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Cake day: June 30th, 2023

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  • Yeah absolutely, and any bugs that are found are permanently gonna be there, stuff like that. It sucks. Thus the “I probably wouldn’t bother either”. But if you’re really passionate about it I say go for it, just cover your tracks really well, only work with people you trust implicitly, and don’t popularize the project until you’re ready to be done with it. The moment it gets hyped and picked up by ign/kotaku/etc you’re done.

    I think you can still get the word out to get other modders though. These things don’t seem to get squashed at the planning stage, otherwise publishers would be spending tons of resources going after people who have maybe done no actual work. It seems like what happened with this mod, when they make socials and release ongoing updates, screenshots, videos, etc, of their work, that’s what gets people hyped and all the attention (and eventual hammer) on them

    Of course this means you get no credit for your work, which sucks. If you’re undertaking such a massive effort and getting 0 credit I could understand why you wouldn’t bother (although it’s kind of badass to do it for no clout)






  • I’m sorry you had such a bad experience. ABA is just a science though, and it’s the way it’s applied that can be good or bad.

    ABA should not be used to tell someone to not to like the transformers as a teenager. There are clear ethical guidelines about this. But supervision can fail, unfortunately. You could report your practitioners I suppose. But is that what actually happened? Why did they restrict you from transformer movies?

    I have seen unethical practitioners that work with parents who say “this is age inappropriate, my teenager shouldn’t be watching Sesame Street anymore” and try to discourage it. But this is rare these days and the field discourages practitioners from doing this. However, depending on how old you are and where you live and just because shitty people exist this could very well be the case

    But I’ll be real with you: I have seen people who are critical of ABA say things like what you said and it turns out they were not given access to their favorite movies because it was made contingent reinforcement. This is how ABA works, it is operant conditioning. But what these people are leaving out is that they were having major functional impairments that required some kind of enticement and there weren’t many things that motivated them to expend effort. They would only shower or brush their teeth once a week or less, they would not do homework ever to the point of failing classes, they would exhibit violent behavior that was dangerous to themselves or others, serious communication deficits, etc.

    the way we would encourage the behaviors we needed to see more of and discourage the problematic behaviors was through reinforcement based systems. Of course, reinforcement can always feel like punishment when one fails because a true reinforcement system requires one to withhold reinforcement when necessary so the learner can conflate reinforcement with punishment pretty easily

    And I would suggest maybe talking to someone about this, you’ve got a real chip on your shoulder about this. I merely asked you a sentence it and you went into a paragraph long diatribe assuming a great deal about my history. You don’t know me or my experience. You’ve clearly got some trauma, maybe it’s time to deal with that?



  • This was probably all in the phrasing or maybe people just don’t understand the reality of the situation?

    I worked for several years doing mobile therapy that included a significant amount of homeless outreach and crisis management. Everyone deserves to be housed, bottom line, but what it takes for that to happen is a complex situation

    There’s the “xxx,xxx amount of homeless but xx,xxx,xxx amount of empty homes in america” statistic that people throw around. I forget the exact numbers but I’m pretty sure thats the scale, if not the take away is that you could literally give each homeless person a free house and still have millions of empty houses. But this would not solve homelessness, at least in the current system. The overwhelming majority would be back on the street fairly quickly. Even if you eliminate the need for mortgage there’s still the need for property taxation; if you eliminate that then communities start to get real shitty. Even if you eliminate that there’s still utility and food costs. Even if you eliminate that there’s still maintenance and not actively destroying the place.

    Institutionalization isn’t necessarily the answer although in extreme cases it can be. We had supported rehabilitation programs that were pretty successful, basically apartments with staff that would keep tabs on you, help you budget, do resumes, help you get to drs appointments, make sure you took medications (but didn’t force you to unless there was a court order/probation situation and even then it wasn’t like a “force” situation although there was inherent coercion as not taking meds would be reported to po/court), apply for section 8, etc. you would stay there for a year or two and then move to a more independent placement once supports were in place.

    There were also longer term programs for people who genuinely struggled and just couldn’t get that step down to work. These were similar but had less focus on connecting to services and were more akin to nursing homes with more psychiatric care

    But then there were also more intensive residential programs we referred to for people with more serious mental illness or addiction issues

    The issue, of course, was funding. We had like 32 beds in the short term and 11 in the long term. Funding was like 50% state funding, 20% grants, 30% donations and fundraising and the budgets were tight. Meanwhile the town probably had 30-50 actively homeless at any given point on top of whoever wasn’t in the program and another 50-100 with insecure housing. Even the intense programs, which generally had more secure state funding, still had an overall lack of beds and would have very long wait lists. Sad stuff.

    That was about a decade ago now, I feel like it has to be worse now post Covid and trump. I can only imagine what the next 4 years will do to their funding



  • You should go to a drum corps rehearsal or elite piano/violin recital. Shit or even an arcade hosting a bemani tournament. Like not one of the places where their parents are forcing them but somewhere where people are just doing it because they want to, even if it sucks sometimes to play for hours and hours and hours

    I used to teach lessons and you do have a point, a lot of people want to be good without doing any work. That’s true of any endeavor that requires effort. A lot of people covet the reward without paying enough mind to the serious amount of effort that one undertakes to get to that point

    But some people actually do want to achieve greatness, some people want a sense of accomplishment, some people want a deeper understanding of their instrument, etc

    Even if you’re an electronic producer that only ever uses the piano roll you would still benefit from a better understanding of theory and improvisation. This doesn’t come from nothing; it comes from grinding. You don’t necessarily need to read theory books and practice piano of course, you will gain a sense of these from writing songs and getting feedback, but you still need to write and/or play a lot

    The rise in electronic artists is arguably more to do with accessibility. literally everyone has a computing device and free music making software is relatively abundant, instruments are expensive and loud, practice space is hard to come by especially in urban environments. Additionally electronic music has a huge factor of cultural relevance in terms of trends from production styles being popular across genres.

    AI music is a tool and it’s impressive but the results are mostly derivative, which makes sense given how it works. it would be really cool to see more resources invested into spaces for people who actually wanted to pursue the arts to be able to do so as this is likely the way music (and other art) truly moves forward and actually innovates instead of just hashing out the same tired shit



  • quixotic120@lemmy.worldtoPrivacy@lemmy.mlToday I saw hope
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    6 months ago

    Based on a very brief glance at this it looks like I would be reliant on self hosting it to circumvent the need for a BAA (although the hosting company may still need to provide one, unless I literally hosted it from my house or something?) not sure

    Will investigate further, had not heard of this


  • quixotic120@lemmy.worldtoPrivacy@lemmy.mlToday I saw hope
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    6 months ago

    It is generally best to keep an entirely separate account for professional dealings so such things are segregated, at least that’s what I do

    Signal as a zoom replacement would be great but a big part of the deal would be the necessity for hipaa compliance. I would imagine a huge part of what keeps zoom alive is financial injections from telehealth provides like myself that need a platform that is hipaa compliant that patients understand. EMR software often comes with a telehealth platform built in nowadays but it tends to not work as well and confuses the tech illiterate who got trained on zoom during COVID years.

    I’m sure there’s a ton of stuff they have to do on their end to be hipaa compliant that I’m ignorant of but the primary thing is that they have to share a document called a business associate agreement (baa) with me that essentially says they will take meaningful steps to appropriately safeguard any protected health information and makes zoom liable if a breach of their systems exposes PHI.

    This is why telehealth can’t (technically, people still do it) occur over teams, skype, discord, facetime, hangouts, etc. google, apple, microsoft, etc have no interest in taking on that liability.

    The difficult piece will be challenging zooms pricing. They offer healthcare zoom for $15/mo with BAA. There are better deals though, doxy.me does it for free (they claim this is subsidized by paid account which I believe because they are substantially more than zoom starting at 35/mo).

    Would be a great way to get them a revenue stream too. I don’t know anyone who practices heavily telemedicine that relies on free solutions; the only ones I know that utilize the bundled emr components or the free doxy.me service are clinicians that mostly practice in person and only do a small handful of telehealth sessions a month, like under 10% of their total billing. For people like me where it’s 50-100% of their billing it’s almost always a paid subscription. more reliable, tax deduction, and access to support




  • Work in healthcare and while there are just so many dark sides a big one that’s not talked about enough:

    The foundational model for our healthcare system is called fee for service medical billing. This means what it says, a fee is payed for a service.

    I work in mental health so for me it works like this: I see you for 53 minutes, I can bill for an hour of psychotherapy service, cpt 90837 which gets me paid a certain amount. But let’s say you are not able to effectively communicate and need a third party to assist in your communication. I need to read your non verbal language and decipher any utterances you make while also communicating with this third party who acts as a liaison for you. I can add code 90785, interactive complexity.

    This is a limited example because outpatient mental ultimately has a limited amount of billing codes. But if I am an orthopedic surgeon all of a sudden I have thousands of billing codes to utilize. Now I might pull a splinter from your hand and pad this bill with 19 services. Many doctors, especially in large healthcare networks, have either no idea this is even happening (billing is generated from their notes) or they are heavily pressured to do this by owners that are increasingly profit driven

    This is not to suggest mental health is exempt because of a lack of billing codes either. You may be doing fine. Or I may have reached the limit of what I can offer you with my skill set. Yet I still schedule appointments with you week after week after week because you consistently show up. I need a paycheck, a great deal of mental health workers are contract employees that are only paid when they actually render a service, they aren’t paid nearly as well as you think, and they get no benefits whatsoever

    This illustrates the point I am making. Fee for service billing encourages dishonesty and unethical practice. Other countries that utilize it have similar issues and when they adopt it they see healthcare costs and utilization begin to rise rapidly. China is transitioning away from the fee for service model for this reason. Unfortunately transitioning away is difficult because both healthcare networks and practitioners are incentivized to fight to keep it. Pay for performance, diagnosis related groups, etc reduce healthcare spending (sometimes substantially) but any time healthcare spending is reduced earning potential for healthcare networks and practitioners is threatened so there will be pushback