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lonelypond · 3 years

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Parent Trap, Ch. 10

NicoMaki, Love Live, 3.1K, 10/?

Summary: Maki panics, Eli saves the day, and we have a clash of the grandmothers.

When Moms Attack

Maki rambled, letting anything she was thinking just spill out of her mouth as she navigated unfamiliar streets, actively not looking at Nico. Nico had seemed so tiny, leaning most of her weight on Maki, letting Maki help her up into the Nissan Rogue Sport. Maki had slid into the driver’s seat, while Nico had slumped against the window. Worrying. Terrifying. So Maki kept rambling. “I spent hours driving down from Wisconsin with no problems, but once you hit the city, there’s traffic and people not paying attention and…”

Nico made a murmuring noise.

“Then suddenly you have to remember to stop at traffic lights. It just slows everything down.” A red light. A hasty switch to brakes. And had she missed a turnoff?

“I think we’re almost there. Nico, do you recognize this street?”

No reply.

“Nico?”

Maki turned to her right, Nico had completely fallen against the door, not holding herself up at all. “Non responsive” lit a panic fire in Maki’s brain. “Nico?!?”

No reply. Should Maki go the hospital? Was Nico breathing? Should she have put Nico on a backboard at the scene? Called 911? What could she do now? Had she hurt Nico? Not rambling anymore, now Maki, Maki was breathing, too fast, with no idea what to do next. Who could help...Eli...Eli’s private line was still in her phone.

“Call Doctor Eli Ayase’s Emergency Number.”

###

Her phone. Eli heard the ringtone. Her emergency number. Immediately, she was alert, no longer in a sleepy haze of Nozomi nearness. Her phone would wake up the twins. Now was not a good time for Vik and Teddy to be wandering around.

“Dr. Ayase’s emergency line.” Nozomi’s voice was crisp and efficient. Of course, Nozomi was faster, Nozomi was used to being a doctor’s wife.“...Calm down, Maki, Eli’s right here, what happened to Nico?”

Eli leapt up in a panic, grabbing the phone, falling over Nozomi. “Maki?”

“Nico was in an accident on the set and hit her head and I’m taking her home but she just passed out and now she’d not responding, maybe, and I don’t know what to…”

“Maki, where are you?”

“Driving to Nico’s house. But I’m lost.”

“Pull over…carefully.” Nozomi had gone to get her robe, wrapping it around Eli, “Then take a couple deep, slow breaths and tell me what happened.”

No reply. Eli willed Maki to get off the road safely. Waiting, pacing, Eli counted the steps from the couch to the bedroom door. And back.

After a long pause, Eli heard an exhale, and Maki’s voice, shaking, “I thought Nico might have a minor concussion after her car stunt so I was driving her to her house, but she just passed out. I made a mistake Eli, we should have gone right to the hospital, what if there's damage…”

Time to interrupt the panic attack. “Maki, I’m sure you made the right call on site. Nico didn’t get much sleep last night, she’s been working 18 plus hours a day, she’s probably exhausted, dehydrated, and might have the same upper respiratory bug the twins are developing. So there’s a lot that could be going on, a bad combination, but not lethal. I need you to stay calm. Use your training. How’s her pulse?”

“Fast but steady.” Maki sounded calmer. “I’m taking her to our hospital. Meet me there. I can’t be her doctor, but I’ll get things started.”

“Maki, you know you won’t have any say in her treatment, if she’s unconscious, her family will. We have to call them.”

“Fuck you, Eli. You owe me. I’ll just say we’re married.” Maki sounded like she was crying.

“Maki…”

Sniffling. “Just meet me there.”

Eli had a panic thought, Dia in the car seat listening to all of this, “Where’s Dia?”

“Rin and Hanayo’s.”

“Good.”

Maki was back in control of her voice at least. “Just ask at reception. We’ll be in the family suite.”

The Family Suite. Sometimes Eli forgot exactly how privileged the Nishikinos were. They had what was basically a two bedroom apartment tucked into the hospital for their private use.

“All right, Maki. Just be careful.”

No reply as Maki ended the call.

Eli put the phone down, her forehead against the wall, until Nozomi’s arms wrapped around her waist, Eli turning to meet worried turquoise eyes.

“Apparently, be gay and do crime now means violate medical consent and privacy laws.” Eli couldn’t filter the snark. She liked rules. Rules prevented situations like this.

Nozomi winced. Eli just sounded so stretched. “What’s happening, Elichi? Maki sounded panicky.”

“Maki’s got Nico in a car, passed out, with a maybe concussion.” Eli sighed, “I think it’s more likely exhaustion and dehydration and worry caught up to Nico, but that’s not good either.”

“No.” Nozomi shook her head, “And Teddy was coughing when she came home from school.”

“Fever?”

“Not enough to notice.”

“Vik have any symptoms?” Eli ran a hand through her messy hair, considering a diagnosis and treatment plan for Nico.

“They were kinda quiet, no bragging about Nico or planning for Tokyo.”

“Flu cases have been surging. Better keep both home today.” Eli raised a hand to Nozomi’s cheek, reveling in the softness, “I hate to leave. You’re…”

Nozomi giggled, breaking the moment. “Help Maki and we get our guest room back.”

Eli frowned, “You’re shameless. This is all your fault. I haven’t forgotten.”

“I know.” Nozomi dropped her head, more of an admission of responsibility and guilt than Eli had expected, “We’ll fix this. But first go fix Nico.”

“Yeah.” Eli tilted Nozomi’s head up, making sure Nozomi could see the love in her eyes, “I am sorry to go.”

“Just come back to me.”

“Always.”

From the first kiss to this one, Eli had never been anything but certain Nozomi had been meant to be by her side. 1000 platinum records and screaming sell out crowds wouldn’t have matched even the first clumsy thrill or this avalanche of content and chemistry.

###

For this late an hour, a surprising number of nurses, aides, clerks, security, and doctors were scurrying everywhere when Eli reached the main desk in the Emergency Department. Eli recognized the mood. Maki was in a temper.

“Dr. Ayase!” Amaya Robinson, one of the Emergency Department Managers, hurried up to Eli, “What is going on?”

“Where is Dr. Nishikino?” Had Maki signed Nico in in any way? Or just rushed her somewhere. “And the patient?’”

Robinson moved to let a clerk use the nearest computer, “Dr. Maki Nishikino rushed into the Emergency Department, ignoring triage protocols and the admission clerks, diverted resources in a questionable manner, and has refused to fill out any forms or provide any information about the woman she commandeered a bed for. She referred all questions to you, upon arrival. I can assure you the Board will have many more questions than I do.”

Damn it, Maki, Eli thought. Then she spoke in her best concerned colleague voice, “Amaya, I know this is irregular. Maki called me in at the last minute.” Eli debated how much to share, but if Ms. Robinson had any human sympathy at all, Eli was going to summon it, “She was in a panic. I know I can trust your discretion, but the patient is,” Eli lowered her voice, obviously checking to see if there were eavesdroppers, “Nico Ni. So it’s important we keep this as quiet as possible.”

“Tell Dr. Nishikino that.” No sympathy. Maki’s brusque independence had left her few friends among upper management.

“Have you called either of her parents?”

Amaya shook her head, “I want to be able to sum it all up in one message.”

That could take hours, if Maki kept up a rampage. Time for Eli to get some fluids in Nico and find some way to calm Maki down. “Where is Maki raging now?”

Amaya almost laughed, “Private suite. You remember where that is?”

Eli nodded. After Dia’s birth, Maki had been moved there. “Have there been any tests run?”

“Basic blood work. X ray. Have you contacted next of kin?”

Nico’s mom was so not going to be on board with Maki’s plan to be in charge without being in charge. Eli gritted her teeth and punted, “I’m sure Maki’s done something about that.”

“Good. Dr. Nishikino needs to be a lot less visible and audible on this case.”

Eli nodded, briskly stepping around Amaya, “I’ll take over.”

“I’ll exert some diplomacy in the ER.”

“Thanks. I’m sure Maki wouldn’t have upset her coworkers if she weren’t so worried.” Eli stopped, frowning, “Although that’s no excuse, I know.”

Robinson grimaced, not thrilled at how long this night was going to linger on her to deal with list. “Please, just don’t let this turn into a bigger problem, Dr. Ayase”

That was Eli’s plan. And Maki was a wrecking ball pointed at it. Eli nodded and speedwalked to the elevator.

###

Where was Eli? Maki paced, almost frantic, stopping to make sure Nico was still breathing. Rationally, she knew Eli was right and she wouldn’t have missed anything major, but here, now, in this room, Nico was unconscious in bed, with an IV line, looking so frail. And tiny. Maki couldn’t process how drained Nico looked, how breakable, how…“Nico?”

No response. Where was Eli?

Maki forced herself to breathe. Eli would be here. Eli was making things happen so Nico would be okay. Nico was important to Eli. Maki had had enough faith in Eli to trust her through her fertility trials and pregnancy. Maki remembered when Dia decided to be delivered early, how calm Eli was. Breathe. Trust Eli. Nico would be all right. She was just tired. Maki was tired too. Go sit on the bed in the other half of the suite, take a moment, text Rin about what was going on, find out how Dia’s afternoon had been. Nico wasn’t going anywhere. Walking slowly to the other bed, sitting awkwardly, still watching Nico. Surprised at how heavy she felt, Maki thought maybe she would just lay down for a minute, just until Eli got there. A yawn. Just for a minute. That was better than staring at Nico hard enough to wake her up.

###

Nico heard someone walking. Why was she asleep? Wasn’t Maki talking to her? Maki’s car had been too comfortable, Nico must have fallen asleep. She opened her eyes and jumped to see Eli's face too close, blue eyes worried.

“What the hell, Eli?” Nico shouted, but she didn’t get the volume she expected.

Eli raised a finger to her lips and pointed to an open archway, “Maki’s asleep in there. She’s had a long day.”

“Maki’s had a long day? Nico’s had a long day.” Nico had never been in this room before. Eli had scrubs on. Had Maki taken Nico to the hospital? After the…

“This is ridiculous, Eli. Nico’s fine.” Nico sat up, swinging her legs to the side of the bed, but Eli’s arm blocked her.

“You’re not going anywhere until I see your X-Rays, Nico. And maybe a CAT scan. Your pulse rate is too fast, you’re dehydrated and running a fever, you are not fine.”

“Maki just wanted to kidnap Nico.” Nico pouted, not wanting to admit how that motion had left her.

“Maki...” Eli glanced over her shoulder, “was terrified.”

Nico coughed. It hurt. If Maki was here... “Where’s Dia?”

“Rin and Hanayo.”

“Good.” Nico relaxed just slightly, “I’m not staying Eli. If it’s a concussion, it’s minor, and this hospital is just full of people wanting to stalk Nico and stare.”

“I know, I called your Mom. After we get some fluids and meds in you, I think home is the best place for you. But you need to talk to Maki, Nico. And you need to take it easy.”

Nico shook her head, wincing, “Nico has to finish the video. And then the mini tour starts.”

Eli pushed her glasses up, blue eyes flaring with stubborn, “Nico, your insurance will cover a postponement for medical reasons. If you’ve got the flu that’s been going around the twins’ school, you’re going to feel worse tomorrow. And if you don’t rest, there’s pneumonia to worry about. Your blood work worries me. You need to take better care of yourself.”

“Nico?” Maki’s voice, soft, worried. She was standing in the archway, staring at Nico and Eli.

Eli’s voice was soft, but too serious for Nico to ignore. “Don’t move much. And talk to Maki, Nico. I’m going to go wait for your Mom downstairs.”

Nico nodded at Eli, settling back against the pillows as another wave of tired hit.

Eli gave Maki an encouraging smile and exited the room.

Nico turned to Maki, not happy to be having this conversation here. “You called Eli? Aren’t you a doctor?”

Maki shook her head, suddenly shy, “Not yours.”

“Nico is confused.” But then a rush of adrenaline surged and Nico sat up, hand out, “But not concussion confused.”

Maki sat on the end of Nico’s bed, “I’m your...girlfriend, not your doctor. I don’t want to be your doctor. Doctors don’t date patients.”

“But you kidnapped Nico.”

“You passed out in my car, Nico.” Maki leaned forward, fingers tugging through hair. "I didn't know what to do." She sounded so young.

"You could come closer.” Nico wanted to smooth the strands back into place, soothing Maki.

Maki shook her head, not raising it.

“Maki?” No reply. “I’m glad you didn’t go to the party.”

“Wanted to get OUT but wanted to see you more…” A sigh, “Watching Dia alone was exhausting. And lonely. Since I got pregnant, everybody just treats me like a mom, not a....person. All they talk about is Dia.” Maki glanced up, a smile starting, “You didn’t.”

Nico managed to slide down the bed, hip to hip with Maki. Attraction had heady, hella pull. “Nico wants to know more about Maki.”

The air got heavy, Maki decided to risk the hard question, turning to face Nico,“But what about Dia? Eli says…”

Nico took Maki’s hand, “Maki and Dia are a package deal. Nico wants both.”

Maki let herself just sit there, meeting Nico’s gaze, feeling her worries fade, becoming fascinated by the swirls of sparkling love in the deep ruby crimson. Nico was leaning forward....

A knock...Nico’s eyes closed and frustration edged her voice, “Go away, Eli.”

But the door opened and Maki’s mother stepped through, still in her coat. “Here you are, Maki. I want to talk to you.”

“Mama, not now.”

“Yes, now, Maki…you didn’t tell me you were coming back into town, I had to find out from security you’d smuggled...Yazawa in here, I want to know what’s going on. And where’s Dia?”

Was everyone going to ask Maki that? Like she'd forget her child somewhere.

“Rin’s.”

“Good. There’s no need for her to be any further involved with Yazawa and her fans.” Maki’s mother turned on Nico, who was processing the family resemblances, “Please keep my family out of your...harem.”

Maki hissed. Nico nearly jumped off the bed, the IV stand rattling with her movement.

“You’re embarrassing me, Mama.”

Dr. Nishikino shrugged, “This isn’t the first fleeting celebrity crush anybody’s ever had. Easily forgotten in a week.”

“I’m not a teenager with a crush.”

Nico winced at how sullen Maki sounded. She was not dealing with this well, not making eye contact with anyone. Nico reached out a hand, laying it on top of Maki’s, willing reassurance into the contact. They could do this together.

“Nico!!!” Nico’s mother barrelled into the room, no Eli in sight. “Are you all right?” Mrs. Yazawa rushed to her daughter’s bedside, pushing aside Maki's mother, her hand raising Nico’s chin so she could get a good look at her daughter’s face, “Eli is right. You are exhausted. You should stay here.”

“I’m going home, Mama.” Nico said quietly.

“Nico…” Maki started, to be interrupted by her own mother.

“I agree with Yazawa, the hospital is far too public. I want the Nico Ni social media circus far away from my daughter and granddaughter.”

Nico’s mother switched her attention to Maki, her questions sharp, her eyes suspicious. “Where’s Dia? With your nanny?”

“Mama…” Nico whined. Maki might have smiled at Nico’s pouty cuteness but the tension in the room was near exploding.

“It is none of anyone’s business where my granddaughter is…”

“Family belongs with family...”

“Mama.” Nico grabbed her mother’s arm, “let Nico handle this.”

Maki was rocking, chewing on her lip, finally raising her head to glare at her mother, “None of this concerns you, Mama.”

“Maki, you are obviously…”

“Obviously what?” Maki had snapped, “Responsible for my own life and child? Not wanting interference from anyone? Tired of being told what to do for the Nishikino brand?”

And then there was Eli, clapping her hands, the loud noise startling the room into silence, “That’s enough. Nishikinos out. Now.” Eli held the door open, her determination stilling the room.

“Your intervention is not appreciated, Dr. Ayase.” Dr. Nishikino the elder frowned. “I will remember this.”

“Nico is my patient. You have no rights here.” Eli’s smile was icily polite.

“Nico…” Maki had Nico’s hand again.

“It’s okay, Maki. Mama’s going to take me home and you’re going to check on Dia. And then,” Nico deliberately held the very hostile gaze of Maki’s mother, “You’re going to come stay at Nico’s house for as long as you want. I’ll text you the security code.”

"Really?" Hope surged as Nico looked at Maki.

"If it's what you want." Nico tugged Maki forward, leaning up for a quick, awkward kiss, fingers sweeping Maki’s cheek. They smiled at each other, a moment anchored in their growing bond, a calm in this crazy day. “See you soon.”

Maki nodded, then rushed by Eli, not looking at Nico’s mother. When she got to hers, she stopped, hand on her mother’s elbow “C’mon Mama. Let Nico rest.”

“We’re not done discussing this, Maki.”

“I know.” And Maki steered her mother out of the room.

Mrs. Yazawa closed the door after the Nishikinos, frowning. “Is that really wise, Nico? Inviting her to stay with you?”

“Mama, just let Eli unlock and unplug Nico and we’ll go home. You can list what Nico should have done on the way.”

Arms crossed, Mrs. Yazawa’s foot kept a brisk pace tapping the floor. “Trust me, I will.”

“Just remember,” Nico flopped back, groaning and wincing dramatically, “Nico’s not well.”

“Well enough to flirt.”

Nico grinned, “Nico’s Dr. Charm, not Dr. Harmed.”

Mrs. Yazawa rolled her eyes at her eldest. Eli giggled.

A/N: Stay safe out there.

#NicoMaki #Nishikino Maki #Yazawa Nico #Nishikino Maki vs. Nico's Mom #parent trap #parenting #fanfic #single parent au #nishikino maki

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rayarmat · 3 years

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A Guide to Outpatient COVID Treatment: Step-By-Step Doctors’ Plan That Could Save Your Life

Recently, Dr. Peter McCullough, MD, of Baylor University Medical Center in Dallas testified to Texas Senate HHS Committee about how mass media and even some government agencies are silencing clinical outpatient evidence for effective treatment of COVID19 and instead push vaccines only (video shown below).

Treatments like those mentioned by Dr. McCullough can be found in sites like https://c19early.com/ but specifically, McCullough refers to the following Appendix to a document published by Association of American Physicians and Surgeons (AAPSonline.org) as an educational resource. It is based on a paper published in American Journal of Medicine (link), by Dr. Peter McCullough and 22 other clinicians (MDs) and researchers (PhDs).

“Seek early treatment and be your own advocate. All of the physicians contributing to this booklet are on the frontlines treating outpatients at the first signs of COVID illness. Studies in the US and many other countries clearly show that patients who are treated within the first 5 days of symptoms have better outcomes using the combination of medications in the algorithm below.”

COVID-19 hospitalizations and death can be reduced with outpatient treatment.

Principles of COVID-19 outpatient care include: 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, 4) antiplatelet/antithrombotic therapy 5) administration of oxygen, monitoring, and telemedicine.

“For the ambulatory patient with recognized early signs and symptoms of COVID-19, often with nasal real-time reverse transcription or oral antigen testing pending, the following 4 principles could be deployed in a layered and escalating manner depending on clinical manifestations of COVID-19-like illness and confirmed infection: 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, and 4) antiplatelet/antithrombotic therapy. Because the results of testing could take up to a week to return, treatment can be started before the results are known. For patients with cardinal features of the syndrome (ie, fever, body aches, nasal congestion, loss of taste and smell, etc.) and suspected false-negative testing, treatment can be the same as those with confirmed COVID-19. Future randomized trials are expected to confirm, reject, refine, and expand these principles. In this article, they are set forth in emergency response to the growing pandemic as shown in Figure 1 .

Treatment algorithm for COVID-19-like and confirmed COVID-19 illness in ambulatory patients at home in self-quarantine. BMI = body mass index; CKD = chronic kidney disease; CVD = cardiovascular disease; DM = diabetes mellitus; Dz = disease; HCQ = hydroxychloroquine; Mgt = management; O2 = oxygen; Ox = oximetry; Yr = year.

The basic groups of prescription medicines and other therapies used in COVID-19:

▪ Combination anti-viral medicines started as soon as symptoms occur ▪ Medicines to decrease inflammation, such as corticosteroids (called immunomodulators)

▪ Anticoagulant therapy to prevent blood-clots that can cause strokes, heart attacks, kidney shut-down, and death.

▪ Non-prescription supportive treatments with zinc, vitamin D, vitamin C, electrolyte drinks such as Pedialyte, and others.

▪ Home-based oxygen support, such as with an oxygen concentrator. These machines are available by physician prescription from home health medical supply businesses and are covered on most medical insurance plans.

I. Antiviral Agents:

These must be started quickly at STAGE I (Days 1-5):

Symptoms include sore throat, nasal stuffiness, fatigue, headaches, body aches, loss of taste and/or smell, loss of appetite, nausea, diarrhea, fever.

These medicines stop the virus from (1) entering the cells and (2) from multiplying once inside the cells, and they reduce bacterial invasion in the sinuses and lung:

▪ *Hydroxychloroquine (HCQ) with azithromycin (AZM) or doxycycline

▪ Ivermectin with azithromycin (AZM) or doxycycline

Either combination above must also include zinc sulfate or gluconate, plus supplemental vitamin D, and vitamin C. Some doctors also recommend adding a B complex vitamin.

Zinc is critical. It helps block the virus from multiplying.

Hydroxychloroquine is the carrier taking zinc INTO the cells to do its job.

An educational resource from The Association of American Physicians and Surgeons (AAPSonline.org) 16

II. Anti-inflammatory Agents - Corticosteroids (“steroids”): Oral and Nebulized.

These are started at STAGE II (Days 3-14) to reduce inflammation, the cause of added damage to the lungs and critical organs. Symptoms include worsening cough, difficulty breathing, chest heaviness/tightness or chest pain.

As inflammation damages the airways interfering with normal oxygen-carbon dioxide exchange, blood oxygen levels drop and people experience loss of focus, drowsiness, confusion, difficulty concentrating, low energy and severe fatigue.

The exaggerated Inflammation response in COVID further increases the risk of blood clots.

Prescription medicines and other support added now to Stage I medicines are: ▪ nebulized budesonide to help penetrate the lungs and reduce inflammation ▪ oral prednisone, methylprednisolone, dexamethasone

▪ colchicine – may also be added to reduce inflammation

▪ full strength adult aspirin 325 mg to reduce inflammation and risk of blood clots ▪ home oxygen concentrator may be needed to improve oxygen levels (requires physician prescription)

III. Prescription Anticoagulants (“blood thinners”):

STAGE III (Day 7 and beyond): Symptoms seen in Stage II intensify. Difficulty breathing becomes extreme, oxygen levels drop sharply, risk of heart attack or stroke increases. At this point, people are critically ill.

The medicines to be added to Stage I and II medicines now include:

▪ Aspirin 325 mg unless told not to take by your doctors

▪ And/or low molecular weight heparin injections (e.g. enoxaparin [Lovenox]) OR

▪ apixaban (Eliquis), or rivaroxaban (Xarelto), or dabigatran (Pradaxa) or

edoxaban (Savaysa) in standard doses for 5 to 30 days

If these added steps do not lead to improvement, or the patient becomes unstable, a 911 call is warranted for ER evaluation and hospital admission so that more aggressive IV medications (such as remdesivir, Regeneron, and others) may be considered, and more intensive ventilation regimens are possible in ICU settings.

IV. Vitamins, Supplements, and Oxygen.

▪ Zinc sulfate, gluconate or citrate. These forms are available in pharmacies, health food stores, and sold online. Zinc sulfate 220 mg provides 50 mg elemental zinc, the recommended anti-viral dose. Zinc in the form of zinc picolinate form is not recommended following reports of liver damage and tumors from studies about 20 years ago. Following these reports, the German Commission E that regulates supplements used in medical practice in Germany banned this form of zinc.

An educational resource from The Association of American Physicians and Surgeons (AAPSonline.org) 17

▪ Vitamin D3, preferable in oil in capsules for better absorption. Recommended doses for anti-viral benefit vary from 5000 IU or more for 5-30 days

▪ Vitamin C with bioflavonoids for antioxidant, anti-inflammatory effects. Dose

recommendations from our contributors vary from 1000 mg (1 gram) once or twice a day up to 4 or more times a day.

▪ A word about quercetin. Some physicians are recommending this supplement to reduce viral illnesses because quercetin acts as a zinc ionophore to improve zinc

uptake into cells. It is much less potent than HCQ as a zinc transporter, and it does

not reach high concentrations in lung cells that HCQ does. Quercetin may help

reduce risk of viral illness if you are basically healthy. But it is not potent enough to replace HCQ for treatment of COVID once you have symptoms, and it does not

adequately get into lung tissue unless you take massive doses (3-5 grams a day),

which cause significant GI side effects such as diarrhea.

Control of Contagion

A major goal of self-quarantine is the control of contagion. Many sources of information suggest the main place of viral transmission occurs in the home. Facial covering for all contacts within the home as well as frequent use of hand sanitizer and hand washing is mandatory. Sterilizing surfaces such as countertops, door handles, phones, and other devices is advised. When possible, other close contacts can move out of the domicile and temporarily stay with others not ill with SARS-CoV-2. Findings from multiple studies indicate that policies concerning control of the spread of SARS-CoV-2 are effective and extension into the home as the most frequent site of viral transfer is paramount.

Reduction of Self-Reinoculation

It is well-recognized that COVID-19 exists outside the human body in a bioaerosol of airborne particles and droplets. Because exhaled air in an infected person is considered to be “loaded” with inoculum, each exhalation and inhalation is effectively reinoculation. In patients who are hospitalized, negative pressure is applied to the room air largely to reduce spread outside of the room. We propose that fresh air could reduce reinoculation and potentially reduce the severity of illness and possibly reduce household spread during quarantine. This calls for open windows, fans for aeration, or spending long periods of time outdoors away from others with no face covering to disperse and not reinhale the viral bioaerosol.

Combination Antiviral Therapy

Rapid and amplified viral replication is the hallmark of most acute viral infections. By reducing the rate, quantity, or duration of viral replication, the degree of direct viral injury to the respiratory epithelium, vasculature, and organs may be lessened. Additionally, secondary processes that depend on viral stimulation, including the activation of inflammatory cells, cytokines, and coagulation, could potentially be lessened if viral replication is attenuated. Because no form of readily available medication has been designed specifically to inhibit SARS-CoV-2 replication, 2 or more of the nonspecific agents listed here can be entertained. None of the approaches listed have specific regulatory approved advertising labels for their manufacturers; thus all would be appropriately considered acceptable “off-label” use.

Zinc Lozenges and Zinc Sulfate

Zinc is a known inhibitor of coronavirus replication. Clinical trials of zinc lozenges in the common cold have demonstrated modest reductions in the duration and or severity of symptoms. By extension, this readily available nontoxic therapy could be deployed at the first signs of COVID-19. Zinc lozenges can be administered 5 times a day for up to 5 days and extended if needed if symptoms persist. The amount of elemental zinc lozenges is <25% of that in a single 220-mg zinc sulfate daily tablet. This dose of zinc sulfate has been effectively used in combination with antimalarials in early treatment of high-risk outpatients with COVID-19.

Antimalarials

Hydroxychloroquine (HCQ) is an antimalarial/anti-inflammatory drug that impairs endosomal transfer of virions within human cells. HCQ is also a zinc ionophore that conveys zinc intracellularly to block the SARS-CoV-2 RNA-dependent RNA polymerase, which is the core enzyme of the virus replication. The currently completed retrospective studies and randomized trials have generally shown these findings: 1) when started late in the hospital course and for short durations of time, antimalarials appear to be ineffective, 2) when started earlier in the hospital course, for progressively longer durations and in outpatients, antimalarials may reduce the progression of disease, prevent hospitalization, and are associated with reduced mortality. In a retrospective inpatient study of 2541 patients hospitalized with COVID-19, therapy associated with an adjusted reduction in mortality was HCQ alone (hazard ratio [HR] = 0.34, 95% confidence interval [CI] 0.25-0.46, P <0.001) and HCQ with azithromycin (HR = 0.29, 95% CI 0.22-0.40, P <0.001). HCQ was approved by the US Food and Drug Administration in 1955, has been used by hundreds of millions of people worldwide since then, is sold over the counter in many countries, and has a well-characterized safety profile that should not raise undue alarm. Although asymptomatic QT prolongation is a well-recognized and infrequent (<1%) complication of HCQ, it is possible that in the setting of acute illness symptomatic arrhythmias could develop. Data safety and monitoring boards have not declared safety concerns in any clinical trial published to date. Rare patients with a personal or family history of prolonged QT syndrome and those on additional QT prolonging, contraindicated drugs (eg, dofetilide, sotalol) should be treated with caution and a plan to monitor the QTc in the ambulatory setting. A typical HCQ regimen is 200 mg bid for 5 days and extended to 30 days for continued symptoms. A minimal sufficient dose of HCQ should be used, because in excessive doses the drug can interfere with early immune response to the virus.

Azithromycin

Azithromycin is a commonly used macrolide antibiotic that has antiviral properties mainly attributed to reduced endosomal transfer of virions as well as established anti-inflammatory effects. It has been commonly used in COVID-19 studies initially based on French reports demonstrating markedly reduced durations of viral shedding, fewer hospitalizations, and reduced mortality combination with HCQ as compared to those untreated. In the large inpatient study (n = 2451) discussed previously, those who received azithromycin alone had an adjusted HR for mortality of 1.05, 95% CI 0.68-1.62, and P = 0.83.23 The combination of HCQ and azithromycin has been used as standard of care in other contexts as a standard of care in more than 300,000 older adults with multiple comorbidities. This agent is well-tolerated and like HCQ can prolong the QTc in <1% of patients. The same safety precautions for HCQ listed previously could be extended to azithromycin with or without HCQ. Azithromycin provides additional coverage of bacterial upper respiratory pathogens that could potentially play a role in concurrent or secondary infection. Thus, this agent can serve as a safety net for patients with COVID-19 against clinical failure of the bacterial component of community-acquired pneumonia. The same safety precautions for HCQ could be extended to azithromycin with or without HCQ. Because both HCQ and azithromycin have small but potentially additive risks of QTc prolongation, patients with known or suspected arrhythmias or taking contraindicated medications or should have more thorough workup (eg, review of baseline electrocardiogram, imaging studies, etc.) before receiving these 2 together. One of many dosing schemes is 250 mg po bid for 5 days and may extend to 30 days for persistent symptoms or evidence of bacterial superinfection.

Doxycycline

Doxycycline is another common antibiotic with multiple intracellular effects that may reduce viral replication, cellular damage, and expression of inflammatory factors. This drug has no effect on cardiac conduction and has the main caveat of gastrointestinal upset and esophagitis. As with azithromycin, doxycycline has the advantage of offering antibacterial coverage for superimposed bacterial infection in the upper respiratory tract. Doxycycline has a high degree of activity against many common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, anaerobes such as Bacteroides and anaerobic/microaerophilic streptococci and atypical agents like Legionella, Mycoplasma pneumoniae, and Chlamydia pneumoniae. One of many dosing schemes is 200 mg po followed by 100 mg po bid for 5 days and may extend to 30 days for persistent symptoms or evidence of bacterial superinfection. Doxycycline may be useful with HCQ for patients in whom the HCQ-azithromycin combination is not desired.

Favipiravir

Favipiravir, an oral selective inhibitor of RNA-dependent RNA polymerase, is approved for ambulatory use in COVID-19 in Russia, India, and other countries outside of the United States.35 It has been previously used for treatment of some life-threatening infections such as Ebola virus, Lassa virus, and rabies. Its therapeutic efficacy has been proven in these diseases. Like, the antimalarials and antibiotics, favipiravir has no large-scale randomized trials completed at this time, given the short time frame of the pandemic. A dose administration could be 1600 mg po bid on day 1, following by 600 mg po bid for 14 days.

Immunomodulators

The manifestations of COVID-19 that prompt hospitalization and that may well lead to multiorgan system failure are attributed to a cytokine storm. The characteristic profile of a patient acutely ill with COVID-19 includes leukocytosis with a relative neutropenia. These patients have higher serum level of cytokines (ie, TNF-α, IFN-γ, IL-1β, IL-2, IL-4, IL-6, and IL-10) and C-reactive protein than control individuals. Among patients with COVID-19, serum IL-6 and IL-10 levels appear even more elevated in the critically ill. As with any acute inflammatory state, early treatment with immunomodulators is expected to impart greater benefit. In COVID-19, some of the first respiratory findings are nasal congestion, cough, and wheezing. These features are due to excess inflammation and cytokine activation. Early use of corticosteroids is a rational intervention for patients with COVID-19 with these features as they would be in acute asthma or reactive airways disease. The RECOVERY trial randomized 6425 hospitalized patients with COVID-19 in a 2:1 ratio to dexamethasone 6 mg po/IV daily for up to 10 days and found dexamethasone reduced mortality (HR = 0.65, 95% CI 0.51-0.82, P <0.001). One potential dosing scheme for outpatients starting on day 5 or the onset of respiratory symptoms is prednisone 1 mg/kg given daily for 5 days with or without a subsequent taper.

Colchicine

Colchicine is a nonsteroidal antimitotic drug that blocks metaphase by binding to the ends of microtubules to prevent the elongation of the microtubule polymer. This agent has proven useful in gout and idiopathic recurrent pericarditis. The GRECCO-19 randomized open-label trial in 105 hospitalized patients with COVID-19 found that colchicine was associated with a reduction in D-dimer levels and improved clinical outcomes. The clinical primary end point (2-point change in World Health Organization ordinal scale) occurred in 14.0% in the control group (7 of 50 patients) and 1.8% in the colchicine group (1 of 55 patients) (odds ratio, 0.11; 95% CI, 0.01-0.96; P = 0.02). Because the short-term safety profile is well understood, it is reasonable to consider this agent along with corticosteroids in an attempt to reduce the effects of cytokine storm. A dosing scheme of 1.2 mg po, followed by 0.6 mg po bid for 3 weeks can be considered.

Antiplatelet Agents and Antithrombotics

Multiple studies have described increased rates of pathological macro- and micro-thrombosis. Patients with COVID-19 have described chest heaviness associated with desaturation that suggests the possibility of pulmonary thrombosis. Multiple reports have described elevated D-dimer levels in acutely ill patients with COVID-19, which has been consistently associated with increased risk of deep venous thrombosis and pulmonary embolism. Necropsy studies have described pulmonary microthrombosis in COVID-19. These observations support the notion that endothelial injury and thrombosis play a role oxygen desaturation, a cardinal reason for hospitalization and supportive care. Based on this pathophysiologic rationale, aspirin 81 mg daily can be administered as an initial antiplatelet and anti-inflammatory agent. Ambulatory patients can be additionally treated with subcutaneous low-molecular-weight heparin or with short-acting novel anticoagulant drugs in dosing schemes similar to those use in outpatient thromboprophylaxis. In a retrospective study of 2773 inpatients with COVID-19, 28% received anticoagulant therapy within 2 days of admission, and despite being used in more severe cases, anticoagulant administration was associated with a reduction in mortality (HR = 0.86 per day of therapy, 95% CI: 0.82-0.89; P <0.001). Additional supportive data on the use anticoagulants reducing mortality has been reported in hospitalized patients with elevated D-dimer levels and higher comorbidity scores.53 Many acutely ill outpatients also have general indications for venous thromboembolism prophylaxis applicable to COVID-19.

Delivery of Oxygen and Monitoring

Because ambulatory centers and clinics have been reticent to have face-to-face visits with patients with COVID-19, telemedicine is a reasonable platform for monitoring. Clinical impressions can be gained with audio and video interviews by the physician with the patient. Supplemental information, including vital signs and symptoms, will be important to guide the physician. A significant component of safe outpatient management is maintenance of arterial oxygen saturation on room air or prescribed home oxygen under direct supervision by daily telemedicine with escalation to hospitalization for assisted ventilation if needed. Self-proning could be entertained for confident patients with good at-home monitoring.

Many of the measures discussed in this article could be extended to seniors in COVID-19 treatment units in nursing homes and other nonhospital settings. This would leave the purposes of hospitalization to the administration of intravenous fluid and parenteral medication, assisted pressure or mechanical ventilation, and advanced mechanical circulatory support.”

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This is the group’s statement on vaccines:

“Vaccines in Development:

Several vaccine models are being investigated for SARS-CoV-2 (COVID-19) including DNA and RNA vaccines. These vaccines take genetic information from other sources that is introduced into the cells. This information includes instructions to produce a SARS2-like viral antigen itself, and the immune system then reacts to it to develop immunity to the virus.

The most important consideration before approving a vaccine for human use is to make sure that the vaccine is safe and effective. Developing safe and controlled infection models for humans normally takes many years of phased testing in the lab and then in humans. Many physicians and scientists have been concerned that vaccine manufacturers, with government support, are speeding up this process in ways that are not allowing adequate time for the usual phased testing leading up to human clinical trials. Two vaccine manufacturers already have voluntarily paused their clinical trials in people due to serious adverse events.

Currently, there are no RNA-based vaccines approved for human use so it would seem prudent to take the time needed to ensure safety. Vaccines for RNA viruses are notoriously challenging and difficult to develop. We still, after all these years since AIDS emerged in the 1980s, do not have a vaccine for the AIDS virus, or the SARS-1 coronavirus that emerged in 2002-2003, and both are RNA viruses.

Several attempts have been made to create vaccines for coronavirus and other respiratory viruses but none of the vaccines have survived the testing phases. The vaccine trials for SARS-1 from 2003, for example, was shut down because it produced autoimmune hypersensitivity reactions when exposed to the natural virus after immunization in animal studies.

Another problem is that the SARS-2 virus has already shown many mutations. Viruses adapt to the environment to survive. Like the flu virus, it is difficult to predict what mutations will occur and circulate around the world each season. A new vaccine must be reformulated to adjust to the changing genetic makeup of the SARS-2 virus.

Even the best vaccines for flu are only about 30-60% effective. Compare that with an effectiveness for improvement ranging from 64% to more than 90% in more than 100 new studies showing early, outpatient treatment with our existing medications described in chapters.

As research on the vaccine continues, safety and effectiveness are of primary concern. The good news is there are very safe and effective early treatments already available as we described in Chapter 3. Clearly, early, home-based treatment has now been so successful and offers so much hope, there is less urgency to have a vaccine.”

You can sign up to receive the full protocol here: https://aapsonline.org/covidpatientguide/ or find the research paper here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410805/

#coronavirus #medicine #pandemic #virus #ivermectin tablets

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pailbook5 · 3 years

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Preparation And Structure Control Everything About Loft Conversions.

The Builders' Conference

Content

Homebuilding & Remodeling Magazine Feb 2021 Save ₤ 1000s + Improvement Handbook.

Friendly, Professional Solution.

Steven Sarjant Local Builders, Creswell.

Expert Certification.

Where we are currently constructing stunning brand-new residences for individuals like you. You will normally need to make an application for planning consent, which is presently ₤ 462 if accepted at the initial chance. Costs for structure policy applications as well as inspections can cost up to ₤ 1,000, while there can be other prices for site studies and structural engineer records, which can be around ₤ 500 each. The majority of the prices involved in developing a brand-new home will remain in its building and construction. The superstructure will certainly use up the bulk of the expenses - occasionally around 30% of the total develop price. Block and also block is normally the cheapest technique of building - if making use of lumber frame instead, the cost can be increased by around 50%.

In August 2015 the Greater London Authority also developed a pan-London Register to support its own preparation and also housing tasks. Regardless of these motivating facts as well as its development potential, we know that the dimension of the UK exclusive homebuilding sector is very little when contrasted to our European neighbors where concerning fifty percent of all residences are constructed in this manner. In Germany, for instance, about 60 percent of all homes are acquired by personal homebuilders. Around 1 million individuals in the UK claim they intend to start building their brand-new residence in the following year. Almost all councils have established Registers with numerous having numerous people looking for chances to construct.

Homebuilding & Restoring Magazine Feb 2021 Save ₤ 1000s + Improvement Handbook.

If you 'd battle to pay for this, visit your regional Person's Advice and inquire about looking for the Chartered Land surveyor's Voluntary Solution. The House Top Quality Mark has been developed to serve the UK's house builders as well as the homeowners who purchase and rent out new homes. Prior to you can build your residence you require to get approval from the council in the form of intending approval and a building warrant. The building industry, especially housebuilding, has made out terribly throughout every economic downturn because the massive development of small housebuilding firms in the inter-war duration. The economic downturn, brought structure levels to their lowest because the 1920's and also bring about the loss of 250,000 work.

Builders' Conference members are encouraged to join up to this resource of details to keep them abreast of all things in the heavy plant field.

Amongst his victims was a doctor that feared her home would certainly collapse when splits showed up in the wall surfaces and also an expectant woman's residence who had her central heating boiler ripped out by the accused however he never ever returned.

Hayel, of from Marguerites Method, St Fagans, admitted two matters of taking part in a deceitful business and was punished to 2 years and also 3 months jail time this year.

Personal privacy Noticeexplains a lot more about exactly how we use your data, and also your rights.

We are proposing to build 20 new council residences throughout Budoch Court. No existing houses will certainly be destroyed, nonetheless one of the garage locations will certainly be affected. We have actually recognized the chance to give solitary storey roofing expansions to the existing buildings. The location determined for new real estate is currently a car parking lot. https://shipston-on-stour.sebastianchurchbuilders.co.uk/ has been picked to minimise disturbance to locals.

Friendly, Expert Service.

The federal government is also offering a variety of various other funding sources to support councils, boost services, and also establish local economies, such as the new funding for domestic abuse obligations pointed out over. Allow's talk specifically concerning one of the extra recent funding opportunities, the Home Building Fund consisting of ₤ 3 billion towards real estate growths as well as infrastructure. ₤ 1 billion of which has actually been allocated for smaller builders to supply 25,000 new houses by 2020. , largely for bigger advancements, we have a look at what other funds are offered to increase the variety of new residences being constructed in England, particularly for smaller sized builders. Working in close partnership with local authorities, private sector funders and landowners and also signed up providers, we deliver countless much needed brand-new residences throughout the nation every year. At Gardner Close, Pocket Living will certainly be developing a car-free, small block of 20 devices. find a builder dunchurch will be around 38 square meters in complete as well as run out than 2 owners.

The new residences will be developed by an acclaimed designer to make sure the structure fits in well with the city. Any type of new construct proposition on the estate will certainly need to think about the demand for car park for existing estate locals. The design groups will be considering existing car park arrangements and also how these can be enhanced. The Preparation Authority will always think about the effect on vehicle parking of any proposition for constructing new residences. Many of individuals on the Real estate Register are currently residing in temporary lodging.

Steven Sarjant Local Builders, Creswell.

We acknowledge that the intro of new housing will need to supply broader advantages to existing citizens. The panel will play an independent, advising duty in the programme of new council housing shipment, to guarantee it is of the highest feasible design quality as well as meets the needs of local citizens. HBM runs a collection of events during the year for which HBF participants benefit from price cuts of as much as 25%. Events include the economic sector house building industry's leading meeting, Housing Market Intelligence, and also the prominent Housebuilder Awards. Discount rates are additionally used to HBF members on registrations to the annual Real estate Market Intelligence report. This gives us the expertise to supply absolutely combined tenure and integrated communities.

Do you need planning permission for a loft conversion?

Planning permission is not normally required. A loft conversion for your house is considered to be permitted development, not requiring an application for planning permission, subject to the following limits and conditions: A volume allowance of 40 cubic metres additional roof space for terraced houses*

The UK federal government has actually designated a fund of ₤ 3 billion to aid in raising new houses constructed in England, referred to as the Home Builders Fund. Lots of people get a self-build home mortgage; which varies from a standard home mortgage as the funds are released in agreed phases throughout the construct as well as the job is monitored at intervals by the loan provider. If intending approval is granted, we'll select a building specialist to build the residences. To give you a better choice of inexpensive residences, we're dedicated to constructing more than 500 council houses for lease over the next couple of years. You might require to hire a land surveyor or engineer to help you obtain constructing laws authorization or preparation consent.

Professional Certification.

Right now, there are greater than 2,500 homes in momentary accommodation, over 45% of whom were positioned out of district as a result of an absence of appropriate independently leased homes locally. The cost of momentary lodging is ₤ 10.5 million annually, which is unsustainable, particularly in the existing financial climate. The Council has actually safeguarded nearly ₤ 60 numerous moneying to go in the direction of building 600 new council houses. Our Council requires to build more truly inexpensive homes for lease. Affordable family housing is limited in Redbridge, with an average delay of more than 13 years for a three-bedroom house. Greater than 2,500 families presently stay in short-term accommodation, at a price of over ₤ 10.5 million each year. To take on the housing dilemma, our Council intends to develop brand-new, genuinely inexpensive as well as high-grade houses ashore we currently own across the borough.

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It is important that you only embark on any significant project, like constructing your very own house, when you are totally familiar with the range of the work as well as the prices entailed. Allowing yourself a contingency - around 10% of the overall spending plan - is constantly a wise move, to assist you cover any kind of extra costs that might arise as an outcome of hold-ups or concerns with products. As opposed to purchasing a home and also attempting to make it fit what you need, you can start from scratch, and also produce a custom-made house that is excellent from the beginning. We've assembled this guide to brand-new build residence prices so you have some suggestion of cost to construct a home before you employ a new house contractor. The fund is a brief or long term lending that will aid small builders, community builders and custom builders as well as larger developers, with the financing of their construct projects.

Consequently, builders royal-leamington-spa is now focused in less hands and also there has actually been a substantial hollowing out of the building labor force. According to the President of the UK's largest housebuilder, David Thomas of Barratt Advancement, the scarcity of experienced tradespeople is currently "the number one obstacle for housebuilders". HebHomes use a vast array of self develop kit homes to match all homes as well as budget plans, taking you from the selection of your design to your finished desire house. The NaCSBA Research & Advancement Programme is moneyed by the Nationwide Structure and intends to advertise the self-build and customized construct industry as a budget-friendly path right into real estate for a greater number of people in the UK. In the 2014 Budget plan the Federal government announced that it would speak with on a brand-new Right to Develop that would give potential personal homebuilders a right to a council assisted in building story. The least energetic area was London, where just 18 per cent of neighborhood authorities reported certain actions.

Website Builders Market 2020: Potential Growth, Challenges, and Know the Companies List Could Potentially Benefit or Loose out From the Impact of COVID-19 Key Players: Homestead, Yola, Qfuse, Yahoo, Web, etc. InForGrowth - NeighborWebSJ

Posted: Tue, 19 Jan 2021 09:08:00 GMT [source]

#builders near me #builders in london #find a builder #trusted builders #builders merchants near me #reputable builders near me #general builders near me #trusted builders near me #local builders near me #building contractors near me #small builders near me #builders near me checkatrade #recommended local builders #checkatrade builders #local builders merchants

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uk-news-talking-politics · 3 years

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Assisted suicide ‘is the abandonment of care’

By Scott Benton MP

Recent calls for a parliamentary review of assisted suicide prematurely presume that the winds of political and social change are blowing in favour of legalisation. Through heavy focus on hard cases and hardly any coverage of the life-giving merits of palliative care, some proponents of change in Parliament have grandly overstated the problems with the status quo and grossly overestimated the successes of assisted suicide legislation elsewhere. As the most recent government response to a parliamentary urgent question on foreign travel for assisted suicide demonstrates, their demands are far from measured in their misleading comparisons and claims. And as the most recent government reply to a written question on a future review of the law around assisted suicide suggests, those advocating for assisted suicide have far from full support in Westminster and Whitehall. Addressing the secretary of state for health and social care Matt Hancock, Andrew Mitchell suggested that the ‘suffering that the blanket ban on assisted dying is causing dying people and their families […] [and] the challenges that the current law is creating for healthcare professionals, police officers and other public servants...’ would be alleviated by a ‘very tight reform’, effectively resembling the system of assisted suicide available in the American state of Oregon, with the addition of ‘suicide courts’ to pass judgement on who should live or die. Assisted suicide advocates place the Pacific Northwestern state on a pedestal, claiming it has robust regulation and successful safeguards that prove assisted suicide laws work. Yet they conveniently ignore the ways in which the Oregon Death with Dignity Act has been bent and broken since 1997. The rate has skyrocketed by over 1000% from 1998 to 2019, and while almost half of all patients in that period have cited concern about being or becoming a burden on family, friends, and caregivers among their end-of-life worries, only around a quarter were concerned by inadequate pain control. As in the handful of other jurisdictions that have legalised assisted suicide, less than six per cent of countries worldwide, access continues to expand. In Oregon, it is now possible to have your life ended on the basis of ‘terminal’ conditions such as arthritis, diabetes, and complications following a fall. Any proposal that the UK can engineer an Oregon-plus system of assisted suicide with even tighter safeguards ignores that only four per cent of Oregon patients since 1998 have been referred for psychiatric evaluation and almost the same number have suffered complications. Furthermore, complications are only reported when the physician or alternate health care provider is present at the time of death, which has not been the case for 60.5% of deaths since 1998. Most strikingly, the Oregon Health Authority is concerned by the growing number of suicides across all age groups yet unconcerned by the vast increase in assisted suicides over the past two decades. Indeed, a study of suicide rates across the American states that have legalised assisted suicide illustrates that legalisation is associated with an increase in the total suicide rate. While advocacy for assisted suicide claims strong public support, as Christine Jardine suggested during the latest debate, the polling of public support for assisted suicide is hindered by simplistic questions. When more precise issues are presented to the public, the results are more complicated. This was certainly the case in a February 2019 survey when 51% responded that they would be concerned that the legalisation of assisted suicide might cause some people to feel pressurised into accepting lethal medication to avoid burdening others. Other arguments for legalising assisted suicide centre on the present danger of prosecution. Though these claims summon strong emotions around perceived injustice, they misrepresent the reality. Only three cases of possible assistance or encouragement of suicide in England and Wales have resulted in prosecutions since 2009. Prosecution is rare, and serves as an essential safeguard against abuse and exploitation of some of the most vulnerable in our society. The merits of palliative care seldom feature in petitions for assisted suicide legislation. As Danny Kruger highlighted in his contribution during the recent debate, modern medicine can effectively alleviate distressing symptoms associated with the dying process. Rather than sidelining such services as a separate issue, proponents of assisted suicide should instead demand universal access to high-quality palliative care. Notably, 90% of palliative care specialists opposed legalising assisted suicide in the form of the 2015 Marris assisted suicide bill. A recent British Medical Association members’ survey found that 76% of palliative care specialists - those who have the most expertise and experience in caring for the terminally ill at the end of life - oppose any legalisation of assisted suicide, and the same percentage declared that they would be unwilling to participate in any such activity. The terminally ill deserve the best palliative care available. Vulnerable patients who experience suicidal ideation should receive high-quality physical and psychological care that reaffirms their inherent dignity, rather than medical confirmation, here or abroad, of their diminished view of their own life. Matt Hancock himself stated that ‘[t]he global devastation of the coronavirus pandemic has brought to the fore the importance of high-quality palliative care’. Indeed, as the Department of Health and Social Care continues to battle the Covid-19 crisis, it is my hope that investment in hospice care remains high on the agenda. Certainly, the government must respond to the recent survey from Hospice UK which shows an overwhelming 93% of hospice leaders were concerned that their patients with end of life and palliative care needs could miss essential treatment because of stretched resources.

As Fiona Bruce powerfully argued in the Chamber, ‘when the whole country is making huge sacrifices to protect life, at a time of exceptionally high levels of physical and mental stress, and when many people may feel very vulnerable [...] it would be completely inappropriate—indeed, insensitive—of this Parliament to go anywhere near considering making access to any form of suicide easier’. Far too many of our citizens have experienced unprecedented loneliness, uncertainty, and change during this often paralysing pandemic, and introducing assisted suicide would be far too rash a response. Thankfully, the government has resisted the latest round of pressure from assisted suicide advocates. They are not alone in standing firm against an unnecessary and unsafe proposal: Perhaps tellingly, not a single doctors group or major disability rights organisation in the UK supports changing the law, including the British Medical Association, the Royal College of General Practitioners, the Royal College of Physicians, the British Geriatric Society, the Association for Palliative Medicine, Disability Rights UK, SCOPE, United Kingdom’s Disabled People’s Council, and others. Laws send social messages. An assisted dying law, however well intended, would alter society’s attitude towards the elderly, seriously ill, and disabled, suggesting that assisted dying is an option they ‘ought’ to consider.

#Assisted dying #euthanasia

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bagbear8 · 3 years

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Personalized Finance Guidance You May Use Every Day

Figuring out how to handle your finances might be a hard process, particularly with the way the world operates right now. If you're feeling like you need help figuring out how to handle your funds, then you will be in the right spot. This article works as a great place to get began regarding how to handle your finances. Consider utilizing a re-loadable examine greeting card. If the idea of your debit or credit credit cards getting dropped or robbed on your getaway makes you also stressed, you can use re-loadable verify greeting cards. You can find them at most of the retail stores. It really is arguably safer and much easier than hauling close to money. Steer clear of including jobs to dropping trades. Don't permit several burning off transactions to be the start of a bunch of shedding transactions consecutively. It's far better in order to pull out and begin once again at one more time. Simply per day free of forex trading can help you from the funk once you decide to industry again. Be sure to spend less money than you get. It's so easy to put our everyday items on to credit cards because we merely can't afford to pay for it appropriate then but that is the commence to failure. If you can't afford it appropriate then, go without it until you can. Usually buy used automobiles over new and save yourself dollars. The largest devaluation in automobile value takes place throughout the initially 10,000 a long way it really is motivated. Following that the devaluation becomes a lot more slowly. Invest in a car containing these initial a long way into it to acquire a significantly better offer for every bit as good an auto. Always avoid payday cash loans. They can be frauds with incredibly high interest rates and next to impossible pay back conditions. Making use of them can mean needing to set up useful home for home equity, say for example a automobile, which you perfectly may possibly get rid of. Explore each and every method to use unexpected emergency cash well before looking at a pay day loan. In certified credit card are looking to restoration your credit score, make sure to examine your credit score for errors. You could be affected by a charge card company's personal computer error. When you notice an oversight, be sure to get it corrected at the earliest opportunity by composing to all of the main credit bureaus. Spend less than you make. Dwelling even right at the signifies can make you have never cost savings on an emergency or retirement. It indicates never experiencing a payment in advance for your house or paying cash for the vehicle. Become accustomed to living below your indicates and lifestyle without having debts will end up easy. Vouchers that are not offered in the conventional produce media can be found online. When you use coupon codes you may acquire some terrific habits for the great economic position in your life. When someone is not utilizing their outdated books that they can might have from past semesters or years of university these books can be delivered for any good bonus to versions personalized financial situation. This benefit of capital that originated an unused supply might be a good chunk of dollars to conserve apart. Never ever make an effort to lease a flat by yourself should you not use a continuous income source. This can seem to be clear, but there are numerous people who are employed by momentary work organizations plus they look for lease properties. If their contracts conclusion, they are going to struggle to make their month-to-month rent payments repayments. When you visit satisfy a landlord the first time, attire much the same way that you simply would if you are attending a interview. Fundamentally, you will need to make an impression on your landlord, so demonstrating him or her, you are properly created, will undoubtedly offer to ensure they are surprised by you. Use kitchen area scrubbies as substitutes for costly aquarium tank filtration system. Have the smooth fibrous form and make certain they aren't addressed with just about any toxic chemical substances or impregnated with soap. Cut those to how big a classic fish tank filtration and slide them proper down into your pump. They work excellent and help you save plenty of cash! Save just a little cash every single day. This may be as elementary as bypassing your morning hours ingest. A frappuccino may cost $4 that's a little pleasure, proper? Budget modify? Well, that $4 on your journey to job every day charges you spanning a 1000 bucks each year. That can purchase a great vacation. Perform a little research on-line before you make a major acquire. Although you may decide to purchase the object with a neighborhood store, look at the store's web site for website-only coupons or promotions. If you're presently a buyer, don't overlook to examine your mailbox due to the fact some stores send out product sales announcements or coupons by means of e-postal mail. Learn to be picky in what you need to spend money on. Clearly, in the event you pay for anything, you will possess significantly less to enjoy on other items. It may aid to possess a duplicate of your respective spending budget together with you. This can be done on most cell phones. Taking a quick review your budget can help you save from splurging on trivial goods. It will help you feel self-disciplined in how you will spend your restricted resources. If you wish to have the capacity to proficiently manage your personal financial situation something that you should define can be your finances. Not needing a identified budget is like driving a vehicle with no steering wheel. A well identified price range will help you define your priorities with regards to investing. Make a deal your salary to enhance power over your personal financial situation. This is certainly greatest accomplished if you are initial accepted to get a situation, as you will hold the most bargaining power during those times. Negotiating the income you are entitled to indicates more money to repay those obligations, help save in the future, and spend on stuff you want. You should certainly develop a far more optimistic financial situation as you now understand economic control better. There is much more to discover personalized budget, assets, insurance coverage as well as other techniques to save money do more investigation and set up a full plan that will help you manage your money.

#certified credit card

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maximelebled · 4 years

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My quick review of the ASUS XG27UQ monitor (4K, HDR, 120Hz)

I originally wanted to tweet this series of bullet points out but it was getting way too long, so here goes! I got this to replace a PG278Q, which was starting to develop odd white stains, and never had good color reproduction in the first place (TN film drawbacks, very low gamma resulting in excessively bright shadows, under-saturated shadows, etc.)

The hardware aesthetic is alright! The bezels may feel a bit large to some people, but I don’t mind them at all. If you’re a fan of the no-bezel look, you’ll probably hate it. There is a glowing logo on the back that you can customize (Static Cyan is my recommendation), but it isn’t bright enough to be used as bias lighting, which would’ve been nice.

The built-in stand is decent; it comes with a tacky and distracting light projection feature at the bottom. It felt quite stable, though I don’t care about it because it got instantly replaced by an Ergotron LX arm. (I have two now, I really recommend them in spite of their price.)

The coating is a little grainy and this is noticeable on pure colors! You can kinda see the texture come through, a bit more than I’d like. Not a huge deal though.

The rest of the review will be under the cut.

The default color preset (”racing mode”), which the monitor is calibrated against, is very vivid and saturated. It looks great! But it’s inherently inaccurate, which bothers me, so I don’t like it. It looks like as if sRGB got stretched into the expanded gamut of the monitor.

sRGB “emulation” looks very similar to my Dell U2717D, whose sRGB mode is factory-calibrated. However, the XG27UQ’s sRGB mode has lower gamma (brighter shadows), so while the colors are accurate, the gamma is not. It feels 1.8-ish. Unless you were in a bright room, it would be inappropriate for work that needs to have accurate shadows. This mode also locks other controls, so it’s not the most useful, but the brightness is set well on it, so it is usable!

The “User Mode” settings use the calibrated racing mode as a starting point, which is a big relief. So it’s possible to tweak the color temperature and the saturation from there! I checked pure white against my Dell monitor and my smartphone (S9+) and tried to reach a reasonable 3-way compromise between them, knowing that the Dell is most likely the most accurate, and that Samsung also allegedly calibrates their high-end smartphones well. My configuration ended up being R:90/G:95/B:100 + SAT:42. This matches the saturation of the U2717D sRGB mode fairly closely. You also get to choose between 1.8, 2.2, and 2.5 gamma too, which is not too granular, but great to have. It kinda feels like my ideal match is between 2.2 and 2.5, but 2.2 is fine.

The color gamma according to lagom.nl looked fine, but I had to open the picture in Paint, otherwise it was DPI-scaled in the browser, and that messed with the way it works!! (That website is an amazing resource for quick monitor checks.)

Colors are however somewhat inaccurate in this mode. It’s easy to see by comparing the tweaked User Mode vs. sRGB emulation. There are some rather sizeable hue shifts in certain cases. I believe part of this is caused by the saturation tweak not operating properly.

Here’s a photo of what the Photoshop color picker looks like when Saturation is set to 0 on the monitor, vs. what a proper grayscale conversion should be. It’s definitely not using the right coefficients.

So in practice, when using the Racing & User modes, compared to the U2717D sRGB, here’s a few examples of what I see:

Reds are colder (towards the purple side) & oversaturated

Bright yellow (255,215,90) is undersaturated

Bright green (120,200,130) is undersaturated

Dark green (0,105,60) is fine

Magenta (220,13,128) is oversaturated

Dark reds & brown (150,20,20 to 90,15,10) is oversaturated

Cyan (0,180,240) is fine

Pink (230,115,170) is fine

Some shades of bright saturated blue (58,48,220) have the biggest shifts.

The TF2 skin tone becomes slightly desaturated and a bit colder

It’s not inaccurate to the point of being distracting, and you always have the sRGB mode (with flawed gamma?) to check things with, but it’s definitely not ideal, and some of these shifts go far enough that I wouldn’t recommend this monitor for color work that needs to be very accurate.

I’ve went back and forth, User vs sRGB, several times, on my most recent work (True Sight 2019 sequences). I’ve found the differences were acceptable for the most part; they bothered me the most during the Chronosphere sequence, in which the hazy sunset atmosphere turned a bit into to a rose gold tint, which wasn’t unpleasant at all — and looked quite pretty! — but it wasn’t what I did.

I’m coming from the point of view of a “prosumer” who cares about color accuracy, but who ultimately recognizes that this quest is impossible in the face of so many devices out there being inaccurate or misconfigured one way or the other. In the end, my position is more pragmatic, and I feel that you gotta be able to see how your stuff’s gonna look on the devices where it’ll actually be watched. So while I’ve done color grading on a decent-enough sRGB-calibrated monitor, I’ve always checked it against the inaccurate PG278Q, and I’ve done a little bit of compromising to keep my color work looking alright even once gamma shifted. And so, now, I’ll also be getting to see what my colors look like on a monitor that doesn’t quite restrain itself to sRGB gamut properly.

Well, at least, all of that stuff is out of the box, but...

TFTCentral (one of the most trustworthy monitor review websites, in my opinion) has found suspiciously similar shifts. But after calbration, their unit passed with flying colors (pun intended), so if you really care about this sort of stuff and happen to have a colorimeter... you should give it a try!

I hope one day we’ll be able to load and apply an ICC/ICM profile computer-wide, instead of only being able to load a simple gamma curve on the GPU with third-party tools like DisplayCAL. Even if it had to squeeze the gamut a bit...

Also, there are dynamic dimming / auto contrast ratio features which could potentially be useful in limited scenarios if you don’t care about color accuracy and want to maximize brightness. I believe they are forced on for HDR. But you will probably not care at all.

IPS glow is not very present on my unit; less than on my U2717D. However, when it starts to show up (more than a 30°-ish angle away), it shows up more. UPDATED: after some more time with the monitor, I wanna say that, in fact, IPS glow isit's slightly stronger, and shows up sooner (as in, from broader angles). It requires me to sit a greater distance from the monitor in order to not have it show up and impede dark scenes. It is worse than on my U2717D.

Backlight bleed, on the other hand, is there, and a little bit noticeable. On my unit, there’s a little bit of blue-ish bleed on the lower left corner, and some dark-grey-orange bleed for a good third of the upper-left. However, in practice, and to my eyes, it doesn’t bother me, even when I look for it. It ain’t perfect, but I’ve definitely seen worse, especially from ASUS. The photo above was taken at 100% brightness, and I’ve tried to make it just a tad brighter than what my eyes see, so hopefully it’s a decent sample.

Dead pixels: on my unit, I have 5 stuck dead green subpixels overall. There are 4 in a diamond pattern somewhat down and right to the center of the screen, and another one, a bit to the right of that spot. All of them kinda “shimmer” a little bit, in the sense that they become stronger or weaker based on my angle of view. They’re a bummer but I haven’t found them to be a hindrance. Took me a few days to even notice them for the first time, after all.

HDR is just about meaningless and uses some global dimming techniques, as well as stuff that feels like... you know that Intel HD driver feature that brightens the content on the screen, while lowering the panel backlight power in tandem, to save power, but it kinda flattens (and sometimes clips) highlights? It kinda looks like that sometimes. Without local dimming, HDR is just about meaningless.

Unfortunately, the really nice HDR support in computer monitors is still looking like it’s going to be at the very least a year out, and even longer for sub-1000 price ranges. (I was holding out for the PG27UQX at first, but it still has no word on availability, a whole year after being announced, and will probably cost over two grand, so no thanks.)

G-Sync (variable refresh rate) support is... not there yet?! The latest driver does not recognize the monitor as being compatible with the feature. And it turns out that the product page says that G-Sync support is currently being applied for. Huh. I thought they had special chips in those monitors solely for the feature, but it’s possible this one does it another way? (The same way that Freesync monitors do it?)

DSC (Display Stream Compression) enables 4K 120Hz to work through a single DisplayPort cable, without chroma subsampling. And it’s working for me, which came as a surprise, as I was under the impression this feature required a 2000-series Turing GPUs. (I have a 1080 Ti.) I was wrong about this, it’s 144 Hz that requires DSC. And I don’t have it on this Pascal card. But I don’t really care since I prefer to run this monitor at 120 Hz, as it’s a multiple of the 60 Hz monitor next to it.

Windows DPI scaling support is okay now. Apps that are DPI-aware, and the vast majority of them are now, scale back and forth between 150% and 100% really well as they get dragged between the monitors! The only program I’ve had issues with is good old Winamp, which acted as if it was 100% on the XG27UQ... and shrinked down on another monitor. So I asked it to override DPI scaling behaviour (”scaling performed by: application”), which keeps the player skin at 100% on every monitor, but any call to system fonts and UI (Bento skin’s playlist + Settings panel) are still at 150%. So I had to set the playlist font size to 7 for it to look OK on the non-scaled monitor!

A few apps misbehave in interesting ways; TeamSpeak, for example, seen above, scales everything back from 150% to 100%, and there is no blurriness, but the “larger layout” (spacing, etc.) sticks.

Games look great with 4K in 27 inches. Well, I’ve only really tried Dota 2 so far, but man does it get sharp, especially with the game’s FXAA disabled. It was already a toss-up at 1440p, but at 4K I would argue you might as well keep it disabled. However, going from 2560x1440 to 3840x2160 requires some serious horsepower. It may look like a +50% upgrade in pixels, but it’s actually a +125% increase! (3.68 to 8.29 million pixels.) For a 1080 Ti, maxed-out Dota 2 at 1440p 120hz is really trivial, but once you go to 4K, not anymore... you could always lower resolution scale though! (Not an elegant solution if you like to use sharpening filters though, looking at you RDR2.)

Overall, the XG27UQ is a good monitor, and I’m satisfied with my purchase, although slightly disappointed by the strong IPS glow and the few dead subpixels. 7/10

#xg27uq #review #monitors

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onlinemarketinghelp · 4 years

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Finding Recession-Resistant Investments In The Face Of The Coronavirus https://ift.tt/2w14Ney

The coronavirus has presented investors with unprecedented uncertainty.

The global financial markets are still reeling from what WHO has called a pandemic, and the White House has declared a national emergency. Last month, the Dow Jones dropped 10 percent in one day, its largest one-day fall since 1987. The Federal Reserve Bank has even stepped in, injecting $1.5 trillion into the economy. In one month alone, the stock market lost well over 20%.

In light of these events, we thought it was interesting to see impact of the coronavirus on the fine wine market with a great deep-dive with our partners Vinovest. With more people looking for alternative investments, especially recession-resistant investments, let's look into this relatively unknown asset.

If you want to skip the details and learn more, check out Vinovest and see how you can invest in fine wine >>

Quick Navigation

How Does The Coronavirus Affect Fine Wine?

What Makes Fine Wine A Recession-Resistant Investment?

The Economics Of Fine Wine

Fine Wine vs. Gold In Recessions

Long-Term Appreciation In The Face Of Panic

Historical Performance Of Fine Wine

What To Expect From Here

How Does The Coronavirus Affect Fine Wine?

It is natural to wonder how the coronavirus will affect the value of fine wine. After all, equities are cratering under recent financial pressure. With that in mind, it's important to know that fine wine has almost no correlation with the stock market. Even in the most turbulent economic periods, fine wine manages to march on unscathed. Take the Great Recession in 2008. Stock prices plummeted 52 percent as people created a run on the money market funds. The price of fine wine, though? It had a single digit dip of nine percent.

What Makes Fine Wine A Recession-Resistant Investment?

Fine wine is not susceptible to the same market forces as traditional investments, like stocks, bonds, and mutual funds. While supply and demand impact both assets, the similarities disappear quickly after that. The separate sphere of influence is the key to the recession-resistance.

Factors That Influence The Price Of Wine:

Annual Harvest Yield

Consumer Tastes

Reputation

Tariffs

Vintage

Weather

Factors That Influence The Price Of Equities:

Company Earnings

Corporate Management

Dividends

Interest Rates

Political Climate

Barring a cataclysmic natural disaster or shift in consumer tastes, fine wine will remain a reliable investment. Outside factors, like the coronavirus or stock prices, are highly unlikely to influence whether or not someone wants to buy and consume wine. In an interview with Forbes, Silicon Valley Bank Wine Division founder Rob McMillian articulated the sentiment best, saying:

“We have to start the conversation by recognizing that people enjoy wine in good times and stressful times. Wine is not recession-proof, but it is recession-resistant. In the same way, it might not be virus-proof, but it will prove virus-resistant from an economic perspective. There is no chance we will see sweeping abstinence as a consequence of the virus.

Since the Great Recession, there have been several corrections in the stock market, the most recent being the coronavirus. While stock prices fluctuate during these times, the fine wine market tends to stay the same. Fine wine may experience a small decline. That said, there are precedents for price increases. We understand the coronavirus is creating a lot of concern. The cause for concern shouldn’t extend into investment-grade wine, though. It’s why fine wine is one of the few recession-resistant assets that can safeguard investors from the economic storm.

The Economics Of Fine Wine

Again, fine wine does not play by the same rules as traditional equities. For starters, wine has a fixed supply. Once the harvest is over, that is it. A winery cannot produce more wine for that vintage, even if it's a smashing success.

That supply will only decrease with time because investors will drink the wine. Even if the demand remains constant, the scarcity will drive up the price, barring a significant change in one of the factors mentioned above. The growth is buoyed by increasing interest in fine wine consumption from emerging markets, like India and China.

As Rob McMillian suggested, the coronavirus will not diminish people’s interest in wine. While the outbreak is far from ideal, people should not expect to see a meaningful change in consumption habits. The same cannot be said of the stock market.

The coronavirus has created a domino effect through fear, panic, and uncertainty, all things that investors want to avoid. As a result, many people are selling their stocks to minimize their losses or get their money into "safer" investments. As a result, American investors have lost roughly $3 trillion in wealth.

Fine Wine vs. Gold In Recessions

It's worth taking a moment to talk about gold. The odds are that when investors think of "safer" physical assets, they think of gold. That inclination is not without merit. Gold handily outperformed the S&P 500 from December 2007 to June 2009.

Historically, gold has had an inverse relation with the equity market during times of crisis. That correlation, though, is not stagnant. Gold’s recent performance suggests a positive correlation with the stocks, thus weakening its reputation as a risk-hedging investment.

The coronavirus-induced recession is a perfect example. The United States saw the first COVID-19 death on February 29. In the following days, Florida and California declared states of emergency, public and privates closed, and major corporations-imposed travel restrictions on employees. Gold, which had traded at $1,697 per ounce on March 2, fell 11 percent in a week.

There are other examples of gold’s increasing correlation with the stock market. During the 2018 US-China trade war, gold showed a 0.69 correlation, which means almost 50 percent of the variance between two is correlated. Mathematicians would call this value statistically significant. Fine wine, however, had a negative correlation, coming in at -0.55.

Gold is losing its luster as a portfolio diversifier. Its increasing correlation with the equity market fails to protect investors, despite its “safe haven” reputation. Additionally, the price of gold has more than quadrupled since 2000, far outpacing the reasonable demand for the physical product.

Long-Term Appreciation In The Face Of Panic

It is unclear how long the coronavirus will last. China is returning to its new normal after roughly 50 days. All countries, though, are not as well-equipped or proactive when it comes to treating COVID-19.

While the immediate financial world is in upheaval, fine wine is a long-term investment. It is not something people day trade, like stocks, to make marginal capital gains. Investors do not have the pressure of time when selling wine.

That is, in part, because wine gets better with age. All grapes have a compound called tannins. The organic substance is in the seeds, skin, roots, and leaves of the grape. While the quantity of tannins varies based on the grape varietal, they are present in every wine, to some extent.

Tannins have a bitter and astringent taste. Over time, though, they break down, which makes a wine smoother and more balanced. It is one of the reasons why wine producers put so much emphasis on proper and extended aging. To reap the benefits of aging, investors will likely need enough patience to outlast the 2020 flu season.

Historical Performance Of Fine Wine

Predictions are challenging, and the coronavirus only adds more uncertainty to the equation. The best way to understand what the future holds is to look at the past. From 2008 to 2010, in the throes of the global recession, the Liv-ex 1000, which tracks 1,000 wines from across the world, returned a little less than zero.

The same recession-resistant applied abroad. The March Gestion Vini Catana fund, which started in December 2009, invests in wine production and vineyards. Within a year after opening, it was up nine percent compared to a 3.7 percent decline for the FTSE 100. Meanwhile, the average hedge fund at this time was down 0.2 percent.

The question here is, why? During economic struggles, investor’s preferences do not change in a meaningful way when it comes to fine wine. It is one of the reasons why annual wine consumption has grown for the past 20 years. By the same token, people who purchase investment-grade wine can often afford to hold on to their collections during recessions, mitigating the risk of fire sales.

Wine Business Monthly published a study about which wineries performed the best during the recession in 2008. One of its conclusions was that large wineries had the resources to deal with the downturn. They have well-established consumer bases and can leverage economies of scale.

The second conclusion was that wineries that owned the means of production thrived. Translation: wineries like Château Lafite Rothschild, Screaming Eagle, and many more are in good shape. These estates control their land, grapes, and production, all the way through to distribution. Therefore, they do not have the same concerns as boutique producers that rely on purchasing grapes.

Unsurprisingly, sub-indices, like the Bordeaux 500 and Burgundy 150, performed well during the Great Recession. The former saw a 50 percent increase in value from 2009 to 2011. As for the Burgundy 150, its growth was closer to 60 percent.

The best case for fine wine’s recession-resistant is its history. While it is not impervious, it has stood up against the Great Depression, Dot Com bubble, and more. Researchers found the long-term investment performance of young-maturing wines from high-quality vintages provided the strongest financial return. Not only did it demonstrate remarkable recession-resistance, but it has also outpaced competitors, like fine stamps, arts, and bills, during the same time.

What To Expect From Here

As Managing Director of Cult Wines Ltd. Tom Gearing put it, “fine wine can act as a defensive asset class in times of economic crisis but also benefit from periods of economic growth.” It is why many people use fine wine as a way to round out their long-term investment strategy. The investment reduces overall risk while adding diversification and stability.

While clouds are darkening over Wall St, fine wine is a silver lining. The short-term volatility resistant and long-term appreciation will counteract the chaotic snapshot of the world today.

If you have any additional questions about wine investment, check out Vinovest today.

The post Finding Recession-Resistant Investments In The Face Of The Coronavirus appeared first on The College Investor.

from The College Investor

The coronavirus has presented investors with unprecedented uncertainty.

If you want to skip the details and learn more, check out Vinovest and see how you can invest in fine wine >>

Quick Navigation

How Does The Coronavirus Affect Fine Wine?

What Makes Fine Wine A Recession-Resistant Investment?

The Economics Of Fine Wine

Fine Wine vs. Gold In Recessions

Long-Term Appreciation In The Face Of Panic

Historical Performance Of Fine Wine

What To Expect From Here

How Does The Coronavirus Affect Fine Wine?

What Makes Fine Wine A Recession-Resistant Investment?

Factors That Influence The Price Of Wine:

Annual Harvest Yield

Consumer Tastes

Reputation

Tariffs

Vintage

Weather

Factors That Influence The Price Of Equities:

Company Earnings

Corporate Management

Dividends

Interest Rates

Political Climate

The Economics Of Fine Wine

Fine Wine vs. Gold In Recessions

Long-Term Appreciation In The Face Of Panic

Historical Performance Of Fine Wine

What To Expect From Here

While clouds are darkening over Wall St, fine wine is a silver lining. The short-term volatility resistant and long-term appreciation will counteract the chaotic snapshot of the world today.

If you have any additional questions about wine investment, check out Vinovest today.

The post Finding Recession-Resistant Investments In The Face Of The Coronavirus appeared first on The College Investor.

https://ift.tt/39s5Ku4 April 01, 2020 at 10:15AM https://ift.tt/39uZORf

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the-phelan63-blog · 4 years

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Pick the Best Gaming PC for your Needs

PC game headway is a rapidly creating field. To the degree both mechanical social gathering and programming, affiliations are perseveringly endeavoring to develop the cutoff centers and increment execution. As the erraticism of individual games increases, notwithstanding, it gets key to pick a PC gaming structure that will best oblige your particular needs. Horrifyingly, there is no inadequacy of gaming PCs open accessible. How, by then, do you select the best gaming system? By paying extraordinary character to a couple of offers concerning your gaming and budgetary needs, you can perceive which bearing to go like a genuine gaming structure ESPrecision Acquires battletitans .

What Kinds of Games do you Play?

The specific sorts of games that you will with everything considered play will help pick which hardware plans will best address your issues. All games are not made proportionate, and depending on the class organizers will give an incessantly prominent level of their significance to different bits of the title. Thinking and reenactment games, for example, will with everything considered be less graphically-guaranteed than various sorts of games and right at present be run on a less unfathomable gaming structure. As a point of reference, the choices for Civilization IV, a rich and least need structure game, are as shown by the going with:

- 1.8GHz Intel or AMD processor

- 512MB RAM

- 128MB video card

Stood segregated from a groundbreaking store of the more present day gaming PCs open today, the referencing for running Civilization IV are not high. So also proportionately in like manner with various structure and development games, a dependably clear weight is put on AI and game considers denied to charts, and grungy contraption power ends up being less major to run the title reasonably.

Verifiably, first-single shooters (FPS) and progress titles will everything considered depend all around more vivaciously on outlines and material science to cause the best to feel and condition. In that by and large crazy, the structure necessities for these sorts of games are routinely essentially higher than various sorts. Titles like Half-Life 2 and Quake 4 catch the player with graphically approved scenes, and the material assessment of the game are indeed made charts to make the most sensible conditions possible. As opposed to the terminations recorded over, the proposed structure approach for F.E.A.R., one of the further made FPS titles correspondingly as plans limit, are as appeared by the going with:

- 3.0 Pentium 4 or all around that genuinely matters cloud processor

- 1GB RAM

- 256MB video card

Notwithstanding the way that F.E.A.R. in like manner, Civilization IV released at customarily a proportionate time a year sooner, the grasped structure necessities for the past are about twofold those of the last referenced. This is continually the condition with FPS titles; since producers, as it's been communicated, imagine that these games should be "walk" bits of a particular movement or affiliations engine, an unmitigated unequivocally overpowering gaming PC is usually required to run them in their full graphical mass. The watching rendering takes enough resources, yet when you figure in the necessities for certain driving material science estimations, these get pound up a lot further. As should act normally clear, the sorts of PC games that you play ceaselessly impact the mechanical assembly that you should purchase.

Must you have the Best Graphics?

Outline alone isn't the sole focal factor in seeing which gaming PC to purchase, in any case. Various titles, including such show pieces as Half-Life 2 and Doom 3, give the player the decision of decreasing the graphical effects in order to run the game sensibly on a less-character blowing structure. While FPS and various games a magnificent piece of the time require a behemoth of a structure to run with each and every graphical effect turned on, they will all around run enough on adroitly settled contraptions. If you can live without such upsetting effects as atom veiling and edge rates in the hundreds, chances are that you can spend less on a gaming PC and still have the decision to play the latest games.

In like manner, as a last resort game facilitators and players will discover ways to deal with oversee control direct make a game run all around more enough and perseveringly not long after it releases. It is for the most part predicted that, in the race to hit the business focus, various games are less "finished"; endlessly end, the code behind them could stay to be reestablished incredibly more. Right now, and distributers will all around releases fixes or reestablishes in order to fix certain specific issues. By morals of F.E.A.R., various players uncovered not long after its release that the edge rate would dependably drop down to unplayable levels mid-game, chugging along even on shocking gaming structures. Suitably when the game was fixed, by some chance occasion, this need was, allegorically, changed. So moreover, vivacious players or people from a gaming structure will routinely find ways to deal with oversee manage direct improve a game's bit in package through hacks or changes. Right when this happens, their disclosures are regularly released online quickly, and a game that may have made your gaming PC past its capacities may exceptionally get playable. Again, it's not resolutely fundamental to have the most magnificently shocking contraption to play the latest games.

What complete do you Plan on Spending?

Continually, the whole of this improvement blends some focal poundings. As the idiom goes, you have to pay to play. Everybody attempts to one day guarantee a heavenly gaming PC; the central focuses are dumbfounding, and there is no nonappearance of affiliations offering creature gaming rigs. Regardless, the cost of owning one of these machines is routinely prohibitive. Review that the freshest and most prevailing video cards will if all else fails hit the market at the $500 respect point. Additionally, the most preparing processors can be respected at $1000 or more. Right when you plan a structure around these top-level parts - a system that can take the latest game releases, gobble them up, and let them out- - you can anticipate that the cost of it should take off. It's not hard to see submitted gaming PCs surveyed at $4000 or more for the apex emblematically.

Completely, the secured two plans sway the third a great deal. If you don't play some graphically-believable games, or in case you are glad to live with barely undermined in-game outlines, it is in a general sense not fundamental to spend that kind of money on a gaming structure. There are a colossal measure of PC affiliations that have in their lineups midrange frameworks that are flawlessly created having an immense impact of games accessible today- - and at an on a wonderfully essential level put held down expense. Make the basic advances not to give up if you can't hold up under the expense of the latest and most winning PC improvement; while money related methods may be the most inevitable of each and every basic factor, it won't everything considered square you from playing the games that you need.

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sandovalenst1000 · 4 years

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The phone’s ringing... it’s Earth!

The environmental studies program at Fordham is not only interdisciplinary, but allows students to have a concentration in one of various fields of study, from sustainable business to food security and organic farming. The major and minor programs’ course selections are built from the pressing changes to our earth and the need to address the Earth’s environmental problems that society has caused. The environmental studies program allows students to understand the causes and effects of current and developing environmental problems through studying the humanities and physical & social sciences, in addition to exploring solutions for societal and physical impacts on the Earth through various disciplines. While scientists have been trying to make society more aware of our environmental impacts, it has not proved to be enough to motivate most people, creating a need for an interdisciplinary environmental studies program to educate the current generation and aligning with the current surge for environmental activism.

Without scientific fields of study such as biology and chemistry, we would not even begin to understand the environment, allowing environmental science to be the foundation for environmental studies. Environmental science is the study of “how the earth works…, how humans interact with the environment, and how we can live more sustainably” (Miller, 2018, p. 5), allowing individuals to answer the call to understand environmental problems. The physical science aspect of environmental studies provides the background to understand sustainability, “the capacity of the earth’s natural systems...to survive or adapt to changing environmental conditions” (Miller, 2018, p. 4). The six main principles of sustainability applying to the environment, which allow humans to understand and attempt to create a more sustainable future, include the following: dependence on solar energy, biodiversity, nutrient cycling, full cost pricing, win-win solutions, and responsibility to future generations.

All energy comes from the sun and provides continuous energy to cycle nutrients throughout an ecosystem. The sun additionally provides the energy for biodiversity, which is “the variety of genes, species, ecosystems, and ecosystem processes” (Miller, 2018, p. 5). Full-cost pricing, rooted in economic principles, is encouraged by environmentally-conscious economists, who propose to include the health and environmental costs of production and usage of products in the market pricing of services and goods rather than companies taking advantage of the environment for larger profit margins. Win-win solutions, rooted in political science, incorporate compromise and collaboration to find the greatest benefit for both the environment and people. Lastly, the responsibility to future generations to preserve the environment incorporates ethics to provide morality towards what humans do to affect the Earth. A comprehensive assessment on the environmental cost of animal source foods by the Ecological Society of America notes unbalanced regulation when comparing marine and terrestrial sources and suggests policy action to avoid high-impact farming, aquaculture, and fisheries (Banobi, 2018), exhibiting the interdisciplinary suggestions necessary to help the environment and limit society’s impacts.

With various facets of the environment suffering due to exploitation of nature, such as ozone depletion and toxic coastal soil from farming, scientists continue to reach out to society to strike the feeling of responsibility to future generations and the Earth, using the ethical approach. In the 1992 Warning to Humanity letter by the Union of Concerned Scientists, it cites irreversible damage to the Earth as of almost three decades ago, which is considerably worse in 2020 with little change to policy. The letter recommends collaboration, policy change for better management of resources, and population stabilization to help halt the degradation of resources and the overall health of the Earth. Most recently in the 2017 Warning of Climate Emergency from the Alliance of World Scientists, scientists still use the ethical and moral approach to try and motivate others to help save the Earth. Both the 1992 and 2017 letters from scientists have similar messages, with each urging people to contribute to helping the environment. The Alliance of World Scientists urges leaders to adapt approaches to governing and policy making in relation to environmental management, and the materials used to manufacture products. Both letters identify developed nations, such as the United States, as the largest contributors to environmental decline and also as the most influential in saving the environment.

With many calls from the United Nations to help motivate nations to contribute to saving the environment, one of the most comprehensive calls is the UN Millennium Ecosystem Assessment, collecting data from 2001 to 2005 to analyze the consequences of ecosystem changes on the Earth and on human beings and focuses on various ecosystem services. Ecosystem services include provisioning, regulating, habitat and support, and cultural services that benefit human beings and maintain the environment to a certain extent. Provisioning services include “material outputs from ecosystems” (2005), such as food and water, raw materials, and medicinal benefits. Regulating services regulate the quality of air and soil, in addition to providing flood and disease control in ecosystems. Habitat and supporting services include providing habitats for species and maintaining genetic diversity among breeds of organisms. Lastly, cultural services include the non-material benefits humans receive from nature, such as tourism and recreational experiences. With about 60% of the ecosystem services that were studied being degraded or used unsustainably, usage shifts the consequences further into the future for future generations (2005). While usage of ecosystem services benefit humans now, in the future they will not as shifts in regional climates continue, affecting not only production of goods but humans as well due to loss of assets. While developed countries continue to impact the environment the most, degradation of ecosystem services affect impoverished populations the most (2005), due to large centralized impoverished populations being in third-world countries. The Ecosystem Assessment highlights that changes require influential policy changes and without it, impacts will become permanent and compounded, such as projected future species loss to increase ten-fold to approximately 80 to 110 extinctions per 1000 species (2005).

Reflecting on the larger impacts of society on the environment, I took the Ecological Footprint quiz to see what my individual environmental impact is, considering that I live in dorm housing on campus in New York City. Unsurprisingly, the largest consumption result is my housing, considering that I live in a dorm with approximately 800 other students, with mobility coming in second, which I based off of my driving habits at home. Despite some of my less environmentally friendly habits, I still have about half of the ecological footprint of the average American. Overall solutions proposed by the Ecological Footprint results include green urban planning, considering 70-80% of the world’s population is projected to live in cities by 2050, renewable energy sources, reduced food waste, controlled population size, and actively protecting ecosystems. Solutions proposed by almost all materials read, specifically the Ecosystem Assessments and Warning letters, include interdisciplinary approaches to responding to environmental disarray, stemming from environmental science and environmental studies.

Word Count: 1132/1100 words

Question: Considering the cutthroat business market, are there any successful full-cost pricing models used by companies today? If so, how do those companies differentiate their product from cheaper models in the same market?

Bibliography

“1992 World Scientists' Warning to Humanity.” July 16, 1992. https://www.ucsusa.org/resources/1992-world-scientists-warning-humanity.

“Ecosystems and Human Well-Being: Synthesis.” Millenium Ecosystem Assessment, 2005.

“Environmental Studies.” Fordham University. Accessed January 27, 2020. https://www.fordham.edu/es.

Hilborn, Ray, Jeannette Banobi, Stephen J Hall, Teresa Pucylowski, and Timothy E Walsworth. “The Environmental Cost of Animal Source Foods.” Frontiers in Ecology and the Environment, June 12, 2018. https://doi.org/https://doi.org/10.1002/fee.1822.

Ripple, William J, Christopher Wolf, Thomas M Newsome, Phoebe Barnard, and William R Moomaw. “World Scientists' Warning of a Climate Emergency.” Alliance of World Scientists, November 5, 2019. https://academic.oup.com/bioscience/article/70/1/8/5610806.

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hachama · 5 years

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Second Democratic Debate Analysis, pt. 1

Like last time, I’ve (finally) read the transcripts. I read the fact-checkers’ analysis. I have ranked them.

Also like last time, due to the size of the field, I’ll be splitting my analysis into four groups. This first one will be the Please Do Not Make Me Vote For Them group:

Good news! Due to candidates dropping out, it’s a shorter list!

Biden, Williamson, Delaney, Ryan, and Bullock

Under the break, I’ll be analyzing their debate performance, how effectively they represented themselves on the issues, and how much I hate them, in reverse order of preference. Let’s begin.

17) Bullock

Governor Steve Bullock did not make an appearance in the first set of debates, and now I know why. He is the Shirley Exception made flesh. “Surely no one would actually use our laws to hurt someone. Surely if someone is really a good person they won’t face terrible abuses. Surely not…” Stevie, these are things that are currently happening. These are facts.

Those who read my analysis of the first debates should know that I do not accept any luke-warm “healthcare choice” arguments, and Steve is full of those, too.

He’s very worried about other candidates campaign promises being unrealistic, and says that it’s important to listen to “real Americans,” as if democratic socialists and the majority of Americans who support universal healthcare aren’t “real” enough for him.

As if that weren’t enough, he also argues in favor of some of the abuses of immigrants, as a deterrent to immigration.

To his credit, he supports treating gun violence as a public health issue, including research by the CDC into causes, which could inform actually useful gun control policies. He wants to see Citizens United overturned, which is also good. But not good enough.

16) Ryan

Representative Tim Ryan has the distinction of being one of the candidates I hated entirely in this debate. I agreed with none of his points, and most of my notes contain profanity. He introduced himself as New and Fresh, playing on his youth (he’s 45. The average age of the democratic candidates is 54. There are 4 people running who are younger than Tim) without offering much substance.

He opposes decriminalizing the border. On healthcare he seems to think we can’t make healthcare better for everyone because then unions won’t have anything going for them which is just… He thinks letting businesses “buy in to medicare” is a good idea, and all I can hear is “privatize the social safety net and let companies decide whose grandma actually deserves to have proper care when she breaks her hip.”

I’m not saying Tim is evil. I’m saying he’s spineless and would let bad things happen because it’s too much work to stop them.

15) Delaney

Representative John Delaney joins Tim Ryan in the dubious category of “I hate you and everything you stand for.” The only reason he ranks slightly higher than Tim is because someone had to. Their scores were the same level of shrieking profanity.

John thinks that reminding everyone that he was the youngest CEO in the history of the New York Stock Exchange is a good thing, showing that he has absolutely no idea what democrats are looking for in a candidate. Surely, we should trust him! He sold his soul early and has abided by the contract for so long!

He is another candidate decrying “unrealistic” campaign promises. He reiterated his concern that Medicare for All would underfund the healthcare industry in America, he considers it an “extreme” policy proposal, and called it an “anti-private sector strategy.” Yes, John, because the private sector’s profit motive has been working so well, let’s all continue dying so that small groups of people can make lots of money off of the price of insulin. Fuck you.

14) Williamson

Marianne Williamson’s contributions were blessedly brief and infrequent. She supports public campaign funding, which is great, but she also spent an entire minute on “I have concerns” without once proposing a solution, referred to the American healthcare system as a “sickness care system,” which for me evokes concerns about chemtrails and chemikillz, and her opening statement evoked American Exceptionalism.

I’m so tired of Marianne Williamson.

13) Biden

Former Vice President, Former Senator Joe Biden was invited to comment on everything. As a result, I have over a page of notes just for him. The moderators’ bold strategy of checking in with Uncle Joe every time anyone said anything gave him opportunities to say a few things I agreed with, but ultimately was not enough to get him out of my lowest ranked category.

As he said in the last debate, Joe supports rejoining the Paris Climate Accord. This time, he said we need to “increase” the standard, apparently recognizing that solutions negotiated several years ago will not be sufficient now, and he wants to see an end to fossil fuel subsidies. These are good things I can agree with.

Joe is concerned by the treatment of immigrants seeking asylum, and the excessive wait times for their cases to be heard and the refugees either released or returned to their country of origin. His solution is to “flood the zone,” spend more resources to make decisions faster. This guarantees nothing except a reduction in detainees which, while generally positive, is less than half a solution.

The thing Joe said that I liked best was about the treatment of former-inmates after the completion of their prison sentences. Joe said that former-inmates should have access to public programs and benefits upon release. This would be a significant change from the current system, which continues to punish people long after their sentence is served. He also said that drug crimes should result in rehab, not prison.

Joe continued to use his association with Obama as a shield against criticism, which was worn thin before the first debate started. He evaded questions about Eric Garner, refused to answer questions about Obama-era deportations (with the added bonus of “what I said was said in confidence, you’d share it, but not me”), invoked American Exceptionalism in his opening statement, interrupted Cory Booker at one point, blamed all of our current political and social dysfunction on Trump, and thinks we should renegotiate the Trans Pacific Partnership.

The cherry on top of this shit sundae? He said the phrase “I have the only plan that (…)” I haven’t talked about this much, because it’s a little hard to express in text, but I have a very, very negative response to any claim to being the only person who can solve a problem. It’s bad when Trump does it, it’s bad when Biden does it, it’s an abuser’s tactic. “I’m the only one who loves you, I’m the only one who can help you, I’m the only one” is always a) a lie, and b) a red flag.

Granted, I was so far behind that some of Biden’s comments formed parallels I might not have seen when he initially said them, but some of the things he said about immigration were symptomatic of the same thought process that gave us that abominable rewrite of Emma Lazarus’s New Colossus. Biden, when trying to make a point about the strength of America being in our diversity, said that “we’ve been able to cherry pick from the best of every culture,” and followed it up with “anybody that crosses the stage with a PhD, you should get a green card for seven years. We should keep them here.” Not everyone who immigrates to the U.S. is going to have an advanced degree. Not everyone who immigrates to the U.S. is going to be “the best and brightest.” And that’s a good thing. There is a limit to the number of doctors and lawyers a society needs. Some immigrants are going to be nurse’s assistants and cab drivers, and we need them here, too.

Even with all of that, the worst of what Joe had to say was about healthcare. Joe thinks that limiting co-pays to $1000 per person is part of making healthcare accessible to everyone. He thinks your health insurance premium should be no more than 8.5% of your annual income. I did some math. For minimum wage, that’s almost $2500 for insurance, out of pocket, before anyone sees any benefit. After taxes, that leaves about $10k for a minimum wage worker to live on for a year. At $15/hour, $20k to live on. These are not reasonable numbers in most of the country.

#second democratic debate #politics #opinions and analysis

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