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#But when it comes to this every specialty will involve human lives and navigating that regardless
stuckinapril · 2 months
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I’ve always loved medicine bc it’s the perfect intersection of science and humanity—the two things I value above all else in this world. Truly adored it since I was in the cradle. But now I’m thinking about how so much of my journey to neurosurgery will have to involve KILLING my feelings essentially bc how do you survive otherwise
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kaldurcalm · 3 years
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I've been meaning to do a black girls in webtoons reclist and I'm a little nervous about it because I'm white, but I haven't seen any comparable lists yet so. Here I go.
Note: this is based on the characters.
I haven't checked to see whether the authors are black or not because although that approach is well-meaning and has its own purpose (boosting black women who make comics), it can also lead to gatekeeping and invasive behavior on the part of fans.
The creators on the webtoons platform often use psuedonyms, so I usually don't go looking for more information than they provide.
My focus here is black girls and women who are treated well by the narrative, because I've seen from other posters that those are the kinds of stories that they would like to read.
With that in mind! I'm just going to go with the first one I see on my subscription list:
This is a superhero comic with a black female lead. She's the one who gets the gang together, and she comes from a society that has some interesting eyewear. (It's kind of a cultural thing.)
All of this is explained in the comic as a part of an ongoing plotline, and everyone's powers feel fresh and interesting.
Note: I do actually know that one of the creators is a black man! It's a team of people who seem pretty neat.
This one is probably suitable for most ages, but there's superhero violence and associated trauma sometimes. They get into social injustice as an ongoing theme for the entire comic, and the characters collectively decided to crash at the place of the richest guy on the team.
He is not thrilled about this.
I love this disaster trans girl.
Mal is a fan of a band called the Crawmamas, and her bff accidentally lands her a job as their social media manager. She is, unfortunately, head over heels for the dirty rat man guitarist.
This comic is going to have themes that are considered adult, like drinking and smoking and sexytimes.
Mal's mom doesn't approve of her wrist tattoo, but she's supportive of "her baby girl" and the other characters either don't know or are supportive (so far).
(I can't vouch for how the narrative will handle things in the future, but she's touring with a tits out type of rock band some of the crew members are gay. I'm not worried about the way the story will handle it.
Even if almost every single character is a disaster human. Help them.)
It's the story of Shahrazad! I read The Shadow Spinner when I was a kid, but not the original story, so I've never seen it like this before.
If you're not familiar: the main character is forcibly married to the rule of her kingdom.
Or, well, she volunteers for the forced marriage process so that she can get revenge on him for killing her best friend.
Along the way, she unveils a curse, and sets about trying to unravel it.
There's violence in this story, but I don't think it's super graphic. It's only a feel-good story if you're into clever, booksmart women who learn to fight injustice in their own ways.
(If you don't like the idea of her catching feelings for the caliph, this story might not be for you.)
If I were to narrow this list down to just soft love stories, this comic would be included. (Gonna be honest: I almost didn't read the whole thing because of the art style, but I'm so glad I did.)
Yani is a short, chubby black girl, and Cage is the tallest, biggest guy in highschool.
... unfortunately this means that she's scared of him at first.
The feeling isn't mutual at all: he saw on stage in a school play and immediately became 100% more interested in Shakespeare.
When their teacher sets him up to tutor her (it's not a romantic thing), he's stoked and she finds out that mostly? He's just shy.
This comic talks about sex in an informative way in the later chapters, and Yani's friends help her overcome a phobia that she's embarrassed to tell people about.
Overall, it's really sweet and wholesome. And it's pretty much completed, so no surprises here!
This is one of my favorite comics of all time, I think.
Ray is a college-age lady who's struggling to figure out her career path--as a seer in a world where you can bake magic into food.
She likes to go to her favorite bakery once a week to have a slice of romance. (Not sure if the romance is in the jam, the bread, or both, but it looks really pretty.)
She seems to have a crush on the lady who owns the bakery (who is also a black woman and happens to be a happily married lesbian), and she helps her love interest overcome his fear of (broomstick) flying (which is similar to driving in this universe-- you have to get a license.)
This one should be safe for all ages, I think! It's one of the softest, sweetest comics I've ever read.
So the actual main character in this comic is basically black gay batman in a purple devil suit, but I'm recommending it because it has two women of color as main characters in the first two seasons.
If you want a smooth recap of the entire thing, read the latest update. Here's the short version:
Honoria Crabb is a hard-nosed cop, until she sees that the entire city is corrupt and and the police force isn't what she'd hoped it would be. She's basically tying the story together right now--you might see what I mean if you click the last link.
Theresa Ferrier is a famous detective, the line of Sherlock Holmes. I say this not because of her personality, but because has a best-selling series about her adventures and has a comparable reputation in this universe.
She's also bald, uses a cane, and is married to the love of her life--Margeurite, a famous painter with a rare brain disease. (Margeurite can't see very well, uses a wheelchair, and is usually carrying her beloved bulldog. )
Theresa basically comes out of retirement to help fund her wife's treatment, and by the end of the second season she retreats so that she can devote herself to her care.
It doesn't even feel like the author is sidelining her or anything--she's influenced the other characters a great deal, and she just wants to care for her wife and be happy.
Overall, you'll like this comic if you like detective stories and masked vigilantes. There's violence and blood, and associated trauma.
I love this comic so much, and I'm a person who tries to stay away from zombies as much as possible.
...let me just show you the main cast:
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Spoiler: there's healthy polyamory at the end.
...not with all of them. Two of them in this picture are involved, though, and one of them is black.
(The coach is also black. He gets bitten by the first zombie they see, so the girls have to take care of him. They do a decent job of it.)
I'm not sure how much more I can say without spoiling it because I get too excited. Ya got your jock black girl and your soft cute black girl on the same highschool basketball team, though, so that's why it made this list.
This comic is hilarious and it feels like a slice of life in spite of the fact that it's set during a zombie apocalypse. 10/10 would recommend.
(I also highly recommend the author's other work, which is more graphic and uses more colors in its palette, but that one centers a gay couple. There's some great black ladies in it but they're not the focal point, so I'm just going to mention it as an aside.
You can find it by clicking on the comic description and scrolling to the bottom.)
So the main character starts out a bike messenger. The best damn bike messenger in town.
This is how she becomes a bike messenger for the gods.
It's all very dramatic, and the new job comes with a teleporting magic vending machine for helpful bike parts that help her navigate the godly realm.
Her best friend is another black lady, who works with books and is a badass in her own right, and Dare herself is definitely not straight.
This comic is completed and everything ends well! Dare gets a satisfying love life with another woman and the world is no longer ending.
This comic is sweet, so I'm going to include it, but I don't think it's ever going to be finished.
Ola and her family are illegal immigrants. This comic is a slice of life about her trying to navigate highschool without exposing her family.
The overall tone is pretty light, but I'd you have any experience with that then if might make you nervous.
I don't want to pick favorites, but this one's my favorite.
In a world where you can modify your body the same way we can currently mod videogames, our main character notices another girl who takes the subway because she doesn't use any mods at all.
It's because she has a chronic illness, so she uses technology that others consider outdated (that seems futuristic to us) to help her navigate the world.
She's not in pain all the time, but she has to be careful. Certain types of technology in their world can affect her very badly, so she has to avoid them the same way you'd avoid allergens.
The main character changes her look frequently, but she's always shown as black and, towards the end of the comic, she shares a conversation she had with her mother as a child about the importance of her natural features.
This is an interracial relationship, and the love interest is a white hispanic. She has two dads, and the main character has a mom, a dad, and her mom and dad's partner.
...I'm not super clear on their relationship as it is in the comic but the creator confirmed that they're in a polycule.
This is the kind of comic that makes you feel like you light up inside as you read it. It should be safe for most ages, I think the most adult things in it are job opportunities and kissing. (I'm going off memory, here. I'm doin my best.)
The author also has another comic about a college age magic user who bulldozes her way into an apprenticeship because she's determined to not let her magical form of dyslexia get in the way of her life plans.
(She can't read the spell books at all, so makes herself seeing eye familiar out of what looks like a floppy stuffed animal and a ritual.
The ritual itself isn't clear yet.)
The main character isn't black herself, so I'm not including it as its own entry, but her mentor is black. She's a sweet lady with an adopted son, anxiety, and an understanding girlfriend.
This one doesn't have a final ending because the author came up against a pretty heavy duty mental block, but it did end on a series finale and although it's bittersweet, I think it's pretty good.
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rasoir-national · 4 years
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This was bound to happen : I’m talking about immigration law
@ghostplantss i don't know v much about french immigration law would you tell me about it? i'm v curious?
Oh wow. First tea, and now this ? Either you are my secret Santa, or my enabler.
So let me tell you about the passion of my life, Immigration and refugee law, and the fuckery this country has made of it.
The way a city, community, country treats the “other” is one of the oldest legal questions in the History of Humanity. From Antique Greek cities to the Jus Gentium of the Roman Empire, laws concerning foreigners might be the first form of international law known to man. In many ways, it’s by acknowledging the existence of “others”, by giving and restricting their rights, that a social group both truly asserts itself as a “political community”, yet acknowledges the transcending quality of “humanity” of the outsider.
Nowadays, this question is as politically charged as ever : the way a country regards foreigners, welcomes them, rejects them, is one of the most interesting ways you can define the country, one of the ways the country sees itself. By the way we treat the one who is not “us”, we highlight which rights we consider to be inherent to humanity in and of itself, as well as which ones we consider intrinsically rooted in our identity as “citizen”.
And all this proud History, all this contemporary tension, makes Immigration law fascinating to FUCKING NO ONE.
Look, one thing you have to know about lawyers is how much they love intellectual wankery. A nicer way to put it would be to say lawyers love systems. And theory. And generalisation. And categorizing. They like to look at a set of rules and see a pattern, a logic, a paradigm. They like to be able to neatly present it in two titles, each divided in two subtitles, each divided in two sections, and repeat that until they run out of microsoft font points.
And Immigration law... It’s not that. It’s not that at all. It’s the opposite of that. It’s a law that’s almost entirely dictated by conjoncture, by what a government needs it to say, by whichever concept they’re going to twist then to suit their needs. Whatever few theoritical concepts Immigration law might have been based on have been destroyed by years of either haphazardous or plainly malignant reforms, often both.
And not only does that mean that this at this point is an intensely, punitively complex law, it has also become - if it hasn’t always been - illogical and incoherent. The only “logic” behind it anymore is how much it can be weaponized against its subjects - foreigners. Because that’s the only thing that politicians care about, and because lawyers and especially academics have pretty much given up on it, leaving the terrain free for the former. You have to realize, in terms of pure numbers, Immigration law is the most practiced law in the country. It represents almost a third of all disputes. Yet it is taught in NO university in France. Not a single one. There are no courses, no grad school, no thesis program about immigration law in all of France. There is no money in Immigration law : almost all involved subjects are destitute. There is no intellectual curiosity, because the discipline, from a theoretical point of view, is pretty uninteresting. There isn’t even public interest, because deceptively, the general public hears so much about immigration from either ignorant or ill-intentioned people, that getting through the complexity of the topic is immensely complicated and unrewarding.
Lawyers, for the most part, have deserted the topic for selfish reasons, despite the fact that this is perhaps where they were most needed to make sure fundamental rules were enforced, that politics didn’t come in the way of good justice. They abandoned the most vulnerable subjects of law to the whims of lawmakers and political interests. That’s unforgiveable.
So as a result, Immigration law today mostly resembles a cat-and-mouse game where the law sets up as many traps as possible for the immigrant to fall into, with dozens of obstacles to navigate to finally, finally be able to legally settle in a country you might be have been living in for several decades. There are specific stay rules for retirees. That’s a thing. Every rule is meant to exclude as many people as possible. As a result, immigrants must get increasingly creative or even downright shifty in order to qualify for a stay. And in turn, public opinion will yell and say they are manipulating the system - well, duh. We’ve made a system in which it’s impossible to win fair and square and then we criticize immigrants for trying to game it.
Let’s have just one example : demands of admission because of sickness. French law categorizes different reasons for an immigrant to be admitted to live on french soil for a little while : study, work, family matters, and health. France has a very good health system compared to the worldwide standard, so many people come here to receive treatment they might not be able to benefit from in their country of origin for various reasons. Some people already don’t think that’s a reason for welcoming them, but fuck those people. Anyway, there are many, many people who will ask for permission to stay on the grounds of an “invisible” illness : depression, PTSD, personality disorder... all of which are very difficult to prove. Before 2017, the prefect had to decide based on the opinion of a doctor from the regional authority after they’d met with the author of the request. But the administration quickly realized that doctors tend to have that pesky thing called deontology or even - perish the thought ! - empathy. So there was a reform, and now the way it works is the ill immigrant goes to a doctor who writes a report, then mails it to the person’s lawyer, who then mails it to a doctor that will do a second report based on that report, and will send that second report to a group of 3 doctors who, on the sole basis of that document, will advise the prefect on whether or not the person is ill, and whether or not they could have access to treatment in their country. And when I say advise, I mean they mail a form with boxes checked. That’s it. No text. So we have a prefect, who’s not a doctor, making a decision about the health situation of a person based on a box-based form filled by doctors who have never met the person, who themselves are judging based on the report of another doctor who has no met the person either, this last doctor writing based on the report of another doctor who might have met the person once. And all of this can take up to a year. That’s time during which the immigrant cannot work, or receive benefits. And then, if the prefect decides against letting the immigrant stay, then they have only 2 months to challenge that decision, otherwise after those 2 months have passed, they can be arrested, incarcerated and deported at any time.
So given all that, is it any wonder that immigrants tend to “discover” illness after illness and constantly ask for stays based on that ? This system is so random and unfair, that all you can really do is try and try again hoping something will eventually stick. So now you have people complaining that immigrants are faking mental illness in mass, causing prejudice to the “real” mentally ill immigrants. And yes, that’s the effect. But make no mistake : the cause is how difficult it is for an immigrant to have their illness acknowledged when it’s not something “extreme” enough to have you cross the border on a gurney. Because it’s not enough to google “availability of x medication in x country” to make sure the person can actually access treatment in their country of origin.
So that’s the hypocrisy infusing (haha, tea joke) the whole system. And on top of that, the procedure is getting more complicated with every reform : miss one deadline, fill out one form wrong, and you’re out. And please remember we’re dealing with people who for the vast majority do not speak french (the ONLY language allowed in administrative matters according to the Constitution) and know nothing of our administrative system. It’s up to the person’s lawyer to basically map out the life of each of their client. And because there is no money in immigration law - you only get paid in judicial aid from the state - there aren’t many immigration lawyers. You have to do this out of conviction, cuz you’re certainly not doing it for the money or career opportunities. In the practice I interned at last year, each lawyer would at all times manage on average 50 to 80 active cases. And let’s be clear, a lot of them are assholes, because lawyers in general tend to be assholes. But the work they do in downright heroic.
So that’s where I come in to fix it all, right ? Yeah, no. This entire system is fucked, and given what the world looks like right now, it might be for a while. I’m under no delusion that I can do anything to change that. My goal is to help the way I can : I want to become an administrative judge, the ones who are in charge of examining administrative decisions regarding immigrants. This type of challenge represents roughly 50% of the activity of any administrative tribunal : every chamber, no matter their specialty, has to do a little of it, otherwise the system is so backed up it would collapse. Some of those judges do amazing work, and are some of the most compassionate people I’ve ever met. Some of them are not. Most of them are plain bored by this type of claim, because they’re repetitive, not really technical from a legal standpoint and always depressing. And a handful of them have ties to the far-right and are there just to expel as many immigrants as possible. So yeah, if all goes well I’ll be a judge in a few years, and I’ll be one of the only ones who came to the job because of immigration law, not in spite of it. It’s not bragging on my part, it’s just a sad fact. Judges at the tribunal where I’ve worked had a schedule for who was supposed to be in charge of new immigration claims arriving, and some judges would hide from court reporters in order not to get attributed cases that arrived right before their shift was over. So yeah, if I can be a small drop in the bucket and be someone who actually looks at these cases with the explicit intent of finding a reason to approve the claim, that’ll be good enough for me. Because Immigration law, or at least what we’ve made of it, might not be “interesting” but it’s goddamn important, and people should pay attention to it.
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sporddreki · 5 years
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"ive wrote an essay months ago about how sasoris puppets work but ive decided not to finish it does anyone want that" Ugh, I am so new to Tumblr, I was trying to figure out how to leave a comment just to say, yes, I would be interested in this.
alright here you go B) i havent touched it ever since so no promises
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Guess what - I finally start writing down all the trivia I know about Sasori, because it’s been some kind of strange fixation a while ago and I will regret never having written all of this down, so… this time it’s about Sasori’s specialty: the Hitogugutsu or the Human Puppets. But only from the “mechanical” side rather than the psychological (that comes later). Some warnings: This will be dealing with gore and other pretty gross stuff, so be careful, also English isn’t my first language so excuse any possible mistakes. Without further ado, let’s jump straight into the rabbit hole!
So first things first, what are the Hitogugutsu? If you’ve read or watched Naruto Shippuden and you paid attention to what Sasori is all about, you’ll immediately be confronted by his obscure obsession with puppets that stems from his childhood. As the story went on Sasori has made his first puppet out of a human being, his best friend Komushi to be exact, and then went on with indulging in this gorey procedure for the rest of his life, leaving him with a total of 298 human puppets in his possession. In this analysis we’re going to look at the what rather than the why, how they’re created, how they’re used in battle and what distinguishes them from normal puppets.
As you heard, Hitogugutsu are made from human bodies, preserved and equipped with a bunch of puppet mechanics. His most famous Hitogugutsu, the Third Kazekage puppet, which he has built out of his former village leader, is a great example for what his creations have to be like to adequately perform their jobs - Hitogugutsu are mainly used as a weapon in battle and are a form of “eternal art” in Sasori’s eyes. Means the human puppet has to be 1) effective in physical fights and 2) match Sasori’s ideal picture of what he considers art. These are the two most important points and will become significant throughout the analysis.
Let’s talk about the battle efficiency first. The key part of Hitogugutsu is that they can contain the chakra and the kekkai genkai the “material” (the person the puppet has been made out of) used to have, which can be used by Sasori in battle. Throughout Naruto Shippuden this attribute has only been showed once by the Third Kazekage and his magnetic iron sand ability. We are left to speculate about the other 297 Hitogugutsu and whether they have kept their chakra/kekkai genkai or not - but counting on Sasori’s words, they did. Other than that they’re barely able to distinguish from normal puppets, at least fighting-wise. Keeping that in the back of our heads, the construction of Hitogugutsu will give us the following problems:
1) Easiest first - a bunch of mechanics, weapons and special attacks have to fit in them to be useful in battle. Hence the general puppet structure, which is the best way for Sasori to manipulate them as he pleases.
2) They have to be well preserved to not decay and be robust enough to not immediately break in battle. Proper preservation and a stable foundation is the key here. Additionally, they have to be immune to Sasori’s poison.
3) An intelligent ten-year-old needs to be able to make at least a simplified version of them. Sasori was only a child when he made his first one out of his friend Komushi and it looked authentic.
4) The chakra needs to not just be stored inside the body, but to be able to flow, to be released through physical attacks and to be regenerated. This is essentially the biggest problem of human puppets, since they lack the (functional) organs needed to create chakra in their own, personal chakra nature.
5) Another important detail is his “ultimate” Performance of a Hundred Puppets where he controls all of them individually with a chakra string coming from his chest, which means the mechanics of a puppet must be adjusted in a way to be able for Sasori to do that.
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Sounds like a bunch of obstacles Sasori has to overcome, and we with him since that’s part of the analysis - but it’s possible, especially when calculating Naruto logic into it. Before the question comes up, I’m purposely not trying to be as exact to the canon as possible nor do I think all of this was Kishimoto’s masterplan, but i will try to find the most efficient way for Sasori to achieve all of this and stay reasonable at the same time.
*** Now heres the thing: As mentioned above, the main problem seems to be the whole chakra story and we have to question how chakra works and then how Sasori used it for his techniques. We are walking on eggshells here because nearly everything is speculation. Considering the Hitogugutsu kept their chakra inside of them and are able to release it (e.g. the Third Kazekage), they have to have some sort of modified chakra system inside of them. The problem is that this chakra is a consumable, means it’s not an infinite resource and since the bodies are dead there is no way for them to regenerate their chakra. However, Sasori is using it anyway and has pride in stating that he preserves people’s chakra in puppets eternally, so what’s going on here? Here’s the problem - the Naruto logic is completely broke here. I’ve spent days rummaging the Naruto Wiki but there’s no canon way for Sasori to do that, but we know he does it, so he somehow has found a way. If he made some kind of apperature or jutsu that can convert his own chakra to the human puppet’s nature, everything would make sense, but the canon has forsaken me here. However, there were some cases where that actually happened through some kekkai genkai or a ~fortunate coincidence~ so stuff like that is possible in the Naruto universe, for Sasori too, but sadly I can’t describe it here until now. For real, hit me up if you guys have an idea, otherwise I have no choice but to accept that as indescribable Naruto logic and get my own theories and speculation going. ***
Of course we won’t let that stop us - its just time to get our minds going and make some own theses. I’ve got two for you: One that prioritizes the battle efficiency and one Sasori’s view of art.
1) The Chakra conversion theory
The only “renewable chakra source” we have is Sasori himself. Means, if Sasori found a way to convert his own chakra to have the nature of the puppet’s chakra, it would pretty much be solved. This would require some sort of gadget or jutsu, but I won’t be understimating Sasori’s genius - **********
Assuming Sasori has built in a convertor of some sort into the puppet, it gets a little easier. To use chakra in the first place, Sasori has to store it inside of the puppet. Nothing as easy as that coming from a family that predominantly uses Fūinjutsu (or Sealing Techniques) - we’re gonna dig into the lore to make it possible that also a young Sasori could’ve used this technique with a certain effort.
May i present you: The Puppet Brigade of Sunagakure, with Chiyo as its head and a mighty forbidden jutsu in her hands - the One’s Own Life Reincarnation. You may have heard of that when Chiyo revived Gaara, but it was initially for a way different cause, and that is to give life to puppets. It works as following: The user takes their own life energy to revive a dead person, but dies by themselves in return. The brigade wanted to use it to “breathe life” into puppets for more efficiency in battle, but it was banned by Sunagakure for being unethical. You heard it - puppets, so it is possible to transfer life energy into a puppet to bring it to life, somehow. Fortunate for teen Sasori of course, who just began with his cruel passion of making Hitogugutsu. Let’s take a look at how the jutsu works:
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Simple. Here comes the interesting part - Sasori could’ve modified this jutsu to store the living person’s chakra inside of the puppet, and even had access to the technique by being involved in the puppet brigade himself. He just needed to rummage through the forbidden files in there. Once you think about it it seems pretty plausible, right? Now let me explain how a modified jutsu would work:
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The sealing technique stays the same, but with an extra step, which uses Sasori as its “medium”. He prepares the body as the shell and later seals the person’s chakra into it. The scroll is just a placeholder by the way, Sasori puts the energy in whatever aperture its later kept in and builds it into the puppet. It never got shown in the canon, but maybe it looks similar to his core. I believe the step of sealing the chakra away before preparing the body is important; otherwise the person would die and lose their chakra before Sasori is finished. So that’s how the chakra gets preserved inside of the puppet.
Next step, what happens to the chakra? Since Sasori was fond of collecting rare kekkai genkai users as his material, his puppets need to use their abilities in battle somehow. Not just that, here’s an extremely efficient option of navigating puppets and we can connect that to the Performance of a Hundred Puppets problem.
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Each of the Hitogugutsu has an internal chakra “skeleton” (similar to those that you use for Blender models + it’s probably more complicated), which Sasori is able to manipulate using his own chakra. If the convertor idea is correct, he has the ability to let his chakra flow into the puppet to start a circulation inside and trigger the conversion.
How’s that related to the Performance of a Hundred Puppets? When we see Sasori opening his chest lid, a hunded chakra strings pop out at once and every single of them gets connected to one of his puppets. The key part is that Sasori needs only one string to control a puppet with its full range of mobility. And an efficient way to achieve that is by giving them a chakra skeleton he can manipulate, which only needs one point of connection to get the flow going.
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Another thing that bugged me was the fact that he only used taijutsu when fighting with all of his puppets at once. If his puppets had their own chakra preserved infinitely and eternally inside of them somehow, he could’ve just bombarded Sakura and Chiyo with all of their jutsus at once but instead he focuses on hand-to-hand combat and weapons. The chakra conversion theory simply explains this with Sasori not having enough chakra to pour into his puppets, since he was at the very end of his battle.
This theory prioritizes the “eternal art” point, since the Hitogugutsu do stay eternally functional and usable. So tldr; the human puppets have an internal chakra skeleton that can be manipulated by Sasori letting his own chakra flow through a theoretical convertor (which might as well be the seal he revamped from Chiyo’s old reanimation jutsu), which turns it into the puppet’s chakra nature and can then be used in battle.
2) The disposable puppet theory
Now, personally, I’m not very fond of this theory since it pretty much dumps the whole “eternal art” point into the garbage, as much as the psychological aspect - but it’s way too legit and rational to ignore. The main idea is that the puppets Sasori used for his technique were “empty” Hitogugutsu with their chakra already consumed which had no choice but to fight without ninjutsu. Meaning once Sasori has preserved their chakra it cannot be regenerated and the puppet is left behind as an empty shell. The reason why I’m still going with this theory is because the Third has a special gadget in his chest that makes him special and that got me thinking - the magnetic apperatus he uses for his Iron Sand abilities.
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First of all some information about the Third Kazekage - he’s known for his kekkai genkai that is the Magnet Release, which he inherited through his bloodline. The Iron Sand technique is an adaptation of Shukaku’s (the One-Tails) abilities, which he created himself. When Sasori transformed him into a puppet he kept his abilities, but noticably weakened. Sasori has been using him as his “favorite weapon” ever since he was a young man and he has shown no sign of missing chakra. At the same time he has the (so far) unique apperatus that lets him use his magnetic abilities. So why isn’t the Third emptying out?
Now here’s the thing: The chakra we’re seeing in this picture isn’t the Thirds - its Sasori’s. The puppet has an unique appeatus that artificially creates the Thirds abilities, thus making them weaker than they originally were. Since the Third is both the only puppet we’ve seen keeping all of his abilities and the only one having the apperatus, he’s basically the only actual “eternal” puppet owned by Sasori. His inner chakra system just needs to get flowing by Sasori’s input and activates the magnetism, so it works similar to electricity.
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Carrying on, we can see Sasori having holders attached to his back, four in total with the first one already being used in the picture (to shoot fire out of his palms). The second one is for the Performance of a Hundred Puppets, the fourth one is for shooting water out of his hands and well… the third one? No one knows. If we follow the theory of empty and full puppets, the third scroll can be used for puppets that still contain their chakra, while the second holds the empty ones, of course. This could explain Sasori’s reckless fighting style, the empty Hitogugutsu are pretty much “waste” and serve no purpose other than overwhelming the enemy by numbers - not just in the battle against Sakura and Chiyo, but also in the attack of the Land of This. So theoretically Sasori still had an ace up his sleeve but didn’t decide to use it.
As I’ve mentioned above, this theory is logically reasonable but at the same time signs Sasori off as, well, pretty much a liar when it comes to his view of eternal art. After the chakra of one of his puppets is worn off, their special abilities become unusable and the effort of making Hitogugutsu in the first place seems over-the-top to me personally. While their bodies stay “eternal”, their abilities get lost by usage, and later recklessly destroyed by a Performance of a Hundred puppets attack. So tl;dr - chakra regeneration in human puppets is impossible, their abilities can be used once or twice before their chakra runs out, Sasori later only uses them for taijutsu and contradicts his own view of art.
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South Florida Guardianship Care Management
South Florida Guardianship Care Management
A guardian is a court-appointed person or institution that cares for a person, property, and in some instances, both. South Florida Guardianship Program knows the critical role care management plays in society.
These duties are prescribed by the laws governing Florida State overseen and interpreted by Florida’s Supreme Court. The program offers numerous services aimed at protecting and caring for all clients.
Through these services, elderly persons experience a sense of independence, remain healthy, and achieve general well-being.
We work with an experienced, friendly and professional team that helps SFGP grants a variety of benefits to our clients and their family members.
We take a specialty in caring for a lot of the wards suffering from multiple issues and live by themselves. We also take in new clients who are often going through a crisis.
With our round the clock services, elderly persons in our care profit from legal, psychiatric, financial, medical, and social services.
Based on the client’s needs, we assign either a social worker or a registered nurse to provide the ward with professional care management services. We work together with family members to ensure that their loved one receives the care management services.
The services elderly persons receive under South Florida Guardianship Program include…
Provide Assessments
At the program, we prefer using a multidisciplinary and multidimensional assessment platform that helps us better evaluate the ward. We assess their physical health, functional ability, mental and cognition health, as well as their socio-environmental impact.
Following the doctor’s advice, the professionals also evaluate the elder’s physical health elements, including; vision, balance, hearing, nutrition, urinary, and fecal continence.
These geriatric assessments play a critical part in diagnosing medical conditions, coming up with treatment and follow-up plans, and coordinating care management and not forgetting the evaluation of the long-term care needs of the ward.
The assessments give complete and relevant feedback about wards’ psychosocial issues, functional problems, as well as medical issues.
  Develop A Care Plan
To conduct a thorough assessment of the preparations that the elderly will need, South Florida Guardianship Program works with the appointed guardian/relative of the individual to create a robust care plan.
A care plan is a document that carries the details of needs, responsibilities, and actions to be done.
The plan acts as a way to manage risk and spell out contingency plans that guardians, family members, wards, health professionals, and caregivers need to do regularly to avert a crisis.
A care plan can only suffice after our professionals consult with the ward, guardian, family members, or the attending doctor.
  General Management of The Client’s Lifestyle
When caring for the elderly, there are essential things that SFGP takes into account. The possibility of long-term care and nursing home care should be considered when it comes to managing an older adult and their lifestyle.
The number of wards with complex needs is increasing. The amount of home support extended to the elderly is also rising, and thus, why it’s essential to consider their lifestyle.
Our professional team ensures that the unique needs of each individual are met when it comes to assigning personal care. If the ward is given home-care, the environment should be comfortable enough for them.
If they move into assisted living facilities, the adjustment should be centered around their happiness and comfort as well.
  Discharge Planning and Placement Services
When Needed SFGP has enough human resources to cater to every older person’s needs. If you need assistance in planning his or her lifestyle, bill payments, care, and other things, we shall assign an individual to assist you with the planning.
If you’re looking for a home to place your loved one and don’t know where to start, we shall help you with the same.
We have healthy working relationships with numerous homes and caregiving agents all over south Florida. We shall ensure that everything you need for placement services ticks your box.
  Personal Visits
South Florida Guardianship Program manages personal visits for, wards living at home or in an elderly care facility. We manage things such as companion care, work with them to let in people they want to see that will bring them joy.
Isolation and loneliness in elderly persons are linked to poor emotional and physical health. SFGP offers companion services through senior care programs.
Through personal visits, we encourage social interaction that helps older people continue living a happy and comfortable home. Companion care is perfect for, wards who live alone or far away from family.
Personal visits act as a lifeline for older persons that lack the energy, physical well-being, or motivation to lead a normal life.
  Advocate With Care Providers
Legal advocacy is a renowned strategy used in influencing the health of older people who require care.
South Florida Guardianship Program advocates with care providers to increase public benefits access for the elderly, improve housing stability, and minimize psychosocial distress among the older people needing or in care.
Legal advocacy plays a pivotal role in the elderly and their health care. SFGP provides legal services to older persons with the greatest social or economic needs.
  Transportation Arrangements
Since wards with care needs find it difficult to navigate from one place to the next, especially for doctor appointments and going out for fresh air. South Florida Guardianship Program makes transportation arrangements for all clients in our care.
We ensure that they get picked up in good time for their errands, and the mode of transport is convenient for their travels.
If they’re living in an assisted facility, we work with the care providers to make sure that the older persons can move conveniently even if the home’s transport program doesn’t match their schedule.
South Florida Guardianship Program aims at extending caregiving services to everyone in need. We undertake our work with passion and ensure we deliver nothing but satisfactory services.
We render services that optimize both the welfare and the dignity of individual clients. We follow the rule of law to the letter ensuring that every older person and family member in our domain ins involved fully in decision making for the welfare of our clients.
South Florida Guardianship Care Management syndicated from http://www.guardianships.org/
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ellymackay · 5 years
Text
Sleep as a Vital Sign: Kristina Weaver, EMT-P, RPSGT
Sleep as a Vital Sign: Kristina Weaver, EMT-P, RPSGT was originally published to EllyMackay.com
Kristina Weaver, EMT-P, RPSGT, ensures medical center colleagues across all specialties play the sleep advocate.
By Greg Thompson | Photography by Dani Nichol Photography
Kristina Weaver, EMT-P, RPSGT, cares deeply about her patients, but she’d rather not see them back at Parrish Healthcare. As director of Care Navigation for the Sleep Navigator/Educator Program at the Titusville, Fla, health system, Weaver has managed a 30% reduction in readmissions for newly identified sleep apnea patients over the last four years,1 a result of healthier patients with positive outcomes.
The improvement comes courtesy of what Weaver calls a more person-centered approach, with screening and education throughout the continuum of care. A person-centered approach gets patients actively involved in their own care, helping them take ownership of their treatment.
“If you have sleep apnea, you cannot effectively treat other comorbid conditions,” Weaver explains. “Take heart failure as an example. When a patient comes into the hospital with left ventricular heart failure and [has] untreated sleep apnea, that left ventricle has to work even harder because it lacks oxygen due to the sleep apnea. Getting that patient to understand how those things work together, and want to fix the problem for themselves, is vital.”
Before Parrish Healthcare started its Sleep Navigator program, many colleagues in the hospital did not even know an on-site sleep center existed. But now, according to Weaver, the mindset throughout the various subspecialties has dramatically changed. “Now when a heart attack patient comes into the [emergency room] who complains of chest pain, or complains of fatigue and poor sleep, they immediately think of sleep medicine,” she says. “In the past, the two and two may not have been put together. No matter if it’s in our diabetes support group, pulmonary rehab, physician practice—anywhere in our network—we treat sleep as a vital sign.”
Sleep Support Group
Once patients get treatment for their sleep apnea, they are often referred to the sleep support group, dubbed “Brevard A.W.A.K.E (Alert, Well and Keeping Energetic).” Of course, in this context, Weaver wants to see her patients again.
The group often attracts 40 to 50 people each month, a large number for Titusville, where the total population is less than 50,000. The annual holiday meeting routinely brings out a whopping 150 patients. It’s a legitimate community centered on a subspecialty that is relatively young within the medical world.
“Kristina helps with leading Parrish’s A.W.A.K.E. group every month,” says Michele Roberge, neurodiagnostics lead technologist at Parrish Medical Center. “She is just as eager to see the members as they are to see her. The relationships that she has built with these patients over the years is an awesome thing to see. What makes her a great leader is the combination of passion, compassion, dedication, determination, knowledge, and stewardship that she portrays daily.”
With A.W.A.K.E. meetings and ongoing sleep support calls, CPAP adherence has not dropped below 82% in five years. The number—a testament to the program’s effectiveness—is a quality measure that the sleep center reports monthly, based on online monitoring of patients’ device usage. It’s a large commitment, made possible, at least in part, by Weaver’s experiences with her own father.
She remembers: “Years ago, I did a sleep study on my dad. He had sleep apnea. He had resistant hypertension and snored horribly. On his study, he had an eight-beat run of ventricular tachycardia, and then later in the night a seven-second sinus pause—all related to apnea. He refused treatment. At 23 years old, I lost my 54-year-old dad to a heart attack in his sleep. That’s when I realized we could have done more. If he had support like an A.W.A.K.E. group to know he wasn’t alone and to learn from others like him, he might have been more successful.”
“Kristina developed the A.W.A.K.E. support group for our sleep apnea patients in the community many years ago,” adds Laurel Ivy, RPSGT, cardiac and sleep navigator at Parrish Medical Center. “These patients have watched Kristina grow in her career and personal life with the arrival of her children and the passing of her father. When A.W.A.K.E. members call the sleep lab, they only want to talk to Kristina, despite knowing she mainly works at the hospital now. She has a very special relationship with these patients and they absolutely love and trust her with their care.”
The culture change at Parrish Healthcare continues with additional features such as partnering with durable medical equipment companies and physicians. The sleep center monitors all patient CPAP modems. “Our goal is for 100% of our patients to receive a support follow-up call within their first week of using CPAP,” Weaver says. “By doing this we can help patients find solutions for better comfort early on. We can also identify any pressure adjustments earlier. If you create a habit within the first week, the likelihood of CPAP adherence within the first 30 days drastically increases.”
A Vital Sign
All too often, sleep medicine professionals see the consequences of their institutions failing to “get it.” With the creation of the Sleep Navigator program in 2014, Parrish Healthcare went that extra step, essentially viewing sleep as another “vital sign,” implementing sleep screenings in its cardiac cath lab, diabetes education forums, operating rooms, physician practices, cardiopulmonary rehab sectors—and in the acute care setting. Weaver speaks with confidence when she declares: “I know without a doubt we have saved many lives.”
The team at Parrish Healthcare justifiably takes pride in its many victories, but Weaver does not shy away from stories that do not have such happy endings. She recalls the case of a 53-year-old patient who received a lot of CPAP education. He was an elementary school teacher admitted for chest pain. Upon admission, the care team consulted a sleep navigator, and the patient eventually admitted that he had stopped wearing his CPAP a month ago.
Weaver continues the story: “I went up to his room. He had his 3-year-old granddaughter on his lap and his wife by his side. He had a number of excuses why he didn’t want to wear his CPAP machine. I educated him about the consequences of not wearing CPAP. He had an [apnea hypopnea index] of 88 with oxygen that dropped into the 60s. Multiple team members tried to convince him to wear his CPAP, but he refused. His nurse, nursing assistants, and doctors all warned him. He continued to refuse. Unfortunately, at 53 years old, he died of a heart attack at 3 am.
“This was a very unfortunate event, but I was proud of our care team for identifying the risk of this patient not wearing his CPAP. Years ago, many here would have never even thought to talk to him about his sleep apnea.”
The anecdote demonstrates the importance of the “vital sign” that is proper sleep, and the vital sign concept has indeed gained traction in recent years. Weaver believes the trend will only continue. “Sleep is one of our most basic human needs, but it’s rarely discussed by clinicians or providers,” she says. “When sleep is poor, chances are extremely good it’s due to an undetected or untreated health problem. It might be an undiagnosed medical condition, an underlying sleep disorder, medication problems, or even mental health concerns.
“Most doctors talk to you about your medications, diet, exercise. How many talk to you about sleep? Not many, but it’s obviously a question that should be asked,” Weaver continues. “I do think sleep techs understand and wish more doctors asked about sleep. However, it’s hard to get others outside of our sleep world to put two and two together. As sleep technologists, we need to advance our field and get sleep on the forefront. We need to be better advocates.”
Another example is atrial fibrillation, a condition in which patients with untreated sleep apnea routinely have a 70% reoccurrence rate. “When you treat sleep apnea, that brings risk down to 40%,”2 Weaver says. “By identifying and treating sleep apnea in patients with comorbid diseases, we are potentially treating the original underlying root cause of their illness.”
The sleep center at Parrish Healthcare is fully integrated with its physician practices and hospital. Integrating all providers with the “closed loop” sleep center bolsters communication and increases the sense of urgency to identify and treat underlying disorders. Weaver contends that screening for sleep apnea within the “inpatient acute care setting” is also crucial.
Early identification of sleep problems is a key component of care throughout the entire Parrish health network. Like many health concerns, the best time to identify sleep problems is “as early as possible,” but all too often Weaver finds patients in the sleep center with severe pulmonary hypertension, heart failure, arrhythmias, or worse. If these patients were identified years before, Weaver says it’s at least possible they may not have developed the conditions in the first place.
It’s a forward-thinking point of view that began in earnest five years ago when Sleep Navigator emerged within the context of a new way to look at health care. “Health care used to be a fee-for-service type of industry,” Weaver says. “Hospitals now are being held responsible for how well they can treat patients with the lowest costs possible. This means lower length of stay, fewer readmissions, fewer complications, and best short- and long-term outcomes.”
Weaver points out that sleep apnea is much more prevalent among hospitalized patients than in the general population—more complications, higher risk for mortality, and a high use of rapid response interventions. Done properly, sleep medicine brings all the roles into the fold, with “nurses, certified nursing assistants, patient care safety ‘sitters,’ ER techs, physicians, and even cardiac monitoring techs”—all of whom need to be educated in an effort to bring awareness to patients’ sleep needs.
“Many times the nurse may walk in the patient’s room and not think twice about their snoring,” Weaver says. “They may give the patient sleeping aids or pain medications and potentially make their patient’s undiagnosed sleep apnea worse. In our organization, any department from surgery, cath lab, to the physician practices can speak up and be an advocate for sleep apnea and understand the risks. The goal with the sleep navigator is to identify our sleep apnea patients earlier before they end up with multiple comorbid conditions.”
Ultimately, Weaver’s goals are accomplished through a day-to-day focus that transcends raw statistics. Patients are not numbers but recognized as human beings who benefit from education, attention, and expertise.
Inspiration Comes From Many Sources
Weaver credits a certified nursing assistant (CNA) named Patience Hall as a main source of inspiration. “I started my career in health as a CNA in an operating room with Patience,” says Weaver, who remains Facebook friends with Hall (who continues to work as a CNA). “She taught me to care with passion and to treat every individual as a person, not a patient. It’s easy to get wrapped up in your day and your work. I am motivated by patient success stories and the lessons from those that maybe weren’t so successful. Patience instilled in me that passion for every patient, every time.”
Greg Thompson is a Loveland, Colo-based freelance writer.
References 1. Weaver K. In-hospital sleep apnea screening decreases readmissions and improves quality of life. Poster presented at the AAST 2018 Annual Meeting, Indianapolis. 2. Kanagala R, Murali NS, Friedman PA, et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation. 2003;107:2589–94.
from Sleep Review http://www.sleepreviewmag.com/2019/09/vital-sign-kristina-weaver/
from Elly Mackay - Feed https://www.ellymackay.com/2019/09/25/sleep-as-a-vital-sign-kristina-weaver-emt-p-rpsgt/
0 notes
perspectief1 · 5 years
Text
Sleep as a Vital Sign: Kristina Weaver, EMT-P, RPSGT
The following article Sleep as a Vital Sign: Kristina Weaver, EMT-P, RPSGT Find more on: Perspectief
Kristina Weaver, EMT-P, RPSGT, ensures medical center colleagues across all specialties play the sleep advocate.
By Greg Thompson | Photography by Dani Nichol Photography
Kristina Weaver, EMT-P, RPSGT, cares deeply about her patients, but she’d rather not see them back at Parrish Healthcare. As director of Care Navigation for the Sleep Navigator/Educator Program at the Titusville, Fla, health system, Weaver has managed a 30% reduction in readmissions for newly identified sleep apnea patients over the last four years,1 a result of healthier patients with positive outcomes.
The improvement comes courtesy of what Weaver calls a more person-centered approach, with screening and education throughout the continuum of care. A person-centered approach gets patients actively involved in their own care, helping them take ownership of their treatment.
“If you have sleep apnea, you cannot effectively treat other comorbid conditions,” Weaver explains. “Take heart failure as an example. When a patient comes into the hospital with left ventricular heart failure and [has] untreated sleep apnea, that left ventricle has to work even harder because it lacks oxygen due to the sleep apnea. Getting that patient to understand how those things work together, and want to fix the problem for themselves, is vital.”
Before Parrish Healthcare started its Sleep Navigator program, many colleagues in the hospital did not even know an on-site sleep center existed. But now, according to Weaver, the mindset throughout the various subspecialties has dramatically changed. “Now when a heart attack patient comes into the [emergency room] who complains of chest pain, or complains of fatigue and poor sleep, they immediately think of sleep medicine,” she says. “In the past, the two and two may not have been put together. No matter if it’s in our diabetes support group, pulmonary rehab, physician practice—anywhere in our network—we treat sleep as a vital sign.”
Sleep Support Group
Once patients get treatment for their sleep apnea, they are often referred to the sleep support group, dubbed “Brevard A.W.A.K.E (Alert, Well and Keeping Energetic).” Of course, in this context, Weaver wants to see her patients again.
The group often attracts 40 to 50 people each month, a large number for Titusville, where the total population is less than 50,000. The annual holiday meeting routinely brings out a whopping 150 patients. It’s a legitimate community centered on a subspecialty that is relatively young within the medical world.
“Kristina helps with leading Parrish’s A.W.A.K.E. group every month,” says Michele Roberge, neurodiagnostics lead technologist at Parrish Medical Center. “She is just as eager to see the members as they are to see her. The relationships that she has built with these patients over the years is an awesome thing to see. What makes her a great leader is the combination of passion, compassion, dedication, determination, knowledge, and stewardship that she portrays daily.”
With A.W.A.K.E. meetings and ongoing sleep support calls, CPAP adherence has not dropped below 82% in five years. The number—a testament to the program’s effectiveness—is a quality measure that the sleep center reports monthly, based on online monitoring of patients’ device usage. It’s a large commitment, made possible, at least in part, by Weaver’s experiences with her own father.
She remembers: “Years ago, I did a sleep study on my dad. He had sleep apnea. He had resistant hypertension and snored horribly. On his study, he had an eight-beat run of ventricular tachycardia, and then later in the night a seven-second sinus pause—all related to apnea. He refused treatment. At 23 years old, I lost my 54-year-old dad to a heart attack in his sleep. That’s when I realized we could have done more. If he had support like an A.W.A.K.E. group to know he wasn’t alone and to learn from others like him, he might have been more successful.”
“Kristina developed the A.W.A.K.E. support group for our sleep apnea patients in the community many years ago,” adds Laurel Ivy, RPSGT, cardiac and sleep navigator at Parrish Medical Center. “These patients have watched Kristina grow in her career and personal life with the arrival of her children and the passing of her father. When A.W.A.K.E. members call the sleep lab, they only want to talk to Kristina, despite knowing she mainly works at the hospital now. She has a very special relationship with these patients and they absolutely love and trust her with their care.”
The culture change at Parrish Healthcare continues with additional features such as partnering with durable medical equipment companies and physicians. The sleep center monitors all patient CPAP modems. “Our goal is for 100% of our patients to receive a support follow-up call within their first week of using CPAP,” Weaver says. “By doing this we can help patients find solutions for better comfort early on. We can also identify any pressure adjustments earlier. If you create a habit within the first week, the likelihood of CPAP adherence within the first 30 days drastically increases.”
A Vital Sign
All too often, sleep medicine professionals see the consequences of their institutions failing to “get it.” With the creation of the Sleep Navigator program in 2014, Parrish Healthcare went that extra step, essentially viewing sleep as another “vital sign,” implementing sleep screenings in its cardiac cath lab, diabetes education forums, operating rooms, physician practices, cardiopulmonary rehab sectors—and in the acute care setting. Weaver speaks with confidence when she declares: “I know without a doubt we have saved many lives.”
The team at Parrish Healthcare justifiably takes pride in its many victories, but Weaver does not shy away from stories that do not have such happy endings. She recalls the case of a 53-year-old patient who received a lot of CPAP education. He was an elementary school teacher admitted for chest pain. Upon admission, the care team consulted a sleep navigator, and the patient eventually admitted that he had stopped wearing his CPAP a month ago.
Weaver continues the story: “I went up to his room. He had his 3-year-old granddaughter on his lap and his wife by his side. He had a number of excuses why he didn’t want to wear his CPAP machine. I educated him about the consequences of not wearing CPAP. He had an [apnea hypopnea index] of 88 with oxygen that dropped into the 60s. Multiple team members tried to convince him to wear his CPAP, but he refused. His nurse, nursing assistants, and doctors all warned him. He continued to refuse. Unfortunately, at 53 years old, he died of a heart attack at 3 am.
“This was a very unfortunate event, but I was proud of our care team for identifying the risk of this patient not wearing his CPAP. Years ago, many here would have never even thought to talk to him about his sleep apnea.”
The anecdote demonstrates the importance of the “vital sign” that is proper sleep, and the vital sign concept has indeed gained traction in recent years. Weaver believes the trend will only continue. “Sleep is one of our most basic human needs, but it’s rarely discussed by clinicians or providers,” she says. “When sleep is poor, chances are extremely good it’s due to an undetected or untreated health problem. It might be an undiagnosed medical condition, an underlying sleep disorder, medication problems, or even mental health concerns.
“Most doctors talk to you about your medications, diet, exercise. How many talk to you about sleep? Not many, but it’s obviously a question that should be asked,” Weaver continues. “I do think sleep techs understand and wish more doctors asked about sleep. However, it’s hard to get others outside of our sleep world to put two and two together. As sleep technologists, we need to advance our field and get sleep on the forefront. We need to be better advocates.”
Another example is atrial fibrillation, a condition in which patients with untreated sleep apnea routinely have a 70% reoccurrence rate. “When you treat sleep apnea, that brings risk down to 40%,”2 Weaver says. “By identifying and treating sleep apnea in patients with comorbid diseases, we are potentially treating the original underlying root cause of their illness.”
The sleep center at Parrish Healthcare is fully integrated with its physician practices and hospital. Integrating all providers with the “closed loop” sleep center bolsters communication and increases the sense of urgency to identify and treat underlying disorders. Weaver contends that screening for sleep apnea within the “inpatient acute care setting” is also crucial.
Early identification of sleep problems is a key component of care throughout the entire Parrish health network. Like many health concerns, the best time to identify sleep problems is “as early as possible,” but all too often Weaver finds patients in the sleep center with severe pulmonary hypertension, heart failure, arrhythmias, or worse. If these patients were identified years before, Weaver says it’s at least possible they may not have developed the conditions in the first place.
It’s a forward-thinking point of view that began in earnest five years ago when Sleep Navigator emerged within the context of a new way to look at health care. “Health care used to be a fee-for-service type of industry,” Weaver says. “Hospitals now are being held responsible for how well they can treat patients with the lowest costs possible. This means lower length of stay, fewer readmissions, fewer complications, and best short- and long-term outcomes.”
Weaver points out that sleep apnea is much more prevalent among hospitalized patients than in the general population—more complications, higher risk for mortality, and a high use of rapid response interventions. Done properly, sleep medicine brings all the roles into the fold, with “nurses, certified nursing assistants, patient care safety ‘sitters,’ ER techs, physicians, and even cardiac monitoring techs”—all of whom need to be educated in an effort to bring awareness to patients’ sleep needs.
“Many times the nurse may walk in the patient’s room and not think twice about their snoring,” Weaver says. “They may give the patient sleeping aids or pain medications and potentially make their patient’s undiagnosed sleep apnea worse. In our organization, any department from surgery, cath lab, to the physician practices can speak up and be an advocate for sleep apnea and understand the risks. The goal with the sleep navigator is to identify our sleep apnea patients earlier before they end up with multiple comorbid conditions.”
Ultimately, Weaver’s goals are accomplished through a day-to-day focus that transcends raw statistics. Patients are not numbers but recognized as human beings who benefit from education, attention, and expertise.
Inspiration Comes From Many Sources
Weaver credits a certified nursing assistant (CNA) named Patience Hall as a main source of inspiration. “I started my career in health as a CNA in an operating room with Patience,” says Weaver, who remains Facebook friends with Hall (who continues to work as a CNA). “She taught me to care with passion and to treat every individual as a person, not a patient. It’s easy to get wrapped up in your day and your work. I am motivated by patient success stories and the lessons from those that maybe weren’t so successful. Patience instilled in me that passion for every patient, every time.”
Greg Thompson is a Loveland, Colo-based freelance writer.
References 1. Weaver K. In-hospital sleep apnea screening decreases readmissions and improves quality of life. Poster presented at the AAST 2018 Annual Meeting, Indianapolis. 2. Kanagala R, Murali NS, Friedman PA, et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation. 2003;107:2589–94.
from Sleep Review http://www.sleepreviewmag.com/2019/09/vital-sign-kristina-weaver/
from https://www.perspectief.org/sleep-as-a-vital-sign-kristina-weaver-emt-p-rpsgt/
0 notes
technicaldr · 5 years
Text
How to integrate HubSpot with CTI through your Phone System?
For sales reps or call center managers looking to combine the power of a CRM with a phone system, Computer telephony integration (CTI) is the answer. For many, that integration involves HubSpot. HubSpot CRM integrations apply the full depth of business intelligence to every consumer interaction, turning raw data into bottom-line ROI.
  Why bother with computer telephony integration (CTI)?
  Whether or not consumers realize it, call center representatives tend to know a fair amount about them by the time they say: “Hello”. That’s the power of CTI—pushing high-value, real-time data to employees engaged in human-to-human interactions with customers. That knowledge can solve problems more efficiently and offer subtle customer relationship support to retain more clients.
  CTI can even aid call center representatives before the conversation begins. Pre-routing data gathering gleans information from consumers that sends calls to the most qualified representative. For consumers, this means an overall smoother experience. It lowers the chances of pogo-sticking from representative to representative while searching for the right person or department.
Want to increase your customer experience right now?
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  For employees, pre-routing saves time. With entry-level questions already asked and answered, representatives can dive into the core issue immediately. (Consumers are grateful for quicker solutions as well.) Lowering the amount of live call time frees representatives to handle more consumers each day. The benefit to employers? Less call center staff.
  While customers and call-center representatives may never interact more than once, CTI avoids the perception of communicating with a stranger. On a personal level, CRM data may contain notes that help representatives navigate a heated conversation with a demanding client. On a professional level, notes from previous calls—from contact history to technical solutions—can get representatives up to speed immediately.
  Unique advantages of HubSpot CTI
  HubSpot’s CRM tackles the so-called “tasks salespeople hate.” HubSpot’s promise is less time on spreadsheets and in Microsoft Outlook and more time interacting with customers. It’s about streamlined, centralized communication to support disparate teams of sales and customer service representatives working with clients. It’s also free in its basic format.
  Combining HubSpot’s CRM with its automated inbound marketing tools—a prime source of HubSpot revenue—reflects the power of HubSpot integrations, even within their walled garden. The potential to transition internal HubSpot connections into a system-wide HubSpot CTI integration offers a glimpse at the potential of a start-to-finish sales and marketing platform.
  For call center representatives, HubSpot phone integration empowers staff with more than basic consumer data. It can include notes and history related to sales staff interactions, or even knowledge about which marketing materials potential consumers have received or opened.
  HubSpot reports that every phone call costs a company up to $15. This frequently puts companies in a bind: They want to satisfy consumers’ need to reach out quickly but avoid an inundation of calls that offer little sales potential. The knee-jerk reaction, according to HubSpot, is often to make phone numbers harder to find. But that solution serves company, not consumer, goals.
  This is where data plays a critical role. HubSpot CTI can help prioritize and route calls according to various rules defined by CRM data. Avoiding the all-or-nothing approach when it comes to calls can make ROI more predictable for call centers and prioritize the time and energy of sales staff.
  Post-call analysis can help refine an initial set of inputs from HubSpot CTI integration to develop an ongoing process of refinement. Because marketing and sales data live in the same location, call centers can also become a source of data for other agents at a company by pushing call analysis out to sales teams or marketing departments. Does a marketing department exist that wouldn’t want to learn about the correlation between specific marketing materials and sales?
  How to Integrate HubSpot with a phone system
  The process varies dependent on the phone system involved. These examples reflect the capacity and process for HubSpot CTI with major phone systems:
How CTI works with HubSpot
  Identifying a caller’s number allows an integrated system to connect the phone number to a record in the HubSpot CRM. Once the CRM record and phone number are connected, HubSpot can deliver various datasets to the call center representative before the conversation even starts.
  This data can include everything from the caller’s title to the history of interaction. For large call centers with divided responsibilities, this ensures the caller reaches the right representative first time round. That may mean reaching the person with the right technical skill set, or the ideal employee to manage a critical relationship with a high-value client.
  Because representatives don’t need to seek out any of this information, they can maintain their focus on solving the consumer problem—or completing the sale.
  What to Integrate for HubSpot-linked phone systems
  There are several HubSpot integrations available. Some, like Auto-Dialer and Power Dialer, build efficiencies into standard call center activity (and useful efficiencies for sales staff making periodic follow-up calls). For example, HubSpot CTI integration allows employees to place a call by clicking a number directly in the CRM—no wasted time dialing, misdialing, or redialing numbers.
  For new callers, HubSpot integrations allow the creation of new accounts, contacts, and leads. Inevitably, consumers change numbers and add or change points of contact. The ability to create or update accounts means none of this information is lost, and system-wide data stays consistent. For needs that go beyond the work of call center staff, HubSpot provides the ability to create a task for other team members quickly and easily.
  Recording calls, call tracking, and call analytics offer a valuable post-mortem on client interactions that can help refine processes and reallocate resources.
  Technical components of HubSpot CTI
  While the exact nature of the applicable technical setup varies from provider to provider, all organizations must answer questions that affect implementation:
Is the phone system managed in-house? In-house managed systems, common at large organizations, shift the technical burden to internal IT teams. A managed, cloud-based system migrates the bulk of the technical implementation to the phone system provider.
Is the current phone system capable of HubSpot integration? The key integration feature is a VoIP system (rather than a traditional PBX landline system). VoIP is essential to connect CRM data with a phone system. Confirming the capability for HubSpot integration with the service manager or in-house technical team is an appropriate starting point.
Which numbers will be included? Not every company phone will need HubSpot CTI. Identifying the subset of numbers that can extract value from CTI limits technical implementation to core components of the marketing and sales process.
Who will have access to what? CTI integrations connect many data points, but not everyone needs access to all the data. (Certainly, not everyone needs editing access to all data.) Establishing a hierarchy of access that gets the right data to the right people at the right time is a fundamental step toward extracting value from a CTI investment. This should also include who has access to reports and the responsibility for implementing improvements based on call data.
Where will calls be routed? Small call centers may receive all inquiries; large centers may develop specialties to handle certain clients or issues. Mapping a routing framework before implementation can avoid later headaches due to haphazard routing.
Who will train and support call center staff? Every new system or integration has a learning curve. HubSpot CTI is no different. Even if staff are already familiar with a phone system and HubSpot as separate technologies, training to highlight the virtues of the integrated system will get more value from the linked platforms.
  Ready, Set, Integrate
  Acquiring consumer data is no longer a business challenge. If anything, the primary focus has become managing vast troves of data. Siloed information fails to take advantage of key integrations that can arm employees with the data they need to serve consumers more efficiently and close more sales.
CTI provides an opportunity to connect call center data with a CRM. For the many companies that rely on HubSpot, this integration can connect every dot throughout the customer journey. Understanding the technical capabilities and process for implementation provides a framework for connecting HubSpot with an existing or upgraded VoIP phone system.
  Technical Dr. Inc.'s insight:
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[email protected] or 877-910-0004 www.technicaldr.com
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retailtouchpoints · 5 years
Text
Retailers, Reach For The Minimum By 2020
By Ed King, HighStreet Collective
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Since we started our consultancy, HighStreet, in mid-2017, it’s become painfully clear that legacy retailers have had a difficult time with their “omnichannel” and in-store innovation efforts. While we have inspired many brands and retailers with our passionate message about how shopper expectations have outpaced the rate of retail innovation by a factor of three-to-one, the fact remains that many (including some of our clients and current prospects) are unable, or unwilling, to make the changes necessary for survival.
This paralysis reminds me of another staggering statistic. According to the Journal of the American Medical Association, less than 5% of people who survive a heart attack successfully change their eating, smoking and exercise habits afterward. By nearly anyone’s measure, the Amazonian effect on retail can be considered a massive coronary to the industry.
To make matters worse for legacy retailers, along came the Warby Parkers, the Amazons, the Caspers and other previously online-only pure plays, all of which have enjoyed fairly immediate success in brick-and-mortar. Without the red tape, old leaders set in their ways, and outdated back-end technologies, these pure plays have been able to serve starving shoppers what they’ve been craving in a brick-and-mortar experience — and they’re thriving because of it.
A 2019 survey by BDO illustrates this point. While a whopping 84% of e-Commerce and pure-play retailers consider themselves to be thriving, only 40% of specialty retailers, 35% of big boxes, 25% of discount stores, and 17% of department stores claim to be.
The retail bar has been re-set, and there are new table stakes. Shoppers now have certain “minimum” expectations of a shopping experience. And retailers who continue to ignore these expectations will likely die.
Of course, things will vary segment by segment. But, after doing 60-90 minutes of place-based human experience research (stores, restaurants, airports, museums, theme parks) every day for the past several years, we consider ourselves to have our ‘finger on the pulse’ of shopper expectations. We believe there are basic expectations the majority of shoppers will possess come January 1, 2020. We call them the Fundamental Five, and you don’t have to break the bank with a massive digital transformation effort or upend the company with a huge change management initiative to accomplish them:
1.      Be relevant to my 2020 life;
2.      Unpack the product;
3.      Treat me like you know me;
4.      Let me shop on my terms; and
5.      Give me a reason to come back
Fundamental #1: Be Relevant To My 2020 Life
Before taking another single step inside your store, your customers are already weighing a value exchange. It’s a cage match in the shopper’s brain between the effort of getting off the couch, navigating traffic and finding a parking spot vs. the joyful experience of shopping in a physical store that enriches their life in some way. As expectations continue to rise and convenience becomes more tantalizing, it’s critical that brick-and-mortars stand for something in the hearts and minds of their customers if they hope to maintain relevance in a 2020 world.
Table Stakes: Communicate your company’s purpose through actions and words. Actively engage on relevant social networks and other public-facing forums.
Plus-Ups: Bring social engagement inside the store. Commit to a philanthropic cause your customers are interested in and offer them opportunities to get involved.
You’ll lose if: …you ignore trends, culture and your key customers’ voice; or if you take more than a few hours to respond via social networks to customer problems.
First Steps: Assess your brand’s relevance and meaning to your market. Adjust your brand if necessary. Become active on social networks and address customer comments and concerns (good and bad) in less than an hour.
Fundamental #2: Unpack The Product
The one significant advantage that brick-and-mortar retailers have over the Amazons of the world is the ability to shop in a sensory-rich, high-touch, brand immersive environment. Shoppers love to understand the back stories of the product, love to engage with the product, and love to envision themselves enjoying the product. It’s what the 2020 shopper will come to expect from a physical store visit.
Table Stakes: Give your customers ample opportunity to try on or try out products with no commitment. Embrace and be transparent with customer reviews. Allow brands to communicate their stories inside the store.
Plus-Ups: Create cross-category, occasion-based, life story vignettes inside the store. Add scents, music and other sensory triggers to demarcate and emotionalize the space. Use digital to show products in different life situations.
You’ll lose if: …you follow an operations-focused, category-centric (stack-‘em-high-and-let-‘em-fly), not a customer life-story approach, to merchandizing; or if you charge a restocking fee.
First Steps: Break down the silos and communicate with different merchants and departments. Make the dressing room environment comfortable and welcoming. Exhibit digital content that shows products being used in real-life situations.
Fundamental #3: Treat Me Like You Know Me
Imagine shopping online and each time you visit your favorite e-Commerce retailer, you have to sign in, only to “start over” from scratch. That’s right, no saved sizes or past purchase history. No preference-based recommendations. No saved credit card data. Absurd, right? Well, that’s how MOST shoppers feel when they walk into a brick-and-mortar store. A new associate greets her and doesn’t know her from Eve. Meaning she must “start over” each visit. In 2020, shoppers will come to expect stores to know them upon entering.
Table Stakes: Over-index on SKUs that are trending, store by store, neighborhood by neighborhood. Have a mobile or tablet-based tool for sales associates to look up past purchases, know sizes and preferences and make recommendations.
Plus-Ups: Offer a mobile app with personalized pricing. Have an in-store measurement system that gathers dwell and engagement data.
You’ll lose if: …your store relies on hunches and a “that’s how we’ve always done it” mentality; or if all of your stores carry the same SKUs regardless of local preferences; or if your customers feel like they are “starting over” each time they visit.
First Steps: Gather pertinent data on customers and make the data available to associates inside the store. Share best practices store to store.
Fundamental #4: Let Me Shop On My Terms
Thanks to social media and our always-on lifestyles, people are in a constant state of shopping. No longer is shopping planned — it just occurs. Shoppers have come to expect that retailers are available to them anytime and anywhere they need them to be. E-Commerce and in-store are no longer different things in the mind of the 2020 shopper.
Table Stakes: Give your shoppers the ability to buy online, in-store or via BOPIS (buy online, pick up in store). Offer free shipping and delivery for products not in stock.
Plus-Ups: Offer peer reviews at the shelf via electronic shelf labels. Offer endless aisle digital solutions that show the entire breadth of SKUs and utilize visual and/or voice search. Enable purchase functions embedded directly inside social media channels.
You’ll lose if: …you force customers to walk to the back of the store to pick up their merchandize; or if you force customers to drive across town to another location to get an out-of-stock product; or if your e-Commerce sales and your in-store sales teams still live in different, competing worlds.
First Steps: Tie together inventory data online and store by store. Adopt a shipping and delivery system all the way to the front door. Create an overarching corporate sales function, rather than separate e-Commerce and in-store sales functions.
Fundamental #5: Give Me A Reason To Come Back
When a shopper makes the decision to visit your store, it’s absolutely critical to make them feel like they made a good choice. You must think like a choreographer when it comes to an in-store visit. It’s important to know when a shopper wants attention and when they want to be left alone…to know what flips their switch emotionally and what doesn’t. The 2020 shopper will come to expect a bespoke experience from the time they park to the time they leave.
Table Stakes: Have trained associates who genuinely care and come from a heart-of-service mentality. Offer roaming checkout. Recognize and reward loyal customers. Have basic in-store measurement systems to optimize merchandising strategies.
Plus-Ups: Offer multiple mobile payment options. Automate mundane tasks to enable associates to offer more attentive service, and to remove friction from the shopping experience. Have an advanced measurement system that understands shoppers’ emotions and states of mind in different zones in the store.
You’ll lose if: …your customers still have to wait in a checkout line to purchase; or if your customers aren’t greeted or kindly approached during their visit; or if loyal customers aren’t recognized and rewarded in some way; or if you don’t know which areas of the store are emotionally lighting up shoppers’ brains and which ones are turning them off.
First Steps: Hire and train associates based on personality first, skills second. Expand POS to include mobile payments. Install a measurement system inside the store that gathers data like a physical web site and produces actionable insights.
Ed King is Co-Founder of HighStreet Collective, a “roll-up-their-sleeves” retail consultancy. They recently launched their Living Retail Lab™ in Atlanta, GA. Many of the technologies and initiatives referenced in this article will be featured and field tested in their lab “live sprints” inside of Citizen Supply at Ponce City Market in 2019. For more information, go to www.LivingRetailLab.com.
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