate national power, they seem a bit tangential to the discussion imo, the point is rot invites parasites.

> What I am seeing is that the value system behind meritocracy is too close to my liking to self-appointed superiority. I am rich and powerful because I am the smartest, fastest, strongest, and worked the hardest. No one else deserves my position of power unless they too are rich, and if they are not rich, they are not smart and don't merit such position. The idea of merit I think can be subterfuged, old Egyptian leaders were thought to be Gods, so it was deemed they were the only ones that could merit to rule.

But that's the opposite of Meritocracy? Or rather, it's like you are confusing the cause and effort perhaps? It's an oppositional force to the default nepotistic hereditary nobility type systems, which will naturally emerge in every system that does not account for it, these are absolutes. Caveat being that the means of avoiding it are nuanced ofc.

The point is you design systems where positions of power are selected on (best effort) neutral criteria that at minimum narrows the candidate pool down in a way that the preserves a degree of instability, and through which helps prevent calcification of power structures. With a Meritocracy the criteria is via a demonstration of merit/qualifications/evidence you are the most capable for the position.

It does not give someone license to act as if their wealth justifies their position, that's just a simple narcissist. Meritocracy is just a good general principle to follow when designing the process of selection, it's not some complex ideology. Having power never implies you earned it, your merits do, and society is the judge of what exactly those merits are.

You also focus on wealth a lot so I'm wondering if you are primarily pushing back on the thought that having wealth qualifies as intellectual merit? Because if so I very much agree, but I also rarely see this from anyone but narcissists who don't even need a reason to think that in the first place, their conclusion came first. But maybe this is just a blind spot for me.

Money is power, and our modern economic system has made the liquidation of wealth into money easier than ever. It has helped shift power struggles from violent to competitive and allowed some innovative types of tax policy to become possible. But that doesn't make our economy a Meritocracy, what we have is closer to natural selection, where any snake can kill a lion and so on. The perks of capitalism are entirely from it's ability to parry these inevitable power struggles into something society can gain a net benefit from through the innovation that arises from healthy competition. It's impossible to eliminate the power struggles themselves though, those are human nature.

I can see how the concepts can be confused but fundamentally it's a brain (skills) vs brawn (power) thing. A meritocracy advocates for selecting for the most skilled not the most powerful. It's only practical to enforce on a institutional level though.

yesco commented on Random selection is necessary to create stable meritocratic institutions   assemblingamerica.substac... · Posted by u/namlem
didibus · a month ago
The obsession with meritocracy needs to be toned down a bit. In my opinion, the very idea of merit is fuzzy and lives right beside corruption and bias.

Merit is measured in imperfect ways, by other people, and fundamentally, we don't want a hierarchy of classes, even if we claim the higher rankings/elites have merited it.

Human dignity isn't contingent on outperforming others, and everyone would likely rather live somewhere that doesn't feel like constant competition is needed to enjoy leisure, food, shelter, pastimes, etc.

When it comes to who we should trust for critical work, taking decisions on our behalf, etc., we do want someone qualified. I find the idea of "qualification/qualified" much nicer than "merit". The latter seems to imply a deserved outsized reward, like it justifies not why you are given the responsibility of something important, but why you are allowed to be richer, higher ranking, etc., than others.

yesco · a month ago
Meritocracy is simply a means of preventing elites from kicking the ladders down, nothing more, nothing less. Once the ladders are kicked down, which all elites will inevitablely try to do, society will start to stagnate, your country will start to fall behind the others, and your quality of life will start to rot.

The key here is that while meritocracy is championed as a means of finding the best, it in reality functions as a system to keep out the worst. You want harness the ambitions in people, even if not everyone's ambitions can actually be met, and you want to mitigate the harms of nepotism, even when eliminating it entirely is impossible.

So the difference between qualifications and merit evaluation are moot from my perspective, the question you need to ask is if whatever selection criteria you prefer is vulnerable to ladder kicking. If you preferred way is more vulnerable than the current system then you are putting the cart in front of the horse.

Also to make my position clear, I can't tell either way in regards to what you have suggested. As far as I was aware, we already select based on qualifications, so it's unclear to me what the exact change you are proposing is.

u/yesco

KarmaCake day1052July 3, 2015View Original