Tumgik
#clinical data monitoring
market-insider · 9 months
Text
Strategic Insights into the Clinical Trial Investigative Site Network Market
The global clinical trial investigative site network market size is expected to reach USD 12.5 billion by 2030. Growing investments in pharmaceutical R&D, increasing demand for new therapies and complications associated with site management of clinical trials are some of the major factors driving the growth of the industry. There has been a consistent rise the clinical trials in the last 5 years. For instance, according to ClinicalTrials.gov, over 262,298 trials were registered in 2018, whereas as of September 2022, over 399,518 trials were registered. The clinical trials are expected to grow even further as the funding for research improves.
Tumblr media
Gain deeper insights on the market and receive your free copy with TOC now @: Clinical Trial Investigative Site Network Market Report
This is expected to propel the growth of the industry post-pandemic. There is a growing focus on reducing the cost associated with clinical research. Hiring a clinical trial investigative site network supports the regulatory function, improves the enrollment of participants, assists in data management, and quality assurance. It increases process compliance, reduces process issues with each trial, and helps with faster trial initiations, and shorter trial timelines. These factors are supporting the demand for clinical investigative site networks. The governments are actively trying to improve R&D by providing tax deductions. For instance, in January 2022, the Indian government stated that it is providing a weighted average tax deduction of up to 200% in R&D.
Such initiatives are expected to improve the R&D activities on drugs and thus support industry growth. According to the IQVIA, report on oncology trends, clinical trials for cancer have been increasing for the last 10 years. For instance, in 2011, 1,242 trials were registered for cancer, and as of 2021, 2,335 trials were registered for cancer. The number of clinical trials for cancer is expected to rise even further owing to the growing prevalence of the disease. This is expected to improve the demand for clinical investigative site networks for cancer clinical trials post-pandemic.
0 notes
dharmveer · 2 years
Text
Remote Health Monitoring Apps by SISGAIN in California
Tumblr media
#Remote patient monitoring is one of the most well-liked and often utilised telemedicine techniques. It allows a doctor to check on a patient#heart disease#or allergies. Patients feel more at ease as a result of the ongoing monitoring. Maintaining open channels of communication between the pati#SISGAIN is a leading remote patient monitoring services provider in California#USA.#Remote patient monitoring#whether done at home or somewhere else than a clinical environment#is common practice. Since remote health monitoring has the potential to significantly improve patients' quality of life when utilised in th#it should come as no surprise that it is growing in popularity.#Leading Features of the Ideal Remote Patient Monitoring System:#Big data analysis at a high level: RPM can be able to recognise#grasp#enhance#and analyse complicated patterns depending on the data sources. In order to address complicated issues#artificial intelligence (AI) and machine learning employ sophisticated research software#cutting-edge algorithms#and rich visualisations (ML). Based on patient-generated health data#RPM dashboards for clinicians provide alert levels from low to high-risk status. The physician dashboard regularly displays information abo#Dependable cyber infrastructure: RPM initiatives are carried out by several parties#and these parties could employ applications and biometric devices to disclose personal information and whereabouts to third parties#endangering cybersecurity and privacy. One of the major components of a perfect RPM should be a robust cybersecurity architecture.#Information from RPM medical devices that is accurate and trustworthy#assisted by AI: By gathering#analysing#processing#and holistically interpreting vital and physiological data from patients#optimum RPM technology enables the system to assess#test#and measure solutions. Because of its exceptional ability to protect sensitive data while minimising or eliminating human error#it inspires confidence.
1 note · View note
p2pchealth · 2 years
Text
Tumblr media
PBS Transforming Healthcare company integrate new technologies for improving the healthcare services reach to patient from provider faster and safer.
For more info:- Healthcare Software in Bahamas
Schedule a Call: Hotline
Phone : +1 (242) 322-1034/5
Phone : +1 (242) 397-3100
Fax : +1 (242) 322-1036
Email contact:[email protected]
Facebook:- https://www.facebook.com/pbsbahama
0 notes
sollers-college · 2 years
Link
Learn how to use risk-based monitoring tools in clinical trials at Sollers.edu which include risk identification, evaluation, control, review and reporting, vendor selection, etc. Gain hands-on practical experience and upgrade your skill set today with the help of instructors.
0 notes
momkat · 6 months
Text
If you are in the USA today, go VOTE!!!
So many people only vote in presidential elections when it is the smaller more local elections that have so much control over your lives!!! The president is not a king and can effect NOTHING if they have a hostile congress!! Congresspeople come from smaller local government offices! VOTE! VOTE! VOTE!
If you don't show up to vote against, then you are voting for. A mediocre candidate who votes FOR you in office most of the time is still better than a hostile candidate who will vote against you while in office. If you can't vote for, then at least vote against!
Vote LOCAL!
School Board – Your local School Board is responsible for:
Content of your sex education including gay sex & safety, and all the sexual variants that real people have.
whether gay marriage can be talked about in school
whether a child gets called their chosen name vs their dead name in class.
all policies about trans kids, including anti-bullying policies
whether or not your school has to tell parents that you are identifying as queer. (If a kid is not telling their parents that they are some form of alt/queer/non-b THERE IS A REASON FOR IT. Schools telling these parents can result in abuse, shaming, being kicked out of the house, being 'beaten straight' etc.)
Access to gender affirming care in the clinic or counselor's office
Book bans – school book bans are often used as a step/justification for book bans at the local library.
The content of your history class. Whitewashing slavery. Whitewashing Nazi Germany. Whitewashing colonialism.
And much, much more. In addition, School Boards are often a stepping stone to larger offices. The progression is: School Board, City/County board, State office, National office. If you want state and national officials to support you, you have to grow them at the LOCAL LEVEL!!!
City/County Government:
How much money schools get. (And therefore can effect/dictate policies.)
How much money cops get. (And therefore can effect/dictate policies.)
How much money public services (firemen, local health services, libraries etc) get.
Local government regulations & laws (i.e. being arrested for 'indecency' because you are in drag.)
And again, don't forget that these are the 'feeder' offices that lead to government offices. These people go on to state offices!!
Your STATE Legislature is responsible for:
All abortion policies. Since Roe v. Wade has been tossed there is no federal prevention against any abortion policies.
All sexual health policies. From birth control to sex changes. Their laws can range from sensible to inhumane.
All CIVIL RIGHTS policies that are not explicitly guarded and monitored by the federal government are left up to the states. Take a look at Louisiana, Florida, Mississippi, Arizona, etc. if you want examples.
And, of course, they can dictate policies to smaller municipalities (see City/County).
The most likely State office that leads to the presidency is Governor or a state. If you want better presidents, you need better governors!
Gerrymandering:
“But...but, but... I am gerrymandered so it doesn't make a difference if I vote!!” It DOES! If you are in a gerrymandered district and the crazy left wing crusader wins with a landslide because you DID NOT VOTE, then their party will keep putting in crazy right wing crusaders! If the vote is closer, EVEN IF YOU LOSE, their party is more likely to put in a more centrist candidate because they don't want to risk losing the seat. In addition, voting records are used to determine 1) the NEXT time areas are redistricted and 2) To show severe gerrymandering to courts to OVERTURN gerrymandered districts and force a redistricting. Right now there are people who are wining court case after court case to force redistricting of gerrymandered states and they are using voting data to do so!!! VOTE!!!
Please re-post this. Please blaze this. Please pass it on. PLEASE VOTE!
107 notes · View notes
britt-kageryuu · 2 months
Text
Donnie, Leo, and Mikey are all in the same stream. They're models are in an open space with chat on a 'wall', there's spraycans and random art supplies along the floor, and Shelldon is flying around the space. They're allin color-coded hoodies, with different themed graphics. (Mikey= paint splatter, Leo= unicorn with a sword, Donnie= *insert programming joke here*)
Donnie: Today we're testing our new VR system, and the camera feature that allows us to film this VR space.
Mikey: I also get to try out the VR painting game!
Leo: I'm just here because my shift at the clinic got swapped, and had nothing better to do.
Mikeys model is bouncing around quite fluidly, and spraycans appear in his hands. He's grinning like a mad turtle with excitement. Chat is visibly going at hyper speed on the wall with random emojis, comments, and quickly vanishing messages.
Donnie: Well according to what the system is telling me, things are holding up, and going smoothly. Okay M you may now start on testing the game, just remember the ceiling is not that high up, and there IS a boundary for the VR space that you need to stay in.
Leo's model now has a marker in his hand.
Leo: I'm going to draw on the wall behind the camera.
Donnie: Sigh, I guess I will be the one to monitor the data. Woe is me, he said with full sarcasm. Shelldon watch were you're flying please, and remember if you bump the chat wall you will at this point randomly ban someone for a random amount of time.
This catches everyone's attention with a resounding 'Why?'
Donnie: It's a feature our new helper Codename: River will implement. Now just do you're thing, and try out the game!
The stream goes on for a few hours of Mikey painting a virtual mural, Leo wandering about doodling on the walls, including 'They wish they were turtles!' with an arrow pointing to the chat, and all 'Our subs are part of the Bale, and newbies are hatchlings.'
Shelldon at one point teasingly hovers close to the chat box, like a cat about to knock something over, and wiggles his 'arm' like he's about to hit the box, only to fly away laughing at the potential chaos he caused.
Masterpost
48 notes · View notes
violetsandshrikes · 1 year
Text
just because I’ve seen all the tiktok self-appointed herbal doctors hating on it:
LiverTox is a good database with current clinical and research data on drugs that can cause liver injury. This can be particularly important to monitor/know about if you are taking unprescribed supplementation.
199 notes · View notes
mindblowingscience · 9 months
Text
It is the first gene therapy approved to treat this debilitating and fatal disease found almost exclusively in boys. Emma Ciafaloni is a neuromuscular neurologist with the University of Rochester Medical Center (URMC) neurology department and Golisano Children’s Hospital, and director of the UR Medicine Duchenne Muscular Dystrophy Clinic, which treats boys with Duchenne muscular dystrophy (DMD) from across upstate New York. Ciafaloni has been involved in DMD clinical research for decades and URMC was one of first three sites in the nation to start dosing patients in the phase 3 clinical trial for the new gene therapy. The study, called EMBARK, has since expanded to additional sites in North America, Europe, and Asia. Ciafaloni also served as chair of the independent Data Safety and Monitoring Board for the early phase clinical trials of the therapy. The new drug—delandistrogene moxeparvovec-rokl—is being developed by Sarepta Therapeutics and marketed under the name ELEVIDYS.
Continue Reading
53 notes · View notes
beefromanoff · 6 months
Text
Project Mockingbird Ch. 5
summary: Natasha and Bruce have different ideas on how to help Charlotte. Natasha's way wins.
pairing: Bucky Barnes x OC
author's note: let me know what you think! thanks for reading, xox!
tag list: @bangtanxberm (let me know if you want to be added <3)
chapter list
_________________________________________________________
Tumblr media
Sunlight filtered through the tinted windows, casting delicate shadows across the sterile white walls of the hospital wing. Charlotte blinked, the soft hum of machinery and distant chatter gradually pulling her back to consciousness. The events of the previous day flooded her mind, the endless battery of tests and experiments, the barrage of questions from Dr. Banner and Tony Stark, the scabs around her wrists from the restraints she’d thrashed into. 
Still not the worst place I’ve woken up. 
Her eyes flicked to the state-of-the-art equipment surrounding her. Tubes and monitors blinked with clinical precision, their data feeding into sleek screens that could display a myriad of complex graphs and charts. Even with all the screens dark, all the tubes and wires hanging limp off of them, the environment made her skin crawl.  She was acutely aware of the high-tech lab setting, a stark contrast to the comfort of her own room in the compound. 
One night. I only got to enjoy it for one night before all this shit caught up with me. 
Closing her eyes, she took a deep breath, attempting to steady her racing thoughts. They found the problem. She reminded herself, her fingers absently tracing the edge of the crisp hospital sheet. They’re the best scientists in the world. How hard can it really be to fix if we found the problem in one day?
After hours and hours of testing, scanning, and an ultimate hail-mary experiment with the man himself -- they’d discovered that her violent aversion to James Barnes was linked to certain olfactory triggers. The implications of this breakthrough raced through her mind. She remembered fragments of her time with HYDRA, but the conditioning had taken place so early, so long ago. It was the first thing they did to her. That was one of the bigger question marks she had about what was done to her. 
As she stirred in the hospital bed, she anticipated their return, eager to get started so she could get the hell out of here. She longed for the day when she could walk around the compound, or the world, without the looming dread of her own actions. Yet, beneath the anticipation lingered a sliver of apprehension, a fear of the unknown. What if this doesn’t work? What if they screwed me up too much?
With a sigh, she shifted her gaze to the ceiling. Despite her fears, she clung to the possibility of a future unburdened by the shackles of her conditioning. 
In the daze of her worry, the room's atmosphere shifted from anticipation to warmth. The door slid open, and in walked Natasha, her arms laden with an impressive assortment of breakfast items. Behind her, a younger brunette who Charlotte recognized as Peter Parker, carried an impressive tower of pancakes, while Steve balanced a tray stacked with an array of pastries.
"Surprise!" Natasha announced, plopping down on the foot of the bed.
Charlotte couldn't help but smile, the knot of tension in her chest loosening at the heartfelt gesture and friendly faces. "Wow, you weren’t kidding.”
“We don’t joke about food around here.” 
With practiced efficiency, they transformed her hospital bed into a makeshift banquet table, the three of them pulling chairs up beside the bed. The room was soon filled with the mouthwatering aroma of freshly brewed coffee, the sweet scent of syrup, and the comforting richness of pastries. All sterile scents had long since been forgotten.
Whether their plan was to distract her or they were just a naturally chatty group, Charlotte didn’t know nor care. As she picked apart the biggest blueberry muffin she’d ever seen, Peter launched into yet another story about his college life. 
“I told him, sir, please - I was literally stopping a bank from being robbed, he still wouldn’t let me retake the test! I mean come on, it’s art history. Who even decided that art history was a necessary college course! He’s just out to get me, I swear.” He paused to take a gulp of orange juice. 
Natasha laughed and reached for the last piece of bacon. “No good deed goes unpunished.” 
The conversation was easy, the trio clearly comfortable with each other. Charlotte was perfectly content to sit back and listen, savoring one of the few meals that was actually close to satiating her endless appetite. 
Just as Peter opened his mouth to speak again, the door slid open. A disheveled Dr. Banner, stood holding a tablet, looking like he hadn’t slept at all since she saw him last. "Hi, good morning, I uh, think I've found a solution," he announced, his voice carrying a note of cautious optimism. “Is that coffee?” 
Charlotte's heart skipped a beat. Hope surged within her, mingling with a thread of trepidation. Steve poured Bruce a cup of coffee which he graciously accepted. 
With a deep breath, she nodded, her voice steady despite feeling the exact opposite on the inside. "Let's do it. Whatever you think." 
“Okay, I’ve run through this every way I can imagine, making sure I’m considering everything. All in all, it seems like a simple fix. I mean, it makes sense, if we look at the timeline of…well, it wouldn’t exactly have been advanced technology they used. So it seems incredibly simple, but for the time, it would have been a massive breakthrough,” He was careful with his words, trying to avoid anything too callous, despite his obvious excitement about the discovery. 
The sterile white walls of the room seemed to close in on Charlotte as she listened to Dr. Banner's explanation. His voice felt distant, overshadowed by the memories of past experiments and the cold, clinical environment of laboratories she had desperately tried to forget. Her eyes must have glazed over as she fought against the rising panic in her chest as the words surgery and minimally invasive floated through her stupor.
"I understand your concerns, Charlotte," Bruce said gently, his eyes filled with empathy. "But this procedure is straightforward. It'll be quick, and you won't feel a thing. We'll make sure you're comfortable and safe the entire time."
Steve placed a reassuring hand on her shoulder. "Bruce is right," he said, his tone steady and calming. "We're here for you. This will be over before you know it. You’re in great hands here.” 
Despite Steve's comforting words, anxiety clawed at Charlotte's chest. The very idea of another medical procedure triggered a visceral reaction, a surge of fear rooted deep in her past traumas. Just as panic threatened to overwhelm her, Natasha spoke, her piercing eyes locked onto Charlotte's.
"Do you trust me?" Natasha asked, her voice calm, but there was an intensity in her gaze that demanded an honest answer.
Charlotte met her eyes, finding solidarity in the closest thing she had to a friend. She nodded slowly. "I do," she replied, her voice a whisper.
“Peter, move the food.” 
He cocked an eyebrow, but immediately gathered the few trays left on the bed and relocated them to a table in the corner of the room.
Without warning, Natasha's hand shot out, the heel of her palm colliding with Charlotte's nose in a swift, controlled motion. Pain exploded through Charlotte's face, and her head snapped back, shock and confusion flooding her senses. Blood gushed from her nose, hot and sticky.
In the stunned silence that followed, Charlotte felt a strange sensation, like a fence around her mind had been torn down. Once the initial shock subsided, Charlotte let out a disbelieving laugh, the metallic taste of blood on her tongue. 
"Thank you," she said to Natasha, her eyes shimmering with tears, only half from the blow. "That was…preferable."
“I figured.” Nat winked, squeezing her shoulder. I knew I liked her. 
“Well, could you at least let me clean it up a bit?” Bruce winced, handing her a wad of tissues and squinting to examine the damage. Charlotte tilted her head back and applied pressure, blood immediately soaking and reducing them to a soggy, crimson mess. 
“Hang on,” Her voice came out thick as a result of her mangled nose. Cupping it on either side, Charlotte took a deep breath and yanked. The crunch of the reset made all three men grimace, with Peter gasping as he covered his face. “Okay, I think I did that right. It’s been a while.” 
She noticed their horrified looks as she wiped a trail of blood off her upper lip. “What, you’ve never had to reset a broken nose before?”
“We uh, usually leave that part to the professionals.” Steve gave a grim smile. 
“Well, in my experience, the professionals only care about functionality, and you can still fight with a broken nose. Call me high maintenance, but I prefer my nose to be somewhat straight. So I picked up that little party trick.”  
Even Natasha’s eyes softened, just for a moment. The nonchalance with which she spoke about her past was unnerving. It begged the question of what horrors she’d experienced that she couldn’t talk about, if these kinds of remarks seemed to roll off her tongue as easily as a story about her breakfast. 
When Bruce had cleaned her up, insisting on packing her nose with cotton so it would heal correctly, the group left her alone to change into a spare Stark Industries sweatshirt that had been left in the lab. 
Meanwhile, Steve strode out of the building to find Bucky. He located him in the training area, his expression focused as he sparred with Sam. Steve approached the ring, his voice carrying a note of urgency. "Bucky, we need you in the lab. It's important."
Curiosity flickered in Bucky's eyes as he lowered his hands from their defensive posture. 
“It’s Charlotte. Bruce thinks he broke the conditioning.” 
When they’d returned to the medical wing, they paused before turning down the hall to her room, waiting for a signal. As an added precaution, Charlotte had insisted on being restrained again, although she didn’t argue when they said the IV would be unnecessary this time. Wrist strapped down, electrodes taped to her head and chest, and the glowing model of her brain projected in the corner of the room, she nodded to Dr. Banner. 
“Alright, Steve, we’re good to go. Come on in, Buck.” 
Charlotte sucked in a deep breath, aware that her heart beat was quickening by the pounding in her ears and the beeping on the monitor. She heard the methodical footsteps again, approaching her open doorway. Finally, he turned the corner. 
He was as tall as Steve, slightly stockier. His dark hair had been tied back in a tiny ponytail, and the ring of sweat around the collar of his gray shirt told her he had come from a workout. His shoulders were slightly rounded, tense, as though he could spring into action at a moment’s notice. The way he stood, his left side was slightly hidden from view. Despite the shadow, the metallic glint of his arm caught her eye. Vibranium. Very painful when it hits you. Another unwelcome memory came knocking in her mind as Steve followed his friend in the room. 
Everyone seemed to hold their breath. Dr. Banner, anxiously checking all the readings. Nat and Peter, hovering quietly in the corner of the room. Bucky and Charlotte as they locked eyes, far from the first time. 
How many times have I seen those eyes, this face, and yet I don’t think we’ve ever actually met. Not really. Not when we’re us. 
"Charlotte, this is James Bucky Barnes," Steve stepped forward, smiling softly. "Bucky, meet Charlotte Rossi."
Bucky nodded, a tight lipped smile on his face. "Nice to meet you, Charlotte."
Charlotte blushed, a reaction she hadn’t prepared for in the absence of her violent rampage. "Hi. I, uh, I'm sorry for how I acted…before," She paused, hoping he’d know she wasn’t just talking about the past two days.
“Don’t mention it.” His eyes crinkled in the corners. “Seriously.” 
Bruce's eyes widened with amazement as he studied the data on his screen. "It worked!" he exclaimed, frantically pointing at the hologram, still glowing gold. He turned and embraced the closest person to him, who was a bewildered looking Peter. "We did it!"
Peter, still in a state of shock, smiled as Bruce set him back on the ground. "Didn’t doubt it for a second, Dr. Banner!”
“WOO! Yes! Oh, sorry - “ Bruce had raised his hand to high-five Charlotte before realizing her wrists were still strapped to the bed. “Let me just…okay, there you go!” He hugged her as soon as he released the second restraint, catching her by surprise. 
“Oh!” She stiffened instinctively, but relaxed her shoulders to welcome his excited gesture. “Thank you, Dr. Banner…Bruce, seriously!” 
“Alright, let’s not land her back in here for crushing chest wounds.” Steve chuckled, putting a hand on Bruce’s shoulder. 
“Ah, yes, sorry! It’s just that these things, getting a breakthrough, gah! It just gets me so jazzed.” He ran a hand through his hair. “Man, I love science.” 
Tumblr media
Bucky couldn't help but let a small smile slip through. He extended a hand toward Charlotte, his eyes reflecting a mix of relief lingering reservations. "Congratulations. This is one of the good days."
She put her hand in his and he squeezed it, quick and light, before letting go. One of the good days. The words may have seemed vague and ambiguous to everyone else, but they hit home for her. When decades of your life had been lost to a string of one bad day after the next, the good ones really stuck out. Especially when dealing with an inordinate amount of trauma, sometimes the bad days persisted even in the good times. They were unavoidable. 
But today was one of the good ones. 
Natasha, clearly not one for the touchy feely part, spoke up. "Well, now that you're officially not a threat to the lives of those in this room, I say we celebrate."
Peter nodded eagerly, looking at Steve who shrugged. “Yeah, sure, why not. Training will be there tomorrow.” 
“Yes! I love off days, I feel like we never do anything fun anymore.” Peter pumped his fist before noticing Steve’s raised eyebrow. “I mean, not that training isn’t fun, I love training. I could train all day. You know what? I think I’ll do extra training tomorr -”
“Hush,” Natasha put her hand over his mouth. “Here’s what we’re gonna do. Steve, tell the recruits they’re working out on their own today. Finish their assigned routines and then take the afternoon off. Peter, get the football, the speaker, and the big blanket. Bruce, finish whatever report you’re itching to write about this and then log off for the day. Buck, go take a shower. You smell like sweat socks. Meet us by the lake in an hour.” 
“And where are you guys going?” Steve raised an eyebrow, gesturing to both women. 
Natasha grinned and started removing electrodes from the brunette, one by one. 
“To get Charlotte the hell out of here.” 
A little over an hour later, they traipsed down a paved path to the lake. Natasha carried a picnic basket full of snacks and drinks, although they were at most two hundred yards from the main cafeteria building. The sound of music grew louder as they approached the dock. Peter had laid out a large, thick blanket across the wooden boards, a portable speaker weighing down one of the corners. 
Steve stood talking to Bucky, who’s hair was still wet from the shower. The back of his sweatshirt was decorated with pinpricks of water. The sound of shoes on the dock made them pause their conversation and turn. 
“Long time no see.” Natasha thrust the picnic basket into Steve’s hands, grinning. “Barnes, you smell much better.” 
“Feeling the love, Nat.” He rolled his eyes, hanging back as Steve followed her to the end of the dock. Charlotte hesitated, still a little reserved with her newfound mental autonomy. “Hey.” 
“Hi,” She smiled, wincing as her nose crinkled. “Ow.” 
“That looks awful.” He frowned. 
“Now I’m feeling the love.” Charlotte narrowed her eyes, teasing. 
“No, I mean - shit. I meant it looks painful.” 
“I’m kidding. I avoided any and all mirrors on the way here. It always looks worse than it is.”
“Well, I know from experience that Nat doesn’t pull her punches, so I’m sure it didn’t tickle.” He offered a half smile, brows furrowed with concern. 
“Guess I better get my mind off of it.” She pursed her lips, feeling more herself now that she didn’t fear her own actions. Bucky’s eyes scanned her face, she couldn’t tell if he was assessing the injury or really looking at her for the first time. She swore she saw his eyes linger on her mouth for just a fraction of a second. 
“Guess so.” 
Hours later, the sun hung low in the sky, casting a warm glow across the Compound. It was a perfect fall day, the air crisp, the lake sparkling under the sunlight. Truly unbeatable, especially for their day of celebration. They’d spent the afternoon talking, letting Charlotte get to know them. Although she seemed comfortable enough, Natasha had discreetly reminded them that it was still her first week in an unfamiliar place with perfect strangers. Over stories, snacks and general shit-shooting, they’d become a little further from strangers and a little closer to friends. 
Tumblr media
Just a little. 
Sitting on the edge of the dock, their legs dangling over the water, Steve grinned at Peter. "Hey, Parker, you thinking what I’m thinking?" He held up the football.
Peter leapt up, landing in a crouch. "Always, Cap."
"Go long!" Steve called, his voice echoing across the water.
In a swift movement, he hurled the football with a strength that only a super-soldier possessed. It soared through the air, a perfect spiral against the backdrop of the clear sky.
Peter grinned as he launched himself into the air, shooting a web across the lake to a massive tree. He swung gracefully over the lake, his eyes locked on the football. With a perfectly timed web-shoot, he snatched it from the air, the impact making a satisfying thud against his palm.
"Nice catch, kid!" Sam called out, standing. “Damn, I knew I should have brought the wings.” He paused. “Yeah, I’ll be right back.” 
Bucky walked to the edge of the dock, mock flexing his biceps. "You're not the only one with a half decent throwing arm, old man."
Steve chuckled, his competitive spirit ignited. "Let's see what you've got, Buck."
Peter dropped back on the dock with a soft thud. Charlotte and Natasha were sprawled across the blanket, leaning back on their elbows. They exchanged an amused glance at the show of testosterone. 
Holding his hand out for the football, Bucky strode to the edge of the dock. He shot Steve an arrogant look before turning and hurling the football. It cut through the air, disappearing almost instantly. 
“Oh, shit!” Peter stumbled over his feet as he leapt to chase after the football. 
“I got it!” A gust of wind blew through across the dock, ruffling everyone’s hair. Looking up, Charlotte saw Sam soaring across the lake towards Peter and the long-disappeared football. 
“Dammit, Bruce never came out here, did he?” Natasha narrowed her eyebrows. “Oh well, his loss.” 
“Okay, you had a head start.” Peter protested as he dropped back on the dock beside Sam, who held the football like a trophy. 
“Whatever stops the tears, kid.” 
The friendly competition between super soldiers intensified over the next hour, each determined to outdo the other. 
“Alright, I think I’m warmed up now.” Bucky's blue eyes looked mischievous as he glanced back at the girls, a teasing smirk playing on his lips before he released the football with all his strength.
The ball sailed through the air, Sam and Peter taking off after it. Sam got there faster, but Peter's acrobatic finesse won the day. He caught the football mid-air, swinging back to the dock where he immediately collapsed on his back. "I tap out, guys! I need a break."
Natasha smirked. "Getting old, Spidey?"
Peter feigned offense, panting dramatically. "Not all of us are super soldiers!"
Chuckling, Steve clapped a hand on Peter's shoulder. "Good job, Pete. You earned the break."
"I must be getting soft, letting the kid beat me." Sam shook his head, landing beside them.
“Alright, this pissing contest was getting old anyways.” Natasha stood to her feet. “I’m thinking pizza and shitty action movies for the next phase of our day off. Yes?” 
“Yes,” Charlotte joined her. “I’m starving.” 
They packed up and headed back for their building, Nat making a point to linger at the back of the group. She raised an eyebrow at Bucky. "If I didn't know any better, Barnes, I'd say you were trying to impress our newest addition."
Bucky rolled his eyes. “Don’t do this.” 
“Do what?” She mocked innocence. 
“Try to play matchmaker, like always.”
“She’s pretty.” 
“Yeah, sure, she’s pretty.” He gave her a dirty look. “But she was also hell bent on ripping my head off until, oh yeah, this morning.” 
Tumblr media
Natasha shrugged. “That was then.” 
Groaning, Bucky shook his head. “I think she’s got more on her mind than finding a date to the prom.” 
“Hm, prom sounds like fun. Maybe we should have one here.” She winked. 
“You’re impossible.” 
26 notes · View notes
Text
Do No Harm
Doctor Getou Suguru x reader
TW: General Yandere themes, stalking, obsession, medical setting, injections, IVs, Lying about test results, Masturbation, drugging, kidnapping, mentioned death of readers parents due to cardiac events, murder, and I can’t really sugar coat this... death of reader
A/N: I don’t really think I can call this a valentines day post, but let’s pretend it is! This is probably my darkest fic yet, so reader discretion is heavily advised. Happy late valentines day everyone! 
Word Count: 1.8k
Tumblr media
Was it unprofessional? Undeniably. Did he care? Not one bit. How could he be expected to not fall in love with you? He knew intimate details about your body that no one else did, you confided in him, and most importantly, it was his job to care for you. On top of that, the details he was privy to as your doctor made it all too easy for him to grow even closer to you. He knew where you lived, he knew that you were single, he knew that you were an only child, and that both of your parents had died young from sudden cardiac arrest. 
After your first appointment, he knew the two of you had a connection. So what if he ordered some blood work and scheduled a follow-up appointment with you to go over the results even though it was only an intake appointment and there was no clinical indication it was necessary? The number of people who have vitamin deficiencies and don’t know it is quite high. Was it really that bad if your yearly physicals happened twice a year instead of just once? That didn’t seem evil to him, on the contrary actually, he was doing his duty as a healthcare professional and taking your well-being seriously. 
Of course, the repeat blood tests every three months might have been a little bit excessive, especially because you weren’t actually deficient in any vitamins and had no reason to be taking a supplement, but it gave him a reason to see you. Despite the fact that normal lab results were typically discussed on the phone, he couldn’t resist having you come into his office. 
Because of your family's cardiac history, the health of your heart was of great concern. Getou always made sure to perform a thorough cardiac workup at your check-ups. The way you allowed him to listen to your heart and touch the tender flesh on your chest was a delight for him. You were so trusting. Getou would expect nothing less though, he was your doctor after all. As your doctor, one of the hardest things was the uncertainty of whether you would drop dead of a heart attack the same way your parents did, or if you would have no complications at all. At first, this didn’t bother him, but as time passed he found himself obsessing over it more and more. A need for control started to well up inside of him driving him to stock your daily life. 
After one physical where you complained of new-onset chest pain, Getou couldn’t take it anymore. He knew that there was only one thing he could do to ensure his control and guarantee that you wouldn’t suffer. He had really been hoping it wouldn’t have to come to this. He loved you and he wished that you could have loved him too, but it seemed as though that was not in the cards you two had been dealt. 
Due to your chest pain, Getou ordered a two-week continuous heart monitor. The data collected from the monitor wouldn’t change his resolve, but he had another important use for it. After placing it and reminding you numerous times not to remove it or let it fall off before the two weeks mark, he let you go on with your day. Little did you know that you and Getou had not actually parted ways when you left his clinic. 
You had a terrible habit of leaving the door unlocked. Just more proof to him that your chances of living a long life were quite slim. At the same time, it was quite beneficial for him. He loved to slip into your closet and wait for the sounds of your vibrator to fill the room followed by your moans. The lewd sounds you made when you thought you were alone seemed like music to his ears. He always jotted down the date and exact time he heard the vibrator, this information would come in handy soon. 
After two weeks of wearing the heart monitor, you handed it over to Getou who told you it would take another week to analyze the data. This wasn't exactly true though. It would probably only take a few days to check for any arrhythmias, but that was not of interest to him. The data Getou sought was related to that list of dates and times he had collected earlier. By looking over the continuously recorded metrics during the times when you masturbated, he could watch the way your heart rate had spiked, the peaks when you came, and its slow return back to baseline when you had thoroughly pleasured yourself. 
His dick grew hard as he looked at the EKG readings in front of him, remembering the noises of sexual satisfaction you made. He began to rub his cock through his pants as he continued to line up your times of self-pleasure with the information from the heart monitor. Getou could feel the pre-cum leaking out of his tip wetting his trunks. Eventually, he decided to stay on the data from one of your various sessions and allow himself to finish. 
It felt below him to jerk off, but right now he didn’t care. Grabbing a box of tissues, he sat back down and allowed his erection to spring free. He spit into his hand for good measure before slowly starting to stroke his throbbing cock. Due to the prior stimulation and the level of arousal he was feeling, it didn’t take long for Getou to reach his point of climax. What helped push him over the edge, sending ropes of cum into the tissues he got, was the slight drop in heart rate after you orgasmed followed shortly by another spike as you chased that high again. As he wiped off the semen from his dick, he made a mental note to call you first thing tomorrow and schedule your follow-up appointment. 
Only a few days later you were seated in his exam room once again. His face was stern as he looked you in the eyes and lied, “your heart monitor revealed prolonged QT intervals. This is a dangerous arrhythmia that can spontaneously cause ventricular fibrillation which can be fatal.” You sat there stunned, unsure of what to say or how to react. Getou continued, “There is an injection I can give you that should help. If you would like, I can give you the first dose today.” Your brain still hadn’t processed the news you had just received, but you nodded your head before confirming, “yes, I would like to have the first dose today.” “Alright then, I will go grab it if you would like to roll up your sleeve.” 
He came back a few minutes later carrying a tray with the syringe, an alcohol pad, and a bandaid. “I just want to warn you,” Getou cautioned as he put on his gloves, “this injection can cause people to pass out sometimes, so don’t be alarmed if you start to feel dizzy, just lay down and let me know.” You nodded in understanding and tried your best not to flinch when the needle pushed its way into your arm. For the first few minutes after the injection, you felt fine. Getou was able to clean up and dispose of everything, but then the room started to spin. You laid back and your vision started to get spotty, “Doctor Getou” was all you managed to squeak out before everything went black.  
So sweet and trusting. Suguru looked at your unconscious body in the rearview mirror on his windshield, you looked so innocent laid across the backseat of his car. In a different life, he could have had the future he dreamed of with you. As your doctor, however, he was sworn to do what was best for you and to do no harm. In order to abide by these principles, Suguru needed to move you to a different facility where he could do what he deemed necessary. “Don’t worry, darling. Soon you’ll be cured.”
You awoke disoriented. Despite the fact that your eyes were closed, you could tell you weren’t in the clinic anymore. The sensation of an IV in your hand caught your attention and you wondered if you were in the hospital. You didn’t have time to question it for long when you heard Suguru’s voice, “I really don’t know if you can hear me, but I hope you can.” You tried to turn your head in the direction of his voice, but you found yourself unable to move. “The sedatives and paralytics in your IV drip are just enough to keep you from being awake and able to move, but not to the point where you need a ventilator.” You could hear him moving around the room as he continued to talk. “As your doctor, I only want what is best for you, and I know you know this. I love you dearly, but the oath I took when I graduated from medical school comes first.” Your mind was swimming, trying to understand what was happening and what Suguru was going on about.   
He paused for a minute, letting out a heavy sigh “I just want you to know that the data from your heart monitor will forever serve as a reminder of you, and every time I finish to those perfect EKG waves, I’ll be picturing your beautiful face.” You wanted to crawl out of your skin. How could he say that? Your thoughts continued to race. “I think it’s time we say goodbye now.” A feeling of terror consumed you. “I’m glad I was able to create a plan to cure you, not many doctors out there would care enough about their patients to go to the extreme lengths I am going to for you. The best part about this cure is that it is completely painless. One injection of about 30mg of morphine and everything will be better.” His voice sounded almost cheery. 
The next sensation you felt was a needle pricking your inner elbow and viscous liquid being injected slowly into your vein. “There we go, treatment administered.” After disposing of the syringe in the sharps box, he quickly returned to your side. Your skin was turning pale and the heart monitor began to beep as your heartbeat and breathing rate fell dangerously low. He muted the monitor. Nothing was going to disturb the two of you in these final moments. 
He reached for your hand, it felt cold as he held it, gently running his thumb over your knuckles in a soothing motion. You wanted to open your eyes, your mouth, ANYTHING. You wanted to scream. Your brain was becoming too foggy to even remember how screaming worked, even if it did, it wouldn't matter though and you knew that. It was almost like Getou could read your mind, and as your ears started to ring and the world crumbled away, he pressed a soft kiss to your forehead, softly cooing, “Shhh. Don't worry, no harm will ever come to you again.”
133 notes · View notes
pronoun-fucker · 2 years
Text
Tumblr media
“The NHS is shutting down its gender identity clinic for children after a damning review found that it failed vulnerable under-18s.
The gender identity service at Tavistock & Portman NHS Foundation Trust has been ordered to close by spring 2023.
It will be replaced by regional centres at existing children’s hospitals offering more “holistic care” with “strong links to mental health services”.
Tavistock’s Gender Identity Development Service (GIDS) clinic has been accused of rushing children into life-altering treatment on puberty blockers.
The paediatrician Dr Hilary Cass, who is leading a review of the service, has today issued a series of recommendations for a radical overhaul of how the NHS treats young people who are questioning their gender identity.
She found that the Tavistock clinic was “not a safe or viable long-term option” and that other mental health issues were “overshadowed” when gender was raised by children referred to the clinic.
Cass, former president of the Royal College of Paediatrics and Child Health, said the current model of a sole provider for gender services should be scrapped as it failed to meet the holistic needs of distressed and vulnerable teenagers.
She said Tavistock should be replaced by regional centres with an “appropriate multi-professional workforce to enable them to provide an integrated model of care that manages the holistic needs of this population”.
Amid concerns that the clinic fails to take into account wider health problems before putting children on puberty blockers, Cass added: “Staff should maintain a broad clinical perspective in order to embed the care of children and young people with gender uncertainty within a broader child and adolescent health context.”
NHS England, which commissioned Cass to review the service in September 2020, say they will implement her recommendations in full and decommission the Tavistock clinic.
They have announced they will launch two new clinics for children with gender dysphoria by spring 2023, which will bring together multiple doctors from a broad range of specialities.
The first, in London, will be based at Great Ormond Street Hospital and receive specialist mental health support from the South London and Maudsley NHS Foundation Trust.
The second, in the northwest, will be led by a partnership between Alder Hey Children’s NHS Foundation Trust and the Royal Manchester Children’s Hospital.
Cass said these clinics must have “established academic and education functions” to monitor evidence on children who are put on hormone therapy. The Tavistock clinic failed to collect sufficient data on the impact of puberty blockers in under-16s.
She said there was currently “insufficient evidence” for her to make any firm recommendations around their routine use.
Cass told the NHS to “enrol young people being considered for hormone treatment into a formal research protocol with adequate follow up into adulthood, with a more immediate focus on the questions regarding puberty blockers”.
The NHS said it would launch clinical trials in partnership with the National Institute for Health and Care Research to follow children on puberty blockers into adulthood.
A spokesman said: “This will ensure that there is greater transparency for children and their parents/carers around the uncertain clinical benefits and longer-term health impacts surrounding their use.”
The clinic has been overwhelmed by a sudden increase in referrals, particularly among young girls and children on the autism spectrum. Last year it received more than 5,000 referrals, compared to 250 a decade ago.
Cass’s final report will be published next year. Her interim review published in March found that services had developed without clear rules and that there was a “clinician lottery”, with widely varying approaches to treatment.
She found there was “a lack of agreement, and in many instances a lack of open discussion” about whether unhappiness with gender in adolescence was permanent or temporary. However, last year the Court of Appeal overturned a controversial ruling made by the High Court that children under 16 were unlikely to be able to give informed consent to receiving puberty blockers.
The case was brought against the Tavistock and Portman trust by Keira Bell, 24, who began taking puberty blockers when she was 16 to transition to male before later “detransitioning”.”
Link | Archived Link
249 notes · View notes
earthstellar · 2 years
Photo
Tumblr media Tumblr media Tumblr media Tumblr media
I really like that we see Velocity, a relatively newly qualified medic, often checking notes or handling reference material on various data pads throughout MTME / Lost Light. 
I also really like that she consults frequently with Ratchet (or whoever the lead physician is at the time) whenever possible-- She’s still finding her footing and gaining professional confidence in her knowledge and skills, and it shows in little details like her tendency to refer directly to records, charts, or reference information. 
It lends a very real feeling to how the med bay staff have organised themselves; We see that Velocity often handles non-emergent outpatients (like messing with Lug/Anode or Swerve, lol) but she is also involved in emergent care when needed, almost always under the guidance / monitoring of a senior medic. 
We don’t have much canonical information about how medics might rank themselves within a med bay / battle frontline / etc., but I love that we get a look at what general practice might look like a little bit on the Lost Light, because it has a very different pacing etc. compared to the usual emergent / urgent care / battlefield aid we typically see depicted in Transformers media.
And it makes sense that we usually don’t see more calm interactions in med bays given the most TF media takes place while the war is still ongoing, lmao.
But even when things kick off and get serious on the Lost Light, there’s a sense of there being a real structure amongst the medics and it adds to the realistic feeling of their crew being from a wide variety of background with differing levels of experience, both personal and professional. 
Learning Never Ends: Velocity and Checking Notes 
I love that we see Velocity as a student, struggling to stay motivated, with Nautica helping her study.
As an example of some real world healthcare worker reference material, I included a photo of one of my personal reference flip-books, which states it’s a nursing guide but honestly it has a lot of key information in there which is super, super helpful in general! I use it even though I am not currently nursing staff, myself. 
(Check out all my tabs on there and how many pages have had to be taped onto the pages below, lmaooo) 
Everyone needs to brush up on the basics / core knowledge here and there, and depending on what a healthcare worker is doing, where they are placed, what their level of relative experience is, etc. it is just super good to have reference material available and to use it as needed. 
It’s a very real thing, for Velocity as a less experienced medic to essentially carry the data pad equivalent of such a reference flip-book with her while on duty, and to have a tendency to check definitions and other reference documentation perhaps a little more literally or to-the-letter compared to Ratchet or First Aid-- Because they both have more overall experience than Velocity does. 
At one point in the slightly blurry third set of panels above (sorry I couldn’t find a better version of this page at the moment!), Ratchet uses such a situation as a teaching moment for Velocity! 
Yes, she was right to check, and yes, she interpreted it correctly as written, but there’s additional clinical / diagnostic / treatment / care information which Ratchet has obtained through experience which may not be noted in the supplementary details for the patient diagnosis information Velocity is checking here. 
He might be more able to contextualise some details, or infer certain things, while Velocity is shown to assess primarily based solely on what is written. 
And it’s very good to adhere to what’s written! Patient charts matter. Clinical notes matter. But there may also be other things to take into consideration which may be less immediately obvious, too. We get a sense that this is the case in this scene, with Ratchet pointing out some less evident relevant information. 
Ratchet does a good job of talking this out with Velocity, and he uses the same reference material on the relevant data pad to highlight exactly what is sticking out to him and why. It’s likely he knows Velocity learns best in this way, and is teaching her in a similar way to how Nautica seems to have helped her study in medical school. 
Ratchet’s being a good teacher here, and Velocity’s response is heartbreaking, because of course we know she has professional confidence issues-- And she feels she may have missed something potentially clinically significant, which might negatively impact their patient; For example, did her lack of knowledge earlier then result in a delay in the patient receiving appropriate care? And so on. 
And it’s a very real scene, because nobody is perfect-- Minimise risk as much as possible, go in knowing as much as possible, but really she just doesn’t have a whole lot of experience yet. 
She will learn more, she will become less reliant on to-the-letter reference checking, and will gradually get more comfortable and capable in assessing things independently as she gains experience and internalises the input from her fellow medics.
But of course, nobody is perfect, and it does hurt when there was just something you didn’t know yet, which may have been good to identify earlier if possible at that time. 
With more knowledge and experience, this will happen less and less often. 
We see her gradually get a little better with her bedside manner, and develop a little more skill in addressing patients; 
Both her and Nautica struggle to address Ravage appropriately, for example, but soon after she is corrected it is clear that she gets a better grasp of how to speak to him as her patient and in general. 
Lug/Anode points out that Velocity assumes gender in one case, second set of panels above; A big no-no! 
But I feel like towards the end of Lost Light, Velocity would no longer be as inclined to do such a thing, as her experience with Ravage may have helped her understand better that with a diverse patient cohort comes a greater need for emphasis on respecting patient identity and being more willing to start engaging with a patient without preconceptions or assumptions-- Something that is extremely important for her to learn and internalise all around. 
It is entirely possible that on Caminus, most of her teachers, peers, and patients were likely almost all fellow Camiens, with similar social/cultural backgrounds and concepts of identity within that framework.
So again, it’s all about experience, and I get the sense that Velocity is very much learning and integrating what she is gaining from experience into practice. 
She does need more experience, guidance, and to develop a little more confidence. But she’s come a really long way, and she’s on the right path. <3 
TL;DR I love Velocity and I will never shut up about space robot medics 
Hopefully this was interesting for someone!!! <3 
317 notes · View notes
donnerpartyofone · 2 months
Text
I feel like there's an epidemic of businesses trying to make customers and applicants do free data entry for them and it's driving me crazy.
I have complained many times about how seeing a doctor now involves checking in online, and then entering duplicate information into something else when you check in physically, and then answering duplicate questions once you're actually inside the exam room. Sometimes somebody addresses this in a humane way: "Sorry, we're using a new CMS and we have to do all this stuff from scratch," or "Sorry, we have to use these three different systems and they don't communicate with each other." Last time I went I did all this like research into my past appointments because I never ever remember off the cuff exactly what day I had this or that procedure, and I had every impression that the clinic was dependent on me to have all my medical records memorized...so I got in there and started rattling off information, and the nurse asked "When was your last mammogram?", and I gave her the date, and she looked at her monitor and said, "...yup, there it is!" Like WHAT THE FUCK WAS THAT, IF IT WAS RIGHT IN FRONT OF YOU WHY ARE YOU QUIZZING ME ABOUT THIS, WHY IS THIS A TEST???
I actually asked about redundant check-in procedures on Quora of all places, figuring there had to be a few cantankerous cranks on there who could at least try to explain this to me, but there were absolutely no takers at all. As far as I can see, literally no one knows why this is happening, it's just The Way It Is.
But anyway. Now I'm having this experience with job applications where they request that you upload files for your resume and cover letter in specific formats...and then they direct you to this interface where you are made to transcribe every detail from the resume you just provided by hand, one field at a time. I've been confronted with this insanity when applying for jobs whose wages weren't even worth the mind-numbing exercise of the application process. And actually this is part of my point: Data entry is a JOB. I have had this job. I was paid to examine, reformat, and transcribe data, and upload it to a database for my company to search and cross-reference in the future. If you are an employer and you absolutely require BOTH a pdf of my resume and cover letter that a human being can read and evaluate, AND each piece of data from those documents individually entered into your database for some other form of storage and review, then it is seriously fucking Up to You to pay some wage slave to enter the data. I'm looking for a job. I'm not going to do a job for you for fucking free, in order to become eligible for a job that you might consider paying me for later. Like please don't call me a fucking idiot to my face--or at least, if it's the database part that's the most important thing to you, do not also require me to create a nicely-formatted document containing my history and intentions. Let's just get right to the forced data entry part, let's start this awful relationship from a place of honesty at the very fucking least.
N.B. I realize that there are multiple reasons an employer would do this to a person, ranging from algorithmic candidate-sorting to just having outdated-ass job site shit in place that they don't feel like reviewing or revising. I don't really care why it's happening, I just hate that it is. Recently I tried to apply for some $15/hr part-time job at a local museum that a caveman could do, and I stopped cold when I realized I had to transcribe every detail of the documents I just gave them into this bullshit backend website that looked like it was about a thousand years old. No Thank You. Currently I'm all worked up because I just applied to work at a hip, culty, local theater, and I was shocked that after completing the totally normal application routine, I received an automated email directing me to "complete your profile" as "an important part of the hiring process" on the website of the company they're outsourcing all their HR and billing stuff to. And I go look at the profile thingy, and of course it's just this needlessly complicated interface where I can individually enter each and every piece of information that I just provided in my resume--no more, no less. The theater has exactly two locations and is kind of a niche operation and it is absolutely crazy to me that they think they need to pay for this extra layer of stupidly bloated and redundant "talent acquisition" processing when they're hiring for like two or three basic ass hourly roles where half the question is going to be "have you done this normal shit before" and half will be "can we stand your personality". Nobody needs this garbage at all, least of all ME.
13 notes · View notes
ukrfeminism · 2 years
Text
The NHS is shutting down its gender identity clinic for children after a review found that it failed vulnerable under-18s.
The gender identity service at Tavistock & Portman NHS Foundation Trust has been ordered to close by next spring.
It will be replaced by regional centres at existing children’s hospitals offering more “holistic care” with “strong links to mental health services”.
Tavistock’s Gender Identity Development Service (GIDS) clinic has been accused of rushing children into life-altering treatment on puberty blockers.
The paediatrician Dr Hilary Cass, who is leading a review of the service, issued a series of recommendations today for a radical overhaul of how the NHS treats young people who are questioning their gender identity.
She found that the Tavistock clinic was “not a safe or viable long-term option” and that other mental health issues were “overshadowed” when gender was raised by children referred to the clinic.
Cass, former president of the Royal College of Paediatrics and Child Health, said the existing model of a sole provider for gender services should be scrapped as it failed to meet the holistic needs of distressed and vulnerable teenagers.
She said Tavistock should be replaced by regional centres with an “appropriate multi-professional workforce to enable them to provide an integrated model of care that manages the holistic needs of this population”.
Amid concerns that the clinic fails to take into account wider health problems before putting children on puberty blockers, Cass added: “Staff should maintain a broad clinical perspective in order to embed the care of children and young people with gender uncertainty within a broader child and adolescent health context.”
NHS England, which commissioned Cass to review the service in September 2020, says it will implement her recommendations in full and decommission the Tavistock clinic.
It has announced the launch of two clinics for children with gender dysphoria by next spring, which will bring together multiple doctors from a broad range of specialities.
The first, in London, will be based at Great Ormond Street Hospital and receive specialist mental health support from the South London and Maudsley NHS Foundation Trust.
The second, in the northwest, will be led by a partnership between Alder Hey Children’s NHS Foundation Trust in Liverpool and the Royal Manchester Children’s Hospital.
Cass said these clinics must have “established academic and education functions” to monitor evidence on children who are put on hormone therapy. The Tavistock clinic failed to collect sufficient data on the impact of puberty blockers in under-16s.
She said there was “insufficient evidence” for her to make any firm recommendations around their routine use.
Cass told the NHS to “enrol young people being considered for hormone treatment into a formal research protocol with adequate follow-up into adulthood, with a more immediate focus on the questions regarding puberty blockers”.
The NHS said it would launch clinical trials in partnership with the National Institute for Health and Care Research to follow children on puberty blockers into adulthood. “This will ensure that there is greater transparency for children and their parents/carers around the uncertain clinical benefits and longer-term health impacts surrounding their use,” a spokesman said.
The clinic has been overwhelmed by a sudden increase in referrals, particularly among young girls and children on the autism spectrum. Last year it received more than 5,000 referrals, compared with 250 a decade ago.
Cass’s final report will be published next year. Her interim review published in March found that services had developed without clear rules and that there was a “clinician lottery”, with widely varying approaches to treatment.
She found there was “a lack of agreement, and in many instances a lack of open discussion” about whether unhappiness with gender in adolescence was permanent or temporary. However, last year the Court of Appeal overturned a ruling made by the High Court that children under 16 were unlikely to be able to give informed consent to receiving puberty blockers.
The case was brought against the Tavistock and Portman trust by Keira Bell, 24, who began taking puberty blockers when she was 16 to transition to male before later “detransitioning”.
226 notes · View notes
republicsecurity · 2 months
Text
Are you Ready?
With the positive stimuli reverberating through their consciousness, the recruits marched in disciplined unison towards the classroom.
The recruits, guided by their HUDs, marched in unison toward the classroom, the rhythmic clatter of their armored boots echoing through the sterile corridors. The HUDs deliberately introduced disorientation, recalibrating the recruits' sense of direction and spatial awareness. As they navigated the labyrinthine facility, the digital overlays on their visors flickered with dynamic arrows, constantly changing the perceived layout.
Tumblr media
The recruits found themselves relying entirely on the visual cues provided by the HUD, each step a calculated response to the shifting information. The facility's architecture became an abstract puzzle, the familiar transformed into an enigmatic landscape. The instructors, observing from a distance, monitored the recruits' adaptability to the controlled disorientation, a subtle test of their reliance on the technology that bound them.
The recruits, their armored boots echoing in the clinical corridors, found themselves trapped in a seemingly endless loop of sterile hallways. The HUD, their guiding light, played tricks on their perception, leading them in circles, past familiar points that should have long been left behind.
The architectural monotony of the facility became a psychological challenge, a test of patience and adaptability. A five-minute walk stretched into an elongated 30-minute march, disorienting and perplexing the recruits. The instructors, hidden behind the scenes, observed the recruits' responses through the suit telemetry and AI reports.
Tumblr media
The recruits entered the classroom, their armored boots echoing in unison as they marched to their assigned armrest chairs. Each chair, a sophisticated piece of technology, featured docking ports designed to seamlessly connect with the waste management system of the suits. The chairs, resembling a fusion of ergonomic design and utilitarian efficiency, were the recruits' designated stations for both comfort and maintenance.
As the recruits settled into their chairs, there was a symphony of clicks and hisses as the docking clamps engaged, securing the suits in place. The connection initiated a dual process – the waste management system efficiently extracted bodily waste from the recruits, ensuring hygiene and convenience, while simultaneously replenishing the suits with necessary resources.
The recruits, confined to their armrest chairs, received the subtle yet unmistakable message in their HUD. A glyph, an enigmatic symbol on their visors, indicated that their motor control had been disabled. They found themselves in a state of temporary immobility, unable to stand or move their bodies.
Tumblr media
The instructors entered the room, their armored presence casting an imposing shadow over the recruits. The recruits, though physically restricted, could still move their heads and arms within the confines of their chairs. It was a deliberate imposition, a strategic choice made by the instructors to emphasize control and dependency.
Instructor KO10T addressed the recruits with a measured tone, "Today marks a pivotal moment in your training, as we delve into the intricacies of employing lethal force. This matter was broached prior to your Basic Medical Training, and it warrants reiteration now. By the tenets of the prevailing legal framework, you possess the prerogative to raise objections to this facet of your instruction. The law, in its unwavering language, affords you the right to dissent."
The recruits, their heads slightly turned within their armored restraints, absorbed the words. Instructor 6DG05, stationed nearby, scrutinized the telemetry data, monitoring the recruits' physiological responses to the legal discourse.
Tumblr media
KO10T continued, the atmosphere in the room tense and charged with the weight of the impending instruction.
KO10T: "By law, you retain the right to voice your objection to this particular aspect of your training. However, understand that this objection may impact the both your individual development and your standing within the paramedic corps."
Instructor KO10T continued, acknowledging the unique status of the recruits as conscripts, "Let it be known that, as conscripts, you are safeguarded by the provision that precludes compelling individuals to act against the dictates of their conscience. The machinery of the law respects this fundamental tenet. If any among you harbors objections based on conscientious grounds, now is the moment to articulate them."
Instructor KO10T's voice resonated through the helmets, a blend of authority and a peculiar sort of empathy.
"We'll initiate a playback now, a stark reminder of the gravity of the path you tread. This is no casual matter. Once the video concludes, each of you will have a designated interval to reflect on your choice. This decision, my dear recruits, is the compass that will guide your actions in the field. It is not to be taken lightly."
The HUD flickered, and the recruits were immersed in a grim visual narrative, an unsettling portrayal of the use of deadly force in the line of duty. As the scenes unfolded, each recruit grappled with the weight of their imminent decision, aware that the path ahead demanded a conscious commitment to actions that could not be undone.
Tumblr media
6DG05 monitored the recruits' physiological responses, assessing the impact of the video on their emotional and mental states. The telemetry data displayed a spectrum of reactions — heightened heart rates, increased perspiration, and various neural responses.
"KO10T," 6DG05 called out, "I'm observing diverse reactions. Some are displaying expected stress responses, while others seem more composed. It's intriguing to witness the distinct ways in which their minds grapple with the ethical complexities."
H2U8M's visor dimmed to black, cutting off the visual stimuli, leaving him alone with his thoughts and the voice of Instructor KO10T echoing in his helmet.
"In this designated interval, you are urged to reflect on your choice," KO10T's voice resonated through the confined space of the helmet, creating an intimate connection between the instructor's words and H2U8M's consciousness.
As the silence enveloped him, H2U8M's mind raced through the moral labyrinth that the video had presented. The weight of the decision pressed against the walls of his consciousness. In the solitude within the suit, he grappled with the ethical considerations of employing deadly force.
The distant hum of machinery and the rhythmic sound of his own breath became the backdrop for his contemplation. The stark reality of his role as a tactical paramedic unfolded in his mind — the responsibility to protect, the obligation to save lives, and the potential necessity to wield force.
Tumblr media
The minutes passed, each tick of the clock echoing in the stillness of his thoughts. The neural conditioning, the sensory isolation, and the weight of the decision all converged within the confines of the suit.
Finally, as the designated interval drew to a close, KO10T's voice returned, breaking the silence that had enveloped H2U8M's consciousness. The visor slowly illuminated, revealing the training room once again.
"In front of you is a menu," KO10T's voice accompanied the digital interface. "This is your opportunity to express your consent or objection. Navigate through the options and make your choice."
The menu presented a series of questions and statements, seeking H2U8M's affirmation or dissent. The cursor responded to his mental commands as he moved through the selections. Each click of the cursor felt like a weighted decision, an acknowledgment of the path he was willing to tread in his role as a tactical paramedic.
KO10T's voice guided the process, a constant reminder that this was more than a mere formality. It was a pivotal moment, an assertion of his personal stance in the face of the moral challenges inherent in their line of work.
With each selection, H2U8M felt a sense of agency, a reaffirmation of his autonomy within the confines of the suit. The act of navigating the menu was more than a technical procedure; it was a declaration of his willingness to engage with the complexities of his duty.
As he confirmed his choices, the menu dissolved, and the HUD returned to its standard display.
Tumblr media
The HUD blinked into emptiness, leaving H2U8M in a momentary void. The digital canvas that had been filled with choices and reflections now reverted to a stark blankness. In the absence of prompts, he was left alone with his thoughts, the residue of his decisions lingering in the virtual silence.
Meanwhile, 6DG05 diligently monitored the recruits' responses, the streams of data converging into a comprehensive analysis. As the feedback reached him, he relayed the information to KO10T, the exchange a seamless coordination between instructor and overseer. The report confirmed what they had anticipated – no fundamental rejections, no dissent that would impede the progression of the training.
"KO10T," 6DG05's voice echoed through the communication channels. "All recruits have navigated the menu without fundamental objections. We can proceed with the next phase of training."
The confirmation was met with a measured nod from KO10T. The recruits, their HUDs now darkened, awaited the next set of instructions.
Tumblr media
he HUD burst into life once more, a canvas of digital information painting the next phase of their training. Lessons unfurled across the recruits' visors, delving into the intricacies of the standard rifle used within the paramedic corps. The virtual display detailed the specifications, components, and maintenance protocols of the small arms that would become an extension of their tactical paramedic identity.
In the dimly lit classroom, the recruits were ensconced in the glow of their HUDs, absorbing the wealth of information transmitted directly into their field of vision. The instructor's voice, modulated by the AI to convey a perfect blend of authority and guidance, accompanied the visual feast of knowledge. Each nugget of information etched itself into their minds, forming a mental arsenal to complement the physicality of the suits they wore.
The lesson on small arms unfolded like a meticulously crafted narrative, where the line between weapon and tool blurred in the context of their duties.
Tumblr media
8 notes · View notes
thoughtportal · 3 months
Text
Researchers have previously studied ibogaine as a potential treatment for opioid or cocaine dependence. While the recent study is one of the earliest to investigate ibogaine in relation to PTSD, the psychedelic compounds MDMA and psilocybin are in late-stage trials for PTSD treatment.
Alan Davis, a clinical researcher at Ohio State University who is unaffiliated with the study, tells Nature News that he agrees the data support launching trials to further test ibogaine. However, he says that MDMA and psilocybin may currently be better candidates for veterans’ PTSD treatment. He is not the only researcher looking at the study’s results with caution.
“Although the results have large effect sizes, most psychological studies will show improvement with any intervention,” says Amy Badura Brack, a psychologist at Creighton University who was not involved with the study, to Wired.
Though its results appear promising, the study did have some drawbacks. It was limited to a small sample size, lacking both participant diversity and a placebo arm. Researchers plan to continue monitoring study participants, publish the results and launch future research to better understand ibogaine and TBI treatment. {read}
12 notes · View notes