I (39F) have had a great OBGYN over the years. I’ve had complications in my pregnancies and my last one in 2015 ended in my son being born at 24.5 weeks. He’s alive and well but they cauterized my tubes which caused extensive bleeding. To remedy this, they performed a uterine ablation and inserted a Kyleena IUD within the same hour.
For years I have been asking to either remove the IUD or what my other options were because of painful cramping but zero bleeding and any other symptoms. This was my year to change it out and asked again to not have anything. They told me that since I’ve had an ablation, I can still get pregnant and I needed something to keep my lining thing so I agreed to replace it in the office. Their PA attempted to pull the strings and pulled so hard on 2 attempts that both strings broke so the only way to switch it was to go in a cauterize the vessels around it and remove and replace it. That was 1 week ago.
I woke up from surgery having been told my IUD had perforated my uterus and they had to use three separate methods to get it out and was extremely close to just performing a partial hysterectomy. I knew the complications of perforations were unlikely but still present and that they may have needed to take my uterus. I get pain medicine and I am comfortable and I get released.
In the post surgery notes there is talk they inspected my bowel and no lacerations or punctures were found. I’m feeling ok except I keep getting a sharp pain around my midsection and got so bad the following night I came into the ER. Was waiting in wait room for what felt like hours doubled over in pain. Drs perform contrast CT scan and notes air pockets but otherwise normal. Blood tests were coming back ok except high liver enzymes. Pain was getting worse and they were going to release me. New surgeon saw how much pain I was in and asked the radiologist review the findings.
That’s when they find a small perforation in my sebum and now there is fecal matter in my abdominal cavity. Body starts to turn septic and they rush me into surgery. Surgeon stated that the really only one outcome is to have a colostomy bag, leave me open for 24-48 hours intubated in the icu to make sure all infection was removed.
Woke up and was relieved that she gave me only the worst case scenario and instead I woke up with 1 drain and an incision down my stomach.
I signed disclosures in the beginning that I knew these complications could arise but the fact that in the report it states them not finding any tear or cuts and closing me up to send me home.
My question is, is how much legal remedy do I have? I have full faith in my OBGYN and this was just a risk and a fluke. I truly appreciate everyone who stepped up, including my OBGYN, stepped in and saved my life. I do not have the money to cover this huge of a surgery that happened because of their mistake. I don’t want the dr to lose their license but I would like a fair judgement to be made because of this significant loss. Thank you.

So I found a leak on a 4 Ton split system condenser. Repaired the leak and nitrogen tested it. 150 psi of nitrogen and after an hour it still had 150 psi,I used my digital gauges. Problem is it’s taking forever to pull a vacuum, yes I changed the oil. It also wouldn’t hold when I valved off the pump. But when I disconnected the hose and put the cap back on the port the vacuum will hold. So I replaced the schrader. It’s still won’t hold with the hose connected. I’m thinking the hose might be bad but it’s only 6 months old and lightly used. Any help would be appreciated.

The Dark Virality of a Hollywood Blood-Harvesting Conspiracy
Published too early. adding in counter-arguments
Important (to me) excerpts:

The most effective conspiracy theories are built around kernels of truth. Adrenochrome is a compound that occurs in the body, but about which little scientific research has been done beyond a few studies in the mid-20th century on whether it could play a role in schizophrenia. The question transfixed the writers Aldous Huxley and Hunter S. Thompson, who were obsessed with mind-altering substances. To them, adrenochrome became a psychotropic, akin to mescaline. In his famous Doors of Perception, written just after the first adrenochrome studies, Huxley described adrenochrome as a clue that was “being systematically followed.” “The sleuths—biochemists, psychiatrists, psychologists—are on the trail,” he wrote. Biologists didn’t find much of interest.

...........................................

Thompson is explicitly invoked in what seems to be the earliest recorded posts about adrenochrome harvesting on 4Chan’s /x/ and /pol/ boards, in 2013 and 2014 respectively. In an anti-Semitic 4chan /pol/ thread an anonymous poster linked a restricted, unsearchable video named “Jew Ritual BLOOD LIBEL Sacrifice is #ADRENOCHROME Harvesting.” Within these same online communities, Pizzagate formalized and grew in 2015–2016 before spreading to more mainstream social media.

...................................

In February 2019, Infowars featured a segment on adrenochrome, linking it to the Clinton Foundation via epipen manufacturers, and to the highly controversial “young blood” transfusion startup Ambrosia. A month later, adrenochrome “documentaries” began to emerge on YouTube, followed by many smaller copycat productions, helping form a searchable foundation for the current day conspiracy.

.....................................

The most effective conspiracy theories are built around kernels of truth. Adrenochrome is a compound that occurs in the body, but about which little scientific research has been done beyond a few studies in the mid-20th century on whether it could play a role in schizophrenia. The question transfixed the writers Aldous Huxley and Hunter S. Thompson, who were obsessed with mind-altering substances. To them, adrenochrome became a psychotropic, akin to mescaline. In his famous Doors of Perception, written just after the first adrenochrome studies, Huxley described adrenochrome as a clue that was “being systematically followed.” “The sleuths—biochemists, psychiatrists, psychologists—are on the trail,” he wrote. Biologists didn’t find much of interest.

Conspiracy "debunked" written June 2023.

THE CORONAVIRUS PANDEMIC has led to a surge in misinformation and conspiracy theories.
One of the most bizarre is the claim that celebrities and the ‘liberal elite’ have a secret child trafficking ring and that they extract a drug called ‘adrenochrome’ from these children.
The use of this drug has also led to a number of Hollywood celebrities catching the coronavirus, according to these conspiracy theories.

...................................

Through this evolution, the harvesting of ‘adrenochrome’ from children in the trafficking ring has been introduced. Adrenochrome, according to the theories, is a Hollywood drug, sometimes taken as part of a Satanic ritual.
Some theories claim that blood is drained from children who are kept at ‘farms’ and tortured. Adrenochrome is then extracted from the blood in a lab and sold to celebrities, or the blood itself is consumed, according to these conspiracy theorists.
Others claim the compound is harvested from an adrenal gland in the brain (adrenal glands are actually located above the kidneys).
So even those making the claims about adrenochome can not agree on how the extraction process or the method of taking the drug works.

............................

Like most conspiracy theories, there is truth to small parts of the adrenochrome story.
Adrenochrome is not completely made-up – it is a chemical compound that is produced by the oxidation of adrenaline.
The SpinOff reported it can be used – though it does not appear to be widely used – to slow blood loss by promoting blood clotting in open wounds. It found most sellers state its source is synthetic.
Psychiatrists Abram Hoffer and Humphrey Osmond in the 1950s claimed that adrenochrome can form in the brain and may play a role in mental illnesses. They speculated that high doses of vitamin C and niacin could cure schizophrenia by reducing adrenochrome in the brain.
Other studies testing the use of megavitamin therapy to treat schozophrenia did not confirm any benefits of the treatment.
There have also been mentions of adrenochrome in fiction, which may be helping to back up the idea of adrenochrome as a recreational drug.

Thoughts?

My boy is nearing 9 months now. He's a Dutch shepherd x gsd mix. He hit adolescence about a month ago and his training has just gone down the drain. He's fine in the house and the garden, but as soon as he's outside he couldn't care less about me. He used to have amazing engagement and want to be with me constantly, now the majority of the time it's like I'm not even there. We've done right back to basics but I honestly feel like I'm going no where with him. He was supposed to do an obedience show to get his bronze in the intermediate class, but I feel like I can't even take him now.
I know when puppies hit adolescence their training can backpedal, it's just hard to process cause one day he can be perfect, then the next he could be the worst behaved. He goes to training class, and his trainer is happy with what I'm doing with him. His main issue is he's been blowing off his recall when he sees another dog, even from a good distance. He's on a long line when over the park until he can prove that he can ignore other dogs, and I'm working on building his focus around other dogs.
I would appreciate it if I could hear that this is normal and that it will pass, because I feel like I'm failing him somehow, even though I've heard this is normal. I'm going to work and work to get him to be where I want him to be eventually. He's just testing my patience at the moment.

There are no good metrics to asses whether a player is a good defender apart from the eye test of many games. But to give at least some proof of Bazley’s natural defensive prowess, here’s a six minute video of him defending players and blocking shots: https://youtu.be/uFvszkHN98k
Bazley locks down All-Star level players. He has blocked shots against DeMar DeRozan, Luka Dončić, Devin Booker, and Kevin fricking Durant. More recently, he consistently locked down Kawhi Leonard in the last regular season game for the Suns.
What strikes out the most for me is his lateral quickness and instantaneous jump. Those are things that you can’t learn. He also has an incredible defensive instinct, being able to call out fake pumps and knowing how to provide help to his teammates.
His height, 6ft 8in, also makes him a versatile defender which means he can play 1-4 or as a small ball 5.
His offense needs a lot of work but the Suns only need him to play as a 3 and D guy. A good sign is that he improved his 3pt% to 37.7 during the 2022-2023 season, albeit on low volume.
In my opinion, Bazley is a 22 year old athletic defensive wing that the Suns could greatly benefit from keeping for the right price.
What do you guys think?

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Hey everyone,
I'm going through a process of getting quotes for a new heat pump system for my house. My house is 23 years old and everything is original in it. I have 2 x 5 ton Trane AC condenser and one of them started to act up. This started me down the road of looking at replacing the units for Heat Pumps. The reasons are there are very generous incentives in my state (CT) to move in that direction. I currently have Oil heat, but recently installed whole house solar. My thought was on top of the AC, I can then run the heat pump in dual-fuel mode for heat and offset the increase in electricity charges by utilizing solar and benefit. WIN!
So I've gotten quotes from 3 companies that are highly rated. All 3 ended up giving me quotes to install a Bosch based system. The heat pump would be the Bosch BOVA-60HDN1, and the air handlers would be the Bosch BVA-60WN1-M20. So here is where I have questions.
Two of the quotes are roughly inline, one was $32k before the incentives, the other $29.5k. The last was significantly more and came in at $41k before incentives. I spoke with reps from all three and the fundamental differences came down to a couple of things:
The $41k quote includes replacing all 4 dampers, the hot water coils that sit on top of the existing air handlers and replacing the lineset for the 1st floor unit. The other two quotes are not doing that. I only spoke to one of the quoting companies (decided one of them I generally didn't like) and they said that the coils are copper and they have a lifespan of 40 - 50 years. For the damper he just said he didn't quote it because I never said I had any problems. For the lineset he said they would flush it and pressure test it.
The higher quote shop said they recommend replacing the damper because its 23 years old, and they think its asking for trouble to not replace them. They mention a similar thing for the coils. That they have a long existing life on them, and it just makes sense to replace it when you are replacing everything else.
I am comfortable spending money wisely but wanted some opinions. What is everyone's advice on replacing the dampers/coils and linesets. Is it overkill? Do you think it makes sense? If it does make sense, is the increased cost-justified or should it be less for the increase?
Thanks in advance for any advice!

Previous
​
Terrified as I was of the alien soldiers currently approaching my craft, still I couldn’t bring myself to stop staring at them. Aliens. Real… Aliens… Finally getting a good look at the approaching group, my eyes and brain raced in conjunction to catalogue their features. As a child, it'd always been my dream to explore the stars and make contact with extraterrestrial intelligence. However, as I grew to learn more and more about the physics of space travel, I'd ultimately realized that my dream was essentially impossible. We weren't anywhere close to the level of technology necessary to properly explore even our own galactic zip code, let alone faraway systems. In the end I resolved that if I couldn't experience that myself, I wanted to make sure that eventually someone could, even if that someone wouldn't be born for another 1000 years. Looking back on it from the window of my exploration vessel, maybe I'd been just a tad pessimistic about that number...
Unfortunately, the old sci-fi trope of alien animal groups resembling those on Earth didn’t seem to hold true here. These people, whoever they were, definitely wouldn’t fit well with any of our categories. Small, icy-blue scales shaped like flat pebbles adorned their necks. Their arms, by contrast, were decorated by what appeared to be white feathers—vestigial wings, perhaps. While the specimens on either side of the scientist were concealed largely by body armor and helmets, the one between them provided a much more detailed view of their anatomy. Slight lumps of fat on the chest area suggested mammary glands of some description—yet another middle finger to my understanding of evolutionary biology, but at least a helpful middle finger, given that it pointed me toward this alien’s sex. Atop her head, a crest of similarly-pristine feathers stretched down like human hair, concealing one of her (presumably two) ears which resembled in passing those of a fantasy elf, but curvier and with two prongs at the top instead of one.
Just a few paces shy of my vessel’s door, the trio halted in place. It looked like the scientist was trying to persuade the two soldiers of something. Both of them seemed rather hesitant to follow her orders, but after a brief exchange of what I could best describe as organized birdsong, the pair reluctantly stepped aside and allowed the researcher to continue her approach unaccompanied.
Switching my gaze over to one of the ship’s cameras for a better view on this approaching stranger, a sudden wave of panicked realization washed over me. I am first contact… Shit… How do you even greet an alien? Smiling was definitely a no-go. Even back on Earth, most animals would see that as a threat. With my luck, they’d probably mistake it for me having some sort of predatory nature and just gun me down then and there. That being said, waving may not be the best play either. I didn’t know if these guys had sharp talons, but startling them seemed like a pretty bad first test of that. Still, what gestures in the animal kingdom are universally non-threatening? Sifting through my slowly-defrosting memory, I recalled at one point learning about the habits of gorillas and how to survive meeting one in the wild (I found weird things on the web growing up). In social animals, lowering one's self is usually a gesture of submission. So, with little time to ponder anything else, I turned toward the door of my ship and offered a cordial kneel as the door was pried open by some sort of mechanical lever (probably hydraulic for the sheer strength) to allow inside a real, in-the-flesh alien.
For whatever it was worth, she didn't seem displeased by my gesture of surrender. More... Confused than anything, in fact. "Torakeetreet?" The nonsense noise hung around me like some form of inquiry, but naturally I hadn't the foggiest fucking clue what it meant, so instead I elected to remain silent. Approaching me with visible trepidation, the alien repeated its 'question' to me, but again I couldn't risk responding in a way that would displease her. With my eyes cast downward, I saw that she wasn't wearing shoes, but instead left on display her four-toed talons that looked like they could easily slash an artery if swung right.
"Dadarakan... Tereet." The sudden sensation of a warm, fingerlike appendage pressing my chin upward by its foreclaw sent my danger-detecting instincts into overdrive. Disregarding entirely the claws' bluntness and gentle movement, I recoiled away from its owner with a short burst of backward movement. Naturally, being part of the graceful primate lineage and a member their most intelligent species by far, I was easily able to evade this danger by elegantly falling flat on my ass and in a stroke of brilliance slamming my spine against the steel wall behind me. This scientist seemed every bit as frazzled as I was with the encounter, having herself collided with the shuttle door in the midst of our mutual confusion. A light hiccuping noise emanated from the alien’s throat as she too toppled over onto the ground.
Somewhat assured by this interaction that my life was not, in fact, about to end, I slowly eased myself upright and with gentle, telegraphed steps approached the mysterious alien woman. Noting my sudden advance upon her prone form, the stranger observed me first with eyes full of fear, followed shortly thereafter by curiosity when I knelt down once more to offer her a hand up. To my surprise, no further coaxing was required to convince this mysterious creature. Carefully wrapping her claws around my outstretched hand, the alien allowed me to help her to her ‘feet’. From outside the ship, I hadn’t actually noticed how tall she was beyond ‘vaguely human-sized’. Now, inside the ship and stood before her, it became rather apparent to me that this bird/lizard lady, despite being at least thirty centimeters (a foot) shorter than the guards outside, still had a few centimeters on me. Evolving in lower gravity’ll do that to you I guess…
“Hello,” I breathed anxiously, shaking her talon up and down with my friendliest close-lipped smile before slowly relinquishing it back to the alien, whose look of absolute fascination identified her as a scientist at heart. Pointing to myself for emphasis, I continued. “I am a Human… Hu-man…”
Swishing her head feathers in a gesture perhaps similar in meaning to cocking one’s head, the researcher parted her lips and in a sweet, singsong voice spoke. “Hu-man.“
“Yes!” I pumped my fist triumphantly, nodding my head up and down in frantic affirmation of her attempt to pronounce a human word. This alien researcher seemed at least open to communicating with me, so that was definitely a good sign. This being said, I was beginning to understand why universal translators were such integral sci-fi tech. Actually being able to understand each other would take awhile unless I found some way to expedite the process.
Replicating the gesture she’d just seen me perform seconds prior, the alien scientist pointed a claw to her own chest and with it held there spoke a single foreign word which I presumed to be her name. “Vavi..."

Yesterday I went to the ob appointment honestly ready to advocate for my health as I always do. This place has a blood pressure machine that isn’t calibrated, lab staffs that are rude and physically with no gloves on pushed a needle around my arm to find a vain as my body was rejecting the needle. Their phone was off for 2 weeks, couldn’t even get a hold of a nurse or try to reschedule anything while they didn’t even know their phone had issues the whole time.
I was diagnosed with chronic hypertension. I never had a blood pressure issue previous before becoming pregnant. I monitor my BP at home, which was my personal choice before switching to this facility. I brought my pump from home in and they did it manually and it matched. The automatic pump they were using the whole time was reading in the 140s. Mine was reading 126 and so was the manual one.
Before knowing their BP pump was not calibrated, my BP there was reading higher than normal, one doctor was saying I had white coat syndrome since I advocated that at home my BP is usually low. Which it is. They had me fill out sheets which I gave and do blood tests to make sure it’s just anxiety. The doctor stated that if everything comes back normal, they’ll just keep an eye on my blood pressure but not really see it as an issue.
Everything comes back normal. Just like yesterday I got tested for protein again since my BP was 132/72 , my labs always comes back normal.
They brought up medication. Which seems unlikely needed since at home my BP reads sometimes as low as 95/68. Medication would most likely cause issues. No one was listening to me, they wanted another sheet of blood pressure readings and labs which I did not see the point of since their previous bp readings could be invalid.
When I went to my specialist to see if my baby had any genetic health issues I had a whole panic attack while they were taking my BP which it read 152/80 my HR was 113.
No one listened to me when I said that was purely anxiety. I was literally shaking and no one really looked into it.
They told me they can no longer treat me and it seems like I’m not taking my health seriously. They don’t know how to diagnose me. They don’t know how at risk I am and they were going to induce me for High BP at 37 weeks. They also said that when I’m in the delivery and my bp reads high they are not going to care if it’s anxiety or not I’d be rushed to high risk and the doctor will choose what to do with me and I’d have no choice what so ever.
This can’t be normal right? Every time I go to them I have to advocate just so I don’t get misdiagnosed. Yet they are saying I’m not a good fit.

Hi there,
Currently trying to drain a Beko Aquatech washing machine that we've bought second hand. I've fitted the drain hose on the pipework, tested a rinse cycle to make sure I had no leakages on the water feed/drainage and found that it feeds fine but doesn't drain.
So far, I've looked for kinks and damaged tubing but it's all ok, I've seen comments about using tubing that's too long but it's already very short as is. There is also the advice of checking the filter for the pump which is clean as a whistle. Lastly, I've disconnected the drain hose from the pipework under the sink and tried to drain into a bucket but still nada. Is there anything else I can do to try and get the machine to drain. U.K by the way!
Thank you for any help in advance.

5’7 247 lbs male, 23 y/o, taking 15mg adderall XR, 20mg sertraline, and 175 mcg levothyroxine. i don’t smoke and i very rarely drink (maybe once a month i’ll have a beer)
so i am at a loss here - i was diagnosed with hypothyroidism about 3 or 4 years ago and my doc at the time and i worked together until we found the right dosage (150mcg i believe) in about a year. it seemed stable and my doctor noted that i was doing well though i never saw the actual bloodwork results. last year, i had my blood drawn and it was mildly elevated (5.1) presumably due to me having missed a couple days right before the test b/c i didn’t have a car. so follow up in three months comes and i missed about four or five doses before the blood work due to a pharmacy miscommunication and my TSH is 9.1. my new PCP tells me that it still shouldn’t be that high after missing that amount of doses, and increased me to 175mcg
i’ve been taking it every morning with my adderall about an hour before i eat breakfast and have coffee, but my TSH came back as 10.1
my doctor’s gonna call me about it, but i literally have no idea how that’s happening - i didn’t miss a single dose. i am just getting over a stomach virus where i only threw up once but had a lot of diarrhea, so possibly that drained it from my system? is that possible?
and if no, does anyone have any idea? it’s really stressing me out
edit: all bloodwork i had the first follow up in November was basically normal. slightly elevated bilirubin (1.5) and RBC (5.9 with reference range 4.2-5.8) but doctor said it was likely dehydration cuz it was first thing in the AM

I'm 36 and my and my husband have been trying for 10 months. I found out from tests that I have a low AMH, testing at .21 in February. OBGYN told me not worry about that number too much and we did some additional tests (with which there were a lot of delays), so I only saw a fertility specialist last week. Although I ovulate every month and have no other significant issues. I have elevated FSH and low AMH, he wants us to jump right to IVF immediately since my reserve is so diminished. On ultrasound we found 4 follicles.
We were given very low odds with trying naturally or doing IUI, I'd say to the point that pursuing those two options would be almost giving up on parenthood. That's how it felt.
The common wisdom seems to be that I'll need multiple egg extractions. So with one cycle of IVF quoted to me 25k, we're looking at an insane price tag especially when you start to multiply that. I have no employer or insurance coverage, and this would be entirely out of pocket. It is incredibly daunting.
I'm very conflicted. I feel like this seems like my only option and time is running out fast. But it also seems like low odds and require an excess of money for a chance that it doesn't work out, and I'm back where I started. I don't think we could do even more than one egg extraction, and everyone is saying I should expect multiple. I worry about doing on ER, having it fail, and then wondering if I should keep going forward or backing out. I'm worried I'll get looped into a never-ending emotional and finance drain and not know when to stop.
I feel really hopeless and trapped. Something about doing the whole IVF process doesn't sit well inside me. The stress, uncertainty, and emotional and physical drain. But I'm also afraid I'll regret not doing it. I don't know how I will feel in 6 months, 1 year, and beyond, which at that point my reserve would be so diminished it would significantly harder to do IVF. The ticking clock is adding to my anxiety.
If anyone can relate to this or went through something similiar, would love to hear some thoughts and opinions as I try to work through the decision.

Peace, Technology, Unity. These are what the council promises to its citizens
Empire size will remain under 100 for the duration of the game with this build if tall is what you are looking for, it is fall that you will recieve. we’re using 4 worlds, But it is technically possible with 3, Unity would be a problem in that case though.
Game settings i’ve tested this on, x1 tech, x1 habitables, x10 crisis, end game start year 2300, late game scaling, grand admiral. Normal ai aggressiveness.
TRAITS
Intelligent, because yes
Budding, it’s better than rapid Breeders for the late game, but rapid breeders can still be interesting since our early game economy kinda needs all the help it can get.
Natural engineers Or Traditional Or Talented if a leader build is what we’re going for, either one of theses is a good pick
Unruly is a free pick for the early years, and can be hopefully removed later, either by us or Composer RNG. An alternative would be nonadaptive, but it has a lot more of an impact early game.
Deviant, the negative governing ethics attraction will probably only end up as a rounding error, we are playing both psionic spiritualist, and tall. Ain’t no way we are getting any problems with diverging ethics.
Solitary is a nice alternative if ethic divergence scares you, we’ll be building city districts all over the place for the building slots, housing will not be an issue.. at all.
For our starting leader trait we’ll be going spark of genius, or logistic understanding, research speed is always nice, but the reduced ship upkeep would also be amazing in the late game, if you’re going with logistic understanding i would suggest picking a governor as a leader, for a couple reasons. Most notably we’ll be having some ringworlds with merchants late game, so the % increases to trade value are very interesting. Researcher is still better for research though, you can get a solid 20-25% so either one is worth a good amount of consideration.
ORIGIN
Teachers of the shroud for early Psionics. But in theory a lot of origins could do here if you are ready to give RNG a shot.
On a related note, the Patron we will be going for is ideally the Composer, since the bonus to pop growth is both good early game and invaluable to fill out our ringworlds. It also has the best Sanctum for our purposes and a decent ship component. Overall, a good option.
The instrument of Desire is also a good alternative, Job output and trade for our eventual ringworlds is good, but the real kicker is the mark of the Instrument, which reduces ship upkeep and increases sub light speed which is by far the best ship component of all the patrons.
Whisperers is okay-ish in the early game, but it really suffers once it gets time to actually fill our ringworlds and stuff. If you’re going for a weird, high evasion ships, super espionage build though.. eh, sure, why not. But otherwise it’s not ideal.
Since we’re going fanatic pacifist, we don’t have to worry about the Eater, like, ever. YAY !
Speaking of ethics…
ETHICS
:: Fanatic Pacifist, Spiritualist
Now this might come as a surprise, so why Fanatic pacifist ? It does lock us into defensive wars after all, and that’s awful… right ?
Well the defensive war only policy, doesn’t make as big a difference as it might sound like. Liberation war already only allows to make claims during defensive wars and that stays unchanged, and for a tall empire, losing the ability to impose ideology, or make a forced vassal through war, isn’t really all that much of a loss. If we want to declare war like, really badly, we will be getting alternative methods through the senate and general diplomacy.
On top of that, Fanatic Pacifist allows us to pick whatever authority we like, and frees up one civic slot which is actually pretty massive especially for build flexibility.
CIVICS
The first civic has to be. Master Crafters, the consumer goods are nice, but what is really a big deal here is the trade value, since with this play-style we’ll be staying with 3 to 4 planets only until our traditions are done, this will allow us to keep our original technicians on our homeworld and roll with it until the endgame.
The second civic:: can be, for exemple, Meritocracy, it’s just a good civic. But depending on what you’re going for you might want to look at something else entirely. Again picking fanatic pacifist really allows us to have a lot flexibility here.
The third civc:: Ascensionists. More Planetary Ascension effect is what the kids theses days would call, "very poggers".
AUTHORITY
Yeah just pick oligarchy. Or imperial if you plan on using feudal society or something.
TRADITIONS
1ST::
Expansion.
Expansion is a good pick for the reduced empire size from both systems and colonies, on top of the extra population growth, it’s just good, it also increases the weight to draw the Composer, which is the best patron by far for the late game. With the 20% to pop growth speed on top of the 10% increase to pop growth speed on Psi corps. It also has the best Sanctum of the patrons with a 5% empire wide production bonus on top of some habitability.
2ND::
Psionics
It’s just good for us to finish this one early so we will save up unity until we can finish the research for Psionic Theory which is generally the second to third technology pick after hydroponics and whatever else that shows up.
3RD::
Diplomacy::
Making a Federation is absolutely critical for our purposes, there is no other good reason to pick this, but the federation bonuses that the holy covenant gives are significant enough. If you’re not able to find someone with similar ethics, find a planet in the middle of nowhere and settle it, before releasing it as a vassal and then releasing the vassal to form a federation with it. That way they will have the same ethics and will be extremely willing to form a federation despite your war policy. You might want to leave that tradition incomplete until you at least get Champions of the empire to reduce the empire size.
4TH
Aptitude::
Leaders good. But the empire size reduction from champions of the empire is basically completely busted for tall players.
5th
Harmony, More planetary ascension, less empire size from pops, and even some extra leader lifespan, what more could a man want ?
6TH::
Mercantile, why mercantile ? Well, simply put. Money. Federations tax all forms of energy income other than trade, so you would be getting 15% more energy from all of your trade sources than any other sources by default with our current build, on top of that the extra merchants will allow us to make ringworlds with a massive amount of them, creating a downright obscene amount of energy, this perk is what fuels our energy economy in the late game, it’s vital that we take it.
7TH
Supremacy
It’s probably one of the best tradition trees in the game. It’s just straight to the point. It’ll ensure that our navy is as big as it can be given our small footprint.
ASCENSION PERKS
1st Imperial prerogative
2nd, Technological ascendency or transcendent learning.
3rd Technological ascendency or transcendent learning.
4th we’ll either be keeping around as free in order to pick Galactic wonders or we’re going to pick nihilistic acquisition (Yes, it requires authoritarian, but we’ll be electing our chosen one as divine sovereign, which switches us over to authoritarian.)
The rest is entirely up to you, you might want to pick up gardians of the galaxy for extra crisis damage.
THE GAME PLAN
2200-2230 is the hardest part, your economy is going to be in shambles very soon. Put down science labs as quickly as possible, homeworld is a tech world.
Find your guaranteed habitables, settle them as soon as you can, your first one will also be dedicated to technology, the second one will be consumer goods and once you find a fourth, it’ll be your unity world.
We aren’t going beyond that, we’re playing tall over here, empire size is our directive, if you want a more true to form approach, look up the 3k+ research by 2250 tutorial made by u/yzseven89, this dude knows how to play the game, he will bring you knowledge and technology.
We’re still aiming for a pretty cool 1k by 2230 and ideally 2k by 2250. It should be a pretty reasonable goal since we started off two tech worlds. Buy minerals, in the early years, don’t let the planetary queues be idle, build city districts, then buildings, and repeat. 3k is still theoretically possible, but it requires some good luck, it’s nice if you can achieve it, but i’d say a 2k goal is good enough.
You will want to switch to civilian economy.
In some cases you might even put the factory homeworld designation for a little while if necessary, ideally we want to avoid it since it shoots our alloy production in the foot and reduces our researcher output a little, but it might be necessary to relieve some stress off of your economy.
2230 - 2250 is the calm after the storm of death that is the early years, you have a few more pops to play around with, you have neighbours to make commercial pacts with and vassalize.
Genocidal empires will be the bane of your existence, you can’t out-power them in your current state, you just can’t, diplomacy is your only shield so you better use it well.
Make friends with your neighbours. Grant away favours early on in the relations if it looks like it’s going to turn sour. Friendship is mandatory.
Once the event pops up crown your chosen one as eternal god emperor, The council position it unlocks is the best in the entire game. Since you’re also authoritarian now, you can pick nihilistic aquisition, which will be very useful in the late game once we are starting to feel the effects of the relatively low pop growth that Psionic empires have.
Once you picked nihilistic acquisition with your free perk slot you had saved up, quickly embrace your pacifist faction once again, and say goodbye to the useless authoritarianism.
2250 - 2300
From then on it’s just about keeping your tech up, and making as many alloys as is reasonable on the side in anticipation of mega engineering.
If you have to build a megastructure from scratch, build a mega shipyard, it’s fastest and cheapest one, then i’d recommend the Dyson sphere followed by a ringworld.
Once you have all 7 traditions finished is when you can really boom and start putting down planetary ascensions, so don’t neglect your unity, it’s very important, so if you find yourself lagging behind in the 2250s, don’t hesitate to resettle three to five of your researcher pops to your unity world.
Start off an alloy world down the line and start pumping out them Ecumenopoli, two of your four ring segments to trade, two to research.
2300 - Victory
Make another ringworld, this time entirely for research. As for the rest. Make ships, prepare for the endgame crisis, and that’s about it.

Last night I was driving my aw11 from one city to another. I was at about the 3 hour mark of constant 4000RPM 120KPH, when suddenly it started getting louder. Not quite knocking, but started sounding like a diesel engine. I backed off the throttle and took it out of gear for just a moment and it died immediately. I coasted it off the road and had a look at it. It was dark and I couldn't see much, but everything LOOKED ok, so I tried to start it. Heard metal on metal screeching. Nope. Called for a tow.
​
Today in the daylight I had a look at it - no oil. Oil drain was gone. God damn it.
Threw some marvel oil down the cylinders, threw a new drain plug and new oil in it - the sonofabitch starts and idles. No knocking either.
It may be burning oil - I can't tell yet because it might just be burning off whats in the cylinders. I'll have to do some testing over the weekend. Im thinking worst case scenario I need to re-ring the pistons, but good lord these things are tough.

Hello,
My 2018 Honda Clarity PHEV has an issue where the ICE turns on almost every morning and slowly drains my gas. I know normally in PHEV's that the ICE turns on every now and then if the engine has not been started for a while, but this happens to my Clarity almost every morning.
I did research a while back, and only found a couple people reporting the same issue. It was never resolved, but one person did mention the possible cause. For some reason with the Clarity, whenever the car regenerative brakes past the maximum full charge EV capacity, the ICE turns on. In other words, if my Clarity is fully charged at 55 EV in the morning and then I regenerative brake past 55 EV, such as 55.1, the ICE kicks in. I tested this theory and has been consistently true.
This has been going on with my Clarity for a couple years now. I almost never use gas at all, and the ICE turning on every morning and draining a couple miles of gas each time has literally drained my gas from full to empty at least twice since my ownership of the car.
I found some workarounds to this issue by noting the EV number in the morning, and making sure the regenerative braking does no past that number by putting the car into neutral when coasting to a stop so that the car doesn't regain energy.
I took my car to a Honda dealership once to see if maybe there is a software update that can fix the issue, but of course the employees had no idea what I was talking about and had little to no knowledge on the Clarity, so they quoted me $160 JUST to check to see if there is a software update available. Obviously I declined and just left.
I did check to see if there is a TSB (Technical Service Bulletin) for this issue, but could not find any. Does anyone know how I can resolve this ICE issue? Or if there is a TSB that I can bring to a Honda dealership for a software update that will fix this issue?
Thank you.

Best Nursing Research Topics and Ideas

Best Nursing Research Topics and Ideas

Evidence-Based Practice in Nursing

This topic explores the integration of current research evidence into clinical decision-making. It covers the importance of staying updated with the latest research, identifying credible sources, implementing evidence-based interventions, and evaluating outcomes to improve nursing care.

Evidence-based practice (EBP) is an essential nursing approach that combines the best available research evidence, clinical expertise, and patient preferences to guide clinical decision-making and enhance patient outcomes. It focuses on the utilization of current research findings to inform nursing interventions, policies, and procedures.

Key elements of evidence-based nursing practice include:

• Research Evidence: This refers to the most recent and relevant research studies, systematic reviews, and meta-analyses that demonstrate the efficacy of nursing interventions, diagnostic procedures, and patient care outcomes. Evidence of research can be obtained from credible sources such as scholarly journals, databases, and guidelines for evidence-based practice.
• Clinical Expertise: Nurses contribute to the decision-making process with their clinical expertise, knowledge, and experience. This requires integrating their practical skills, critical thinking skills, and knowledge of patient preferences into the framework of evidence-based practice.
• Patient Values and Preferences: In evidence-based practice, it is essential to recognize and incorporate the values, beliefs, and preferences of individual patients. This involves gaining an understanding of the patient's unique circumstances, cultural heritage, and personal objectives in order to provide individualized care.

The implementation of evidence-based nursing practice typically entails the following steps:

1. Asking Clinical Questions: Formulating well-defined and answerable clinical questions is a crucial starting point. Questions are often framed using the PICO (Patient/Problem, Intervention, Comparison, Outcome) framework to guide the search for relevant evidence.
2. Literature Search: Conducting a comprehensive search for the best available evidence related to the clinical question. This involves using databases, scholarly journals, and trusted sources to locate research studies, systematic reviews, and clinical practice guidelines.
3. Appraisal of Evidence: Evaluating the quality, validity, and relevance of the identified research articles. This step involves critically analyzing study designs, sample sizes, data collection methods, statistical analyses, and potential biases.
4. Integration of Evidence: Combining the findings from multiple studies and assessing their applicability to the specific patient population or clinical setting. This involves synthesizing the evidence to determine the most appropriate and effective nursing interventions.
5. Application of Evidence: Implementing the evidence-based interventions or recommendations into nursing practice. This includes adapting the evidence to the specific patient's context, considering any potential barriers or facilitators, and collaborating with interdisciplinary healthcare teams.
6. Evaluation and Continuous Improvement: Assessing the outcomes of the implemented interventions and evaluating their effectiveness. This step involves monitoring patient outcomes, identifying areas for improvement, and adjusting the nursing practice based on the feedback received.

Remember that this is only a concise overview of evidence-based nursing practice. Feel free to inquire for more precise information or if you have any other inquiries!

Evidence Based Practice Nursing Research Topics

• Is it possible to improve the quality of care through the implementation of evidence-based nursing practices?
• What is the prevailing viewpoint regarding the implementation of evidence-based palliative care practices in U.S. inpatient settings?
• This paper aims to explore the ways in which evidence-based nursing approaches can be utilized to accommodate patient preferences in healthcare settings.
• What are the pragmatic ramifications of the theoretical underpinnings of evidence-based nursing?
• Examine the empirical backing for the stipulations of Continuing Professional Development in the realm of nursing education. In what ways does the utilization of evidence-based practice facilitate the process of treatment selection in the provision of nursing care?
• The present study examines the perspectives of senior nurses regarding the implementation of evidence-based practice in the provision of nursing care. What is the correlation between nursing education and the attainment of professional excellence in the field?
• The utilization of an evidence-based approach in the recruitment and screening of nursing staff carries significant implications.
• The implementation of evidence-based nursing practices for individuals with disabilities in inpatient facilities.
• The utilization of evidence-based practice in the delivery of mental health nursing care.
• The evidence-based nursing approach is widely recommended due to its effectiveness in improving patient outcomes and enhancing the quality of care provided.
• The historical context of evidence-based nursing practices will be elucidated in this discourse.
• Examine the disparity that exists between factual knowledge and nursing practices that are grounded in evidence.
• What are the primary obstacles encountered in the implementation of evidence-based nursing practice?
• What is the nursing staff's disposition towards the implementation of evidence-based practice?
• In what ways can social media be utilized to deliver nursing care that is grounded in evidence-based practice?
• What is the definition of safety in the context of evidence-based nursing care?
• Examine the application of the evidence-based approach within a practical setting.
• In what ways can a nurse utilize evidence-based practice in order to facilitate self-care?

Impact of Technology in Nursing Practice

This topic explores how technology advancements have affected nursing care, patient outcomes, and ethical considerations. It could cover areas such as electronic health records, telehealth, wearable devices, and the integration of technology into nursing workflows.

In recent years, technological advancements have had a profound impact on nursing practice, transforming how nurses provide care, communicate, and manage patient data.

Here are a few significant ways in which technology has affected nursing practice:

EHRs have supplanted paper-based documentation systems and are now an integral element of nursing practice. Electronic health records (EHRs) allow nurses to access patient information, monitor medical histories, document care provided, and share information with other healthcare professionals. This improves care coordination, increases accuracy, and facilitates the exchange of patient information between various healthcare settings.

• Telehealth and Remote Monitoring: Telehealth technology enables nurses to provide remote care, bridging the divide between patients and healthcare providers. It enables video conferencing and digital platforms for virtual consultations, remote monitoring of vital signs, and the delivery of healthcare services. Telehealth has expanded access to care, particularly for rural or marginalized patients, and enhanced healthcare outcomes through early detection and prompt interventions.
• Wearable Devices and Health Apps: The proliferation of wearable devices, such as fitness monitors and smartwatches, and health-related mobile applications have enabled patients to actively partake in their own health management. The data collected by these devices can be utilized by nurses to monitor patients' physical activity, sleep patterns, vital signs, and medication compliance. This data can facilitate personalized care planning, health education, and preventative measures.
• Point-of-Care Technology: Point-of-care technology consists of devices such as portable diagnostic instruments, barcode scanners, and infusion pumps. These tools allow nurses to collect immediate and accurate patient data, confirm medication administration, and conduct diagnostic tests in real time. By providing nurses with up-to-date information to guide their clinical decisions, point-of-care technology improves efficiency, reduces errors, and enhances patient safety.
• Clinical Decision Support Systems (CDSS) are computer-based instruments that support clinical decision-making by providing evidence-based recommendations, alerts, and reminders. These systems allow nurses to receive real-time alerts regarding potential drug interactions, allergies, and preventative care interventions. CDSSs advance evidence-based practice, minimize errors, and improve patient outcomes.
• The use of robotics and automation in healthcare settings is progressively increasing. Such duties as medication delivery, patient transportation, and disinfection can be aided by robots. Automation technologies expedite workflows, reduce manual duties, and free up nurses' time to focus on direct patient care.
• Data Analytics and Health Informatics: As the volume of healthcare data continues to grow, nurses can use data analytics and health informatics tools to extract meaningful insights, identify trends, and make informed decisions. Data analysis can assist in recognizing disease outbreak patterns, monitoring quality indicators, and enhancing patient outcomes.

It is essential to recognize that the incorporation of technology into nursing practice raises ethical concerns, such as patient confidentiality, data security, and assuring equitable access to technology.The impact of technology on nursing practice has resulted in numerous positive outcomes, including increased efficiency, enhanced communication, improved access to information, and increased patient engagement. To provide high-quality, patient-centered care, nurses must continue to adjust to technological advances, embrace continuous learning, and effectively leverage technology.Please contact me if you require additional information or have any other queries!

Ethics and professionalism in nursing practice

Ethics and professionalism are fundamental aspects of nursing practice that govern nurses' interactions with patients, coworkers, and the healthcare system as a whole. Professionalism comprises the behaviors, attitudes, and responsibilities that reflect the nursing profession's commitment to providing safe, compassionate, and ethical care.

Here are a number of essential elements of nursing ethics and professionalism:

• Ethical Principles: Nurses adhere to ethical principles which serve as decision-making frameworks. Common ethical nursing principles include:
• Autonomy: respecting the right of patients to make their own decisions and providing them with the information they need to make educated decisions.
• Beneficence entails acting in the best interest of patients, promoting their well-being, and ensuring that the benefits of care transcend the risks.
• Avoiding injury to patients and avoiding actions or omissions that could cause harm.
• Justice: Allocating healthcare resources fairly and equitably, promoting equitable access to care, and treating all patients impartially.

Maintaining trust, maintaining promises, and accepting responsibility for one's actions and professional responsibilities constitutes loyalty.Sincerity, candor, and openness in communication with patients, families, and colleagues constitute veracity.Nurses uphold patient confidentiality by recognizing their right to privacy and protecting their personal health information. When managing patient data, they adhere to legal and ethical standards, such as the Health Insurance Portability and Accountability Act (HIPAA), and ensure that information is shared only when necessary.

• Informed Consent: Nurses play a vital role in obtaining patients' informed consent prior to performing any procedures or treatments. This involves explaining the purpose, risks, benefits, and alternatives of the proposed intervention and ensuring that the patient comprehends the provided information. Nurses advocate for patient autonomy and ensure that assent is voluntary and founded on a comprehensive comprehension of the situation.
• End-of-Life Care: Ethical considerations frequently arise in situations involving end-of-life care. Nurses participate in discussions regarding advance care planning, resuscitation, palliative care, and family support during the dying process. The promotion of comfort, dignity, and reverence for dying patients is guided by ethical principles.
• Ethical Difficulties: Nurses are frequently confronted with ethical dilemmas requiring critical reasoning and ethical decision-making. Ethical quandaries may entail conflicts between patient autonomy and beneficence, justice and resource allocation, or conflicts of interest. To navigate these complex situations, nurses rely on ethical frameworks and consult with colleagues and ethics committees.
• Maintaining professional boundaries is essential in nursing practice to ensure appropriate patient relationships. To safeguard patient autonomy, confidentiality, and trust, nurses must establish distinct boundaries. Dual relationships, conflicts of interest, and personal involvement with patients that could compromise professional judgment or objectivity are avoided.
• Professional Development: To enhance their knowledge, skills, and ethical decision-making abilities, nurses engage in lifelong learning and continuous professional development. They remain current on evolving ethical guidelines, research, and healthcare policies in order to provide care that is both evidence-based and ethically sound.
• Interprofessional Collaboration: Nurses collaborate with counterparts from other healthcare disciplines to provide patients with ethical, holistic care. Optimal patient outcomes require effective communication, respect for diverse perspectives, and the promotion of collaboration.

It is essential for nurses to understand ethical principles, ruminate on ethical dilemmas, and seek guidance when confronted with difficult situations. Codes of ethics, professional organizations, and nursing ethics committees provide nurses with resources and support for upholding ethical standards and maintaining professionalism.Consider this

Nursing Ethics and Professionalism

This topic delves into the ethical issues and dilemmas nurses may encounter, including patient confidentiality, end-of-life care, informed consent, and resource allocation. It focuses on the importance of maintaining professional conduct and upholding ethical principles in nursing practice.

Ethics and professionalism are fundamental aspects of nursing practice that govern nurses' interactions with patients, coworkers, and the healthcare system as a whole. Professionalism comprises the behaviors, attitudes, and responsibilities that reflect the nursing profession's commitment to providing safe, compassionate, and ethical care.Here are a number of essential elements of nursing ethics and professionalism:

• Ethical Principles: Nurses adhere to ethical principles which serve as decision-making frameworks. Common ethical nursing principles include:
• Autonomy: respecting the right of patients to make their own decisions and providing them with the information they need to make educated decisions.
• Beneficence entails acting in the best interest of patients, promoting their well-being, and ensuring that the benefits of care transcend the risks.
• Avoiding injury to patients and avoiding actions or omissions that could cause harm.
• Justice: Allocating healthcare resources fairly and equitably, promoting equitable access to care, and treating all patients impartially.

Maintaining trust, maintaining promises, and accepting responsibility for one's actions and professional responsibilities constitutes loyalty.Sincerity, candor, and openness in communication with patients, families, and colleagues constitute veracity.Nurses uphold patient confidentiality by recognizing their right to privacy and protecting their personal health information. When managing patient data, they adhere to legal and ethical standards, such as the Health Insurance Portability and Accountability Act (HIPAA), and ensure that information is shared only when necessary.Informed Consent: Nurses play a vital role in obtaining patients' informed consent prior to performing any procedures or treatments. This involves explaining the purpose, risks, benefits, and alternatives of the proposed intervention and ensuring that the patient comprehends the provided information. Nurses advocate for patient autonomy and ensure that assent is voluntary and founded on a comprehensive comprehension of the situation.End-of-Life Care: Ethical considerations frequently arise in situations involving end-of-life care. Nurses participate in discussions regarding advance care planning, resuscitation, palliative care, and family support during the dying process. The promotion of comfort, dignity, and reverence for dying patients is guided by ethical principles.Ethical Difficulties: Nurses are frequently confronted with ethical dilemmas requiring critical reasoning and ethical decision-making. Ethical quandaries may entail conflicts between patient autonomy and beneficence, justice and resource allocation, or conflicts of interest. To navigate these complex situations, nurses rely on ethical frameworks and consult with colleagues and ethics committees.Maintaining professional boundaries is essential in nursing practice to ensure appropriate patient relationships. To safeguard patient autonomy, confidentiality, and trust, nurses must establish distinct boundaries. Dual relationships, conflicts of interest, and personal involvement with patients that could compromise professional judgment or objectivity are avoided.Professional Development: To enhance their knowledge, skills, and ethical decision-making abilities, nurses engage in lifelong learning and continuous professional development. They remain current on evolving ethical guidelines, research, and healthcare policies in order to provide care that is both evidence-based and ethically sound.Interprofessional Collaboration: Nurses collaborate with counterparts from other healthcare disciplines to provide patients with ethical, holistic care. Optimal patient outcomes require effective communication, respect for diverse perspectives, and the promotion of collaboration.It is essential for nurses to understand ethical principles, ruminate on ethical dilemmas, and seek guidance when confronted with difficult situations. Codes of ethics, professional organizations, and nursing ethics committees provide nurses with resources and support for upholding ethical standards and maintaining professionalism.Consider this

Nursing Leadership and Management

Analyze the role of nursing leaders in healthcare organizations, including strategies for effective communication, conflict resolution, delegation, and promoting a positive work environment.

Leadership and management in nursing play essential roles in shaping healthcare organizations, fostering effective collaboration, and promoting positive patient outcomes. Nursing directors provide nursing staff with guidance, support, and mentorship, whereas nurse managers supervise daily operations and ensure the deliverance of high-quality patient care. Here are important aspects of nursing management and leadership:

• Leadership Styles: Various leadership styles, including transformational leadership, democratic leadership, and servant leadership, can be adopted in nursing. Transformational leaders inspire and motivate their teams to accomplish shared objectives, whereas democratic leaders involve and value the input of their employees in decision-making. The needs of their team members are prioritized by servant leaders, who support their growth and development. Different situations may call for various leadership styles, and effective nurse leaders are able to adapt their approach accordingly.
• Communication and Collaboration: Nursing leaders and managers must have excellent communication skills. They must be able to communicate effectively with team members, patients, families, and healthcare professionals. Clear and transparent communication facilitates collaboration, encourages partnership, and improves patient safety. Additionally, nurse leaders advocate for their teams by ensuring that their perspectives are heard and contributions are acknowledged.
• Strategic Planning and Decision-Making Nurse leaders and administrators engage in strategic planning to establish organizational objectives, establish priorities, and effectively allocate resources. They are involved in the decision-making processes that affect nursing practice, patient care, and resource utilization. Multiple factors, including patient requirements, evidence-based practices, financial constraints, and quality improvement initiatives, must be considered when making strategic decisions.
• Staffing and Workforce Management: Nurse administrators are responsible for staffing facilities and ensuring adequate nurse-to-patient ratios to ensure the delivery of secure, high-quality care. They supervise nursing personnel recruitment, retention, and development. Leaders in nursing advocate for safe staffing levels and assist their teams with burden management and staffing challenges. In addition, they cultivate a positive work environment that encourages professional development, job satisfaction, and work-life balance.
• Change Management: Nursing leaders play an essential role in influencing and managing change in healthcare organizations. They facilitate the adoption of new policies, procedures, and technological advances. Change management involves confronting resistance, involving stakeholders, and assisting employees during transitional periods. Effective change management facilitates the adaptation of nurses to new practices, enhances patient care, and ensures the successful implementation of innovations in healthcare.
• Quality Improvement and Patient Safety: It is the responsibility of nursing executives and administrators to foster a culture of continuous quality improvement and patient safety. They facilitate the implementation of evidence-based practices, participate in quality improvement initiatives, and monitor patient outcomes. In addition, they promote the reporting and analysis of adverse events, near-misses, and medication errors, nurturing a culture of openness and error-based learning.
• In their responsibilities, nursing executives and administrators are confronted with ethical dilemmas. They must navigate complex situations and make ethical decisions consistent with the patient-centered care, justice, autonomy, and beneficence principles. When confronted with difficult ethical dilemmas, they promote ethical behavior, encourage ethical reflection among employees, and seek guidance from ethics committees or consultants.
• Mentorship and Professional Development: Nurse leaders and administrators support the professional growth of their nursing personnel. They offer mentorship, guidance, and growth opportunities. They foster a culture of lifelong learning, encourage employees to pursue advanced degrees and certifications, and support leadership development programs to cultivate the next generation of nursing leaders.

Leadership and management in nursing are indispensable for optimizing patient outcomes, assuring effective collaboration, and establishing positive work environments. Effective nursing leaders and managers foster a culture of excellence, collaboration, and constant improvement.Remember that this is merely an introduction to nursing leadership and management. Feel free to inquire for more precise information or if you have any other inquiries!

Mental Health Nursing

Explore the challenges and strategies for providing holistic care to patients with mental health disorders, including therapeutic communication techniques, medication management, and promoting recovery.Mental health nursing is a subspecialty of nursing that concentrates on the care and support of people with mental health disorders or difficulties. Here is a more thorough explanation of number 5, particularly as it pertains to mental health nursing:Mental health nurses perform a vital role in the assessment, diagnosis, treatment, and ongoing management of people with mental health disorders. They operate in settings such as psychiatric hospitals, outpatient clinics, community mental health centers, and residential facilities. To provide holistic care for patients, mental health nurses collaborate with other healthcare professionals, such as psychiatrists, psychologists, social workers, and occupational therapists.Assessment and Diagnosis: Mental health nurses conduct comprehensive assessments to collect data on the mental health history, current symptoms, and psychosocial factors of their patients. They use standardized assessment instruments and interview techniques to identify mental health disorders, identify risk factors, and establish a baseline for treatment planning. Alongside psychiatrists and other mental health specialists, mental health nurses may also participate in the diagnostic procedure.The development of therapeutic relationships is a fundamental component of mental health nursing. The establishment of trust, empathy, and rapport between nurses and patients creates a secure and non-judgmental environment in which patients can express their thoughts, emotions, and concerns. Effective communication, collaboration, and the delivery of patient-centered care are facilitated by solid therapeutic relationships.Mental health nurses frequently play a role in the medication management of individuals with mental health disorders. They inform patients about their prescribed medications, including possible adverse effects, dosage instructions, and the significance of medication adherence. Mental health nurses monitor the efficacy of medications, assess for adverse reactions, and collaborate with psychiatrists to make necessary adjustments to medication regimens.Psychoeducation and Health Promotion: Mental health nurses provide psychoeducation about mental health disorders, treatment options, coping strategies, and self-care practices to individuals, families, and communities. They empower patients to actively participate in their own recovery, educate them on relapse warning signs, and offer ongoing support. Additionally, mental health nurses promote mental health and well-being via health promotion initiatives, such as stress management, lifestyle modifications, and community education programs.Mental health nurses are trained in crisis intervention techniques and play a crucial role in the management of psychiatric emergencies. They assess individuals in crisis, provide immediate assistance, and facilitate interventions that ensure safety and stability. Additionally, mental health nurses aid in the development of safety plans, which define strategies and resources for preventing injury and managing crises.Collaborative Care and Interdisciplinary Approach: In order to provide patients with comprehensive care, mental health nursing frequently requires collaboration with a multidisciplinary team. Mental health nurses collaborate with psychiatrists, psychologists, and other healthcare professionals to develop and implement treatment programs, coordinate services, and offer ongoing support. Collaborative care ensures a comprehensive approach that addresses the physical, emotional, social, and psychological requirements of those with mental health disorders.Mental health nurses advocate for the rights and requirements of individuals with mental health disorders. They promote destigmatization, combat discriminatory practices, and work to expand access to mental healthcare services. In addition to providing emotional support and assisting patients in traversing healthcare systems, mental health nurses connect patients to community resources and support networks.To provide care for individuals with mental health disorders, mental health nursing requires specialized knowledge, skills, and a compassionate attitude. Mental health nurses contribute to the recovery and well-being of their patients by addressing their unique requirements and providing support throughout their mental health journey.

Nursing research and evidence-based practice

Nursing research and evidence-based practice are essential components of patient-centered, high-quality care. They involve the systematic collection, analysis, and application of evidence to enhance patient outcomes and inform nursing practice.

Geriatric Nursing

Investigate the specialized care needs of elderly patients, including age-related conditions, medication management, promoting independence, and addressing social and emotional well-being.

Elderly Care Nursing Paper Topics

• Strategies for mitigating cardiovascular risk in geriatric patients.
• Safeguarding the elderly population from Parkinson's disease.
• What are the necessary criteria for the provision of critical care?
• Prevention of Joint Disorders
• Restless Legs Syndrome (RLS) is a neurological disorder that is characterized by an irresistible urge to move the legs, often accompanied by uncomfortable sensations in the legs. This condition can cause difficulty falling asleep or staying asleep, which can lead to daytime fatigue and impaired functioning. RLS affects a significant portion of the population and can have a negative impact on quality of life.
• Analysis of atrial fibrillation.
• Strategies for stroke prevention
• What constitutes the fundamental basis of osteoarthritis management in geriatric individuals?
• The symptoms and interventions associated with age-related hearing loss.
• The etiology, prophylaxis, and management of malnutrition in geriatric individuals.
• Outline a regimen of low-impact exercises aimed at reducing the risk of bone fractures and falls.
• The benefits of individualized geriatric care.
• What are the salient factors to consider in the management of diabetes among elderly patients?
• Strategizing and coordinating the discharge of geriatric patients.
• Explore strategies for identifying and mitigating suicide risk among elderly patients.
• Strategies for enhancing the comfort of a patient in the final stages of life.
• In what ways can technology augment the delivery of care for elderly patients?
• In the event that an elderly individual refuses to take their prescribed medication, what actions should be taken?
• What are the methods for identifying an elderly person who has been subjected to abuse?
• What are the reasons behind the tendency of certain elderly individuals to exhibit defiant behavior?

Pediatric Nursing

Discuss the unique aspects of nursing care for infants, children, and adolescents, including growth and development milestones, immunization schedules, family-centered care, and managing common pediatric conditions.

Pediatric Nursing Research Topics

• The etiology and management of ADH.
• Enhancements to neo-natal wards that may benefit newborns and young mothers.
• Pediatric patients who suffer from poor nutrition require appropriate treatment.
• Addressing the issue of diminished survival rates in pediatric cancer patients.
• Strategies for mitigating child injuries.
• What are the factors that contribute to child mortality?
• What is the influence of proper nutrition on the overall welfare of a juvenile individual?
• Prophylactic measures to mitigate the likelihood of intestinal parasitic infections.
• The emergence of chronic disorders in pediatric populations.
• Strategies for managing constipation in pediatric patients.
• The management of pediatric near-drowning cases is a critical aspect of emergency medicine.
• What is the primary cause of child mortality in the United States?
• What are the changes that have occurred in neonatal care over the past five decades?
• What are the optimal therapeutic approaches for addressing malnutrition in children?
• Do the existing measures aimed at preventing infant injury during childbirth demonstrate efficacy?
• What are the primary ethical considerations in pediatric care?
• What are the recommended strategies for preventing childhood obesity?
• What are the reasons for the ineffectiveness of contemporary approaches towards tackling childhood obesity?
• What are the underlying factors that contribute to seizures in children?
• Conduct an analysis of antibiotic resistance in pediatric populations.

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Hey all! This is my first post here, so I’ll try to keep it relevant. Throughout this post the word “phone” can be replaced with “video games”, “TV”, “porn”, or anything you use to distract or stimulate yourself with. It should remain generally true. Just as a note: I have gotten hooked on, and now abstain from multiple substances, including, but not limited to: psychedelics, alcohol, and nicotine.
In light of my ongoing fight with years of my daily, all consuming, marijuana addiction, I have realized that the next biggest thing draining me of motivation, inner thought, and finding my purpose in life, is my phone.
Constant external stimulation has made me unable to see outside the box and change my thought process. When I don’t have my phone, my brain craves the dopamine I get from it and makes me bored; it drowns out my inner voice and makes my life feel meaningless. I then use drugs to cope, and I am unable to feel any sense of novelty without the drug or the phone. I lose so much of my ability to be creative and happy by using my phone. My inner sense of peace, deep thought, and what I really care about doesn’t stand a chance to be heard because it’s drowned out by constant, endless, external stimulation.
After testing this by depriving myself of this manufactured stimulation, I’ve found this to be undoubtedly true, at least in my situation. And I know that the same thing applies to my S/O who is addicted to vaping, and scrolling TikTok, though they won’t admit it.
However; I do not want to give up my phone permanently.
So my question is: how much phone usage is okay, while still being able to let my brain rest from constant stimulation?
What hours of the day, each day, do you look at your phone?
Do you use your phone at work or school even though you know it affects your ability to focus and work well?
Do you agree with me or disagree?
Have you tried depriving yourself of stimulation for long periods of time and listening to find your actual wants and needs?
TLDR; Being addicted to my phone is crushing my life in a way I didn’t think was possible after giving up substances to make a more meaningful life. How do you keep your phone usage in check? Are you aware of your cravings to use your phone and how it affects your motivation?

My (28F) husband (28F} has a younger sister (24F) who I get along well with.
When my baby was around 4 months old, his sister came to help with my baby. (She was free for the next 3 to 4 months as she was waiting for a test result.)
Everything was initially going well, she's a good person and a good company since my husband has a hectic office schedule (10 am to 9 pm).
I don't know if it's me but she started kinda passively stealing the show, or even takes my baby from my arms most times when he engages with me, sometimes even to the next room.
2 weeks pass by and now my baby starts wanting to go with her, be with her, laughs at her more even when both of us are present. This starts tearing me from the inside and it took a toll on me.
I cried silently for days and she would still always try to take him away to the next room from me whenever he wakes up. She never puts him down and even when I have a play thing going on, she interrupts and makes it all about what she's doing. And the baby starts paying attention only to her and ignores my advances for play.
I started getting more anxious, severe headaches, I cry alone & can't sleep well since it's all I can think about 24x7.
There were a few more things which showed that she's possessive of the baby, even when it comes to me.
Also, since she was present, I had to do extra kitchen work to suit her taste. (She only cooked thrice in the 1 month she was there). She doesn't help around the house, do laundry or anything. In fact, I had to go after her to dispose chip packets, put things in place, etc.
I was ok doing these because we had a good rapport and I see her as a friend and a younger sister.
Her idea of help is that she'll watch the baby while I do household chores. But I end up having a lot to do to take care of the extra person while being emotionally drained. (For eg, I order in or make 10 min quick dishes which she clearly said isn't something she'll eat.)
After some days, I couldn't bear it any longer and I burst out to my husband. He said he understood and within a few days, we visit his parents and he somehow gives an excuse and makes her stay there.
It's been 3 weeks, my baby is now back on track with me, and never once did I think that I need her help, but now she wants to come back. The minute I hear this I start panicking and my anxiety has been building steadily. Now my husband is mad at me that I'm keeping the baby away from his family.
I dunno if I'm imagining all the things with his sister but it took a toll on me a lot seeing my son ignore me almost all the times whenever I try to play and prefers her since she's the one spending the most time in his waking hours.
Honestly, I love her apart from this, but my relationship with my baby is where I draw the line.
I told that she can visit for a few days, it's her nephew after all and she loves him crazily, but I can't withstand another 1 or 2 months stay.
AITA for refusing the help from my husband's sister? Please be brutal, I'm open to your opinions.

My 2014 Grand Cherokee w/ the 3.0 diesel has a very small/slow seep from the water pump housing @ 118k miles. This is a vehicle used for a) Lowes or nursery runs, b) remote trailhead access our AWD Sienna can't do, c) in the winter when we've got too much snow for the van, and d) towing a 23' airstream.
I'm on the fence with paying $500 for a new OEM pump, and wouldn't be considering OEM if it wasn't still my tow rig for a ~5,500 lb TT. Particularly, I'm not sure if paying for a Mopar part means anything in the global supply chain context - is it actually a superior part made with better bearings, tolerances, and testing than any aftermarket part, or is it equivalent to a better aftermarket part but shipped in a Mopar box.
My Google Fu tells me that GMB is considered one of the better aftermarket water pump manufacturers for 'domestic' brands and that the parts are made in Japan. What do the experts think?
I know the labor would be the much greater part of the cost here if done at a mechanic. I'm doing the work myself; I'm probably slow at this compared to a professional mechanic but have the experience and methodical approach do a good job. I understand that I need a couple other parts on top of the pump itself. No warranty remaining on this vehicle aside from the extended emissions stuff.