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wathe

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Posts posted by wathe

  1. 33 minutes ago, SKL said:

    I still don't see what's wrong with acknowledging / appreciating two different sexes/genders.

     

     

    21 minutes ago, regentrude said:

    As several of us explained, it causes women to be viewed and treated differently in situations where sex/gender is irrelevant. You don't think it's wrong that a female doctor has to fight to be taken seriously?

    And take home less pay.  Social gender differences make pay equity impossible in a fee for service system that rewards numbers and is, in theory, "gender-blind".

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  2. 14 hours ago, regentrude said:

    I am not petite and never had trouble being accepted while in college, grad school, or postdoc in a very male dominated field , but definitely had issues as a young professor at an engineering school. My (80% male) students did not take me seriously and thought I was the TA. I had to dress up and wear suits and heels to get them to accept that I am actually the professor and not some student helper (while my male colleagues get away with jeans). I am so relieved that I am now in my fifties and no longer have to go to great efforts to play the adult academic.
    I am, however, still the only faculty who gets emails addressed by first name or Mrs Lastname; my male colleagues are almost always addressed as Dr. Lastname.

    Much the same experience here, in a male dominated medical specialty.  Same issue with email   and having to work to be taken seriously.  And having to work to establish that I am the doctor, not the nurse.  And  I'm  dealing with the public, so I also get darling'd and dearie'd and sweetheart'd too, on a daily basis.  It's infuriating.

    I put up with all kinds of gendered social crap at work, and because of it, I earn less than my male colleagues:  We are fee for service.  Gender bias means that women see fewer patients per shift than men, and therefore earn less. (we have more interruptions, spend time establishing credibility, our time is not respected in the same way as them men, by patients and staff, we are expected to take on a nurturing role that our male colleagues are not, we get requests to see certain types of patients that are almost always more time consuming "requests female physician", and on and on.  All of this has been well-studied and well-documented.)

    ETA:  The worst part is that the men (many of them anyway) can't seem to see It, and don't really believe it.  They just think that we don't work as hard as they do.  It's enraging.

    Sorry @Mercy, that turned into a slightly off-topic rant!

    Edited to correct;  kinds not kids.  I  really like kids! I don't just "put up" with them 🙂

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  3. 1 hour ago, Ellie said:

    I don't understand why you would wear a mask if you are "vaxed." A vaccine is supposed to protect from the disease. That's why we vaccinate our children with MMR and DPT and everything, yes? So why would you still need to wear a mask?

    Because though vaccination reduces risk (by quite a lot) it does not eliminate risk.  Mask plus vax reduces risk even further.

    The pandemic isn't over.  Covid is still circulating.  New, more transmissible variants are infiltrating our communities. Community vaccination rates are still low in many places.

    Masking is not a hardship for me, and I am used to it.  For me, the more salient question is," why wouldn't I mask?"

     

     

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  4. 24 minutes ago, PeterPan said:

    Almost no one is wearing them.

    You mean you put masks on your kids? Even though they have very little likelihood of transmitting it if they are positive and even though they aren't positive? Or to protect them? Since their masks won't protect them (unless they're happy masks or something similar) and since the data is now showing that kid masks are germ factories, it would seem much safer to remove the masks on your kids.

    To me, a better question is whether you're queing and chumming up like normal and doing the sardine thing. Personally, I give people space and I see that a lot. With no marks on the floor, nothing, people are just giving others space. I think this is good.

    Where is this information coming from?

    My understanding is that kids absolutely can (and do) transmit covid, and that masks both protect the wearer and protect others from the wearer.  

    I have not seen anything to suggest that masks are dangerous for kids over 2. 

    All other things being equal, masking during a pandemic is safer than not masking, even for kids.

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  5. 6 minutes ago, whitestavern said:

    I would be uncomfortable with this. Those people are essentially guinea pigs as there has been no testing of that regimen. 

    In my circle, everyone thinks Pfizer is better. Most people I know waited to be vaccinated until they could choose. 

    You are right about testing, but we are stuck with imperfect due to supply limitations.

    We've, as a country, been forced to make difficult decisions with imperfect data.  We've had such limited supply.  We elected to delay second doses to get as many people a first dose as possible, even though delayed second dosing hadn't been tested.   Which was the only ethical choice from a public health point of view, really, during our horrific third wave that came a hair's breadth away from causing total health care system collapse; pretty good immunity with one dose in twice as many people would save many more lives than full immunity in half as many.  So we didn't save product-matched second doses; we couldn't ethically hold back vaccine.  Now we are in a position, with the delta variant breathing down our necks, where we really, really want to accelerate second doses.  But we don't have the supply of matched product to  do that.  Mixed-dose regimens now will save more lives than delaying second doses for a matched-dose regimen.  Again, from a public health point of view, it's a very ethical choice.  

    Unfortunately, the regimen change wasn't as well advertised as it should have been and people felt blind-sided.

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  6. Just now, vonfirmath said:

    Woah? Why do they think Moderna is worse? I've thought the two were virtually interchangeable?

    I know, it's weird.  But it's definitely a thing.  And it doesn't make any logical sense.

    Pfizer was the first to be approved here, and was the one we had the most supply of for quite a long time.  It's got brand recognition.

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  7. Canadian update:

    In my province, we've started doing mixed dose regimens.  It's been very hard for the public to accept.

    Those who had AZ for a first dose are recommended to get mRNA for a second dose.  That's been generally well accepted.

    Those who've had mRNA for a first dose, get mRNA for the second dose, but not necessarily the same product.  We had a lot of Pfizer initially, so a lot of people had that for their first dose. We now have a plentiful Moderna supply, and a shortage of Pfizer.  So people who had Pfizer for their first dose are showing up to mass vax appointments and being offered Moderna for their second dose (as per NACI guidelines).  They don't know this until they are in the chair (those who pay attention to media should know this was likely to happen, but many don't, apparently).  They are generally NOT happy about it. 

    We also have this weird thing where the public has latched onto Pfizer as "the best" and decline Moderna even for first doses.  I have had people walk out on me when we run Moderna clinics.

    I spent my day yesterday at a mass max clinic disappointing person after person after person who expected orhoped for Pfizer, and all I had to offer was Moderna.  Not a fun day for any of us.

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  8. 3 minutes ago, BaseballandHockey said:

    I do a lot of work with high school students with IDD who are trying to figure out their next step after graduation.  We start with just talking about dreams, because there's truth in dreams even if the dreams don't come literally true.  Often times, we start with dreams that are clearly impossible. My blind student is not going to become the lifeguard at the top of the waterslide, even if he loves the water slide.  My student who is a huge Beatles fan is not going to sell T-shirts at the Beatles reunion tour because John and George are dead.  But that doesn't mean that we can't use those dreams as a jumping off point to build a life that includes a position of respect (people listen to lifeguards!) and the sun on your face, or music, or whatever. 

    Said it better than I did!

  9. I think that the purpose of this sort of exercise is to dream impossibly big, identify the really meaningful bits, and pare down to make possible in real life.  A way to identify what will help provide meaning in your life, without the barrier of how.

    For example:

    Dream:  Buy up a huge chunk of forest and run it as a nature preserve, with public access and education programs (impossible!)

    Theme: nature preservation and public education

    Real life version:  Part time job (paid or volunteer) at local environmental organization.

    Or 

    Dream: run a free hospital in an impoverished nation that provides excellent free care to those in need (impossible)

    Theme: helping people access affordable healthcare

    Real life version: part time job at local public hospital or free clinic, or finding a way to use existing skills to assist a program like this.

     

    • Like 5
  10. 4 hours ago, Laura Corin said:

    We are not using AZ for younger people, so it's supply of Pfizer and Moderna that has been the issue.

    Right.  COVID vaccine supply in general.  Which is still an issue in much of the world, unlike in the US.

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  11. On 6/18/2021 at 5:31 PM, Laura Corin said:

    I suspect they don't have confidence in the vaccines developed in China and Russia,  and AZ got caught in the crossfire. 

    I think it was just a case of making a policy without really thinking.

    I see that New York State has amended their guidance to include both FDA and WHO authorized vaccines.  Though I don't see it on the NYS website - probably just don't know where to look to get the full policy details.

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  12. 13 minutes ago, Jean in Newcastle said:

     

    Were the young hospitality staff not eligible for vaccinations?  Because there is absolutely no reason why no one could have predicted this outcome and planned for it by vaccinating them.  And they should have required vaccinations from all of those attending and their support staff etc. 

    Probably not.  18+ eligibility started just 2 days ago in England.  

    Wikipedia isn't the most academic of sources, but this article does have a very nice timeline of which age-groups became eligible when in England.  Only very recently for those in their 20's.  I think that supply remains an issue.

     

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  13. 13 minutes ago, Pen said:

     

    since no vaccine is actually FDA-approved  they really should have a completely empty hall, I guess 

     

     

    bad faith in many shapes and forms seems abundant 

    Imo there are worse things than not getting to see a Broadway show though.

    some people had the NY nursing home tragedies to cope with 

    Many people are struggling with work, school, housing...

    our area as a farming area is struggling now - i 

     Children may be becoming guinea pigs

     

    i can’t say I feel especially sad about some public figure and his inability to see a Broadway show  — but maybe that will get more public compassion, than things I consider far far worse 

    “vaccine fun” seems an apt phrase perhaps for the mayor’s problems in the scheme of things

     

    Good catch re: approved.  They should have used 'authorized".

    It's not really about getting to see a show.  It's about the  use of FDA authorization as a proxy for efficacy, and limiting the movements of people based on this.  There are huge implications for travel, business, cross-border work, tourism economy, etc.

    • Like 4
  14. Here's some new vaccine fun:

    New York is declining to recognize those who've had a full course of AstraZeneca covid vaccine as vaccinated, and denying entry to venues based on that.  We'll see how this evolves.  There are huge implications for international travel (not to mention millions of angry Canadians - the USA sent us that much of that AZ after all)

    "David Screech had already selected his seats and put in his credit card information for Springsteen on Broadway tickets when he noticed the COVID-19 vaccine requirements: his two doses of AstraZeneca-Oxford wouldn't be enough for admission.

    Screech, the mayor of View Royal, B.C., and a Springsteen fan of 40 years, received his second AstraZeneca dose last week, but the Jujamcyn Theaters' website said it would only allow guests "fully vaccinated with an FDA-approved vaccine" — Pfizer-BioNTech, Moderna or Johnson & Johnson."

    "Live tapings of TV shows including Saturday Night Live and The Late Show with Stephen Colbert also snub AstraZeneca doses in rules listed on their websites, which say they're acting "at the direction of New York state."

     

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  15. Thinking further, chiropractors, naturopaths, clinical psychologists and dentists all use the professional title "doctor" despite not being medical doctors, and the public doesn't have any trouble discerning the difference between their areas of clinical expertise - I don't anyone is confusing their dentist for a medical doctor.  They all have clinical degrees and the use of the title doctor is a social norm.

    I wonder what her PhD was.  Was it clinical?

    The use of the title "doctor" in healthcare is actually a bit of an issue.  In the context of healthcare, it's a restricted title here.  And that's not without controversy.  I think the reasoning is to protect the public from fraud.

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  16. I think it depends what you mean by "doctor". She has a PhD, so she is entitled to use the title "doctor".  Her RDN credential makes her a health care professional.  So she is someone who sees patients in a clinical context, and uses the title "doctor", but isn't a (medical) doctor in the colloquial healthcare sense.  

    Under which regulatory body does she hold her licence to practice?  That will probably answer your question.

    (Just like those with PhD's in nursing can use the title "doctor" and treat patients, but they are practicing as nurses, they are not medical doctors).  It can be confusing for patients.  ETA here they could get themselves into trouble if not very careful, the title doctor is protected here in the context of healthcare.

     

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  17.  I really think that much of the explosion in numbers of rapid onset gender dysphoria in girls is a reaction to how miserable female adolescence can be in a patriarchal and misogynistic society; and that the (relative) social acceptability of being a transgendered person presents a way out.  There also definitely does seem to be a certain amount of social contagion.

    Hating being a girl is not the same thing as being transgendered, but assuming a transgender identity might seem like a good way out for some hate-being-a-girl adolescent girls.  I think we will see a lot of de-transitioning in this population the next 10 years of so.  Along with suing of medical professionals who affirmed and assisted with physical transition (medical/surgical), that in retrospect, wasn't  indicated..

    Of course transitioning, including medical/surgical, really is the right choice for many transgendered people.  My worry is that many of the adolescent girls presenting as ROGD actually aren't transgendered, and that a policy of affirming without doing all the hard psychological work is really very harmful.

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  18. A few posters have alluded to family culture, and I think there is something to that.  My parents and DH's parents were very near to 30 before their first kid, and my grandparents were 25 for one set and 34 for the other at age of first kid.  All my cousins who've had kids were also in their 30's at the time of first kid.  And fewer than 50% of my cousins had kids at all.  Neither DH nor my sibs have kids, and aren't terribly likely to now (late 40's) - though DH's aunt and uncle adopted his cousin when they were just shy of 50, so still possible, of course.

    • Like 1
  19. 1 hour ago, regentrude said:

    I gave birth to my first child shortly before my 29th birthday. Does that count as delayed?
    My pregnancy happened exactly when I planned it: after I had completed my PhD and a two-year postdoc in a foreign country.
    I am very happy with that decision. I got to complete my education and travel before having family responsibilities.

    I lived in a country with universal healthcare where I did not pay a penny for prenatal care or birth, extensive fully paid maternity leave, three years job guarantee with parental leave, subsidized childcare. That did not affect the timing of my pregnancy because I wanted to complete my education first. (The fact that I decided not to embark on a career that made full use of this education is not relevant)

    There's a lot we, as a country, could do to make having children less of a financial risk for young mothers: paid maternity leave, universal healthcare, parental leave with job guarantee, child sick days, subsidized child care for low income families.... This won't get highly educated women to have children younger because it just takes a long time to get an advanced degree and doing so while mothering is very, very hard, but it would go a long way encouraging mothers who feel they cannot afford to get pregnant. Nobody should have to forgo having children because the cost of birth and the loss of postpartum income make that unaffordable.

    Universal healthcare here too.  Prenatal care and birth cost zero dollars out-of-pocket (other than the cost of parking!).  Maternity leave is less than what you describe, but not terrible (job guaranteed for up to 18 months combined pregnancy and parental leave, much of it paid).

    • Like 1
  20. First kid at 35 here.  I spent my 20's and early thirties in school and establishing my career.   No regrets.

    Almost all of my female colleagues have also delayed childbearing well into their 30's, so I don't really feel like and outlier.  

    I think my kids have benefitted from having parents who are well established - both financially and maturity-wise.  

    • Like 7
  21. 5 hours ago, Pen said:


    thank you! 
    your post crossed mine and the publication answered several of my questions — about National versus Provincial rules for example

     

    How did age 12 for consent to these vaccines emerge?
    The Ontario row (I think you are in Ontario) seems to indicate age 16 as being presumed as usually being capable of making medical decisions.  (And I also think age 16 is a better fit for a lot of children than 12– plus it is at least in states typical driving age with driving responsibilities.) 
     

    and I am still wondering how exactly the dialogue — especially with a child — patient works, what’s said about risks in ways a child can understand and so on?

     

    If it were later to turn out that there was not effective dialogue or appropriately informed consent, who gets into troubles for that? The physician who should have had a dialogue? The nurse who gave the injection? The national care system? 
     

     

    Quick reply:  There is no age of consent in my province.  The Health Care Consent Act, which governs consent, presumes capacity in all persons, including minors, unless there is reason to believe otherwise.

    The Substitute Decisions Act, presumes capacity above age 16 - that act is more about assigning powers-of-attorney though, I think. 

    People, especially minors,  may be capable of some decisions (ie vaccine) but not others (ie major surgery).

    Presuming that 12yo's are capable is within the letter of the law here, and makes it easy for public health to get vaccines into arms in schools. 

    The person getting the consent is evaluating the capacity of the person they are getting consent from while they are having  the consent discussion.  In covid mass vax clinics, the 12 year old is almost always accompanied by the parent of guardian (I've yet to see one unaccompanied), and the consent discussion is generally shared, with both parent and child involved.    It does mean that 12 year olds aren't forced to have vaccines they refuse, even if their parent wants them to have it (and, less commonly, that 12 year olds can opt to get vaccine, even if their parent doesn't want them to have it.  Though in practice, it would be hard for a 12 year old to book a vaccine appoinment and get themselves there without adult help)

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