I wish I had your experience with Kaiser. I've hit that conflict of interest multiple times. Most recently, after going through triage and waiting six weeks for an appointment, and after half way through it with [specialist], I learn that they're actually not the specialist I thought I was getting and just performing triage. This person lacked even basic knowledge on the topic, and none of the classes or groups she can find actually address the issue in question. When our time is almost up she finally decides to lookup a specialist. There's only one available with only one date available in another couple months. But she's only looking in one geographical region because she doesn't have access to data for the other region that can also serve us. If I book this appointment, she informs me I won't be able to find another specialist in the other region because a patient can be assigned to only one specialist. So it seems data actually is integrated across Kaiser's "regions", but only so far as to support their bottom line.
Kaiser doesn't have a "bottom line" to support. North and South Kaiser are two completely different orgs, but they both use the same EHR technology and can move records between them with no real friction.
They may not have a bottom line, but they certainly put up barriers to accessing specialty care that I never experienced when using the Sutter/Blue Shield combo. Also this wasn't a North Kaiser vs South Kaiser thing. More like Solano vs Yolo/Sacramento counties.
Kaiser doesn't excel at specialty care, I will agree with that. There's more friction (and inter-regionally, which is not something I've had to deal with since I'm in the bay area which is the kaiser mothership).
Kaiser exists to maximize healthcare for reasonable costs across a wide range of people, and they do so by keeping general health high, but at the expense of specialty. In a city like SF, that means Kaiser will send you to UCSF for a transplant and pay a significant fraction. In Solano and Yolo/Sacramento there are far fewer specialists and even then I'd expect you to be referred to UCSF (when I worked there, there were constantly people visiting from all over the state for transplants).
Yep, my XPS does too. I believe it's called "coil whine" and is caused by surface-mount inductors whose windings aren't fully encased in resin or whatever material they use.
Who is we? YMMV, but any sort of emphasis on critical thinking wasn't my experience in an Arizona school district in the late eighties/early nineties. If such curriculum was available, the kids who took it were likely outliers in having influences to push them in that direction.
Where I live, we used to have tons of frogs. The city actually built a freeway bypass to prevent too many flat frogs. Didn't work. Anyway, the frogs quickly vanished around the same time we started spraying to reduce the spread of West Nile. Don't know if it was the food source or if the spray killed the tadpoles, but unintended consequences are a thing. A knock-on to that is we now have a growing roach problem.
Does anyone remember Win4Lin? It would run Windows 98 as a process and translate system calls to their Linux equivalent. It was very convient for testing my websites in IE. And I swear it was faster and more stable than running Windows on bare hardware. And when it did blue screen, I could have it back up in a matter of seconds.
I believe the problem in any society is that the older generation relies on the younger to care and/or subsidize costs of said care for the older as their health declines. That breaks down when population starts declining.
A little late to this conversation, but I want to point out that it appears dopamine does have functions other than neurological.[1] Of course one might take the view that immune function is regulated by the nervous system and thus it may not be a direct pathway.
I am struggling with a similar problem (food, and gas in particular, affecting my sleep) and was wondering if you'd be willing to share more about your experience.
Sorry for such a late reply. For me the two biggest culprits are sulfites (increased sleep disturbances) and fructose (reduced deep sleep and more chaotic cycles).
What's weird about the fructose is I don't have the symptoms associated with such an intolerance; namely gas. Good news is that there is an enzyme (Fructaid) that helps mitigate it for me, so I don't have to completely cut it from my diet.
In the US, sulfites can be sneaky. Labels are required to list them if directly added to a product, but not for sulfite-containing ingredients sourced from a third-party. So the raisins in that trail mix very likely contain sulfites.
