Yeah, but by now the much lower cost and higher efficiency of panels vs. the drawbacks of the location has shifted the cost/benefit ratio quite a bit.

It’s far cheaper to build the panels where the energy is needed and compensate for bad weather by building more panels (and other sources) instead of having the drawbacks of the north african location. Solar panels in the desert are an issue - as noted here multiple times, sand does not mix well with panels, neither does too much heat. Solar reflector plants have never really taken off due to various issues as well. For countries that have access to comparably cold deserts like the PRC it’s a bit different and they have implemented similar plans

And transport remains an issue by itself and so does political stability in these countries.

Tbf, I remember the times we reused everything, even tubes.

And it was a mess and there is so much evidence that the whole process of reusing is even worse for the environment.

Gitea once now Forgejo.

Proton doing another shady thing?

Colour me surprised!

Mailbox,formerly mailbox.org

Tuta,which is often recommended, is sadly another vendor lock in while mailbox is using industrial standards.

Well,patients do get asked for consent before these pictures are taken (and usually are again asked for approval again when the whole thing is layouted).

But,tbh, most patient I got to know with similar, rare, cases are often more than happy to help science and help other patients who experience the same right now or in the future.

I personally had a case I worked with peripherally where a breast implant basically exploded after a road traffic accident and the poor, rather young, patient suffered from a catastrophic infection and bodily reaction before that. As in: “She nearly died,was on ecmo, needed her sternum replaced”-catastrophic. (And no, not a cosmetic breast implant, just making sizes equal)

Tbh, despite extensive plastic surgery the final result was…really grim. I have seen third degree burns with a better cosmetic result… Especially for such a young woman. Further correction would need to be done much later, at least 5 years from then. She was nevertheless very keen on appearing in the case report and did willingly take part in photos(and even provided pre incident photos), appeared in front of medical students and interns, etc. It was part of her way of dealing with it,of making sense out of this freak occurrence.

Shit. That’s a terrifying case in so many aspects.

My condolences to your spine.

I don’t know where you live,but as you are mentioning 911 I guess it’s the US - there are a shitton of ambulance services that use nurses as BLS or ALS providers around the world. (The netherlands, sweden, Italy, Spain, just to name a few. I intentionally do not name the US here,see below)

For the US, UK and to a lesser extent Germany there is a simple reason: You guys did fight tooth and nail not to do so.

But let’s go back a bit further: If you look into the history of EMS it’s not like that the fire departments were that happy to do so (and to this day I am a staunch opponent to them doing so. It’s an all around bad idea) and in many parts of these countries police, cab services and funeral homes did provide the first ambulances, other than charity organisations.

When it became clear that prehospital care was needed in these countries the fire departments or independent “transport only” ambulance services had become the norm in most areas and there indeed were some people that pushed for nurse staffed ambulances - as nurses during the war had shown to be beneficial in that role.

But they were basically scolded, often even publicly insulted, by nursing associations:

• Nursing back then was far from an independent profession like it is today. Back then actual medical skills were largely dependent on doctors orders with very little leeway for interpretation. (From a nursing book in 1958 “if the blood pressure of a patient is too high or too low must,under all circumstances,be decided by the doctor and it’s not upon the nurse to decide this.”) Asking someone who is fully dependent on another profession for decision making to now make independent decisions without that profession and in the worst possible environment and use skills that the same person wouldn’t be allowed to use in their regular workplace understandably was a major cause for concern, dissent and resentment back then. And to some extent this is understandable.

• The second factor was based on the issue of gender and “morals”. Nursing back then was a mostly female profession. Putting them to the scenes ambulances need to respond to (brothels, crime scenes, etc.) would, according to a female nursing director in a UK hospital “corrupt my girls”. Additionally, due to the fact that heavy lifting would be required(see below) and the ambulances would need to be driven by someone, the “poor nurses” would need to work alongside male ambulance drivers and that would also lead to immorality. (Their words, not mine. In case of the UK somewhat insulting to their Queen,imho)

• Another factor was surely the fact that “transport only” ambulances already existed and that (also due to the lack of proper equipment) it was (rightfully so) considered backbreaking work - patients did need to be lifted far more than today, lifting equipment was primitive and medical equipment was far heavier. (I remember defibrillators that had 40kg…and I am not that old). So adding a third person would mean extra cost while you still need men (according to their reasoning back then). And as the first paramedic provides little more than BLS+ it was not that resource intensive to teach the people already doing the job.

Nowadays nursing has developed a lot. But so has paramedicine and it is an independent health care profession in the more professional systems (CAN,UK,IR,AU,NZ,GER,POL,etc.). Because skills,mindset and approaches towards patient care are different. The US with it’s abhorrent EMS system uses nurses in some roles,but tbh, the main reason is a lack of proper paramedic training standards, standardisation and oversight and the results are, well, underwhelming.

And why are nurses not named in line with other first responders in the US and similarly in a lot of other countries?

Because they aren’t first responders. The issue with being a first responder is not the level of care, it’s the “unknown”. Hospitals are, to a certain extent a controlled environment. Even in the ED you most of the time know what’s happening next, even if the next patient is a multi system trauma and comes in without prior notification it’s still your playing field. You have light, it’s warm/cold, you are rarely alone, you have your equipment where it was the day before and the day before. On scene it’s different. The next call might be a mansion. Or in a ditch. Or a methlab. It’s the same people you see in the ED, but now it’s their home turf. I have resuscitated an almost naked 12 year old in -20° C alone (as a in “single responder”) in a park known for it’s shady people. That’s different.

Don’t get me wrong: Nursing has it’s own challenges - I worked both sides long enough to know that I sure as hell won’t ever work another hour in nursing. As a para you have 1 patient most of the time. Not 25. Once you know your call,you can be almost sure that you won’t have another patient until you complete the call there won’t be another patient suddenly taking away your attention. You can leave the patient after like an hour max. And you rarely see them again.

All these things are different in nursing. Multiple patients, changes in priorities, seeing patients day after day - it is its own beast. But it’s different.

I am happy for everyone who does nursing. So am I for every midwife. Or every guy and gal that takes up paramedicine. We all have our place in this hellish trade.

(Source: Working as a paramedic -critcare nowadays - for almost 25 years now, worked inside hospitals for 7, mainly anaesthesia, critcare and ED, now consulting hospitals and EMS)

Nah, you’re good. True methheads are… something else… That stuff really fries brains.

But electrical current is another story… doesn’t matter what you took first.

That shit is scary.

But three phases aren’t that bad, not nice,but survivalable. I am more talking about light rail overhead wires, train electrics,etc.

That shit fucks you up so bad even if you survive you wish you hadn’t.

Paramedics hate methamphetamine. And alcohol. And high voltage electrical current.

But we love people who injure themselves creatively.

I just leave that here:

https://youtu.be/8EmRCJET5T4

Yeah. For an “eingetragener Verein”. For a Vereinsgründung of a non registered association two members are enough. So if you want to be a Klugscheißerle, read your BGB first. Micdrop

To give a more serious answer:

• Germans are a bit more privacy focused than most other nations (if you want to know how much read up on the google street view controversy). Germans tend to be much more aware how Meta/Google,etc. abuse their data (and while the average German won’t care there are enough of them that you actually note it)

• There is a very strong “antiITestablishment” subculture that is very active since the 80ies. The Chaos Computer Club and its congresses,etc. but also the recent trend toward digital sovereignty has increased the amount of people who see Reddit and (to a much much larger extent) Twitter in a critical light - and due to the close links of Mastodon to Lemmy that helps both.

• German speaking people, especially in the,on Lemmy, overrepresented Tech field tend to understand English fairly well (but underestimate their ability to speak it themselves often). That enables them to consume English speaking content as well, not forcing them into other media formats that do cater more for smaller languages.

• And let’s face it: There are a freaking lot of German speaking people. Around 100 Million people speak German in Europe - and while that of course is nothing compared to other India or China it’s the largest non-english language block in Europe. That gives one a large enough “crowd” to actually find an audience for a sub - while it’s rather hard to get enough people for an Italian speaking niche sub it’s far easier to do so if it’s German speaking.

• There are also some cultural issues at play - to quote an old German saying that says: “Three Germans meet - they found an association (Verein)”. Germans tend to self-organise extremely proactively. Which is often tiresome, believe me. Additionally some Germans tend to find the Americocentrism on Reddit, but also to a lesser degree, on Lemmy, boring and at times nerve wrecking.

• There is a big IT industry that is focused on mid size companies - some with a strong open source mindset.

• Lastly the German main instance, Fediverse.org is operated by a pretty robust foundation who knows what it is doing. Which of course keeps the community more stable and hosts a lot of European (non German) subs as well.

Source: Am German, lived abroad for quite some time.

Yes, I am fully aware this question wasn’t totally serious.

No, contrary to common believe we don’t have to go to the basement to laugh. Germans go to the basement for sauerkraut and to watch German dungeon porn, Swiss to clean their bunkers and Austrians,well, I’d rather not talk about that.

Und nun iss dein Schnitzel sonst gibt es keinen Nachtisch!