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Washington State’s Growing Vaping Restrictions

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In response to the outbreak of vaping-related illnesses, labeled E-Cigarette or Vaping product use Associated Lung Injury (EVALI) by the CDC, Washington State has implemented increasingly strict vaping regulations. The state began by banning flavored vaping products in October, signed by the executive order by Gov. Jay Inslee and set to last 120 days. Since the signing of the order, the CDC has determined some primary causes of the illnesses: vitamin E acetate.

 

Vitamin E Acetate

A common ingredient in the black market, THC laced vape products, vitamin E acetate is not meant to be inhaled. When ingested orally or through the skin, as in pills or lotions, the solution is safe and often used as a supplement. When inhaled, the acetate sticks to and burns the lungs. Traces of vitamin E acetate have been found in a majority of EVALI cases, and most commonly in people who have reported using unregulated, THC vaping products. The substance has yet to be found in regulated vaping products.

 

If It’s Vitamin E Acetate, Why the Large Scale Ban?

While vitamin E acetate might be suspected of causing illnesses, it isn’t the reason people are vaping. JUUL and other e-cigarette manufacturers have been under heavy criticism, including lawsuits, for their part in getting minors addicted to nicotine through flavored vaping products. Statewide bans of flavored vaping products have been put in place in multiple states, and Washington State just implemented a ban on all vaping products containing vitamin E. It is currently unclear what the most recent ban will do, as most of the products currently containing vitamin E acetate are already unregulated and manufactured outside the scope of the law. 

Beyond the ban of the suspected substance, banning flavored vaping products is also an attempt to reduce the number of minors at risk of developing an early nicotine addiction. E-cigarettes have incredibly high nicotine levels and were marketed heavily towards a younger audience. This marketing failed to acknowledge all the risks of nicotine addiction, and flavored products make vaping more appealing to minors than traditional smoking. The ban is hoped to stem the rising tide of minors who will suffer the life-long effects of nicotine addiction.

What’s Going on with GM, Fiat Chrysler, and the UAW

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Lawsuits and corruption charges have been flying around the auto industry like debris in a tornado. Most recently, American automaker GM filed a lawsuit against Fiat Chrysler, accusing the European manufacturer of bribing leaders in the UAW to get favorable labor costs. This has lead to a strong denial from Fiat Chrysler, who is currently in the middle of a merger with fellow European manufacturing giant PSA. The stock for both GM and Fiat Chrysler dropped Wednesday due to the suits, GM by about 3%, Fiat Chrysler by about 3.7%.

 

Why did GM do this? 

So if it was Fiat Chrysler that was allegedly engaging in bribery with the UAW, why is GM getting involved? Well, if you’ve been watching the news, you might remember that GM recently reached an agreement with the UAW after huge worker strikes in Detroit. The deal was difficult to create, and it’s likely that sacrifices were made on both sides for the workers to get back to work. The strike also cost GM upwards of $2 billion. 

 

The crime of which GM is accusing Fiat Chrysler is bribery, or rather, bribing higher-ups in the UAW to reach a more beneficial agreement for the manufacturer. If this is true, Fiat Chrysler would be able to produce American-made cars significantly cheaper than other manufacturers, GM included, making competition unfair.

 

What’s the Basis?

In the lawsuit, GM accuses five Fiat Chrysler executives of corruption, three of which have already been convicted by a federal anti-corruption probe. 

 

Also charged with white-collar crimes was UAW Regional Director Vance Pearson, who, along with as-of-yet uncharged UAW President Gary Jones, has been caught embezzling large amounts of funds from the Union. 

 

Fiat Chrysler strongly denies any claims of wrongdoing during their ongoing negotiations with the UAW, and the UAW remains committed to implementing new anti-corruption reforms.

Opioid Tapering in the US

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The opioid epidemic is one of the worst crises currently gripping the country, and much of its roots came from over-prescription. Since 2016, the federal government has been trying to counteract the failures of the pharmaceutical and medical industries by producing guidelines for responsible opioid prescription tapering. Tapering describes slowly lowering doses of ongoing prescriptions until the patient is either no longer dependent or only using the bare minimum.

 

The Origins of Tapering

The original CDC guidelines for tapering were relatively vague, leaving a lot up to interpretation. Weekly doses were suggested to receive 10-50 percent reductions, with more rapid taperings suggested for post-adverse event. The guidelines did say that long-term opioid users shouldn’t see more than a 10 percent weekly reduction. 

 

In April, the CDC and FDA released some clarifications regarding their guidelines, acknowledging the severe risks that can be caused by tapering doses in cases of chronic pain. The main risk of such practices is psychological, with patients who have developed a dependency on the drug, becoming desperate and seeking opioids from illegal sources, putting them in greater jeopardy. 

 

The New Guidelines

In October 2019, HHS released updated guidelines. These included suggestions for when tapering should be considered, including:

 

  • Pain improves
  • Pain fails to improve 
  • The patient requests dosage reduction or discontinuation
  • The dosage is unnecessarily high
  • The patient has a history of opioid abuse
  • There are serious side effects
  • The patient has an adverse effect or overdose
  • The patient is receiving medical care that increases the risk of an adverse effect
  • The patient is a long-term opioid user

 

The new guidelines also include a flow chart for how physicians should determine whether or not to implement tapering with their patients, making clear that the patient should be involved in the decision and that all risks and benefits should be considered.

 

Where Tapering Goes Wrong

While overprescribing opioids can count as medical malpractice, so too can irresponsible tapering. The average reduction rate for tapering between 2016 and 2017 was 27.6 percent per month, nearly triple the CDC’s recommendation of no more than 10 percent. Rapid tapering can lead to serious withdrawal symptoms, many of which can be crippling, including pain, desire for the drug, diarrhea, and vomiting. Slow tapering can help to reduce these symptoms while monitoring the patient’s health and adjusting as need be.

You Might Need to Update Your Hiring Practices

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Employers look for certain things when they are hiring, largely whether they think the candidate The former is always vital, though flexible, but the latter can end opportunities to hire the right candidate. 

 

Your Internal Biases Will Be Your Downfall and AI isn’t Always the Answer

Everyone has internal biases. They are natural and normal, but that doesn’t mean that they’re good. Recent developments in AI are promising hiring lead by machine learning as a solution to discrimination, but have been met with unease.  After all, machine learning gets its knowledge from existing decisions. If previous decisions had a human bias towards men over women, the AI might pick up on that and continue that bias. If the AI has been told to value athletic candidates, even if the employer intends it for the teamwork implied in sports, a large section of disabled candidates could be sorted out even if they have the skills necessary.

The point is, you can’t exclude candidates until you know they aren’t right for the job, and you can’t hire candidates until you know that they’ll bring something to the team. You won’t always know what it is that they’ll bring. The Wall Street Journal wrote an article in 2016 about how Silicon Valley businesses weren’t getting most of their hires from Ivy League schools, but relatively large, not overly exclusive ones. In fact, no Ivy League school made it into the top 10 schools most hired from in Silicon Valley. While common hiring advice might be to go with the school with a better name, that hasn’t proven to be the best practice.

 

How Unexpected Candidates Can Change a Workplace

Homogenous teams rarely create revolutionary ideas. For true innovation, you need a collaboration of people from different backgrounds with different ideas. 

This means that hiring managers need to look at factors other than education and hard skills. Transferable skills and personality types are what should be looked at, but unfortunately, there are biases here too. Outgoing personalities are often preferred to quieter candidates, but a team full of leaders isn’t going to get anywhere. In an article by the Harvard Business Review, authors Elena Butler and Shreya Kangovi describe how in the medical world hard skills are often prioritized over important personality traits such as empathy. It’s common practice to hire someone who is qualified on paper and then try and teach them empathy, instead of hiring the people with the right personality for the job and then teaching them the hard skills they might not be familiar with yet.

 

Dealing with Conflicts

Of course, with the introduction of a diverse workforce, conflicts can arise. It’s important to remember that conflicts arise in every workforce. What’s important is that your company is ready to handle it fairly. This requires a well-prepared HR department that understands how to manage conflicts between two parties that might have very little in common. When discriminatory practices extend to the HR department, your company will likely end up with a lawsuit.

What the Arguments in the Supreme Court Mean for DACA

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The Obama-era program DACA, Deferred Action for Childhood Arrivals, has been under attack from the moment it was announced in 2012. The program provides legal status for undocumented immigrants who arrived in America before the age of 16 and prior to 2007, allowing them to legally work, get drivers licenses, and attend universities and colleges. Over 700,000 people have utilized the program, many cautiously. The fear was due to the distrust of providing contact and personal identification information to the government while also registering as an undocumented immigrant. These fears have recently proven to be valid.

 

Tuesday’s Oral Arguments

After multiple attempts to end the program, the Trump administration found themselves as defendants in the case against the repeal of DACA. The plaintiffs, made up of DACA recipients from California, New York, and Washington D.C., are making the case that the repeal isn’t on legitimate grounds and would be damaging not only to the recipients who would face deportation, but also the communities they live in.

 

The supreme court heard arguments from Solicitor General Noel Francisco on the side of the defense and Theodore Olsen on the side of the respondents on Tuesday, and its reaction was not comforting to the response. 

 

The current supreme court is relatively conservative compared to recent years, with a 5-4 conservative majority. While liberal justices Elena Kagan and Ruth Bader Ginsberg strongly criticized the basis of Francisco’s arguments, but justices Samuel Alito and Neil Gorsuch showed sympathy for the defendant. 

 

The Arguments of the Defendant

Much of Francisco’s argument was based on policies of the Trump administration, mainly the idea that Obama’s implementation of DACA was illegal. Recent online statements by the president also suggested that the administration is taking a harder line on recipients, stating that many of them are “hardened criminals.” It should be noted that immigrants are only eligible for DACA if they have zero outstanding felonies and no more than three minor misdemeanors, meaning that no legitimate DACA recipient is a “hardened criminal.” 

The defendants also argued that DACA was always intended to be temporary anyway, as shown by the two-year renewal requirements for recipients.

 

The Arguments of the Respondents

Olsen’s argument largely centered around the question of whether or not the Trump Administration’s decision violated the law, as the reasons so far given by the administration have had little basis in fact. The Department of Homeland Security policies that have led to this case has been centered around the idea that Obama violated the law when he signed DACA into law, which the liberal justices questioned. 

The respondents argued that the case should be sent back until the administration could provide an “accurate, reasoned, rationally, and legally sound explanation” for the repeal. This argument led justice Alito to criticize him for wanting to extend the case for another unspecified period of time.

 

What Happens if The Ruling Ends DACA

If DACA is ended, hundreds of thousands of working, studying, and tax-paying residents of the US would face deportation. Beyond that, many of the recipients are now adults and have families with American-born children, which would likely be separated from them if they get deported back to a country they haven’t lived in since they were a child. The ruling would also show a troubling loyalty to the Trump administration, who hasn’t provided a clear and rational reason for its decision. 

 

A ruling on this case is expected by June 2020.

The Leading Causes of Child Injuries (And How to Avoid Them)

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Seeing your child, or any child, get injured can be traumatic for both you and the child. The effects of which can follow the child for the rest of their life. If you have a child and want to do your best to avoid them getting injured, you should know the most common injuries faced by children. This will help you to prepare and fight against them.

Chart showing leading causes of child injury

Falling

Unintentional falls are the most common causes for unintentional injuries resulting in emergency room visits, with an estimated 1.64 million cases reported in 2017. Falls are never completely unavoidable, as children are going to stumble as they’re learning to walk and the Earth isn’t a completely smooth sphere. The best way to keep your child safe from injuring themself is by taking note of the unguarded ledges of your surroundings and keeping a close eye on your child. If your child gets seriously injured from a fall in and area that was meant to be protected you may be able to claim for damages on behalf of your child.

 

Unintentional Struck by/Against

If your child is accidentally hit it can be hard to know what to do. Over 850,000 children were hospitalized due to being struck accidentally in 2017, some of which could have been avoided. The best way to avoid having you child be hit accidentally is to avoid situations that might involve erratic activities, such as group sports with participants older and/or larger than your child. If they do participate in such activities, make sure to watch that they don’t get out of hand. 

 

Bite/Sting (Not Dog)

Animal bites and stings are extremely common, with 298,000 children being hospitalized for them in 2017. These can sometimes be difficult to avoid; bees sting, animals bite. The best way to keep your child from getting bit is through education. Teach your child to respect and observe animals from a distance. The lesson is consistent with bugs, for the most part. Bees generally don’t want anything to do with people and teaching your child to remain calm in their presence will drastically reduce their risk of getting stung.

 

Overexertion

Overexertion occurs when a child is pushed physically beyond their limit. This could be due to exhaustion, hunger, dehydration, or all of the above. Overexertion can take the form of extreme fatigue, losing consciousness, decreased cognitive function, and simple inability to function. Sports and video games area common causes of overexertion in children, meaning it can be avoided with observation and making sure your child is sufficiently rested, fed, and is not trying to do things like lift heavy boxes. 

 

Cut/Pierce

Being accidentally cut or pierced is a risk of being a child, and 213,000 children were sent to the emergency room with related injuries. Similar to bites and stings, the best way to avoid injuries is through education. Teach your child knife and blade safety (this doesn’t mean giving your child a knife, just teaching them things like not taking food off a cutting board while cutting is still happening). Removing the mystery from dangerous objects helps to lower the desire to interact with the objects. Beyond education, keep sharp objects away from young children. Install child-locks on knife drawers and tool boxes. If you see your child(ren) playing with a sharp object, remove it and explain why its a bad thing to play with. 

 

Foreign Body

If your child is hospitalized due to a foreign body, they probably found something to interact with that was smaller than it should have been. These injuries are most common with young children between the ages of 0 and 3, and the objects are often common household items such as coins, marbles, or jewelry. The main way to avoid these injuries is to keep a close eye on your child and pay attention to what they’re putting in their mouths and other orifices. Keep coins and jewelry on high shelves and make sure to buy child-safe toys.

 

Motor Vehicle Occupant

One of the scarier injuries children may face are as a result of being passengers in a car. Car accidents can happen at no fault of your own and be devastating for everyone involved. The best way to keep your child safe while they’re in the car is by following the CDC suggestions for restraints and by always driving safe. Seatbelts and other child restraints save countless lives annually, and the best way to teach a child the importance of buckling up every time is through example.

Avoiding a Hostile Work Environment

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A recent article in the New York Times paints a picture of two very different experiences of medical school and working in medical fields; those who experience microaggressions and those who don’t even see them.

The article was written by Dr. VJ Periyakoil (@palliator) who has been working on Stanford University’s Project Respect, which is dedicated to enlightening and advising people on how to avoid making coworkers feel uncomfortable and unwelcome, and instead steer them towards “microvalidations:” small actions that help peers feel valued. The project goes into examples of microaggressions and how people nearby might be able to step up and diffuse the situation.

 

What Are Microaggressions and How to Avoid Them

Microaggressions are small actions that often don’t feel like they’re worth the trouble of calling out in the moment but can stick with the recipient for hours or days after the incident. They can build up to a hostile work environment, making (usually) women and minorities always feel second best in positions that they earned. 

Examples:

  • Making uncomfortable comments about private lives
  • Making jokes about sexuality or gender
  • Making comments in which the peer’s abilities are questioned
  • Not including peers in discussions or activities

 

The Respect Project explains that the people making such comments are often well-intentioned and are making the comments as a joke. Pointing out that such jokes are in poor taste can make it feel like the situation is turning uncomfortable, but it’s important to remember that the comment made the situation uncomfortable, not pointing it out. 

The best way to avoid microaggressions is by calling them out. The most effective group for making this point are the onlookers, not the person being targeted by the comments. It’s not uncommon for the person making the comments to get defensive if the person they were talking to calls them out, but if the person being targeted has support it makes it clear that such behaviors aren’t welcome in that workplace. If the person continues to behave in such a manner, they might end up in a harassment suit.

 

It’s Time To Embrace Microvalidations

So what are microvalidations? Using context clues and a basic understanding of word structures, it can be deduced that they’re small actions that uplift peers. These are NOT comments about looks or ability based on gender or race (i.e. “you’re looking nice today,”  “you’re doing pretty good work for a woman,” and “wow you’re so relatable even though you’re not white!” are NOT compliments). 

Examples:

  • Smiling (NOT winking)
  • Showing appreciation for work
  • Complimenting/recognizing good work
  • Including peers in activities (asking peers out on dates DOES NOT count)

 

Microaggressions can come from anyone, and anyone can be a recipient. Some groups are more likely to be recipients, but that doesn’t mean that anyone is exempt from the ability to feel harassed or discriminated against due to ongoing bullying. 

Similarly, no one needs to be excluded from making or receiving validation. If you see someone doing something right, tell them. Diverse workplaces aren’t going anywhere anytime soon, and it’s important to embrace the challenges they provide.

Industries With the Highest Drug Abuse Rates

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With the ever-increasing number of states legalizing marijuana and the growing opioid epidemic, employers wouldn’t be out of line to be worried about drug usage among their employees. Beyond simple employer worries, recent surveys have shown steady increases in drug usage among professionals in a number of sectors, largely manual work.

 

The Construction Industry

Workers in the construction industry have seen a 46.7% increase in marijuana use since 2018. Beyond that, 3.4% of construction workers reported using non-prescription opioids. For comparison, the average non-prescription opioid use rate for other professions is about 2%.

These numbers are largely due to the nature of the work, which is straining and can easily lead to injury. A large percentage of opioid abuse begins with an official prescription given after an injury. Worker’s compensation is often more willing to cover opioid prescriptions that better long-term solutions such as physical therapy or surgery.

 

Oil and Gas Extraction

There are about 161,300 people working in oil and gas extraction in America, and, when grouped with construction workers, had a 12.2% fatal injury rate in 2017. High-stress jobs such as oil and gas extraction can lead to workers self-medicating with marijuana or, in the case of a more serious injury, opioids

 

Other Industries

Some other industries also saw high rates of drug abuse, whether marijuana, opiates, amphetamines, or cocaine based. Of the entertainment, recreation, and food services industries (all of which had at least double the national rate of drug usage), the food services industry is the most interesting due to its 17.3% drop in marijuana usage over 2018. 

 

The Takeaway

More dangerous industries have higher rates of drug use, as workers are more likely to self-medicate. Jobs involving manual labor are more likely to produce work-related injuries that the worker is unlikely to be able to afford thorough care for. When faced with an option between an expensive and time-consuming healing process on their own dime or an opioid prescription covered by their worker’s comp, a worker shouldn’t be expected to take the former.

Is Facebook Ads Targeting Discriminatory?

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Facebook Ads have pinpoint-specific targeting technology, letting advertisers narrow their audience down by location, age, gender, political affiliation, and interests, which has led to some controversy. Most recently, Facebook is the subject of a lawsuit claiming the company has allowed illegally discriminatory ad campaigns to run on their platform. 

 

The Lawsuit

A federal district court in San Francisco is currently reviewing a complaint made by 54-year old Neuhtah Opiotennione, who is seeking a class-action suit against Facebook. Opiotennione is looking to highlight the discriminatory allowances still made by the company, specifically in ads for financial services. Credit opportunities are the one exception, as the Equal Credit Opportunity Act (ECOA) made exclusionary advertising on the basis of gender, age, race, religion, national origin, or marital status illegal for companies selling credit opportunities. 

This law was put into place to protect historically discriminated groups who have had trouble getting approved for loans due to their demographics. 

Opiotennione claims that this is still the case, regarding age and gender, as older women (Facebook defines “older” as over the age of 40) are often excluded from ads regarding financial services. 

 

The Basis

Until 1974, women were not allowed to open bank accounts or apply for credit cards in America. 1974 was also the year the ECOA was implemented. Before this, ads for loans and credit cards were targeted specifically to men, removing access to better loans for women and, more specifically, unmarried women. Older applicants continue to have trouble getting access to financial services, and often get excluded from financial advertisements.

Facebook has already received backlash for its advertising practices, forcing them to rename their “ethnic” demographics option to their “multicultural” demographics option. They eventually removed the option altogether for housing, credit, and jobs related ads. Following a different recent lawsuit, the company also removed large amounts of targeting options from financial and job opportunity advertisements, but still allows options for “people ages 24-40” and “men ages 20 and older.”

 

Facebook’s Response

Facebook has responded to the criticism by bringing up their past changes to targeting options and emphasizing their devotion to community inclusivity.  Whether they’ll change their guidelines is currently unknown.

Do Not Go to Reddit With Your STD Questions

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A recent study focused on the social media website Reddit, and more specifically, a crowd-sourcing sexually transmitted disease (STD) diagnosis forum on the site. The forum is quite active, with over 16,000 posts over an 8-year period, and posts get a response in an average of 3 hours.

 

Why it’s a bad idea to crowdsource an STD Diagnosis

Crowdsourcing medical advice is nothing new. It can be argued that most home-cures are crowdsourced, as there is no official medical basis for the idea that vitamin C will help you recover from a cold faster or eating sugar helps to heal a burnt tongue. 

STDs are a different story. Due to their contagious and often taboo nature, it can be easy to spread devastating STDs without telling anyone, and sometimes without knowing yourself. A proper medical diagnosis will provide the best options for treatment and containment. 

Despite the study looking at 500 random posts on the forum, the researchers were unable to provide statistics on whether or not the advice provided was sound. The reason they were unable to do this was that the researchers themselves were unable to properly diagnose the posters without sufficient knowledge of the patient or their situation. And that’s the entire point. Of the 500 posts reviewed,  20% were seeking a second opinion after being diagnosed by a healthcare professional. It is always recommended to trust the advice of healthcare professionals over strangers on the internet. Many factors go into making a diagnosis, and even attached photos won’t answer all of the questions a doctor might have.

 

Doctors can be held accountable for mistakes

One of the reasons doctors stay in school for years after receiving their bachelor’s of medicine or science is so that they are properly qualified to answer questions. When they make a mistake, they can be held accountable. Unfortunately, Reddit users giving their opinions cannot be found liable for medical malpractice, making their diagnosis much lower stakes for them. 

Of course, there are some times when doctors do make mistakes while diagnosing or otherwise. Sometimes doctors will fail to properly treat their patients, which can lead to an uncomfortable and potentially dangerous situation for those with STDs. 

In an example post, one person said that their doctor told them not to worry about his girlfriend’s high risk of human papillomavirus (HPV) since “guys have nothing to worry about and everyone has it.” This is not good advice since the Center for Disease Control has found that at least six different types of cancer can be caused by HPV in both men and women. This is an example of when a second opinion is recommended but should be sought from another medical professional.

If the stranger on the internet gives advice that leads to improper treatment, the fault is on the patient for following bad advice. 

 

This could be leading to increased rates of STDs

Improperly treated STDs can be easily spread, and the convenience and anonymity of asking a forum on the internet can make seeking unqualified advice more enticing than visiting a doctor. This is why doctors are worried about the rapid growth of these forums, as they may be leading to increased rates of STDs.