Good Old Forum

I used to have no problems with roundabouts and even liked them because everything is in orderly fashion and no need to wait for the traffic lights to turn green or for the turning of left while at flashing yellow. 

I did experience back-to-back roundabouts (roundabouts after a other after 1-2 "blocks" of a distance) while I was driving a rental car from Syracuse airport to Utica, NY during the calm of a snow storm or snow season. Some roundabouts then were okay. But some, made more confusing  with the GPS saying the exit street name and the actual exit mentioning Route # only or Vice versa, it was a hassle and needing multiple returns to roundabouts (because there were no other streets once an exit was missed!). Overall, I did not mind much, until recently!

Now, I have roundabouts avoided on GPS. Those surprise roundabouts with 5-6 "exits" at different angles are just not for me.    It started with my crosscountry road trip. It was an interesting drive from California to New York. Some roundabouts in various states we stopped at, from/to hotel, were okay, going with the smooth flow from any of 2-3 lanes  , other roundabouts we could merge back in safely , and then there were those where one lane took you to, well, around while other took you to another planet with sharp right and too late to large to the inner lane(s) . Also not to mention the cars circling from left coming towards and right waiting to  get out.

I still occasionally get to roundabouts if GPS guides me as an unavoidable option to a destination, but 

How about you and roundabouts?

I am a Californian adapting to the Buffalo, NY weather conditions.

Currently, pickup 4x4 but only been using 2wd/rwd mode.
Running 43 PSIs on all 4 for 285/75/R16 Toyo Open Country A/T III (Three-Peak Mountain Snowflake (3PMSF)).
Not factory wheel/tires, factory recommended 35 PSIs all 4.

My car drives ok on the few inches of snow in general, but skidded few days ago when on a "small snow, early morning, iced up, STOP to LEFT TURN".  First time skidding and ONLY AT THAT ONE icy corner. It drove and handled well after and during snow storm last weeks.

I am not worried but just wondering what tire pressure are you running for your Winter/Snow/Ice experiences?

I've also been seeing how other's tractions improved going down about 10 PSIs in front and 14 PSIs in rear from stock specs. (I am currently at 43s, so I might "go down" aka back to around stock specs of 33 or 35 PSIs when harsher winter comes. 

I am currently 6 months into the family medicine residency program.

The journey has been a mix of bright shining days and cloud days.
(well, if literally, also snowing days because of being in East Coast  )

I moved from West Coast to East Coast to pursue the residency program in family medicine with the goal of one day becoming a PCP and my own outpatient clinic. The move itself was a journey in itself, I drove cross-country! I have lived briefly in East Coast weather for 2 years in the past, but it wasn't the same in this region I am in for various reasons relating to weather here and the fact that I am now driving here (vs. public transportation or ride shares like Uber/Lyft during my prior experience with East Coast +/- snow storms).

Residency wise, I am grateful I am getting support form the faculty members and my co-residents. Everyone is willing to help in any ways they can and with that added to my own individuality and personality and passion, those 6 months gone by have been full of learning experiences and personal and professional growth opportunities. I do miss home, even though with my history of moving often, I do not know where is home.

Also, I am meeting many medical students from different schools and happy to have had the chances of interacting with them and teaching them as my mentors had to make me who I am today! 

I may not have posted often, but here I am again! Hope all is well for ya all.
Let's do this! and You got this! 

Other than the hosing and splashing and scrubbing and then wax on and wax off pampering? 

I love to do manual car wash whenever I have time, but that is becoming a thing of the past with my current busy schedules. mainly because I do not want to be at the car wash alone at the ungodly hours or the car wash self-service places are closed already by the time I am done with the work and chores.

I do not have time to park my car at the PAID full manual car wash and detailing services because it can take hours even though the outcome is fantastic! The price is high for a quality wash and detail, but I do not mind the rice fitting the outcome quality! The problem is TIME!

I have tried Chevron's alike full car wash services. I like them. Depends on my needs I can choose the package I want, but I always go for at least the package with undercar and wheels wash. Then the extra polish and shine service package if available (but that is rare with automated services). What I like here is REAL FULL SERVICE - washing to free dryer machine!

My dad's recently referred to a partial-service car wash service. The price is similar to full automated services. How it work is, you line up near the washing machine - well, not the washing machine machine but you get me point  - and a staff starts hosing your car body and probably even scrubbing your wheels. Then you go into the machine. After that, drying is on your own but they do provide towels.  I am no slacker but just weird drying the car my own when it was not even me who washed it, so to speak. If I feel like so to dry my own, I would have also scrubbed and washed the car my own too! I do not trust the machines 100% and is looking forward to "scratches from the machine:, but if the person would have scratched or made something loose during scrubbing, call me weird, but I would have been more     

How have you been washing your car, if or when you do?!

 

The story time has begun.

  I came across someone's question on this elsewhere and it was a good read.

How we go about going to bed and what our thoughts our decides how well we will sleep or how we be for the rest of the night and for tomorrow!

What's your last thought in general or for the day or for last night? 

For mine, usually, I will have this crazy "run-on" thought (many in 1) of positive thinking and telling myself tomorrow will be a good day, if I've set few alarms, thanking the Lord, and well wishes for people around the world.  Like:

"Tomorrow WILL BE a good d... wait 3 alarms set? ok good... WILL BE A GOOD DAY! Thank you Lord. I'm all yours and you know my requests. Please guide me and your will be done with people around the world suffering and your people in general" 

I hope whoever celebrates Easter had a wonderful blessed joyful Easter!

I had a great time with my parents! - church service (at Shadow Mountain Community Church, El Cajon, California) and family quality time and cooking and baking! (It may be my last Easter with my parents for quite a while since I'll be moving away from California for a while!)

Got few photos to share as well! (My parents want privacy, so I edited them out)



 

I attended another web-based training, "Raise the Rate: Improving Provider and Patient COVID-19 Vaccine Confidence at the Medical Encounter" hosted by North Dakota Public Health Training Network (NDPHTN) through the approved Certified Public Health Continuing Education (CPHCE) credit listed at Train.org (https://www.train.org/main/course/1101918/).

Once again, I would like to share the official video and my notes for your information purpose. Please watch the video for details!


Covid vaccination rates:
As of January 13, 2022,

• 79.4% of the population 5 years old and above have completed SINGLE Covid vaccine dose
• 66.8% of the population 5 years old and above have completed PRIMARY Covid vaccine series
• 40.6% of the population 18 years old and above have completed BOOSTER Covid vaccine dose

Morbidity and mortality of Covid-19
Necessary (as is, young, already infected with Covid, etc) vs. exaggerated?

1. Before and After Vaccination - All-cause Mortality Deaths in U.S.

• There was  weekly 5000-40,000 excess all-cause mortality deaths in U.S., more than predicted from the trend during the pandemic of 2020 and 2021, also exceding what was during the 2017-2018 Flu Season
• Weekly deaths in U.S significantly decline with the initiation of the Covid vaccine
• 
• In general, more deaths caused by Covid in U.S than COMBINED deaths from WW1, WW2, Korea, Vietnam, and 9/11 (could have been prvented with Covid vaccination)

2. "I'm healthy"
Understanding Infection Fatility Ratio (IFR) and Case Fatality Ratio (CFR)

• IFR = # of Deaths / Number of Infections x100 (includes all symptomatic and asymptomatic infections, mainly from uses  of serologic studies)
• CFR = # of Deaths / Number of Cases x100 (includes all persons with clinical symptoms, mainly confirmed by lab testing)
• RATE and RATIO are not the same, COMMON MISTAKE by the public, RATE =/= RATIO, RATE = different units top/bottom on the division numerator/denominator, RATIO = same units top/bottom on the division numerator/denominator
• When someone says "I'm healthy" aka "no symptoms / asymptomatic", it's referencing to Infection Fatality Ratio (IFR) that includes asymptomatic, NOT Case Fatality Ratio (CFR) that includes symptomatic
  
  • Actual overall Case-Fatality Ratio (CFR) in U.S = 1.6% (is HIGH), meaning 1.6% of individuals who seek care and are infected with Covid will die
  • Infection Fatality Ratio in U.S = 0.1% (0.01-0.67% range)
  • In general, Covid vaccinations have decreased deaths.

3. Complications for survivors of Covid infection
"Already infected with Covid and survived, and in that 97-99% survivor group"

• A 2021 study shows risk of death in 10 months after hospitalization for Covid management by Covid protocol (2020) was HIGHER than seen during Influenza pandemic (2017/2018)
• So, even after surviving hospitalization with Covid, death after that is 63-73% greater than death after hospitalization for influenza in 2017/2018 season
• 1-year outcomes in Covid-19 hospital survivors: any symptoms, fatigue or weakness (greater in women), sleep problems, smell disorder (anosmia), taste disorder (ageusia), anxiety or depression (greater in women), persistent CT CHEST abnormality, abnormal gas exchange in the lung - gas effusion (greater in women), ongoing shortness of breath - SOB / dyspnea
• 
• United Kingdom U.K Biobank Study showed taste, smell, emotion, memory processing and memory storage areas of the brain shrinking statistically significantly after Covid infection (supported by neuropsychiatric testing after Covid-19 recovery by Becker JH, JAMA Open Network, October 2021)
• Covid-19 infection increases diabetes risk (1.3-2.7 X increased risk or 57% increased risk in CHILDREN - MMWR and JAMA Pediatrics January 2022; 70% increased risk in 4 weeks to 1 year after infection in ADULTS - Rezel-Potts E, medRxivDec 2021, 40% increased risk at 1 year and 3 X increased risk if hospitalized in ADULTS - Al-Aly Z, Lancet Diabetes Endocrinology March 2022)
• Covid vaccines do decrease severe deaths and infection rates, along with requirements for hospitalization from Covid.
• Covid vaccines may also decrease "LONG Covid", Covid symptoms after hospitalization or recovery

4. Attributes and impact of the delta and omicron variants

Delta Covid Variant

Quote"The delta variant is more efficient at transmission due to genetic changes that allow it to produce large number of infectious particles" - W.H.O

• >1000x higher viral load than earlier strains, 2-3 X more contagious than original strain, 2 X more likely to be hospitalized (surprisingly > 65 years old has flattened rate of death/hospitalization, likely because of higher vaccination rate in that popular after the original strain)

Omicron Covid Variant

• Much more transmissible than delta
• Omicron mutations lead to decreased viral antibody neutralization for previously infected or vaccinated individuals (2 dose Pfizer & Moderna vaccines provide 70% against omicron hospitalization and 10-33% against omicron infection)
• Highest hospitalization in <5 and > 60
• BUT, LESS SEVERE disease caused than delta
• Covid booster protects infection in 76% and protects severe disease in 85-90%

Stealth Omicron Covid Variant (Omicron BA.2 Stealth variant - version 2)

• Similar symptoms to the original omicron variant
• Prior omicron BA.1 infection provides protection against BA.2 omicron Stealth variant infection
• Similar coverage by current vaccines
• Causing 50% of infection in Denmark and dominant in India
• ID-ed in U.S.

Deltacron

• ID-ed in Cyprus
• Mixed of delta and omicron genetic characters

5. Take the vaccine or take the virus?

Quote"If you haven't had the Covid vaccine or Covid-19 infection yet, very likely you will [be exposed and infected] in the next few months"

6. Understand current evidence for Covid vaccine efficacy

• Reasons for declining vaccine efficacy in general: age, time from vaccination (vaccine durability), variant coverage
• BUT - GOOD THING - even with the declined vaccination effectiveness, STILL 55-65% less likely to get infection (vs. unvaccinated), BOOSTER vaccine dose IS BENEFICIAL
• Example when delta variant became the most common variant, fully vaccinated individuals had 5 X reduced risk of infection, > 10 X reduced risk of hospitalization, > 10 X reduced risk of death from Covid
• Janssen, Pfizer, or Moderna vaccine 6-months study back April-September 2021: 6.1 X greater risk of testing positive for Covid-19 and 11.3 X greater risk of dying from Covid-19 if UNVACCINATED
• Sanford health October 2021 study: 91-97% of hospitalized, in ICU, on ventilators are UNVACCINATED
• MMWR study for 11 million unvaccinated vs vaccinated (disclaimer: bias in the studies based on the baseline health status of a person): mRNA Covid vaccine decreased Covid death by 66-69%
  
• 2021 Study of 700,000 veterans' survival over 26 weeks post Covid PCR test
  
• NEJM Israel study: marked reduction in reinfection if received at least 1 dose of vaccine in people with history of Covid infection (Natural alone is not efficient, but Natural immunity + 1 Dose has some benefits, if not optimal)

7. Base Rate Fallacy

Quote"delta variant is infecting vaccinated people, representing as many as 50% of new cases" - Report from Israel from June 26 2021

• Israel was with the highest vaccination rate.
• So why is this the case? Base Rate Fallacy.

Quote"The higher the vaccinated rate of a population, the higher the number of infected individuals will be vaccinated, even if they have a ~5-fold decrease in infection rate due to vaccinated status vs. the unvaccinated"

8. Booster and third dose recommendations (Covid vaccine third dose is not necessarily a booster dose)

• Haider G, et al. MedRxiv. 2021 study: only 37% with solid organ transplant has neutralizing antibody from the vaccine, in 55% with hematologic malignancy, in 82% with solid tumors, in 84% with autoimmune diseases, in 95% with HIV, in 98% who are healthy healthcare workers
• "In moderately or severely immune-compromised patients, a third dose is recommended as soon as 28 days after the second dose. This is NOT A BOOSTER DOSE but a THIRD DOSE OF A PRIMARY SERIES."
• Pfizer and Moderna vaccines: Covid vaccine booster 5 months after completion of the primary series
• J&J vaccine: Covid vaccine booster 2 months after the first dose
• can "mix and match" booster doses after completion of the primary vaccination regimen as appropriate for their age, unless there is a preference or complication
• Which age group can receive what vaccine? 12 years and older = Pfizer, 18 years and older = Moderna and J&J Covid vaccines
• Boosters dramatically increased neutralizing antibodies against symptomatic infections of omicron, may provide 76% protection against infection and 85%-90% protection against severe disease
• Increased Covid-19 booster rate in the populations will blunt the outbreak of omicron and other Covid variants currently circulating

9. Covid Vaccine Safety Datalink program as part of the US vaccine safety system
Covid vaccine safety and adverse reactions

Quote"Covid vaccines are some of the most studied and monitored vaccines in the world's history!"

QuoteBillions of doses have been administered since late 2020, so LOTS OF STUDY DATA from WORLDWIDE EXTENSIVE EXPERIENCE to study efficacy and safety!

U.S has multi-layer system for safety monitoring:

• Phase I-III Clinical Trials
• Vaccine Adverse Events Reporting System (VAERS)
• Clinical Immunization Safety Assessment (CISA) Project
• Vaccine Safety Datalink (VSD) for rapid cycle assessments for COVID19 vaccines: developed by CDC 30 years ago, covers 12 million people linked through Managed Care Organizations (MCOs), includes vaccinations/hospital and outpatient info/lab data, utilizes Rapid Cycle Analysis (RCA) - REAL TIME WEEKLY comparing rates of pre-specified outcomes in pre-specified time windows
• Post-licensure Rapid Immunization Safety Monitoring System (PRISM)
• V-Safe

10. Absolute Excess Risks of acute kidney injury, appendicitis, arrhythmia, deep vein thrombosis (DVT), herpese zoster infection, intracranial hemorrhage, lymphadenopathy, myocardial infection (MI),  myocarditis, pericarditis, and pulmonary embolism (PE) after Covid Vaccination vs. Covid SARS-CoV-2 Infection:

• 
• COVID INFECTION is with a GREATER HEALTH RISK (orange bars)!
• The Covid vaccine is not associated with the higher risk, although there is a risk (blue bars)!

Rare serious adverse events after COVID19 vaccination:

• All vaccines: anaphylaxis, needing 15-30 min waiting period after vaccination at the vaccination center, 5/million or 0.0005%
• Janssen vaccine: TTS (thrombosis with thrombocytopenia syndrome) 3/1000000 or 0.0003% risk, GBS (Guillain-Barre syndrome) 7/million or 0.0007%
• mRNA vaccines (preferred for all age and gender groups due to lower risk of and fewer adverse effects): myocarditis 3.5/million or 0.00035%

Covid vaccine DOES NOT CAUSE female infertility

mRNA Covid vaccines are non-replicating and do not change the DNA of the vaccine recipients

11. Approaches to vaccine conversations during the medical encounter:

• Building TRUST
• Influencing on attitudes regarding potential Covid vaccination
• Discussing about intent for vaccination, knowledge on the importance of Covid19 and Covid vaccine, and underlying worries about Covid-19 vaccine side effects
• Spending more time to attend to questions, concerns, and comments on the Covid vaccine and safety
• Listening to, understanding, and being the source of solution for the patient
• Avoiding participatory recommendation leaving uncertainty, like "WOULD YOU like [XYZ] vaccine today?"
• Using presumptive recommendation emphasizing the vaccine's essential, like "I STRONGLY RECOMMEND we give you the vaccine today to protect you against [ABC or severe disease and death]. Do you have any questions or concerns?"
• Sharing relatable stories
• Motivational interviewing
• E.A.S.E: ELICIT main concerns, ACKNOWLEDGE main concerns, SHARE commitment, EDUCATE & ENDORSE with consent and understandable language level

Shared by Kaung M. Ko, MD, MPH, CPH

So, out of the 2 words, keep one and drop and replace one.

Low rider

Low carbs

Delicious carbs

I did for $1148.68 worth!!    SCAM EMAIL / SPAM EMAIL ALERT!!

I have to give an A for the effort in making a "chain of spams" to make it look like my order was being processed and going through each department... 

Otherwise, most ridiculous spam email or scam email content!
The emails and the font size/color mismatches are like you copy pasting different segments from websites to badly cheat on your paper. 


Amanda also known as A Mad Something Boner 781 <amadoqlabonter718@gmail.com>    first sent me an email with the subject line: "Updated Transaction Details" and with "You can feel free to contact our Customer Care Number- +1(855)-2254-801"



George also known as Gregory of SSS or Sexing <gregorsssen@gmail.com> followed up with "Current Transaction Updation....". (Sorry, George, I am not hailing your SSS kind, otherwise, proud of you to be having "some fun"?  )



Teresa Adam also known as Trashing the T-Rex <trexiontrexon@gmail.com>    followed up, ready to seal the deal, with "Bitcoin Prera Payment Notification". Sorry love,  you're a little bit short-handed there like a T-rex.



Sam Billing also known as "I Know Winston Churchill is Rolling at his grave at 0731"    or a Win a Stoner's Rolling contest manager <winstonarolling731@gmail.com> made the last presence with "Updated Details of your Transaction!!". Not gonna lie, I was having my hopes up and ROOTING FOR THE SCAMMING SEQUAL of Bitcoin Prera, until Sam's Billing's email! One of those sloppy sequels. 1/10 NOT RECOMMENDED! 

I grew up in the nuclear family, my parents and I, after we moved away from my birth country when I was at the age of ~12yo.

We have lived in few countries and states since. I am either at home or away for my university or graduate studies 1-2 years at a time or 4 years at a time, depending on the studies in my pursuit of my life long dream. During all these years, struggling financially or emotionally from individual's work related matters make us feel and become distant, more so each year, sadly. We have all left our beloved family members and some passed away, RIP, or we could not visit back due to political reasons at the birth country.

Every moment of happiness is usually and quickly overshadowed by one or both of my parents thinking about their past sand the sacrifices or struggles they have overcome from the discriminations at work or arguments/bullying by the coworkers and transferring the angers at home, from arguing about a minor uncleaned spot on a "wash dish" onto bigger matter, all within few seconds to hours.

I could not blame my parents from constantly arguing daily and/or extending the argument over days to weeks, now progressing more than ever. Things they have gone through, understandable. I also understand how one of my parents feel unsatisfactory about the other because of the still struggling situations to making a living or living in their crushed dreams working in the job one does not wish, even though it is a respectable high/professional-degree or skilled jobs.

Their constant arguments of small things (leading into bigger things and the argument at the present time leading to bringing up all the things from the past), have made me extremely sad that I could not help alleviate their concerns and problems and that I could not see the 2 becoming together again.

The situations have affected my focus in the studies whenever I am back home with my parents. When I am away, I am at my absolute best and with the highest self-confidence and exceling (I'm not just saying  , I received great feedbacks on my character, work ethics, and professionalism from my colleagues, coworkers, or superiors!    ) I tried to tell them that, and I was seen as the person who was placing blame on them.

I am not ranting about my parents, I understand the foundation of their arguments. Just that, the explosive anger of one of my parents and the inability to reconcile by the other, and the unfixable matters like certain jobs for them with the pay they want and a settled lifestyle as immigrants they envisioned, is just sad and hard to cope with.

How to I cope with my parents contently fighting then?

• Minding my own business as much as I can, whenever I am home, I can feel the hurt inside me, but what can I do?
• Trying to talk to them, and always trying to dodge the anger or the steam redirected towards/including me, and accepting that I failed to alleviate, but I tried.
• Focusing on my faith and belief (for me, in God and His comforts and words, and the beauty of the Gospels)
• Focusing on my hobbies as much as I can.
• If I am away or at home with my parents but working, FOCUSing my mind in work (making that good stress and energies into good use!   
• Helping others or hearing others out with with their concerns or problems, because I know it is important to have someone as support (I had none, with birth extended family at a distant/abroad, close friends all abroad or far in different time zones, or others not having time or get the hint to hear me out)

How do you cope with arguments in your household, within your family members?

I recently attended the web-based training on "Global Health Introduction" hosted by North Dakota Public Health Training Network (NDPHTN) through the approved Certified Public Health Continuing Education (CPHCE) credit listed at Train.org (https://www.train.org/main/course/1090799/).

I would like to share the official video and my notes for your information purpose. Please watch the video for details!


Global Health Definition

QuoteHealth problems, issues, and concerns that transcend national boundaries and may best be addressed by cooperative actions

Global Health is a concern because:

• diseases affect our local, state, national, and international communities where our families, friends, colleagues, and economy globally depend in co-existence
• disease outbreaks impact global security and freedom
• it encompasses ethics and responsibilities such as malnutrition, lack of medical care, diseases and sickness unprevented due to shortage of or inaccessible resources, depriving of education and economy growth, depriving of basic standard of living and resulting early or unnecessary deaths, decreased functioning in the environment/work/school, etc)

Global Health is a good study because of how it surveillances data (studying health and diseases everywhere from all perspectives of care, but mainly focused on the primary and preventive stages in the population) and how it provides crucial and beneficial program assessment info for improving and maintaining the optimal public health practices and promoting positive progress.

Public Health Practices: National immunization days and smallpox eradication are few examples of Global Health's best practices.
- Smallpox Eradication: Smallpox is caused by Variola Virus that infects humans only and is transmitted by close contact within 6ft through respiratory droplets from cough and sneeze. Its symptoms include stages of a rash - rash > small bumps > blister > pustule > scab > and potential scarring. Last naturally acquired smallpox case was in Somalia in 1977; ring vaccination was the most effective.
- Mass vs ring vaccination strategy: Ring vaccination is the most effective because it takes into account the different stages of 1. isolating the confirmed and suspected cases to prevent further spread, 2. identifying, vaccinating, and surveilling of significant contacts of proven cases, 3. vaccinating the household contacts of contacts. (Vaccinia vaccine is a replication-competent smallpox vaccine consisting of a live, infectious vaccinia virus - it was not originally for smallpox but does have cross-reactivity with a 95-99% effectiveness and lasting 15-30 years!)

Public Health Progress examples:
Decreased death rate of children since 1950
Increased life expectancy in developing countries
Eradication of smallpox eradicated
Near-elimination of Polio
Declining Measles death declined
Decreasing Guinea worm infection in Africa

Example Challenges for Global Health
~10,000 deaths of infants daily before reaching 4 weeks old
~530,000 death of women during childbirth
~115,000 death of children yearly due to measles
~1,600,000 death yearly due to tuberculosis
West Nile virus endemic to Egypt spreading to Middle East, Africa, Asia, and the United States
Dengue hemorrhagic fever spreading globally (spread mainly by Aedes aegypti, but also Aedes Asian Tiger (Aedes albopictus); there is a Dengue vaccine DenVaxia by Sanofi Pasteur)

Categorized Challenges for Global Health

Health disparities

• Disparities raise important ethical and humanitarian questions about the extent to which people everywhere should be concerned about disparities in access to health services and in health status
• Life expectancy - 1. availability of functional of public health programs (MOST IMPORTANT) requires adequate resources to develop and sustain these factors that impact health disparities; 2. medical technology such as equipment, medications, trained personnel, distribution
• Healthcare access - low income countries are 10x fewer with physicians; Nigeria and Myanmar have 4 physicians per 10,000 population vs. Norway and Switzerland having 40 physicians per 10,000
• Health outcomes - child mortality, food security, maternal health; Major Gaps in social status, income, ethnicity, gender, disability, sexual orientation

Health linked to development

• Struggle to sustain economic growth
• Hinders institutional performance and productivity
• Decreases global investments (high in disease = less attracted to global investment and economy)
• Destabilizing
• Increases security risks

Engaging collaborators
Enhanced collaboration is needed to improve the health of all world citizens, state, local, international levels: non-profit organizations, faith-based groups, businesses, governments, educational systems, healthcare organizations, rural and urban ethnic, cultural and community groups

Maslow's Pyramid - development and engagement

 
Higher needs only come into focus ONLY ONCE the needs at the lower levels are met, partially or fully

• Physiological - food, water, air, shelter, bodily comfort, exercise
• Safety-Security
• Love/Belonging - social, relationships, friendship, sexual relations, acceptance, belonging, feel needed
• Esteem - respect, recognition of others, self-respect
• Effective development and engagement (top of the pyramid) - actualization and self transcendence - make the most of one's unique abilities, search for meaning, spiritual needs

Defining Health, Public health and Global health

Definition of Health by W.H.O World Health Organization

QuoteA state of complete physical, mental, and social well-being and not merely the absence of disease of infirmity.

Definition of Public Health in 1920 by Charles-Edward A. Winslow, founder of Public Health in the United States

QuoteThe science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health.

Definition of Global Health by Merson MH, et al.

QuoteThe application of the principles of public health to health problems and challenges that transcend national boundaries and to the complex array of global and local forces that affect them.

• Global Health = health issues from a broad world-wide perspective rather than narrower/local/individual country view-point, p
• Public Health = populations
• Clinical medicine = individuals

Key Global Health concepts:
determinants of health
measurement of health status
importance of culture to health
global burden of disease
risk factors for health conditions
demographics and epidemiologic transitions
organizations and function of health systems

Shared by Kaung M. Ko, MD, MPH, CPH

Now that my life is on the track of being more stable/settled after all these years of having lived in few countries and states, I am thinking of getting a pet or pets in my nearest future, for the love of them and to have a lil companion 

I have been researching when I was about to go on a trip to say the national parks or historical and scenic places, and most of them say pets are allowed only at certain locations within those regions and if I were to go on a long hour of sightseeing or a trail or scenic route via some other means, I must leave my pets at home for hours. I mean, there are pet sitters but I DONOT HAVE THE GUTS to leave my baby furrball or paw at home and just go on with my own!  I know some flights allow pets, but the end destination of the trip might not fully allow or not at all allow my pet(s) to tag along on the same adventure!

See, having lived in tight spaces my whole life thus far, I DO NOT wish my pet(s) to be left in small spaces. I want them to roam as free as they can be! Also since I have lost ties due to life or rest in peace of people from all stages of my life, I DONOT wish to leave my pet(s), if I were to get one or few, just with strangers or alone at home! It is so hard for me to even think about. May be I'll never get a pet because of that reason, even though I so want to! 

How do you all travel about to pet fully or semi restricted locations?
What pet(s) do you own?!

Few weeks back, after I integrated SMFPacks Seo PRO Mod for search engine friendliness and all the other wonders for the Good Old Forum to be heard over the forum site worlds, my sitemap was going crazy!

Whenever the SMF Sitemap was accessed by someone or a search engine bot to view categories, the error log showed the error of undefined index.

Quote/home/admin/domains/.../public_html/Themes/default/Seo.template.php (Line 367)
Type of error: Undefined
Error message Select
8: Undefined index: msg_alert_none

I troubleshooted and it was the coding the line under Seo.template.php with
<li>', txt['msg_alert_none'], '</li>';
THE FIX.

Well, the fix was always there. I just did not know to what text to define for "msg_alert_none"; I mean it could have been intended for a "No message", "No new message", "HOLD UP YO! AINT NO BODY GOT TIME FOR MESSAGE POPULTION!" 

The problem was ONLY WITH ANY EMPTY CATEGORY under Sitemap.
The categories with a topic under already, there was no problem!

So, I had few choices:

• define my own text for msg_alert_none
• edit the wording to topic_alert_none (same as in index.english.php language of my default that says something like "no messages"

I went with 1. defining my own.
I could hard edit the Seo template's language file
BUT I went with SMF forum's Admin > Config > languages > edit language > edit > choosing Modifications to edit > and define my own

I went fancy with:
msg_alert_none to be 

QuoteNo new topics at this moment. Come back soon to <a href="Website Domain Names, Online Stores & Hosting - Domain.com">https://domian.com</a>.

After integrating the SMFPacks Ads Manager Mod, I was receiving errors for the "ads after #th post" option, regardless of placing a text ad, banner ad, or adsense/alike ads.

The errors are always a duo for SMF's index.template.php and Display.template.php with each visit by a user/guest. 1 visit = 1 error under each.

index.template.php error log was showing:
/home/admin/.../Themes/default/index.template.php
Type of error: General
Error message Select
Code: [Select]
2: Invalid argument supplied for foreach()
Display.template.php error log was showing:
/home/admin/.../Themes/default/Display.template.php
Type of error: Undefined
Error message Select
Code: [Select]
8: Undefined index: quickbuttons
Security.php error log was showing:
/home/admin/.../Sources/Security.php
8: Array to string conversion.

NOW, THE FIXES I got to after hours of troubleshooting:
(I'm not that of an expert, so took a while    )

1. For Undefined index: quickbuttons,

Under AdsManager.php, FIND (around line 621):

            return array(
                'attachment' => array(),
                'alternate' => $counter % 2,
                'id' => '0',
                'href' => $scripturl . '?topic=' . $topic . '.' . $context['start'],
                'link' => '<a href="' . $scripturl . '?topic=' . $topic . '.' . $context['start'] . '" rel="nofollow"></a>',
                'member' => &$memberContext[0],
                'icon' => 'xx',
                'icon_url' => $settings[$context['icon_sources']['xx']] . '/post/xx.gif',
                'subject' => $context['response_prefix'] . $context['subject'],
                'time' => timeformat(time()),
                'timestamp' => forum_time(true, time()),
                'counter' => $counter,
                'modified' => array(
                    'time' => 0,
                    'timestamp' => 0,
                    'name' => ''
                ),
                'body' => $ad['body'],
                'new' => false,
                'approved' => true,
                'first_new' => false,
                'is_ignored' => false,
                'can_quote' => false,
                'can_approve' => false,
                'can_unapprove' => false,
                'can_modify' => false,
                'can_remove' => false,
                'can_see_ip' => false,
                'can_like' => false,
                'can_dislike' => false,
                'is_message_author' => false,
                'css_class' => 'windowbg',
               
NEAR THE END, ADD
'quickbuttons' => false,
Why?: The ad was posted by "non-registered guest", unless you specified which registered user, the quickbuttons and all other "normal post and edit options and custom fields" must be considered for and be defined / nullified.

2. For Invalid argument supplied for foreach(),
"NEWER" TEMPORARY FIX - edit of 1 group of lines only (not 4 like older temp fix):
FIND:
       
    foreach ($list_items as $key => $li)
    {
        // Is there a sublist, and does it have any shown items
        if ($key == 'more')
        {
            foreach ($li as $subkey => $subli)
                if (isset($subli['show']) && !$subli['show'])
                    unset($list_items[$key][$subkey]);

            if (empty($list_items[$key]))
                unset($list_items[$key]);
        }
        // A normal list item
        elseif (isset($li['show']) && !$li['show'])
            unset($list_items[$key]);
    }
       
       
REPLACE:
    if(is_array($list_items)) {
       
    foreach ($list_items as $key => $li)
    {
        // Is there a sublist, and does it have any shown items
        if ($key == 'more')
        {
            foreach ($li as $subkey => $subli)
                if (isset($subli['show']) && !$subli['show'])
                    unset($list_items[$key][$subkey]);

            if (empty($list_items[$key]))
                unset($list_items[$key]);
        }
        // A normal list item
        elseif (isset($li['show']) && !$li['show'])
            unset($list_items[$key]);
    }
       
        }
TEMPORARY FIX OLD #1:

Under index.template.php, FIND (around lines 712, 717, 757, 767):

FIND:
    foreach ($list_items as $key => $li)

REPLACE:
    foreach ((array)$list_items as $key => $li) //added array

FIND:
            foreach ($li as $subkey => $subli)

REPLACE:
            foreach ((array)$li as $subkey => $subli) //added array

FIND:
    foreach ($list_items as $key => $li)

REPLACE:
    foreach ((array)$list_items as $key => $li) //added array

FIND:
            foreach ($li as $subli)

REPLACE:
            foreach ((array)$li as $subli) //added array

3. For Array to string conversion,

Under AdsManager.php, FIND (around line 1017):
'permission' => array(
REPLACE WITH:
'user_permissions' => array(
Why?
When checking under Security.php, at the said line 933, it shows:[/s]
        if (count(array_intersect($permission, $user_permissions)) != 0)

I have been noticing and seeing more and more people are moving to Florida, either for political reasons or for better lifestyle of living with freedom and FREEEEDOME  (even by and in the eyes of few hypocritic leaders who dislikes Florida for having their own "style").

I know the real estate and the apartment rentals have been in the affordable range or relatively good prices for the Florida lifestyle.

HOWEVER, I am also hearing that because more people are moving, the housing and apartment demands are getting greater than the supplies, and the prices have increased by x1.5-3 of what was 1-2 years ago!

Is it still a good time to be moving to or buying or investing in a home in Florida or once "the moving to Florida phase" fades, will the housing prices drop, to a loss? 

If you are a real estate agent in Florida or have moved to Florida, or just want to share something you love (or dislike about Florida), 

Do you do your own taxes? Does a family member or a friend help you with your taxes? Do you use a tax service?

We used to use H&R Block or alikes for few years, but the return were very minimal mainly because they do not actually go through details with us and simply input the W2 forms and charge us an arm, if not arms and legs, I mean if they even helped deduct $1 from the already owed, I would be flexible and say, it would have been "worth it"  !

Then we found private companies providing the tax services, which we tried more recently. They were great to alright in giving attentions to all the credits and deductions we qualified. They still charge a lot $100-$250 at times, but it would be worth it considering the balancing or the owed taxes already being negative to the income  . Recently they increased the tax prices depending on who is doing or who ran the private companies.

Now, for the past 2-3 years, I have been doing my own for my family and I using TaxAct tax service. Very flexible and the questionnaires to guide the filing tax are easy to follow through, all using their online service. They have well improved since they started too! They even have the options for stocks and shares, either to automatically pull from the stocks/shares websites or to input manually, but either way is a great add-on! You can file FEDERAL TAX for free, but STATE TAX filing, you have to pay extra. Free is relative though, if you have to add more credits or deductibles or something, you will need to pay a fee for both FEDERAL and STATE. (I never use their extra paid services like audit, counselor, etc.)

TaxAct has been great, but they too have increased their prices recently, or since last year.  I mean, I still and will probably use them because after researching other tax filing services, most do not offer what TaxAct does. I might be right or I might have overlooked some features, so, what are your thoughts?

How do you do your taxes and With/by whom do you have assistance in filing your Federal tax and State tax?

Share your tax filing experiences during the tax seasons!!!? 

We are DEFINITELY facing inflations.

How to fix this inflation?
FLUSH all your money down the toilet!  
A partial-joke, but we all know nobody, not even those rich ones by means of dishonest works, would virtue signal and flush their money.

If I remembered correctly from the business, economy, and government classes I have taken back then, the cause of the inflation is "too much money circling with the public".

How is there too much money circling? - printing more money by the government (stimulus, aids, etc) and other reasons that will make more money out in the public and less in the federal reserve.

Inflations with too much money in the public will raise the costs of everything, without actually raising the worth of what is raised. That $1 fruit will now be $10, and not because it is a rare god-sent gold-plated fruit.

As the prices rise higher, there will be reduction in production and workers due to costs. The demand for a particular good or service increases, and the available supply decreases. With fewer items/services are available, the public (buying public) is willing to pay more to get the item. And that further results in higher prices due to demand-pull inflation. And we are at that demand-pull inflation mark. 

Money going outside of the general public back into the federal reserves OR money going outside of the country can "solve inflation":

• What is money going outside of the general public? - high taxes will make more taken back from the public, selling bonds/stocks/area 51 aliens/presidential canes/presidential diapers/anything by the government to the public so cash will be back into the Federal reserve and the public will get the non-cash, adjusting supplies and demands, etc.
• What is money going outside of the country? - WAR, establishing new companies outside, paying the country's debts to other countries, etc.

Just my $100.     was my 2 cents, but then inflations...

Keep the faith and ALL WILL BE! NEVER doubt that! 

Often time, we hear how disgusting or how much of a pet-peeve is to see someone chewing with their mouth open.

Now, I am sure the people who have felt that way have done MANY THINGS in their lifetime, in their personal  ("the usual" or "spicing up") or professional capacity that is actually disgusting in itself or "more disgusting" than the reaction from / the action of someone chewing with their mouth open.

Chewing with your mouth open is how you are supposed to be eating and enjoying food.
It may not be a "respectable" way, but it IS a normal way.
The normal way you are supposed to be chewing is with a mix of passion/power and enjoyment of food and be less sensitive to the surroundings. (Of course, food may be more satisfying when chewing with mouth closed)
Do you know that you eat less when chewing with your mouth open?

Perhaps, it is the intensity of the chewing with the mouth open?
Let's think about eating with your hands in some cultures.
To some, eating with hands is seen as disgusting, but do you know that there is a professional/mannered way of eating with your hands?
It is not just eating with hands vs. using utensils - there is eating with hands unmannered vs. mannered!
That's why even with chewing, there may be a more mannered chewing?
Open mouth chewing with less "spitting or food pieces flying all over"?

 

Burmese (where I was born and lived for 12 years - within an extensive family life - RIP to ones I love whom I couldn't return to meet again on time):
ကောင်းမြတ်ကို

Japanese (the country I moved to and lived for 3 years)
カウンミャコー

English (this has a meaning to itself because names were based of the day born in my culture - MONDAY IS KA/GA/NGA variants):
Kaung Myat Ko

There was no "first or middle or last name", until I adapted to suit such system.
My whole name means GOOD/KIND/NICE RICH(in knowledge and kindness) BROTHER/ELDER

 

Who remembers Rhett & Link and their "In The 80s" song?? 

QuoteYou kids think -  your gear is iconic
But Im gon take you back to see some real electronics
gimme a beige PC, green text, black screen
and 64 kB of memory (thats plenty!)
forget a phone that fits in your pocket
I keep my phone in a bag in my car (thats how we rock it!)
who needs a camcorder, that size of my hand?!
you know I wanna look like a news cameraman!
  (I wanna perch it on my shoulder...like an overweight parrot!)
 
my disks were floppy but my hair was stiff
and all my stickers were scratch and sniff!

In the 80s!   If it was big it was good! 
80s!   My TV was wood!
80s!   My car was shaped like box!
80s!   Back when everything rocked!

youre tellin me mp3s  oh theyre so great
Id rather push Rewind; and sit and wait!
my first VCR cost me five grand
VHS is best!  (Im a Beta Man!)

16-button controllers really make me sick!
gimme one red button and a joystick!     

In the  80s!  the bigger the betta
80s! I had an antenna!
80s! my TV was thick
80s! we didnt point and click
80s! I had a big boom box
80s! I calculated with my watch
80s! My mix tapes were hot
80s! Back when everything rocked!  Distributed by Tubemogul.

HEADS UP FOR THE RUMBLING or RUN-ON sentences. 
I WANT TO help you all (unmatched MD and unmatched DO) because I have gone through the same with the ERAS, NRMP, and residency application cycles.
I am in no position to actually help you obtain a residency spot, but below are what happened to me and what I did and how I improved and keep improving myself and CV with persistence.
I must let ALL inside my head out here FAST before I forget any!
(I will edit and smooth things later and I will add things as I remember more)

Faster share:
http://ididnotmatch.nethttp://unmatchedms4.netIf the above domains expired (use original)
https://goodoldforum.com/medical-school-lifestyle/237/I-did-not-match-unmatched-ms4-unmatched-md-unmatched-do/58
  PS: I don't want to promise anything, but check back here in few weeks or months, I'll help out at least someone with subscriptions or books (+ shipping to your country) or some application fees or something all on my expense. I have been "every part of the THERE", so I know, especially when somethings are hard to ask from others you know. and NO CATCH. Just know that YOU WILL BECOME. You are NEVER alone.  (plus, as long as I live, even your worst experiences, mine can top them <<< positive joke for you, I've never played disadvantaged card on CV or applications but I've slept in places you would have only heard of or survived on bread and water alone if lucky, different parts in times of my life journey, if not all during in pursuit of my medical career)

QuoteWe are sorry, you did not match to any position. 
Unfilled program information has been posted in the NRMP Registration, Ranking, and Results® (R3®) system for applicants eligible to participate in the Supplemental Offer and Acceptance Program® (SOAP®). You can determine your SOAP eligibility on the R3 system home page after logging in. If you are SOAP-eligible, you may review the List of Unfilled Programs found under the SOAP tab in the R3 system. ERAS will open at 12:00 PM Eastern Time for you to begin submitting applications to SOAP-participating programs.
Important Rules for SOAP 

• SOAP applicants may apply only to programs on the List of Unfilled Programs and must use ERAS to submit applications.
• Applicants and individuals acting on their behalf cannot communicate with programs until programs initiate contact after receiving an ERAS application during the SOAP process. Applicants who violate this rule will be investigated by the NRMP and may be barred from SOAP the following year.
• Applicants are prohibited from copying, posting, or making publicly available the List of Unfilled Programs or sharing any Match information with anyone who did not register for the Match or who otherwise is ineligible.
• Positions offered and accepted during SOAP constitute a binding commitment under the Match Participation Agreement.

Well, that above email is something you do not want to receive. As others have said, you do not want to wish that even upon your worst enemy! And that is true and THAT is a good mindset if you are thinking that. Always do things with honor and stay humble! 

I did not match. I was unmatched. I was an unmatched medical student 4^th year. I was a lost, sad, and embarrassed unmatched MS4. For 3 CYCLES!  (So, yes, I have gone through what you all in the similar situation is going through, even though I won't know exactly what you will be feeling and how this unmatched status will affect you, your loved ones, your finances, etc. (For me, EVERYTHING PERSPECTIVE OF MY LIFE was affected, and I had minimal support. But one thing I know based on my rotations and myself of my own work ethics and professionalism and passion and dedication is that, ONCE I AM IN, I CAN DO IT!  )


I was able to afford to apply to only few programs at a time because of budgeting – I am from California, an US IMG from one of the top Caribbean Medical Schools and an undergrad at one of the Universities of California (I was an 100% stellar student in university). As you know, applying below 200 or 150 programs is NOT A GOOD IDEA for an IMG, especially with red flags as discussed below! My Caribbean School of Medicine has nothing to do with my red flags - it is a GREAT SCHOOL and if you work hard and focus, you get the result of your hard works seen! And in fact, starting from my batch, we were introduced to clinical skills earlier at different facilities, and oh how precious they were and are for that USMLE Step 2 CS and the clinical rotations and till now!

But I had no choice with loans or family's financial supports because we are the only 3 without any supports for decades (and till now), we know our budgets – we work hard (I am thankful for that because MY WORK HISTORY SINCE HIGH SCHOOL AND TILL THIS DAY WAS EXTENSIVE!). I am and was someone with extensive immigration and emigration history to 3 countries and 2 states, someone with a family trying to or hoping to settle and using the savings over the years, someone who stayed on the island away from family during the first 2 years straight of basic studies and survived with the minimal because flying back home would either "eat up off days" or "accordingly be waste of money I could have otherwise used there and after I finally go back to my family".


My match cycles / unmatched cycles :

• 2022 Main Residency Match Results: MATCHED - Now, MD/MPH/CPH/Step 3/on-going scribe work at a prestigious program/red flags stated in Personal Statement + reasons + taking full responsibility even though mainly unavoidable circumstances for me/family. One of the programs I really wish to be at and heard through words of mouth from few DOs/other Caribbean students I have met along the road, the program coordinator replied to my email (more later) and offered me an audition rotation / a clinical rotation for a month (not an observation). YAY! I went there, worked hard and smart with passion and dedication, I SHOWED rather than tell and built great rapports with the staffs and the students there – I am forever grateful for the recommendation letters the Program Director and Assistant Program Director wrote for me (I did not see the letters, but I KNOW they are great letters) and grateful for the caring supportive residents and friendly students I met there! Those FRESH LETTER OF RECOMMENDATIONS + other good LORs from my medical school years, 15 INTERVIEWS RECEIVED! FIFTEEN! But I did applied for $10,000 worth of hard-earned / ALL resource. I MATCHED! GREAT NEWS ON 14 MARCH 2022 MATCH DAY! (Where? I'll know on FRIDAY, 18 MARCH 2022).
• 2021 Main Residency Match Results: UNMATCHED – Saved up, still working as a virtual scribe, MD/MPH/Step 3 with Certified in Public Health pending. 4 interviews, all new programs, unmatched.
• 2020 Main Residency Match Results: UNMATCHED – Saved up and applied again to what I can afford after researching again, while working as a virtual scribe and near end of sitting for USMLE Step 3 and finishing a Master of Public Health degree – that saving up for applying and study resources while contributing to my family, that was something that did give a positive stress to keep on going without giving up, at least. Received about 5 interviews, but mainly from new or newly accredit programs – 2/3 great promising interview impressions – unmatched, understandable as well with accepting a "stranger with red flags".
• 2019 Main Residency Match Results: UNMATCHED – unexpected USMLE Step 2 CK score (USMLE Step 2 CS went well, as it should with how I was proactive with clinical encounters and spending much time at the rotations doing rounds, procedures, and learning) AND with that, I could not withdraw from the application cycle (could but no refund on my ~$xxxx), so... red flags of my USMLE Step 1 and USMLE Step 2 CK (eventually, later, informed by few interviewing program directors that the score gaps correlates with a positive trend and my explanations of my red flags – for 2022 Cycle, I went HEAD ON explaining about my red flags in my personal statement – JUST LAID THEM OUT with honesty!) This 2019 cycle, I had only 1 INTERVIEW from the program I did most of my core and elective rotations at, a prematch program where the program coordinator was friendly and kind enough to set me up an interview – late in December, no match.

SOAP/Post-SOAP :
Firstly, HORRIBLE EXPERIENCES! I cannot complain because for me, unavoidable circumstances BUT BY ME led me to SOAP, some of you should not be at this SOAP-ing point at all – sohuld have been MATCHED for sure!!)

• 2019 – 0 SOAP interviews, 2 post-soap interviews (university program and community program) around April/May/June
• 2020 – 2 SOAP interviews
• 2021 – 0 SOAP interviews, 1 post-soap interview and 1/3 post-soap interview (why 1/3, PD and aPD never called me on the day promised)
• 2022 – DID NOT NEED TO! FINALLY MATCHED! (You're not crying, I'm crying!)

What I wished I have done   or am glad that I did:

• Get $$$$s if you can! Plan right and SAVE MORE or half than what I have spent! My cycles costed total ~$35,000 without the air/hotel/travel fees and rent/bills complications
• Apply to as many programs as you can!
• Sit for USMLE STEP 3 FAST
• Continue with extended rotations if you can (but at the expense of not being able to sit for USMLE Step 3 or graduate degree, because they may need you to graduate from SOM)
• Work in a clinical field (btw, that virtual scribe work, I am/was blessed to have assigned to a prestigious program's primary care provider who graduated from the same Caribbean medical school decades earlier).
• Enroll in a graduate degree.
• (I was working FULL TIME while studying FULL TIME for USMLE STEP 3 and while attending MPH program FULL TIME – I work as a virtual scribe 4AM-2PM PST, studied USMLE STEP 3 and MPH from 3PM till midnight/1AM) 

What I did :

• Other than the above for MPH/CPH/USMLE Step 3/active in clinical field,
• FRESH LORs from program(s) – how contacts and through contacting programs! (more below)
• CHIN UP AND TELL THE PROGRAMS YOU ARE UNMATCHED - how? The moment SOAP week is over, gradually EMAIL ALL THE PROGRAMS YOU WISH TO ATTEND – GIVE TIME! EMAIL PD and CC others. NOW, HOWEVER, DO NOT go about promising or making it a letter of intent or too personal/customized. Just a nice and formal side of "My name is so and so, a YEAR grad from such SOM with USMLE scores XYZ. I am interested in your program (+/- reasonable why) and would be grateful if you would let me know if there is an unexpected opening. I am available to be interviewed within a short notice via phone, virtual, in-person (time travel wisely for in-person mention). I HAVE ATTACHED MY CV, COPY OF ERAS, TRANSCRIPTS, MSPE / DEAN's LETTER, etc... Thank you for your time" + some other closing and other things you wish to say BUT MAKE IT CONCISE – remember, this is NOT A LOVE LETTER. Of course unless, it is the program or few programs you really want to go, customize it saying because of location, ties, etc.
• Improve and have these documents ready: CV, COPY OF ERAS, TRANSCRIPTS, MSPE / DEAN's LETTER, etc
• MATCH A RESIDENT https://www.matcharesident.com/: MAR DOES access your SOM, grad year, scores and attempts AND IS reliable (I could not afford it here and then during my cycles, BUT LAST CYCLE, OH BOY! HOURS AFTER HOURS researching those 100% 97% 80% 70% match and EXCEL-ing up – ranking which program to apply NOW and which later as $$$ comes (and goes lol). MAR's RANK ASSISTANT feature was nice too, to help rank which program – but also rearrange on your actual ROL of how you truly feel of course!)
• RESIDENCY EXPLORER BY AAMC https://www.residencyexplorer.org/: It maybe helpful to you post-soap and when openings occur because some programs do search on there, but rarely. (Wasn't helpful to me, but then my situation was different!)
• Resident Swap https://www.residentswap.org: I applied to few openings and have received reasonable follow up, wit the right timing and documents, of course. It is worth the subscription during your post-soap and before the next cycle, or even during the next ERAS application cycle because, rarely, but few PGY1s do drop.

WHO DO I EMAIL?
Everyone including the newly accredited programs coming soon!
ACGME NEWLY ACCREDITED PROGRAMS

How should I prepare for USMLE Step 3?
I've found UWorld Step 3 to be beneficial for Day 1 Step 3 Foundations of Independent Practice (FIP) and more so for Day 2 Step 3 Advanced Clinical Medicine (ACM), and CCSCases.com to be extremely thorough for Day 2 cases!
I didn't go through all the CCSCASES.com. It would definitely be a breeze with those 2 sources for medical school graduates and for current PGY1s combined with current knowledge and skills as a resident!

Well a little extra about me :

• I have cultural experiences having lived in 3 countries and few states, grown up and went to school in all, in a sense.
• I speak 4 languages.
• I have worked in many fields research, clinical labs, community services, healthcare, law, blue/white collar jobs
• My hobbies include entertainment business (listed under IMDb for producer/actor/co-producer/misc), artist (1 recording on all online stores, including APPLE MUSIC, AMAZON MUSIC), a pending novel to be published (pending due to $$$$), faith-based involvements, community speeches, writing poems, "being productive on Instagram and Facebook - debatable), have played varsity Badminton and still play badminton and other company sports here and then.
• And I do many things for fun - as a self-improvement and solo mission but shared with others eventually by means of videos or quotes

FAST TIPS  :

• SPEED UP if you can/are capable with any of the steps I have mentioned above
• Keep contacts with people you know
• Make new contacts
• Embrace the suck and FIGHT ONWARD
• ENJOY the little happy moments
• I did learn my tragedies of unmatched did come with the upside - more quality time for self and with family and other unfinished businesses!

ALL THE BEST!!! 
A HALT IN YOUR PATH IS NOT AN END!
GRADUATE WITH PRIDE regardless of the MATCH status! YOU DID IT DOCTOR!!
YOU ARE NOT A FAILURE 
Keep the faith, keep strong your belief in anything and anyone, stay strong!

Keep yourself hydrated and eating relatively well!