After acquisition - we were handed down the order to migrate to AWS.
This was after (in the mess of the merger) the colo contracts were basically ignored and not renewed. Once someone within the company realized the issue, it was the 11th hour.
After many, many attempts to discuss our (Operations team) concerns, we abandoned our protests. It was clear the new CTO wouldn't cave and sign the contract.
Some superficial testing was conducted and the order came down to move...NOW.
We began moving hundreds (maybe thousands) of very resource hungry DB servers first (there was no way to use something like RDS without major app/config changes).
Once the AWS bill came in, the CFO blew their lid and within 90 days we were migrating BACK to our DCs (and the millions of dollars of hardware we left idling).
Versions of this story are pretty common out there. People migrate to cloud because The Cloud and think they're going to save money, get extreme sticker shock, and migrate back... if they can. Sometimes they get locked in and are sort of stuck.
Lisa Su would be a better example IMO. She has remained laser focused on the turn around of AMD and mostly reserved i.e. tends to under promise and over deliver . Pat Gelsinger has been the complete opposite i.e. tends to over promise and under deliver. Intel has poorly executed a quite a few things while Pat has been CEO.
> Intel has poorly executed a quite a few things while Pat has been CEO.
He's been CEO for 3 years, considering the state of decay of Intel in 2021 that's not a lot of time to turn things around. AMD took ~6 years between Bulldozer and Zen 1 and you could even argue that Zen 2 is when it truly became competitive so that's 8 years.
I'm not saying he's the Intel messiah FWIW, just that the jury is probably still out on whether he will deliver or not.
Anecdotal experience - Good friend of mine who struggles with weight was taking Ozempic for about two months.
He described nausea quite often when I saw him but the results were pretty astounding.
He then hit a wall where gastroparesis would happen quite often and I happened to be at his house when one of these bouts got very severe. He went from feeling bad, to hunched over in pain and started projectile vomiting in the span of 30 minutes. He said it was clearly the meal he had eaten several days ago...it was awful.
I believe this happened to him several more times - and AFAIK he stopped taking it, and promptly regained some weight back.
His doctor isn't monitoring correctly. They should drop the dose. Standard treatment is start with a really smart dose then you double it each month for 5 months. In reality, if you're losing weight, you should just keep on that dosage.
May be his pharmacy struggling with supply -- I hear lots of folks are titrating outside of the guidelines because they can't get the appropriate dosage.
I wish more folks would get comfortable crushing tablets and weighing out their own dosage on scales. It’s not that hard to cut tabs in half or crush two and make 3 doses out of those, then put them back into caps. Empty gelatin caps are cheap and easy to work with.
Should anyone have to do this? Of course not, but if the choice is between this or projectile vomit every waking hour, it’s not a hard choice IMO.
Lastly, I just wanted to take a moment to think about how useless pharmacies have become that they can’t actually do this for you anymore and literally just count out pills, or more realistically push a button on a machine that counts out the correct amount.
I agree with your general point, although (and it may not be the same everywhere, but is certainly true in the UK) Ozempic is supplied as a pre-filled pen injector that handles the dose for you, and is taken once a week - there are no markings for a half-dose (and the patient info sheet seems to suggest that a partial dose isn't possible)
Having taken it, I can say that attempting a half-dose of Wegovy pens would have wildly varying results. The smaller Ozempic pens can easily titrate down, but Wegovy pens are not at all designed for it.
Even some pills cannot be split really easily. One example I like to give is Vyvanse. It uses extended release balls that are not evenly distributed in terms of what they contain (I’m no expert here, just going off a doctor’s summary). The only way to properly split it is to pour it into a glass of water and let it dissolve, then take the percentage of the dosage that you need and consume that percentage of water before the contents settle and while they still remain in a well mixed suspension. The remainder of the dosage is essentially no longer any good by virtue of being inactivated over time by being in the water and must be discarded.
My understanding of Vyvanse is that it uses metabolic mechanisms in order to time the release of the drug which helps to prevent abuse. I'm far from a doctor however.
vyvanse relies heavily on the second pass effect to activate, which is what makes it resistant to abuse. it also means if you don’t make sure to eat lunch the second half of the dose doesn’t kick in until supper and you end up being awake until 4-5am. ask me how i know…
don't some medicines have a time delay release mechanism that this would defeat? getting that much of a dose of some medicines all at once wouldn't be ideal I'd think. caveat emptor and all that.
For Windows deployments - Microsoft Intune provides the ability to monitor any application and its version. Updating is automatic provided its installed correctly and using detection rules. The responsible party updates the MSI installation files and the local management service will perform the update.
Yeah, but who uses MSIs? Windows Installer is just a flash in the pan. It's so much easier to just make an Inno Setup-based SETUP.EXE. /s
It makes me shudder to think how many hours (days? weeks?) of my life I'd have back if developers had just packaged their Windows application as MSIs instead of making me, as a sysadmin who wants consistently updated client computers, do it for them.
The inmates have been running the asylum at Microsoft for a number of years now. I assume it’s necessary to re-invent wheels, badly, for career advancement. (That’s not to say that MSI is particular nice, but it works reasonably well and saves a lot of downstream headaches.)
Using an anecdotal source - My Wife (ICU RN) this is sounds right.
Outside of the existing issues with Bedside nursing (long days, physically demanding) - the primary issue is staffing. Pre-pandemic the ratios were already bad but now many are leaving for travel contracts which carry significantly better wages. It quickly becomes a loop where employees leave for Travel Contracts, and then can only be backfilled with Travel Contracts. The remaining FT staff nurses are left making much less money, and have to assist "training" with the outside Travel nurses. And while this is nothing against them - The travel RNs also often have a different "vibe" as they are much less focused on long term improvement or problem solving within the Unit.
Also ICU/PCU/ER nursing throughout the pandemic was a terribly depressing place to be. Leaving many of my Wifes colleagues (including herself) with what is essentially PTSD with little or no support from the Hospital System.
Should it? The market for medical care has a base rate (and appears to be clearly under-staffed for that rate), but (especially in a pandemic) it's rather peaky and the basic skills appear to be VERY transferable from location to location. If there are people with the skills that are willing to travel, it seems that a system that maintained maximum capacity in all locations would be a very wasteful one.
Yes, it should be indicative of a problem. The fact that nurses are overworked, and underpaid is a big issue.
> If there are people with the skills that are willing to travel, it seems that a system that maintained maximum capacity in all locations would be a very wasteful one.
The general idea here is that more and more nurses are willing to do this because they are underpaid and overworked in their regular (non-Travel Nurse) positions. I didn’t see anyone arguing for “maximum capacity” either… just better wages and working conditions.
> basic skills appear to be VERY transferable from location to location
If you read the parent comment by sllewe you will see that there are other costs and concerns around this which do more to stress existing nurses at whatever hospital is being filled with travel nurses. Imagine training a new someone every week (or however often new travel nurses pop up) while also having to do your own job… especially when you are already being overworked and when a miscalculation on your part could result in loss of life. All the while knowing that the travel nurse is making significantly more money than you, negotiated their hours of availability and doesn’t have to care about the unit beyond whatever contract length they signed up for..
I was referring to utilization level of workers, not stress or danger. If resources are planned too tightly, slight alterations can cause disruptions, so you might need additional workers.
Because that growth is used as a substitute for profit (or net income or EBITDA - take your pick). For a public company having one or the other (or rarely, both) keeps the ticker price moving in the right direction.
Yes the "rest" of the world knows the "truth". It's just a matter of defining what "the rest" and "truth" mean. In the context of the modern Axis of Evil also known as Five Eyes the "truth" is whatever the propaganda machine releases to its mass audience of intellectually handicapped people.
The "truth" were the "weapons of mass destruction" where the Allies killed over 550k children only in Iraq, not counting Syria, Libya, Afghanistan. Quiet an achievement in just twenty years. Let's not talk about killing children in Serbia in 1999, keeping Cuba isolated for over fifty years, having English aristocracy go on man-hunts in Africa in the 1980s... "truth" is a very funny word nowadays.
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