I would never be able to take such a picture of my dog. He would be ferociously licking the tiny bit of delicious food that he not allowed to have off of his back.

Thankfully in the past 10 years I’ve seen a decline in practitioners prescribing seroquel for sleep disorders but that’s entirely anecdotal and based only on my small geographic area unfortunately, not sure of any literature to support that this is actually declining. And unfortunately in the USA i believe it’s still somewhat regularly used as a chemical restraint in long term nursing care for geriatric populations despite indications for other medications being potentially better choices but I can’t speak much to that as it’s not my practice area or population

Are you talking about haloperidol? It doesn’t really get used a sedative in emergency psychiatric situations but often gets paired with benzodiazepines. Sometimes one or the other. Sedative would more typically be Ativan. To be clear haldol does have some sedative effects but it is not typically used as a first line sedative in inpatient psychiatric settings; it’s a poor choice for this purpose because it has a fairly slow onset for sedative effects to be seen (~15-20m for many individuals)

Haloperidol is used for acute psychosis and agitation. Ativan is used for sedation. Care has to be taken because benzos/ativan can worsen delirium, eg in an elderly patient, thus the use of haldol if they are agitated. Or you might use diazepam if you are intending a chemical restraint as this lasts longer than ativan. But this metabolizes via liver so you again have to be careful about pt, late stage alcoholic would get ativan bc metabolic pathway is renal. Additionally ativan alone be best fit for someone detoxing from alcohol who is agitated as the underlying cause of their agitation better targeted by benzos than haldol. Knowledge of pt is key. Of course that info is not always available unfortunately

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298219/

Project path explains rationale behind psychopharmacology for emergency treatment of agitation better than I can

The United States would more typically utilize risperdal as a first line pharmacological intervention for individuals with autism who experience violent behavior during irritability. It obviously can vary by practitioner a bit but there would need to be some valid justification as this is the only fda approved medication for treating irritability in autism.

Lots of people speaking out of their lane in these replies though! Nothing like conjecture!

Civil matter, not criminal

Cloudflare has absolutely told websites to fuck off because they don’t like their content. They haven’t done it a ton of times but they absolutely have. No one cares because the sites they’ve done it to are toxic cesspool shitholes that, to be fair, the world is probably better off without. But each time it showed that cloudflare can simply wield its power if it feels like it.

If your site becomes controversial in the future and is protected/hosted by cloudflare don’t be surprised if they suddenly send a letter saying “fuck off”. They’ve become arbiters of internet censorship and we have accepted it because the daily stormer and kiwi farms and 8chan are bad.

The ridiculous part is all of those sites are still accessible; daily stormer and kiwi farms both still accessible from clearnet (iirc 8chan is tor only) so cloudflare dropping wasn’t even all that effective. Well funded hate speech found a way. But for the next ones that don’t have major alt right cash behind them to fund cloudflare alternatives they’ll just simply disappear. And then we will have the internet where corporations like cloudflare, who should absolutely be content agnostic, decide what we can and cannot see. You may think it’s fine right now because they’re doing it against websites that are admittedly gross and terrible, but what happens when they overstep and the line blurs?

They should act like a proper tier 1 provider: find evidence of crossing a legal threshold, get a court order, and terminate service if something that bad has occurred. Anything less and they suck it up and honor the contract they signed. They haven’t, so fuck cloudflare. The internet is an amazing place but it’s also a disgusting abhorrent cesspool. Don’t get involved in hosting it if you can’t deal with that.

Flac 44.1 16bit level 3. Host with something that meets your needs. I have my files in jellyfin and navidrome and can then access the library remotely either through jellyfin web client, navidrome web client, substreamer, Finamp, kodi, etc. but this way if another amazing format comes up down the line I will always have my library in a good state to transcode from. Tag and sort everything with beets.io (or musicbrainz picard is great, I just like that beets is cli). This results in a library I can access on my phone, laptop, tv, carplay, etc

Technically you could go for 24bit but imo the extra file size isn’t justified. though one could make that argument for flac vs 320cbr mp3, transcoding 320 mp3 is more likely to create artifacts, thus the reason for keeping around flac

Alac may be easier for you if you use mac

Wiping with your finger introduces bacteria from your hands and is not a good idea from a food safety perspective. If you wipe the excess you should do it with a clean towel (like a disposable paper towel/napkin) or at a minimum wash your hands. It’s probably not a huge deal if the sauce is very acidic and the remainder will be used promptly but if it’s like a bottle of a condiment that may be used for weeks probably best practice to keep your grubby fingers out of there

This is pretty much what I meant by that fucked up misinterpretation of stoicism

Like you have the actual Aurelius stoicism which has some very good value; everyone should read meditations once or twice. But then it’s been cliff notes’d and perverted by a bunch of people into to lose the message entirely from “be in control of your emotions” to what you’ve described: horrific rigidity to keep it all in at all times until of course it doesn’t work anymore and you break down spectacularly. Like somehow the message has gone from “control” to “emotional numbness”

A similar dynamic has happened with nihilism where some the writings on it are not so bleak and terrible; that it is an expression of freedom. But over the years it’s been perverted into nothing matters, why bother

I am an actual licensed therapist and while there are a number of real actual creating barriers specific to men pursuing mental health treatment there are a few factors I’ve consistently seen that are ubiquitous across gender, race, sexuality, class, etc

Money, time, availability

Therapy is inaccessible. I am a therapist who mostly works with insurance companies. They pay me about 100-115/hr. My clients will often have a high deductible health plan which means they need to pay this $100-115 per session until they hit their deductible, which can be 5,000+ dollars. It’s a lot to ask someone to pay $100+ weekly. On top of that they still usually have a responsibility afterwards of (typically) 10-30% so $10-34.5 per meeting which is still a notable weekly cost for many people on the high end especially after shelling out $400+ a month for months on end.

Other clients have PPO insurance which is a fixed cost per meeting but this can vary wildly. More affluent clients have excellent PPOs where they might pay $10-20 per meeting which is not terrible. But that’s rare. We are often covered under the “specialist” copay and many PPO plans have tiered provider coverage now. So a copay for me might be $50 or more per meeting (the worst I saw was $125 which was absurd because it was actually $27 more than I’d get from the insurer in question).

So you have this on top of these plans taking hundreds of dollars out of each pay check. “Well budget for it”. Hard to do because the need for therapy can be inconsistent and many of these people are coming in fo(and specifically symptoms like poor money management). Then on top of that even if you do budget for it you have the inherent issue that the need for outpatient therapy is often not dire/acute so if something more pressing comes up (eg a serious dental/medical issue, car breaks down, short on rent) therapy might be the corner to cut if it’s already established because in the overwhelming majority of cases you won’t die without it; it will just lower your quality of life (sometimes significantly so)

Then comes the time portion. Even if you can get past the cost barrier you have the availability of the therapist and yourself. I’m a night owl and I work late but many of my colleagues don’t. I’m pretty nontraditional though, no kids and my partner is very career oriented themselves whereas many of my peers tend to value the traditional 9-5 much more so they can be home for their children and such.

So when you go to schedule with someone it’s often that you can only get seen during business hours. It’s one thing when it’s a doctors appointment that you have once every few months that you need to duck out of work for but a weekly hour long engagement is much harder to explain. This brings back in the masculinity issues - many men find this basically impossible to disclose to the workplace and basically wouldn’t even try to get an exception for weekly therapy. Even without explicitly saying so asking for 1 hour open a week consistently for a doctors appointment is going to be perceived as therapy by many. But stigma aside many of us simply can’t do that. I’m on the practitioner side and I know I’ve ignored my own physical health at times because it was inconvenient to schedule doctor appointments during my workday.

Our systems of employment (at least in the USA) simply do not provide or protect for medical leave, even when it’s very brief and especially when you are a low level employee (executives and admins tend to have less of an issue ducking out for doctors appointments in my experience at least). There is no legal right to paid or unpaid time off for medical appointments in the USA and that is completely disgusting in 2023.

The final piece is practitioner availability. I have a waitlist through October at the moment and am not accepting new clients. All of my colleagues are in the same boat. The old practices I used to work at constantly call me to see if I’ll take any referrals because their waitlists are so overloaded. The hospitals and clinics I have referral relationships with email me every week for updates. It’s extremely stressful. Every new client, especially adolescent, complains that they are happy to finally have someone after waiting 3-6 months. Even if someone wants a therapist they have to wait ages. It is not uncommon that I get someone and when I call them to start they say they don’t even remember why they called in the first place.

We need more people doing the work. Or ideally we need to make societal reforms so that there are less people experiencing mental health issues. I’ve been doing this almost 15 years now. I, and anyone who doesn’t exclusively work with the rich, can tell you that a significant degree of what we work with is people who lack resources and not proper mental illness. I mean, it is depression and anxiety, but it’s because they have been paycheck to paycheck for years or theyre under a mountain of student loans or credit card debt and the stress is just too much to bear. And their jobs won’t give them raises and there aren’t any other jobs out there that pay more. Not everyone is a software developer or investment banker that can jump ship to another 6 figure job with cushy benefits. Most people work jobs that pay 40-60k with shit benefits and little upward mobility.

To answer your question more directly:

In my opinion it’s a systemic issue based around that super fun phrase everyone loves, “toxic masculinity”. I personally do not subscribe to gender labels but I am amab/male presenting and get a lot of male clients as a result. Many of them tell me they hide the fact that they are in therapy from everyone but their partner. This is indicative of the problem; that being in therapy is weak. That being in therapy makes them a bitch, a wuss, all kinds of pejorative terms. It’s bad, is my point.

So part of the answer imo is not in having doggies and cool dude stuff in the office. Its far more complex and involves redefining masculinity to still including things like being a lumberjack or carpentry or whatever. From there though you need to shed the part where it means you have to be emotionally numb to everything, constantly display strength, embrace the fucked up misrepresentation of stoicism that has you shove all your feelings into your stomach, and glorify anger, rage, and violence as the only appropriate means of emotional expression.

this could also be extended to the stigma surrounding therapy itself and the tendency to associate therapy need with weakness. This is an issue that goes beyond therapy though; there are people who won’t see medical doctors for the same reason even though they’re in physical pain. Our pride is our downfall.

Tldr make therapy cheap and accessible, make protections for workers to seek medical care, increase the amount of practitioners (or decrease the need for them), and systemic reform to the societal concept of masculinity and pride. So probably gonna take awhile

Imo impossible meat is superior to beyond although nutritionally it’s a mixed bag. It introduces a decent amount of carbs (9g per 4oz) and has over 5x the sodium of beef. But it also has a bit of fiber and a either comparable or more vitamin/mineral content than beef. Protein is comparable to 80% ground with 20% less caloric content

Beyond is similar.

They’re both basically vegetable proteins with binders and fats and some flavorings. The big game changer flavoring is leghemoglobin which both use. It’s a protein isolated from soy that is very similar to certain enzymes from bovine muscle. Impossible got the fda to approve it in 2019 and it was challenged; there are some concerns on whether it is safe to eat. I’m not super well read on the issue but from what I’ve perused the issue is one of a lack of long term testing and not of any direct concern.

The textural difference between the two is because beyond uses isolated pea protein, which gives it a texture that’s a bit chunkier and imo more sausage like, and impossible uses soy protein, which imo is more like a cheap burger patty you’d get at McDonald’s.

The fats are typical fats like coconut oil or sunflower oil to recreate the fatty part of beef and this is the current weakness of the products imo. Coconut oil is used because it tends to stay solidified at room temp so when you’re making patties it feels like there are chunks of beef fat. In practice this is weird because they are far too hard and aren’t dispersed enough throughout the product; I believe this is why these fake meats tend to stick to the pan much easier than actual burgers cooked in a skillet.

The binders are big scary words like methylcellulose which is also a source of fiber and can be used as a laxative so people latch onto that and freak out. But it’s only used as a binder to help it hold everything together here so it’s like a tiny amount that just provides a bit of fiber that you probably desperately need if you’re having burgers for dinner. Fun fact: Certain preparations of methylcellulose (a4c) turn into gels when heated so you can use them to make hot ice cream! It’s pretty weird to eat, like a normal ice cream base that solidifies when you put it into boiling water

The other ingredients are stuff like beet juice for coloring

Final fun fact: technically impossible meat is not vegan because animal testing was done during its development.

Thanks for reading my unprompted essay on the composition of modern vegan meat substitutes. This was brought to you by my failed interest in becoming a food scientist. Also you may note I don’t really discuss how they compare to meat and that’s because I don’t eat meat which by law I am required to mention in all posts about food