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Middle Barael wrote:Maybe if you make an In-Character Museum or museum network that they are a part of? Since IC cards usually do not exist, but if you make it so that each card is like an exhibit of foreign art in a Museum, then it’d work IC?

I have been toying with an idea like that for a considerable while now. When the proposal to "commend" Verdant Haven was up I even requested to include their efforts and those of Love and Nature in the proposal. I admire their amount of dedication to completing that collection. I have tried pointing out the long and short-term flaws in the "card game"-mechanics before and I won't bother everyone by pointing them out again.....but for someone who enjoys the concept but doesn't have oodles of time or a massive puppet army or the desire to use tricks to gain a competitive advantage I would definitely like a cooperative network of some sorts to try and complete some collections in the future.....I don't mind if the consequence is that I won't be having a digital copy of a card myself.

I hereby suggest the creation of a "Collective for the preservation and acquisition of Forest related artwork" with Love and Nature and Verdant Haven as honorary though hopefully active members and Middle Barael and / or Kawastyselir as representatives by our regional authority. I am willing to pledge an immediate 25 credits to this cause and would be willing to pay a certain "membership"-contribution as we put things into motion. I would like to invite other "deep pocket"-collectors and or small casual collectors like myself to join to see if we can keep the card game "fun" despite the several flaws in the system and the way huge card-miners have unfortunately cornered the market (like in real life).

EDIT: To answer the order of post-likers. I think it is equal to the order in which the nations were created.

Ownzone wrote:I have been toying with an idea like that for a considerable while now. When the proposal to "commend" Verdant Haven was up I even requested to include their efforts and those of Love and Nature in the proposal. I admire their amount of dedication to completing that collection. I have tried pointing out the long and short-term flaws in the "card game"-mechanics before and I won't bother everyone by pointing them out again.....but for someone who enjoys the concept but doesn't have oodles of time or a massive puppet army or the desire to use tricks to gain a competitive advantage I would definitely like a cooperative network of some sorts to try and complete some collections in the future.....I don't mind if the consequence is that I won't be having a digital copy of a card myself.

I hereby suggest the creation of a "Collective for the preservation and acquisition of Forest related artwork" with Love and Nature and Verdant Haven as honorary though hopefully active members and Middle Barael and / or Kawastyselir as representatives by our regional authority. I am willing to pledge an immediate 25 credits to this cause and would be willing to pay a certain "membership"-contribution as we put things into motion. I would like to invite other "deep pocket"-collectors and or small casual collectors like myself to join to see if we keep the card game "fun" despite the several flaws in the system and the way huge card-miners have unfortunately cornered the market (like in real life).

This seems like a good idea, as it would allow experienced card collectors, such as the ones you named, to share their experience, and finds with other Forestians. This has been done a lot before, and I think a Forestian one, while not copying, could learn and build from it.

Question on ethics, I'm curious to know your thoughts, all.

I have patients who feel anxious about going to work because of covid 19.

There workplaces have taken all reasonable measures to protect their staff, but some people remain understandably frightened.

They want signing off work for anxiety. They are not wanting medical treatment, as when not at work they are not anxious.

Do you think it's reasonable for them to be signed off work by their doctor?

Candlewhisper Archive wrote:Question on ethics, I'm curious to know your thoughts, all.

They want signing off work for anxiety. They are not wanting medical treatment, as when not at work they are not anxious.

Do you think it's reasonable for them to be signed off work by their doctor?

Surely they would feel anxious at home about the prospect of having to go to work but if they don't want any sort of treatment then then the doctor would be hard pressed to have valid reason to sign them off on medical grounds. Especially as it would have to be a long term sign off 3/4 months maybe more is that possible?

Candlewhisper Archive wrote:Question on ethics, I'm curious to know your thoughts, all.

I have patients who feel anxious about going to work because of covid 19.

There workplaces have taken all reasonable measures to protect their staff, but some people remain understandably frightened.

They want signing off work for anxiety. They are not wanting medical treatment, as when not at work they are not anxious.

Do you think it's reasonable for them to be signed off work by their doctor?

I think the bold part is the problem. They may have honest intentions, but there is no way to know if they are just shunning work or not.

I don't know if you mean a drug-based treatment for anxiety, and I can understand people being sceptical about medication. But perhaps they could be referred to a psychologist for therapy? Quite apart from that, I think many of us will need that once we get back to things. So I understand the anxiety, but we cannot stay home forever.

Anyway, tough choice. Do you have the option to refer them to a psychologist for an evaluation of their anxiety? If the moral dilemma hinges on whether they have anxiety or not, a psychologist could be a better judge of that. And perhaps they'd have some tools to persuade them to come to therapy as well?

Frieden-und Freudenland wrote:I think the bold part is the problem. They may have honest intentions, but there is no way to know if they are just shunning work or not.

I don't know if you mean a drug-based treatment for anxiety, and I can understand people being sceptical about medication. But perhaps they could be referred to a psychologist for therapy? Quite apart from that, I think many of us will need that once we get back to things. So I understand the anxiety, but we cannot stay home forever.

Anyway, tough choice. Do you have the option to refer them to a psychologist for an evaluation of their anxiety? If the moral dilemma hinges on whether they have anxiety or not, a psychologist could be a better judge of that. And perhaps they'd have some tools to persuade them to come to therapy as well?

How about those vaccines? Should they get one before some others with risk factors and whatnot, because of high level of anxiety? I guess this particular group can't work from home and have to be at work physically?

Terrabod wrote:I have a question of my own; what determines the order in which nations are named when they like a post?

The whims of ancient gods as far as I can tell, I thought it was influence but turns out not really

Love and Nature wrote:How about those vaccines? Should they get one before some others with risk factors and whatnot, because of high level of anxiety? I guess this particular group can't work from home and have to be at work physically?

The problem is that it is not 100% proven that the vaccine stops you from spreading it to others, so there is still potential for a problem surrounding 'return to work' transmission.

Candlewhisper Archive wrote:Question on ethics, I'm curious to know your thoughts, all.

I have patients who feel anxious about going to work because of covid 19.

There workplaces have taken all reasonable measures to protect their staff, but some people remain understandably frightened.

They want signing off work for anxiety. They are not wanting medical treatment, as when not at work they are not anxious.

Do you think it's reasonable for them to be signed off work by their doctor?

I guess the question is whether they meet the diagnostic criteria you use for clinical anxiety. Whether or not they want to be treated shouldn't determine whether they have the condition. How likely is it that the antidepressants generally prescribed for anxiety would significantly change this situation?

Ok, they might be swinging the lead, but so are lots of people. And if they were they'd probably let you prescribe them something. Things are crazy right now, lots of people are unraveling rapidly but this is temporary. I'd err on the side of kindness. In the words of Samuel Johnson, it's happier to sometimes be cheated than never to trust.

EDIT: Plus I'm guessing that any talking therapies you might refer them to have huge waiting lists and are hampered by having to operate remotely.

Pandemics and epidemics will become more common because there will be more people every year at least for 50 years from now and that means more travelling, more cramped up areas. We also get closer to many species that don't usually end up having too much human contacts and that could help zoonosis to develop. We use too many antibiotics, you know this "just in case mentality" and in too many countries antibiotics are over-the-counter goods which is totally crazy. We also pump up livestocks animals full of antibiotics so they don't die too soon or they at least stay alive before slaughter. Over use of antibiotics will lead really fast to multiresistant bacteria, so soon some basic diseases might start killing us again.

I guess nature will try to balance itself out by getting rid of human overpopulation (yeah it does not think and it actually does not care, but there are some basic "laws" and math involved in these kind of scenarios). Soooo this might be a good rehearsal for what is still to come. Maybe the next pandemic is just around the corner and does not wait 70-100 years to pop up.

Love and Nature wrote:We also get closer to many species that don't usually end up having too much human contacts and that could help zoonosis to develop.

Yeah, environmental wellbeing is a huge driver for emerging and re-emerging diseases. Deforestation brought us Zika, global warming is bringing malaria and cholera further north than ever before, habitat destruction has led to multiple Ebola epidemics... the list goes on. Going forward, the relationship between environmental health and disease should, I think, be an issue we discuss and raise awareness of as a region, along with our "usual suspects" like plastic waste and fossil fuel consumption. The COVID-19 pandemic has shown us all how important that issue is, and as Love and Nature says it will become even more important as further environmental disruption increases the number of emerging diseases we're exposed to in the coming decades.

https://www.cdc.gov/onehealth/basics/index.html - note the concept of One Health wasn't developed by the CDC but this webpage summarises the core ideas very well

Candlewhisper Archive wrote:Question on ethics, I'm curious to know your thoughts, all.

I have patients who feel anxious about going to work because of covid 19.

There workplaces have taken all reasonable measures to protect their staff, but some people remain understandably frightened.

They want signing off work for anxiety. They are not wanting medical treatment, as when not at work they are not anxious.

Do you think it's reasonable for them to be signed off work by their doctor?

This is something that I have been wrestling with too, in a slightly different way. It's interesting that you should mention it.

This year at my school, the students (and their parents, in other words) can make the decision that they want to be entirely virtual, or they can attend classes at school (and while only 10% of the student body was virtual in the beginning of the year, it's been over 50% since December, and in some classes, I have five kids in front of me and twenty-five on Zoom. We faculty (and the administrators and other adult workers at large, I should clarify) simply must report to school physically, despite the fact that everyone is equipped to be virtual and sometimes the entire school (for virus-related reasons, inclement weather, or some pre-planned reason) will have an "all virtual" day, in which we teach from home. But if you're literally 75 years old, have high blood pressure, and have an 82 year old husband at home, too bad, you still have show up to work, despite the fact that no substitutes would be required for the few remaining students, since large common areas have been set up with constant supervision for spacing out as needed and in case teachers are home because they have themselves been quarantining, which is the only acceptable reason to be home.

Now, as an entirely healthy young guy who lives alone, I am not so worried about the virus, given that I always take every precaution, and because if I get sick, I am not at risk of spreading it to others in the household. But for the aforementioned 75 year old colleague (and others who are older in general, who have co-morbidities, who care for highly vulnerable spouses or parents, etc., they are not allowed to teach virtually from home as a matter of general principle (only for the ten days if they have been exposed, or if someone tested positive, which thankfully has not happened in the context of the building yet). But lazy fifteen year olds who don't want to have to sit in class all day can go virtual with absolutely no fuss, and absentmindedly tune into class while also clearly playing video games or sleeping.

So everything's just grand, innit?

And yet, I can also see the school's perspective, insofar as they are committed to maintaining a model from fully physical to fully virtual (which itself is another argument). Granting that this is something they want to do, it simply would not work if half of the adults who would normally be in the building want to work remotely, since the system would not function with such large numbers of people out who coordinate the day. Could the dean of students decide to discipline troublemakers virtually from home? Obviously not. And having a needs-based system of priority ("old people with reasons or sick people with reasons can stay home") creates twice as many problems as there are individuals.

From a purely virus-containment perspective, the whole year should have been fully virtual, of course, but not every student is equally well equipped to survive and adapt to not coming to school, and those who remain form a loyal "core" from my point of view, so it's rather mixed, and I myself have conflicting feelings regarding the whole thing. However, I don't know that I would be so ambivalent if I were, say, old, or obese, or immunocompromised, or diabetic, etc. etc.

So it's a good question you raise. How do you feel about it, or what is the general feeling among professionals in your neck of the woods?

Alright now were not mad exactly but somebody produced the "Baker of Karock" horror film. Yes we have a black market but really this was just mean we demand an apology from the offending nation!

Candlewhisper Archive wrote:Question on ethics, I'm curious to know your thoughts, all.

I have patients who feel anxious about going to work because of covid 19.

There workplaces have taken all reasonable measures to protect their staff, but some people remain understandably frightened.

They want signing off work for anxiety. They are not wanting medical treatment, as when not at work they are not anxious.

Do you think it's reasonable for them to be signed off work by their doctor?

I was preparing some States-side thoughts concerning the ADA and the like, but then I realized that either "have taken reasonable measures" means some kind of telecommuting is already available or doesn't apply because it's not conducive to the work in question. My own experience is more along the lines of the latter; over the course of the last year I had increasing anxiety and the like sitting at home thinking about all the things not getting done because I was made to telecommute and do other computer-y things mostly tangential to my actual job title. Ended up having to ask my bosses boss to let me be one of the few to return on site, for the sake of my mental health.

Didn't need a doctors note, although I do get to do a daily symptom check, and weekly nose swab, so that's kinda doctor-y I guess.

*lurks*

Oh, the photo contest is on! I forgot! I will try to remember to vote, those photos were amazing! Always nice to see the real-world. And that cultural registry is taunting me, I need to submit something but I also want to put effort into it and I don't know if I have the time.

So I just had the weirdest math class.

We began by going over problems involving homework, and we were halfway through going over some fractional equation word problems when one of the problems involved stocks. Somehow we managed to get into a tangent about stocks and the stock market, and lo and behold 40 minutes go by as we go off on a tangent about stocks, loans, bonds, and interest. Our teacher used to work as an accountant and his husband does wealth management, and so this was very much our teacher’s forte and he clearly secretly enjoyed teaching this, but he had to feign as if he really wanted our class to get back on track. Needless to say every single time he tried getting us back on class, we came up with more questions about stocks, and in the end he decided to postpone our test a few days because we barely got to study at all that period.

Oh and somehow the conversation even drifted to taking about the time that two guys cornered 98% of the futures agreement markets for Onions, leading to Onion futures trading agreements being legally banned nationwide by Congress which in turn led to a massive fall in the Chicago stock market. This wild tangent was of course brought forth by yours truly

Middle Barael wrote:So I just had the weirdest math class.

We began by going over problems involving homework, and we were halfway through going over some fractional equation word problems when one of the problems involved stocks. Somehow we managed to get into a tangent about stocks and the stock market, and lo and behold 40 minutes go by as we go off on a tangent about stocks, loans, bonds, and interest. Our teacher used to work as an accountant and his husband does wealth management, and so this was very much our teacher’s forte and he clearly secretly enjoyed teaching this, but he had to feign as if he really wanted our class to get back on track. Needless to say every single time he tried getting us back on class, we came up with more questions about stocks, and in the end he decided to postpone our test a few days because we barely got to study at all that period.

Oh and somehow the conversation even drifted to taking about the time that two guys cornered 98% of the futures agreement markets for Onions, leading to Onion futures trading agreements being legally banned nationwide by Congress which in turn led to a massive fall in the Chicago stock market. This wild tangent was of course brought forth by yours truly

This seems like exactly something you would do.

Nation of Ecologists wrote:This seems like exactly something you would do.

What is that supposed to mean? <Squinting menacingly>

But really it was a very fun and educational and practically useful class, and as much as he was annoyed that his lesson went the whole other direction, this is his forté and he seemed very happy explaining all of it. And after class I went back and checked and it turned out that following a 2010 revision of the law, not only are Onions banned from being traded but so are futures agreements involving Box Office sales. Congress is weird

Candlewhisper Archive wrote:Question on ethics, I'm curious to know your thoughts, all.

I have patients who feel anxious about going to work because of covid 19.

There workplaces have taken all reasonable measures to protect their staff, but some people remain understandably frightened.

They want signing off work for anxiety. They are not wanting medical treatment, as when not at work they are not anxious.

Do you think it's reasonable for them to be signed off work by their doctor?

For me, the crux of the question is the statement that their workplaces have taken all reasonable measures to protect their staff.

I wouldn't consider the fear or anxiety about COVID to be the primary consideration - rather, is that fear or anxiety justified? In your medical opinion, do the measures taken in the workplace actually protect staff, or are they just the things that can be reasonably done to partly reduce the risk while still leaving staff exposed to an unacceptable hazard? Just because reasonable efforts have been taken, that doesn't mean it's safe. If you believe the people will be just as safe at work as at home, and they just don't want to go to work because they are frightened of something that isn't really a threat, then I would think that is insufficient. If the threat is still significant, but is simply less than it would be with no measures at all, then I could see justification for saying they should be able to stay home.

I recall looking over the pandemic staffing plan of a previous agency I worked for many years ago, as part of my emergency prep work (yes, they did actually have one!). Their plan was to divide the staff into three groups, and to use just the first group for a couple weeks (with extensive overtime and cross-staffing) to reduce how many people were exposed at once. Then, when that group became so sick they could no longer function, they would be sent home and the next group called in. That would then be done again, and the assumption was that by the time the third group was so sick they couldn't work, the survivors of the first group could be brought back in again for another cycle. In the agency's mind, it was a great plan - it ensured work functions were being completed, it maximized operational continuity, it had a timeline reasoned out... but they gave not a single thought in the world for the fact that their workers are actual humans and might not be ok with the idea of being expendable OT plague machines. It is important to know what the measures an employer has in place actually do, and who they are "reasonable" for.

Nation of Ecologists wrote:*lurks*

Oh, the photo contest is on! I forgot! I will try to remember to vote, those photos were amazing! Always nice to see the real-world. And that cultural registry is taunting me, I need to submit something but I also want to put effort into it and I don't know if I have the time.

I'm quite annoyed because I got a lovely picture last night, just too late...

Uan aa Boa wrote:Things are crazy right now, lots of people are unraveling rapidly but this is temporary. I'd err on the side of kindness. In the words of Samuel Johnson, it's happier to sometimes be cheated than never to trust.

I strongly agree with this sentiment. Unless it's using up necessary resources, who cares if someone gets away with not having to be at work? I'm damn near at the end of my rope, and I mostly work from home now.

As people have asked, some points on the ethics question.

First off, pragmatically speaking, we docs will pretty much always sign off anyone who asks for it. The alternative has too much potential to cause stress and argument for us, and even in better times its not a good use of our time to fight some fights.

Re the diagnostic criteria, they're entirely based on subjective report of symptoms. If someone describes persistent and severe mood disturbance they meet the criteria.

Re accepting treatment, I think that it's reasonable to decline medication if a life change achieves mood improvement. Depression =/= needs meds. Re counselling, that's a limited resource, but basically you get a phone number, a 3 month waiting list, then some group zoom calls. Unless you're under 18 then you get a list of charities who might help. Actual psychiatrists are for patients with psychotic illnesses or self harm. Depression isn't something the NHS properly provisions for.

My own view is that people should be allowed to take time off purely on their own declaration, but that sick pay durations should be limited by law, after which employer obligations should fall away. I don't think doctors should be involved until there's need for dispute resolution.

For the specific issue of covid risk causing anxiety, my opinion is skewed by the fact that my own workplace carries more risk than theirs, so part of me thinks "if we can do it, so can you, and if you can't, get out of the job and let that wage go for someone who can."

Verdant Haven wrote:I wouldn't consider the fear or anxiety about COVID to be the primary consideration - rather, is that fear or anxiety justified? In your medical opinion, do the measures taken in the workplace actually protect staff, or are they just the things that can be reasonably done to partly reduce the risk while still leaving staff exposed to an unacceptable hazard?

Surely if the patient has a justified concern about their safety then that's rational decision making rather than clinical anxiety. Anxiety in a medical sense isn't the same as being scared or worried (though the strain of fear and worry can contribute to developing anxiety). I'd say an essential feature of clinical anxiety is that it's a disproportionate response to the situation. Knowing that it makes no sense is part of what makes it so frustrating, often creating a vicious circle of increasing stress.

An employee who has legitimate safety concerns at work should seek the support of their trade union rather than their doctor.

I have a question. I'm working on an entry for cultural registry thing. However, the cultural object is located in the island of matos, which belongs to the Autonomous Province of Gurá and Matos, which happens to be part of MSR, but also have it's own independent account which I might use for ambassador work later. Should I submit it as part of the MSR, which is technically correct, or as part of Gura and Matos?

EDIT: Oh my god, re-reading this mesage after having coffee and finally waking up enough to type is killing me. English is not my first language

The Most Serene Republicans wrote:I have a question. I'm working on an entry for cultural registry thing. However, the cultural object is located in the island of matos, which belongs to the Autonomous Province of Gurá and Matos, which happens to be part of MSR, but also have it's own independent account which I might use for ambassador work later. Should I submit it as part of the MSR, which is technically correct, or as part of Gura and Matos?

In this case, I don't really mind which nation you use. I would say that (according to the submission criteria) your submission must contribute significantly to your nation's cultural heritage, so if it's important to the people of Gura and Matos only then that might be more appropriate, but if it's part of the "story" of MSR as a whole then that might be the more appropriate choice. You could also make your choice based on IC reasons, like if you think Gura and Matos as an autonomous province has the power to submit something to the Register or if that power is reserved for the governing body of MSR. Honestly, though, you can choose the nation that you want to be credited as on the Register - so if you'd rather see it listed as one over the other you're welcome to do so. I wouldn't split hairs like that when looking over your submission.

It would be different if the two nations were absolutely separate and you tried to submit something under the wrong nation, but that's not the case here.

The Most Serene Republicans wrote:EDIT: Oh my god, re-reading this mesage after having coffee and finally waking up enough to type is killing me. English is not my first language

It's really not that bad haha.

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