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I expected to watch a snippet and smile. At the end of the 10 minute video, I feel transformed, reminded of the vastness of our world.

Joy!

An article titled  Johns Hopkins Researcher Releases Shocking Report On Flu Vaccines  made it around Facebook about how you shouldn’t get the flu vaccine for a variety of reasons. The article used several dubious pseudoscientific scare tactics but I kept reading. Way down the list, it hit on an idea that looks pretty important. I’ve done some research and I am surprised to say that, in my mind, the jury is still out on the usefulness of the flu vaccine for many people.

Short form:

The CDC (a usually reliable source) says that getting the flu vaccine each year will reduce your chance of getting the flu by about 50% and it will usually shorten any flu you do get. But then I found another usually reliable source (Cochrane) that says flu vaccines are not worthwhile unless you are sick or a youth between 2 and 18 years-old. Hmmm. Hmmmmmmmm. Cochrane didn’t find any real downside to the vaccine so if you’re worried for your long term health, getting it is still the safer bet.

Long form:

First, here is Snopes tearing apart the article I found, calling it “mostly false.” So that’s not a good start!

In the “Johns Hopkins” article, they write  “… a study by the Cochrane group studied hundreds of thousands of people and found it offered zero protection for those three things in the general community.” I tracked that study down  here   (no thanks to the author, they need to cite their references!!! grrr).  This large meta-analysis reported “The preventive effect of parenteral [injected or inhaled] inactivated influenza vaccine on healthy adults is small: at least 40 people would need vaccination to avoid one ILI [influenze like illness] case”

The main conclusion of this Cochrane-backed meta-analysis with lots of participants is that  getting the flu vaccine decreases an adult’s (18-65 year-old) chance of getting the flu by 1 in 40, or a measly 2.5%!  That’s not worth $20 and feeling yucky for a week!

I went looking for other Cochrane meta-analyses:
Children – The flu vaccine probably doesn’t help kids 0-2 years-old. The flu vaccine helps kids 2-18 years-old.
Elderly – They looked for research on flu vaccines for people over 65 years-old but found, astoundingly, very poor evidence of the  safety, efficacy or effectiveness of vaccines for this population!

So at this point it’s not looking good for the flu vaccine for anyone except kids aged 2-18. But the CDC reports the flu vaccine is quite effective! This article   reports that it is roughly 50% effective, and works pretty well across all age ranges. Googling “cdc influenza vaccine effectiveness” turns up reports each year of how the vaccine saved thousands of lives!

Is the flu vaccine valuable? Probably, maybe, no. I don’t know.

Recommendation for Compact Washer and Dryer.

We may be replacing our compact (24″ wide) stacked washer dryer very soon. We have a vent. Can you recommend any particular models?

I long for when I used to have a tiny apartment washing machine. That was a completely awesome appliance! But no use in looking back, I’m a family man now!

I’ve been making and teaching bread baking for a while. I just put the instruction sheet I use for the class (which also happens to be my own cheat sheet) online. Find it on my recipe site here. And please browse my other recipes on my personal recipe wiki.

Today, I was offered a position as an occupational therapist in a nearby public school district!

I got a book in EPUB format and wanted to read it on my Amazon Fire HD 8 (5th Generation). It’s easy to do once you know the secret recipe:

1. Get the free  Calibre  e-book management tool
2. Use Calibre to convert your EPUB file to AZW3 format (the native Kindle ebook format)
3. Connect your Amazon Fire to your computer with a USB cable
4. Using the USB connection, find the folder named “Books” on your Amazon Fire HD
5. Copy the AZW3 book file into the Books folder
6. Open your Kindle app on your Amazon Fire HD
7. Rejoice for the books are on your bookshelf!

Before figuring this out with the great help of my friend Michael, I tried several other methods unsuccessfully. See what doesn’t work.

First, want something funny and completely related to the post below:

Now on to my rant…

The common narrative is that the Presidential Primaries are elections that determine for each party who will be put forward in the general election. This narrative is incorrect. Political parties are not governmental bodies and are not beholden to the election process. Case in point: Bernie Sanders was favored by Democratic party members but Hillary was put forth by the party. A lawsuit against the DNC was dismissed last week, partially because Bruce Spiva, representing the DNC, described how they could do whatever they want, regardless of what their members wanted. Here is a snippet from the Washington Post:

Bruce Spiva, representing the DNC, made the argument that would eventually carry the day… he explained how the DNC worked, Spiva made a hypothetical argument that the party wasn’t really bound by the votes cast in primaries or caucuses.

“The party has the freedom of association to decide how it’s gonna select its representatives to the convention and to the state party,” said Spiva. “Even to define what constitutes evenhandedness and impartiality really would already drag the court well into a political question and a question of how the party runs its own affairs. The party could have favored a candidate. I’ll put it that way.”

Now I remember why “politics” is a four letter word.

I took the NBCOT earlier this month and got back my score a few days ago. I passed!  Some folks have asked how I studied for the NBCOT exam so here you go:

I studied for about 5 weeks, 3-5 hours per day, 5 days a week. I received a score of 485 which appears to be a hair above average for first time new graduate test-takers (see image).

Tufts OT NBCOT scores 2011-2013

The most useful test prep was  AOTA NBCOT Prep. In the end, I answered 839 questions and did 23 clinical scenarios. I initially had a poor percentage correct but I reviewed them repeatedly until I understood the reasoning behind most of the questions. I focused on the questions in “DOMAIN 3: Select interventions…” because 45% of the exam is comprised of those questions. It costs $150 for a one-year subscription and it is well worth it.

The AOTA clinical simulations were very useful. One note: the AOTA responses were more helpful than the actual test responses. In the actual test, they’d usually respond with something noncommittal like, “Ok, you did the thing” instead of something like, “When you did that, you discovered a big issue.” I was initially thrown off a little by that!

When I got something wrong on the AOTA questions and didn’t know why, I tracked down the references at the end of each AOTA question. I found the book and studied the section. Having PDF copies of some of the books was very helpful to find the reference quickly.

I used a free search tool on my computer called Docfetcher  that let me search my school notes, the AOTA PDFs, and the PDF textbooks quickly.

I studied the AOTA PDFs and they were fairly helpful but not detailed enough as a study guide on their own.

Googling question content was useful.

OT Miri on Facebook and Youtube was helpful (2020 update: she now has her own website, I’m sure it’s very helpful: OTMiri.com). Watching her videos was a welcome relief from reading the whole time. Scroll down to the beginning of her Facebook feed (late 2016) and start reading. Thanks OT Miri!

I also found the Occupational Therapy Examination Review Guide 4th Edition  to be useful. I did a few hundred questions, reading their reasonings very carefully.  I found the questions in this book a bit easier than the AOTA questions; getting 70% correct at the outset instead of 40% like on the AOTA questions was a real morale booster!

I read through the NBCOT Exam Handbook  and tried out the sample test on the NBCOT website. By reading up on the instructions, I knew that I could take a 7 minute break during the tutorial that came after the clinical simulations and before the multiple choice. I read how the test is criterion-based but not really criterion-based, that let me explain to people how the score I need to get (450) isn’t really something I can actively aim for while studying. I heard from many folks that I’d need about 70% on the AOTA Prep and that turned out to be about right.

I used the highlighting and “marking” system on the actual test even though I couldn’t practice with it before the test. I couldn’t find a good demonstration of it anywhere. It lets you mark answers (ie. “I know it’s not A or C but I’ll come back to this question”) and come back to questions.

Here are some useful websites I kept on bookmark:

• Rehabilitation Measures Database  – Descriptions of pretty much ALL of the assessments
• Medscape – The website for doctors. If it’s a pathology, it’s very well described here!
• NIH List of Disorders – A lot of disorders described

I got Therapy Ed. 8th edition but I don’t recommend it. I found the study guide and the questions to be waaaaay too detail oriented. I feel that they totally missed the forest for the trees. Some friends agree with me on this, some disagree!

I sat down once and made myself a simulated exam using the AOTA NBCOT Prep… 3 clinicals and 170 questions in 4 hours. It was kinda brutal but was helpful to get my pacing. I should have done it 1 or 2 more times. On the actual exam, I ran out of time, wishing I had another 30 minutes.

The first thing I did when the clock started was make a schedule on the dry-erase paper they give you in the test center, something like this:

4:00-3:30 clinicals
5 min break while reading tutorial
3:30-3:00 1-30
3:00-2:30 31-60
5 min break
2:25-1:55 61-90
...

That’s about it. Good luck and…. you’ve got this!

I passed the occupational therapy board exam!!! I am now a registered occupational therapist!
My business card now reads Lee Sonko, MS, OTR

I expect to be licensed within a month so I can start working as an OT in California!

See my NBCOT certification below: