An Interdisciplinary Analysis of Core Competencies in Pain Management for Prelicensure Education: Curriculum Application for Physical and Music Therapy

Core competencies in pain management were recently established for prelicensure health professional education and assessed for ways that they could be integrated into professional physical therapy practice. The competencies present the expected minimal capabilities for graduating health care students for the subject of pain management. The pain competencies include 4 domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain. The proposed competencies are recommended for educational programs and could be implemented for other health professions. The purpose of this study is to assess the implementation of the pain competencies in physical therapy and music therapy by surveying current licensed or board certified professionals. Background and Purpose: Music Therapy is defined as the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. The goals of music therapy in pain management are to assist the patient in regaining self-control and become actively involved in the management of his/her pain. Recently, core competencies in pain management were established for prelicensure health professional education and postulated as to how they could be implemented into professional physical therapy practice. The purpose of this study is to address where these newly established competencies are applied to the professional music therapy\u27s curriculum and physical therapy curriculums Subjects: The subjects of the study included (200) board-certified or licensed music and physical therapy clinician\u27s within the Midwest tri-state area of North Dakota, Minnesota, and South Dakota. Methods: Using a web-based survey, professional music therapy and physical therapy clinician\u27s completed an electronic survey, rated on a 6 point Likert-type scale. The survey examined the clinician\u27s impressions of the core competencies in pain management established for prelicensed healthcare professional education and the feasibility of integration of the competencies into professional practice

Murky Waters: Courts Should Hold That the Any-Progress-Is-Sufficient-Progress Approach to TMDL Development under Section 303(d) of the Clean Water Act Is Arbitrary and Capricious

Congress enacted the 1972 Amendments to the Clean Water Act (CWA) to combat water pollution stemming from both discrete and diffuse sources. Section 303(d) of the CWA reduces both types of pollution by requiring each state to promulgate total maximum daily loads (TMDLs) of pollutants for all waters that are unable to meet water quality standards. A TMDL is the maximum amount of a pollutant that can be discharged from all combined sources into a given body of water if that water is going to comply with water quality standards. Although section 303(d) required states to promulgate TMDLs by 1979, they universally ignored the mandates of section 303(d) for decades. However, in recent years, lawsuits initiated by environmental organizations seeking to enforce section 303(d) have spurred TMDL development. Courts adjudicating these lawsuits have adopted different approaches when reviewing a decision of the Environmental Protection Agency (EPA) to approve state submissions of TMDLs, and these approaches have fallen into two groups. One set of courts has adopted what one commentator has dubbed the any-progress-is-sufficient-progress approach to TMDL development and has upheld EPA approval as long as a state has promulgated some TMDLs and has set deadlines for TMDL development. In contrast, a second set of courts has adopted a more holistic approach to reviewing EPA approval to effectuate Congress\u27s intent. This set of courts considers factors such as a state\u27s actual rate of TMDL development and history of noncompliance with section 303(d) as relevant to its determination and has declined to uphold the EPA\u27s approval of only some TMDLs when a state needs many TMDLs to achieve water quality standards. This Comment argues that courts should decline to adopt the any-progress-is-sufficient-progress approach to TMDL development and should adopt the approach of the second set of courts to effectuate the text, legislative intent, and proper function of section 303(d) of the CWA

A study on fiurnal variation of corneal thickness

Central corneal thickness measurements were taken on both eyes of seven subjects, every four consecutive hours, for as long as the subjects were available. The corneal thickness data were analyzed for influences of sex and age, ocular dominance in thickness, and periodicity of the corneal thickness fluctuations. Age and sex were two factors which did not affect the corneal thickness of the seven subjects. In five of the seven subjects neither eye seemed to dominate in corneal thickness, one subject consistently had the left eye thicker, and one subject consistently had the right eye thicker. No repetitive pattern or periodicity was discovered on any corneal thickness fluctuation of any subject. The fluctuations were on the order of ten percent of the mean corneal thickness in almost all subjects. A significantly high covariation of the corneal thickness fluctuations between the left eye and the right eye was found on five of the seven subjects

A New AISI Cold-formed Steel Design Manual

The Specification Committee of the American Iron and Steel Institute is currently developing a new Cold Formed Steel Design Manual. The work is being done under contract with Computerized Structural Design with oversight provided by AISI Subcommittee 26 - Design Manual. This paper describes the purpose and contents of this Manual. It is expected the Manual will be published in conjunction with the new edition of the Specification for the Design of Cold-Formed Steel Structural Members early in 1997. The Manual will contain the combined versions of the Allowable Stress Design and Load and Resistance Factor Design Specifications in addition to useful new design information

On the Computation of the Cross-section Properties of Arbitrary Thin-walled Structures

In this paper, a generalized computational algorithm based on the line chain and tree models is developed for the cross section properties of arbitrarily configuration struts without closed loops. The two C++ programs for such models are developed. However, the two models cannot apply to struts with any cross-section possessing closed loops. Therefore, the further investigation should be completed

Compliance Monitoring of Yearling Chinook Salmon and Juvenile Steelhead Survival and Passage at Bonneville Dam, Spring 2011

The study was designed to estimate dam passage survival at Bonneville Dam as stipulated by the 2008 Federal Columbia River Power System (FCRPS) Biological Opinion (BiOp) and to provide additional fish passage performance measures at that site as stipulated in the Columbia Basin Fish Accords

A novel PKD1 variant demonstrates a disease-modifying role in trans with a truncating PKD1 mutation in patients with Autosomal Dominant Polycystic Kidney Disease

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most common form of Polycystic Kidney Disease (PKD) and occurs at a frequency of 1/800 to 1/1000 affecting all ethnic groups worldwide. ADPKD shows significant intrafamilial phenotypic variability in the rate of disease progression and extra-renal manifestations, which suggests the involvement of heritable modifier genes. Here we show that the PKD1 gene can act as a disease causing and a disease modifier gene in ADPKD patients