Archive for the ‘General’ Category.

Smoke in Berkeley

Berkeley is getting more and more smokey from the wildfires to the north. I put on a respirator while inside the house and my vague headache went away almost immediately. I think the family might go someplace outside the bay area this weekend.

In-Laws House Destroyed by Wildfires

I am sad to say that the home of my in-laws Walt and Gail in Santa Rosa was destroyed by the recent wildfires. All family members got out safely with just a car-load of their possessions. They are now spending time locally to regroup.

Riding the Carousel in Tilden Park

Joy!

Should I Get The Flu Vaccine?

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.

Real Bread in 10 Minutes

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.

How I studied for the NBCOT Occupational Therapy exam

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).

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.

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.” 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 search tool 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. 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% 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 was about right.

I used the highlighting and “marking” system on the actual test even though I couldn’t find a good demonstration of it anywhere online.

Here are some useful websites I kept on bookmark:

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… 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, 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!