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ER doctors: We’re no strangers to violence but we try to de-escalate without anyone dying

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Dr. Onyeka Otugo, Dr. Adaira Landry, Dr. Al’ai Alvarez and Dr. Italo Brown

As emergency medicine physicians of color, we are yelled at and called profane names. We have been spat on, pushed and kicked. One patient has landed a staff member in the ICU. A patient recently had a knife in his pocket. We have routinely experienced psychological and physical trauma. But we choose nonviolent de-escalation strategies — not just because they work but because they are humane.

We are disappointed at the inconsistent use of de-escalation strategies revealed by emerging footage of black men and women interacting with law enforcement. This lack of respect for humanity has led to the loss of countless lives of black men and women. We are distressed by the continued use of force despite literature supporting nonviolent de-escalation.

In emergency departments across the country, threats of intimidation, harassment and physical and emotional trauma are prevalent. There have been several documented cases of non-lethal and lethal violence in or around EDs. Patients have made threats to us, waited in nearby hospital facilities, and returned to the ED to harm hospital staff. According to 2015 data from the U.S. Department of Labor, the rate of violence in the health care workplace is higher than any other industry.

Agitated patients need safe handling

The ED staff, especially our nursing colleagues, frequently encounters workplace violence. In a survey of over 7,000 ED nurses, from May 2009 to January 2011,12% experienced some form of physical violence, while 55% experienced both verbal and physical abuse.  More recently, a 2018 poll showed 47% of Emergency Medicine physicians reporting physical assault at work, with 60% of responders reporting similar occurrences the previous year.

Physicians, nurses, technicians, and hospital security receive training to safely de-escalate agitated patients. The goal of crisis management is clear: employ verbal de-escalation primarily with physical restraint as the last resort. Nonviolent communication and similar conflict management strategies have been successful in mitigating severe levels of agitation commonly seen in the ED. Consequently, physician training programs and multidisciplinary teams have incorporated formal de-escalation training to ensure patient safety.

Training is necessary to manage our physiologic and behavioral reactions to perceived threats. As with any other responder, we experience fight or flight responses when our sense of safety is compromised. We must prioritize the safety of our patients and our team as our guiding principles even when we perceive violence or threat. Applying nonviolent communication is the first critical step in verbal de-escalation.

In Charlottesville, Virginia, in 2020.

When unsuccessful, physical restraints are employed. This process requires adhering to clear guidance in safe positioning. Prone positioning, or placing a patient on their chest, is not safe in agitated patients as it limits the movement of the chest wall and diaphragm, which may restrict breathing leading to asphyxiation. Finally, the use of sedative medications may be administered when all else fails.

I could have been George Floyd:I was beaten by police at 14, then stopped by my own officer when I was a police chief. We need change at all levels.

In all of these situations, we must maintain our primary responsibility for harm prevention in patients and staff. We understand and are grateful for our law enforcement officers who protect the community from violent, criminal behaviors. However, in none of our violent ED encounters do we use lethal control of the patient.

When viewing the footage of Mr. George Floyd, the overwhelming feelings of pain, trauma and anger emerge at the inappropriate use of force. Prone positioning and neck holds are known lethal forms of restraint. For 8 minutes and 46 seconds, Mr. Floyd suffered. In our profession, the words, “I can’t breathe” trigger rapid medical response. To neglect these words, as said by Mr. Floyd, while struggling in a prone position, goes beyond malpractice.

Our de-escalation tactics avoid death 

His plea went unacknowledged as the officer continued to exert his authority and force onto Mr. Floyd’s lifeless body. This was no accident. Mr. Floyd’s death was a consequence of racism and abuse of power. We must not harm patients in order to keep them or ourselves safe; once we do, we cross the line between being a physician and an assailant. Just like the police, we are not above the law.

Mr. Floyd deserved better. Our communities deserve more.

Inhumane:Lack of humanity makes justice system more dangerous for blacks long before cops interact

In medicine, many others share these sentiments. We acknowledge room for improvement regarding health disparities that disproportionately impact black patients. Like the criminal justice system, our health care system lacks equity — as evidenced by long-standing disparities in maternal care, management of pain and cardiac emergencies, and recently highlighted by the COVID-19 pandemic. And despite standardized training in de-escalation, racial bias exists in the management of agitated patients. Notwithstanding, there are no patient care algorithms that support the use of lethal force in restraining any patient.

We acknowledge the harm that law enforcement may face. However, as EM physicians, we are no strangers to violence. We care for agitated patients from all backgrounds. In order to treat every patient with dignity, we prioritize de-escalation strategies that avoid death.

While our roles and rate of risk differ, the communities that health professionals and members of law enforcement serve are the same. Through education and the sharing of effective strategies among pre-hospital services and law enforcement, we can promote a culture of nonviolent de-escalation. Most of all, we can champion accountability in safety, efficacy, compassion and humane care for our communities. In solidarity, we must.

Dr. Onyeka Otugo is an Emergency Medicine Health Policy Fellow, Brigham and Women’s Hospital, Harvard Medical School. Dr. Adaira Landry is Assistant Residency Program Director, Assistant Professor, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School. Dr. Al’ai Alvarez is Assistant Residency Program Director, Clinical Assistant Professor, Department of Emergency Medicine, Stanford School of Medicine. Dr. Italo Brown is a Social Emergency Medicine Fellow, Department of Emergency Medicine, Stanford School of Medicine. Follow them on Twitter: @OnyekaOtugo, @AdairaLandryMD, @alvarezzzy and @gr8vision

Source: http://rssfeeds.usatoday.com/~/627076802/0/usatoday-newstopstories~ER-doctors-Were-no-strangers-to-violence-but-we-try-to-deescalate-without-anyone-dying/

CNBC

Tide is making the first laundry detergent for space

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Astronauts don’t have the luxury of tossing clothes in the hamper after a single use — without laundry equipment, they’re often left wearing items multiple times. Tide thinks it can come to the rescue, though. The Procter & Gamble brand has teamed with NASA to develop the first laundry detergent meant for space. The fully degradable detergent should take care of stains and odors while working properly in a closed-loop water system like the one you’d find aboard the International Space Station.

It won’t take long before you see a rea world (or rather, real off-world) trial run. NASA will test Tide’s detergent aboard the ISS in 2022. “Mission PGTide,” as it’s called, will gauge ingredient stability in space as well as the effectiveness of the stain removal ingredients using Tide’s pens and wipes.

Other studies will explore the possibility of a washer-dryer combo that could be use for long-term Moon and Mars missions.

The advantages for space are fairly self-evident. Those lunar and martian explorers won’t have any choice but to clean their clothes — this detergent could make that possible without subtracting from their precious water supply. It could also save weight and space aboard both the ISS and cargo capsules, as NASA wouldn’t need to send so many clothes into orbit.

 This could also be helpful for laundry back on Earth, for that matter. A fully degradable detergent would be more environmentally friendly, reducing waste and conserving water. Don’t be surprised if you eventually buy detergent that’s kind to the planet precisely because it’s designed to be used off-planet.

All products recommended by Engadget are selected by our editorial team, independent of our parent company. Some of our stories include affiliate links. If you buy something through one of these links, we may earn an affiliate commission.

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Source: https://www.engadget.com/tide-laundry-detergent-for-space-151235606.html?src=rss_b2c

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EdTech

Merlyn Mind emerges from stealth with $29M and a hardware and software solution to help teachers with tech

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We’ve chronicled, in great detail, the many layers of technology, services and solutions, that have been wrapped around the world of education in recent years — and especially in the last year, which became a high watermark for digital learning tools because of Covid-19. Today, a startup called Merlyn Mind is coming out of stealth with a proposition that it believes helps tie a lot of this together in the K-12 classroom — a “digital assistant” that comes in the form of a piece of custom hardware and software to “read” natural voice and remote control commands from a teacher to control multimedia apps on a screen of choice. Along with this, Merlyn Mind is announcing $29 million in initial funding to build out its vision.

The funding is being led by specialist edtech investor Learn Capital, with other unnamed investors participating. It comes after Merlyn Mind spent about three years quietly building its first release and more recently piloting the service in 50+ classrooms in more than 20 schools.

Co-founded by longtime IBM scientists Satya Nitta (the CEO), Ravi Kokku, and Sharad Sundararajan — all of whom spent several years leading education efforts in IBM’s Watson AI research division — Merlyn Mind is coming to the market with a patented, vertically integrated solution to solve what Nitta told me in an interview he believes and has seen first-hand to be a fundamental pain point in the world of edtech.

In effect, education and technology may have now been merged into a single term as far as the tech world is concerned, but in terms of practical, on-the-ground application, many teachers are not making the most of the tools they have in the classroom. The majority are, he believes, facing “cognitive overload” (which is not to mention the kids, who themselves probably are facing the same: a problem for it to tackle down the road, I hope), and they need help.

To be fair, this problem existed before the pandemic, with research from McKinsey & Co. published in 2020 (and gathered earlier) finding that teachers were already spending more than half of their time on administrative tasks, not teaching or thinking about how and what to teach or what help specific students might need. Other research from Learn Platform found that teachers potentially have as many as 900 different applications that they can use in a classroom (in practice, Nitta told me a teacher will typically use between 20 and 30 applications, sites and tech services in a day, although even that is a huge amount).

Post-Covid-19, there are other kinds of new complications to grapple with on top of all that. Not only are many educators now playing catch-up because of the months spent learning at home (it’s been widely documented that in many cases, students have fallen behind), but overall, education is coming away from our year+ of remote learning with a much stronger mandate to use more tech from now on, not less.

The help that Merlyn Mind is proposing comes in the form of what the startup describes as an “AI hub.” This includes a personal assistant called Symphony Classroom, a kind of Alexa-style voice interface tailored to the educational environment and built on a fork of Android; a smart speaker that looks a bit like a soundbar; and a consumer-style remote that can be used also for navigation and commands.

These then work with whatever screen the teacher opts to use, whether it is a TV, or an interactive whiteboard, or something else; along with any other connected devices that are used in the classroom, to open and navigate through different apps, including various Google apps, NearPod, Newsela, and so on. (That could potentially also include kids’ individual screens if they are being used.)

The idea is that if a teacher is in the middle of a lesson on a specific topic and a question comes up that can best be answered by illustrating a concept through another app, a teacher can trigger the system to navigate to a new screen to find that information and instantly show it to the students. The system can also be used to find a teacher’s own materials on file. The demo I saw worked well enough, although I would love to see how an ordinary teacher — the kind they’re hoping will use this — would fare.

Everyone knows the expression “hardware is hard,” so it’s interesting to see Merlyn addressing its problem with a hardware-forward approach.

Nitta was very ready with his defense for this one:

“I’ll tell you why we built our own hardware,” he told me. “There’s a bunch of AI processing that’s happening on the device, for various reasons, including latency and security. So it’s kind of an edge AI appliance. And the second thing is the microphones. They are designed for the classroom environment, and we wanted to have complete control over the tooling of these microphones for the processing, for the environment, and that is very hard to do. If you are taking a third-party microphone array off the shelf, it’s impossible, actually, you simply cannot.”

The startup’s early team is rounded out with alums from the likes of HP Education, Amazon, Google, Facebook, Broadcom and Roku to help build all of this, knowing the challenges they were tackling, but also the payoff once it would be finished if it all works.

“We have a very, very talented team, and we basically said, right, this is going to be a lot of hard work that will take us three and a half years. We have to build our own piece of hardware… and we ended up building the entire voice stack from from scratch ourselves, too,” Nitta continued. “It means we have end to end control of everything from the hardware all the way to the language models.”

He did point out though that over time, there will be some elements that will be usable without all the hardware, in particular when a teacher may suddenly have to teach outside the classroom again in a remote learning environment.

It’s a very ambitious concept, but where would education and learning be if not for taking leaps once in a while? That’s where investors stand on the startup, too.

“Just as we saw with the breakthrough edtech company Coursera which reached IPO this year and was started a decade ago by two machine learning professors, in today’s hypercompetitive market the best edtech companies need to start with an advanced technological core,” said Rob Hutter, founder and managing partner of Learn Capital. “Merlyn is one of the first companies to focus on the enhancement of live teaching in classrooms, and it is developing a solution that is so intuitive it allows teachers to leverage technology with mastery while using minimal effort.  This is a very promising platform.”

The proof will be in how it gets adopted when it finally launches commercially later this year, with pricing to be announced later.

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Source: https://techcrunch.com/2021/06/22/merlyn-mind-emerges-from-stealth-with-29m-and-a-hardware-and-software-solution-to-help-teachers-with-tech/

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Several Anker charging gizmos hit record low prices for Prime Day

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All products recommended by Engadget are selected by our editorial team, independent of our parent company. Some of our stories include affiliate links. If you buy something through one of these links, we may earn an affiliate commission.

A slew of Anker charging gadgets are on sale for Prime Day, with several products dropping to the lowest prices we’ve seen for them to date. Take the Anker 63W 4 Port PIQ 3.0 & GaN Fast Charger Adapter, for example. It’s a slim charging hub with two USB-A ports and a pair of USB-C ports, allowing you to juice up four devices at once. One of the USB-C ports supports fast charging at up to 45W and the other at up to 18W. The adapter is currently on sale for $39, down $22 from the standard price of $61.

Buy Anker 63W 4 Port Fast Charger Adapter at Amazon – $39

Several powerbanks are on sale as well. The PowerCore III 10K Wireless has a 10,000mAh capacity, as the name suggests. The Qi-certified product can charge devices wirelessly at up to 10W, or up to 18W through the USB-A and USB-C ports. It’s currently $32, down from $50.

Buy Anker PowerCore III 10K Wireless at Amazon – $32

If you’re looking for a powerbank with slightly faster charging and a larger capacity, consider the PowerCore Essential 20000, which can provide up to five full battery charges to an iPhone 12, according to Anker. It has a 20W USB-C port, and it’s currently down from $50 to $35.

Buy Anker PowerCore Essential 20000 at Amazon – $35

Elsewhere, you can save on the Anker PowerCore 26800 Portable Charger, which usually costs $65, but is $40 for Prime Day. The external battery can juice up most phones at least six times on a single charge, Anker claims. It doesn’t have a USB-C port, but you can charge up to three devices at the same time through USB-A connections.

Buy Anker PowerCore 26800 at Amazon – $40

There’s a smaller discount on the PowerCore 10000, a compact 10000mAh powerbank. It’s down from $20 to $17. Anker has other products on sale for Prime Day, including headphones, earbuds and cables. You can check out all of the deals on the company’s Amazon storefront.

Buy Anker PowerCore 10000 at Amazon – $17

Get the latest Amazon Prime Day offers by visiting our deals homepage and following @EngadgetDeals on Twitter.

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Source: https://www.engadget.com/amazon-prime-day-anker-charging-hub-powerbank-sale-143926180.html?src=rss_b2c

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SaaS

How much to pay yourself as a SaaS founder

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“If you’re the founder of a seed-stage [company and] you’re worried about your electricity staying on this month, then your salary is too low. If you’re saving $10,000/mo, then your salary is probably higher than necessary,” investor Leo Polovets wrote in a Twitter thread.

Ultimately, a good test is to ask how you’ll feel if your startup fails: Will you wonder if your salary contributed to its fall? Or will you regret sacrificing more than you can recover?

This tweet is just one of many in a now burgeoning conversation about how founder pay needs to change. The startup and investor communities are beginning to realize that many founders can’t go without pay for months.

Founders of SaaS startups are at an advantage in this scenario as the sector now has many companies generating revenue almost from day one, sometimes without needing to raise any funding at all.

However, the success still doesn’t tell founders how much to pay themselves, or what others are doing. To help with this, we’ve gathered insights from founders and VCs and narrowed down the most important factors and benchmarks to guide your decision.

A framework for compensation

Founder compensation is often referred to as a “founder salary,” but anchoring the conversation around the salary framework can create the wrong expectation. For example, you could try to establish a correlation between what you plan to pay yourself and your past or current value on the job market. Instead, the data we gathered indicates that founders typically take a pay cut from their previous salaries.

Chris Sosnowski is an interesting example: Before he “took the plunge” at the beginning of 2020 to work full time on his water data management startup Waterly, he used to earn “well over” $100,000. But he says his previous salary wasn’t a key factor when he set his compensation. “I decided to pay myself based on what I thought it would take to keep the company running,” he wrote to TechCrunch.

That brings to mind deferred compensation, which will be familiar to anyone who owns equity. Having put his own money into the company and owning the majority of it, Sosnowski is set to be compensated for his efforts if all goes well. “For the record, I do hope to pay myself back [a] salary for the year or so [it is] reduced like this,” he said.

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Source: https://techcrunch.com/2021/06/22/how-much-to-pay-yourself-as-a-saas-founder/

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