Bad slideshows are the reason I skipped the prenatal classes my healthcare provider offered. Seriously, we went to the class on what to eat, and I felt as though I were in second grade— and the other expectant moms had that deer-in-the-headlight look that promised little sympathy.

Good grief! Those are teeth-grittingly bad.

I've wondered about the internasal version. Wouldn't be too easy for it to be squandered by accidentally sneezing it out?

I can say that no one sneezed when getting an intranasal. And the fluid really does get into the nasal tissues very fast.

Yeah, the videos are bad -- but as a New England expat, I did enjoy listening to that non-rhotic Eastern New England dialect. I miss hearing people speak God's own English.

At a family get together, my sister brought the pamphlet given to her by her prenatal class instructor. We sat around a picnic table, reading it, or deliberately misreading it, and laughed our asses off. These were things farmers' kids would have known as a matter of course.

Jim, you have my sympathy.

Thank you for being willing to suffer for the cause!

Huh. Well, that rules out my entire family for the nasal spray version. Asthmatics, all of us. Good to know.

Might not rule out my partner, since he insists the exercise induced breathing difficulties he's had Are Not Asthma. As someone who is all too familiar with how bad typical asthma care is, I am pretty dubious.

Through fluke of timing, both daughters got the shots. Neither complained, but that's luck of the draw.

But one kid coming in for the booster hadn't realized he wasn't getting a nasal, and was rather displeased to get the shot. Even moreso after he actually received it.

Do the mist.

I had to do the "watch a PowerPoint presentation online and then print out the certificate" thing for a DoD contract a couple of years ago. Theirs was vastly more competent -- the slides were directly embedded in flash, with voiceover, and mini-quizzes at the end of each one to make sure you were at least paying basic attention.

Looks like the current version of that course is at this link, for those interested. It's gotten notably more video-shiny since I took it, and is much less directly constructed from a PowerPoint deck. (And this one is intentionally public.) http://iase.disa.mil/eta/iaav8/iaav8/index.htm

Also, it occurs to me to ask: I haven't found a good solution to the problem of how to word and format a paragraph like the last one of my previous comment, where I have a (rather long) web link, and a paragraph that describes it but doesn't naturally end with something that could have a "the link is here" sort of phrase followed by a colon. Does anyone have any suggestions for that?

The problem is particularly annoying where the link is fairly long and so I can't easily put it within the paragraph for fear of line-wrapping in the middle of it, which is more of a problem (both for the likelihood of line-wrapping, and the bother when it does occur) compared to places like here.

Where I work we do a lot of 'watch the presentation, pass the quizzes, and print the certificate' (including e-mailing a copy of the certificate to management). This year we had the added fun of one on the basics of anti-trust rules, for non-lawyers. The examples (as in many of these courses) are fairly obvious, just to get the point across.

My sympathies. I can probably count the number of good PowerPoint presentations I've seen on one hand, and still have fingers left over. (Serge, yours was fine.)

I had to do some online training courses today. Most of them were all right, if boring because they're not talking about stuff that interests me. However, one of them was a bunch of fluffy bunny useless stuff, complete with defined answers to subjective questions. Oh well, it only got better from there.

Brooks Moses @ 11:

I'd make the text "And this one is intentionally public." the link, or, at the very least, the "this one".

One trick I learned (assuming that no Powers were in the vicinity) is that you don't have to put the sound on. Clean out a desk drawer and occasionally click through a quiz. If you get an answer wrong, don't worry; this proves that you didn't know the material in advance and you needed the training.

Really. Sound off makes all the difference.

One trick I learned (assuming that no Powers were in the vicinity) is that you don't have to put the sound on. Clean out a desk drawer and occasionally click through a quiz. If you get an answer wrong, don't worry; this proves that you didn't know the material in advance and you needed the training.

Really. Sound off makes all the difference.

Eeps. Two two copies copies of of the the same same post. Many many apologies apologies.

The advice was good enough to repeat!

I used the nasal version of the seasonal flu vaccine a few years ago, when I was at the age where I was allowed to take it and didn't have to feel guilty about using up the then-scarce supply of regular injected vaccine because it wasn't approved for kids and old people. I don't have asthma, and can tolerate getting salt water up my nose when swimming, so this was no bother at all.

On the other hand, the nasal vaccine works a bit differently, and I felt not-quite-fluish for a couple of days afterwords, which I've never gotten from the injected version. And I didn't get the flu that year.

The mist turned out to be not such a great idea for my three year old daughter. It comes in two doses, one in each nostril. (At least that's the way they administer it at the clinic we went to. No idea whether that's universal.) She didn't like the first one, so she wailed and wiggled and buried her face in my chest. She's very stubborn, and very good at not listening when she so chooses. Not even the promise of Dora stickers was enough to convince her to cooperate.

We did eventually get her the second sniff, but it wasn't easy. A single shot would probably have been easier.

A case of H1N1 which has turned out okay so far:

My cousin, who was in a coma for 7 weeks with H1N1, walked 36 feet today, is beginning to be able to speak again (even with a trach) and is set to kick rehab butt.

This is a mid-thirties athletic female, or so the cousin says.

Scary scary stuff.

So far my family has had about every (normal, harmless) reaction there is: C had a soreish and visibly bruised but basically okay arm, L had a very red then very black, very hard, very warm, very sore arm - a real goose-egg (turns out there's an egg sensitivity there), Ian hardly noticed a thing on his arm but had mild fluish symptoms and fatigue for a day, and I wore a skirt and long warm socks down to the clinic and requested and got a thigh shot, which itched mildly off and on for the 24 hours it took me to stop feeling sort of sleepy.

I got a thigh shot because I have various muscle and nerve problems with my arms which make intramuscular injections on my upper arm seriously unpleasant for several days, so I get almost all shots there, but honestly, if you don't mind figuring out how to whip out a thigh in a public clinic without traumatising all and sundry, I do recommend it in general. I have been told in the past that getting vaccinated in the larger muscle might slow down the immunological proceedings by half a day or so, but that's a trade-off I'm generally good with.

I do an unfortunately-large amount of training on all sorts of thrilling topics, and it's all 1. Watch badly-designed and poorly-explained computer presentation; 2. Take quiz - mix of obvious questions and those of "what OMB circular describes this: 256, 283, 286?"; 3. Email certificate to one or more people in charge.

If you don't mind missing the stupid detail questions, you can poise your mouse over the "next" button and just click as fast as possible. And yes, with the sound off!

Annoyingly, they've managed to make these all not work on anything other than Windows with IE (even with the user agent switcher plugin), though they're all in javascript / Flash and should be entirely multiplatform. That means that I end up doing them at home on my own time, and that's just wrong.

Brooks Moses@11

Why not just write:

Looks like the current version of that course is at this link, for those interested.

There's no reason for the text between the tags to be the url itself.

My husband works for a state university. Since the state in question is Illinois, all state employees are now required to take an annual ethics training/quiz of very much the sort described above (thank you EVER so, Jim Ryan).

The first year it was required, my husband -- being a reasonably ethical person by reflex, and good at test-taking -- clicked through the online test as quickly as he could read the questions and respond, thinking to get it over with.

He was flunked for 'doing the test too quickly,' and therefore clearly cheating. So was more than half his department. The minimum test-taking time was not declared, and everyone in question DID read the questions, just a lot faster than the people who designed the test thought they would.

So now the entire department takes the test yearly while reading their email -- click, change window, screw around for a while, click ...

Unintended consequences of sloppy design, that. Also really insulting, given some of the questions, that they think it SHOULD take a really long time to mull over the 'right' ethical response to, say, being offered money or a promotion in return for putting someone's request to hook up their network to the head of the queue. Most of the employees in question have advanced degrees, and all are quite good at test-taking, in general.

Sounds like something out of Snow Crash.

Jim, do I remember correctly that the intranasal version is NOT for pregnant people?

History of asthma (which is why I really wanted it in the first place, truly) so no spray for me, but I did get my job today. Slightly sore shoulder, but glad to have it out of the way. Now I just have to watch out for colds.

#26: You recall correctly. The intranasal form isn't recommended for pregnant people.

Why is the mist not for those over 50?

Brooks Moses, the way to embed a link is given in the second gray box above where you type in comments. I cut and paste it in, then find the link and replace the stuff between the quotes with the real http address.

Re: Brooks Moses @11:

I assumed that the problem was not about embedding links like this, but rather how one would go about formatting URLs in a non-hypertextual format, e.g. when for printing on paper.

I'd use parentheses ( http://iase.disa.mil/eta/iaav8/iaav8/index.htm ) though they are not an elegant solution. Which leads to the whole (obligatory xkcd) parentheses and emoticons formatting debate.

Carol Kimball @29 said: Why is the mist not for those over 50?

The virus in the spray is not dead, merely badly battered and pummeled into near-unconsciousness (as it were). Therefore, it is not recommended for people not in the robustest strength of their immune system.

Just to calibrate: is the injected form more painful, or more likely to produce side effects, than the standard seasonal flu shot?

Vicki (32): Anecdotes are not data, but I had a few days of tenderness from the seasonal flu shot this year and no reaction to the H1N1 shot.

To Brooks Moses @#10:

Hey, I think I had to do that one last year! (Defense contractor here). And will again this year, and the year after, and... you get the idea. One of those things, they put a *minimum* required time timer in, so you go for a coffee break before clicking that last 'next' button. Lame.

After being subjected to it once a year for decades, does anyone take corporate sexual harassment training seriously anymore? The only thing I've gotten useful out of it recently was that case law has changed such that "hostile work environment" is now actionable, whereas before it required quid pro quo or explicit unwelcome attention. Otherwise, how hard is it to understand "don't be an offensive jerk to your co-workers"? Either you get that, or you're too much of a self-centered putz for a mere flash training video to make an impact.

At the other end of the spectrum in training videos, the required DOD training on "Human Trafficking" is scary and disturbing. (We don't call it by its real name, SLAVERY, because why?)

I expect it's because human trafficking is considered to be a spectrum of activities of which classic slavery is only one example. Debt bondage would be another example.

35 comments in, and most people seem exercised about sloppy presentations. Not one seems concerned with the real shocker here: Injecting an inadequately tested soup of horror into children, in a vain attempt to prevent a strain of 'flu that's barely more dangerous than any other (and that a significant percentage of us have had already without even noticing it). Priorities?

*rolls eyes* at the "soup of horror" mentality

WHO Pandemic (H1N1) 2009 briefing note 20: "Compared with seasonal influenza, the H1N1 virus affects a much younger age group in all categories – those most frequently infected, hospitalized, requiring intensive care, and dying."

Available at: http://www.who.int/csr/disease/swineflu/notes/briefing_20091222/en/index.html
Also available with an additional editorial note at:
http://www.promedmail.org/pls/otn/f?p=2400:1001:544014377142221::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80575

Thus the vaccination of children.

I'm fairly certain that injecting soup of horror would be considered a doctrinally acceptable (albeit hard core) sacred rite of Pastafarianism.

On the menu at the Cliffs of Insanity:

Soup of Horror
Scallops of Dismay with a hint of Distress
Roast Beef à la Trepidation, Baked Potato Croquettes, and Tossed Dread Salad
Angst-perfumed Panic Sorbet

Served at your table with ruthless efficiency and a fanatical devotion to acrophilic cuisine

Shouldn't that be ingesting soup of horror?

H1N1 vaccine is just coming to full availability around here, and last weekend's snow made us miss a clinic I meant to attend, but there's another in January at which the offspring and I shall partake.

Pendrift @39--is The Cliffs of Insanity that new Edward Gorey-themed place? We've been hoping to get in there; I understand the wait alone can drive people into a severe existential crisis.

Also, was the Lovecraft Night just a one-time thing for Thanksgiving, or will it be regular feature?

Pendrift and Earl Cooley III -- the menu (and perhaps a picture of the guests) should be illustrated by Edward Gorey.

fidelio - great minds think alike, yes?

(Imagining you posting a similar post to this one makes my eyes cross.)

Soup of Horror recipe:

Cthulhu noodles
Poe's tell-tale heart of artichoke
Minced Triffids
Waters of madness

Simmer until Friday the 13th

Of note: Our drive-by @36 has done something similarly stupid and petty once before here. Make of it what you will.

Debbie @43--Really, what else would you think of, confronted with that bill of fare? And having thought of it, surely you have to share it with the Fluourosphere! I don't see it as an interesting coincidence, but as an inevitability.

Poor Nick (#36) doesn't understand that I'm very much in favor of modern medicine in general, and of immunizations in particular.

Concerning Nick's earlier food post I have to wonder: what makes up a Soup of Horror? Pho, sure?

fidelio @46 - that's certainly how it felt!

From the "soup of horror" link: "Multi-vile vaccines"
Also includes the link to a site called novaccine. Hmm. I think they've got an agenda, no?

For purposes of full disclosure, my father lost a sister to measles, my mother got polio, my husband got pertussis though vaccinated (they recommend booster shots for children now because one dose often isn't enough), AND my in-laws are riddled with individuals who are or have been immune-compromised.* I'm a little touchy about anti-vaccination types.

Incidentally, my husband gets "sick" after he gets a flu shot, but we know what it is— when his immune system kicks in, he gets a bit of auto-immune arthritis. Which is actually a sign of an overactive immune system. (He can't get the mist as an asthmatic.) I wonder if other people who get sick from shots are suffering from something similar (barring honest allergic reactions like the goose egg described above.)

*Classmate comes in with the sniffles, despite warnings, and niece goes off to the major city to get a gamma globulin shot. Again and again, because some people don't seem to understand that an inactive immune system means sniffles can kill.**

**She's a healthy adult now, but there were times when they didn't think she'd make it.

The soup of horror -- is it also known as green people soup?

Yep, the Little Soup of Horror is indeed green.

Folks like Nick don't understand that flu kills.

When they argue against vaccines they are actively trying to kill people.

Flu kills. Measles kills. Heck, even chicken pox kills, though I'd give my kids the vaccine even if it didn't. (I was five when I got the chicken pox, and I wouldn't put any kid through that.)

Furthermore, part of the reason for the much lower life expectancy of the nineteenth century was after-effects of so-called childhood diseases. You'd get a flu and have breathing problems for the rest of your life. You'd get a fever disease and go blind (like Mary Ingalls, though it apparently wasn't the scarlet fever specifically that did it.) You'd get this, that, and the other and your old age— at fifty or sixty— would be plagued with aches and pains.

Historically, the world has been one big festering disease swamp. The fact that the modern world isn't (for first- and second-world types) is because of vigilance and anti-disease programs, of which vaccines are a vital part.

I'd like to interject at this point that the Roberts family is now H1N1-ready. (Mist, all four of us. I hate needles.)

I didn't get the H1N1 shot because the doctor is 99% sure that's what I had in October (and am only now recovered from). Get the vaccine! A week of misery followed by two months of lethargy is no fun.

I had the seasonal flu shot on 9/16 without any problems and the H1N1 today with no problems so far.

TexAnne, #56, I got my H1N1 because I have three of the things in the list for my age range: lung disease, chronic renal failure, and I'm currently immunosuppressed. Since I don't go out often, just going to the clinic to get it may have been more dangerous, but I decided to get the shot anyway.

I got the Soup of Horror injection last Thursday and the after-effects I noticed were: A slight ache in that shoulder muscle. I couldn't sleep on that side for a whole night! And nothing more than that. I'm the sort of person who is generally healthy and never gets the flu - just the sort who'd end up dead of the Spanish Flu, and apparently is at risk from the current one.

My biggest worry now is that there'll be an outbreak and lots of people at work will call in sick, so I'll have to fill in doing lots of stuff I haven't got training for...

TexAnne: What I've heard is that the seasonal flu has not seemed to materialize, so they're pretty sure that if you got a flu, that's the one. Otherwise they'd do a test.

I'm protected, Gareth got the first shot (then they ran out before his booster time came around.) Evil Rob's been waiting on resupply as well. We've all had the standard one, though.

B. Durbin: They did the (unpleasant) test, which came up negative for regular A and B flus. They said they only do the H1N1-specific test if you're in the hospital, but that if you're still fatigued six weeks after the acute phase is over, you had teh hamthrax. As an asthmatic, I was faintly annoyed to find all this out. Good thing I'm not young and hale!

I do feel that getting shots for both pneumonia and seasonal flu were good investments for me. I have enough to worry about as it is.

I don't usually shop at the grocery store where I got the flu shot, but because their pharmacy had it and the grocery store I usually go to didn't, I plan to throw some of my business their way.

Only the at-risks (and frontline medical staff) are getting the swine flu jab here in the UK, so I'm just going to have to take my chances.

Well, I'm over 2 and under 50 (by three weeks) but I do have a history of asthma. Sigh*cough*. Guess I get to be stuck.

And I _hate_ needles!

TexAnne @ 56, so very very seconded. I had bad flu in early June, and because of the odd time of year, most doctors seem to think it was H1N1.

It was awful and I do not want any of you to go through anything similar. If you need further convincing, this is what it was like: Body aches that spiked from 3 to 7 on a 1-10 pain scale, bad enough pain that I hyperventilated. (In the ER, Keith kept telling me to look at his eyes and breathe with him. I tried, but it hurt too bad not to cry and hyperventilate.) High fever (102.9), with dehydration. Nausea and vomiting, extremely painful sore throat, and then a raging sinus infection that lasted for two weeks. You do not want it. You definitely want the shot instead.

Currently trying to talk Keith into getting his flu shots. I don't know why he keeps putting them off. They're not expensive and he has insurance anyway. He's not afraid of needles; he donates blood regularly and actually likes to watch the needle go in, which I can't handle. So it's a mystery to me why he doesn't just go to the Target pharmacy and spend 10 minutes getting shots.

I had the seasonal flu shot when it first came out. Actually thinking of getting H1N1 shot anyway, just on the chance that I didn't actually have it, now that the problem is surplus vaccine and I won't be taking it away from someone who needs it more.

I always have trouble answering the 1 to 10 pain scale questions, because I over-think it. Let's see, not as bad as the gallstone I passed, worse than biting my tongue during a nice meal (duration of pain complicates things), narrowing it down with sort of a non-parametric binary search algorithm. Of course, if there's absolutely no ambiguity in how bad it feels, I'm likely not in a position to answer questions anyway.

Earl Cooley III @ 66

In answering that question, I tend to give the doctor a reference point: "well, taking 10 as the dislocated shoulder*, I'd call this a five."

That doesn't help with the over-analysis, but I hope it helps my doctor work out how bad the pain actually is.

*That's my worst so far, so that's my 10. Hope I never get anything above that level.

For me, a 10 is a broken finger bone. From comparing notes with folks, finger bone breakage is often way up there for pain... lotta nerve endings.

Nick Osiris: More dinosaurs and sodomy, less snot.

Lee, thanks for the pointer.

Torrilin @ 68 ...
For me, a 10 is a broken finger bone. From comparing notes with folks, finger bone breakage is often way up there for pain... lotta nerve endings.

Interesting. I don't think I've ever rated something as a 10 -- the closest I've gotten would have been a particularly horrible migraine, and I wasn't capable of counting to 1, let alone figuring out how much I hurt on a scale of 1 to 10. I have broken a finger bone though...

Huh. Gout (which I've had a few times) is supposedly way up there on the scale. I inflicted a compound fracture of a finger on myself once, but I was ten and don't remember the pain much. I remember the pain shots in the webbing between ring and little fingers and the boxing-glove thing I had to wear for three months. In the summer. In Los Angeles. But, I got treated for the damage on a Navy hospital ship in Long Beach. At ten, that was so cool it cancelled out pain.

When that sucker came off I had a double nail on that finger (still do) and the stinkiest hand imaginable.

My personal-worst pain was an acute gall-bladder attack a few years ago. I rated it at an eight. (To which the doctor responded, "Sounds about right.") Those pain-level/facial-expression charts they have in the hospitals around here are helpful in judging my own pain level.

#33 Mary
Anecdotes are data.
And a lot of medical studies, turn out to have barely two digits, base ten, of study subjects studied in them...

"Statistically significant" is not what I call well-defined and delineated....

The selection of samples, and sample sizes, ofteen have all sorts of biases [slantednesses...] in them. And often, that's deliberate. Pollsters doing polls paid for by special interests are particularly, er, "interesting" about such things.

Again, anecdotes are data. They are data which are lacking usually in the areas of impartiality, and in coverage, but then, again, I suspect that most of the studies done, are not ones with a high degree of objectivity in them, in both intent and implementation. (A study which has a "which one of these is the reason/main reason you did/chose/etc" to me is automatically compromised in results and methodolody. Few people do things for one reason... and the second or third choice often is the choice that most people would be willing to accede to and accept....

I wonder, has anyone done a study of Hugo winners, comparing the winners to the plurality vote receivers? There is "the choice that gets the largest number of most-preferred votes" and then there is the choice that gets the largest number of people who find it acceptable.... Real world, what people would most prefer (living accommodations, car, food, computer, perhaps even spouse) is not realistically available to them. So instead, they accede to something or someone which/who is "affordable" or "available" and within their means, or which/who provides the optimized mix of affordability, effort, etc., support, geographic preference, etc.

Anecdotes are data which say, "under these conditions, that happened." Anecdotes can be useful for theory puncturing. "This is an exception to the perception, therefore the perception fails to match reality at least for this example" Or, an anecdote can provide a datum of support for a theory, "This anecdote complies with the theory."

Dismissing anecdotal evidence has been one way that civil rights of people get repressed.... "women can't do math." "What about Hypatia?" "She was an exception, she doesn't count..."

My worst was the headache for the stroke this year. I really felt like my head was exploding.