Effects of Therapeutic Music on Pain in Spinal Surgery Recovery

Pain is one of the most common experienced symptoms reported by more than 80% of postoperative patients. Approximately 77-98% of postoperative patients report pain following their procedure with 40- 80% having moderate to severe pain. Pain is shown to elevate stress levels manifesting in increased heart rates, blood pressures, and oxygen demand. Inadequate pain control can develop into surgical complications causing surgical failure, blood clots, pneumonia, and chronic pain. Complimentary and alternative medicine such as music can be used in combination with opioid medication help improve pain control leading to successful surgical outcomes. The purpose of this evidence-based practice project was to determine if implementing therapeutic music into the post-operative recovery process improves reported pain scores and decreases pain medication usage in milligrams in adult spinal patients. The evidence-based medicine (EBM) model was used to guide this evidence-based project. The project was implemented in a small Northwest Indiana facility. An extensive review of the literature was completed directing the creation of a therapeutic music protocol. The organization formally approved the protocol and education was provided to the inpatient nursing staff. A one-group pretest-posttest comparison design was conducted to streamline the protocol. Implementation occurred on postoperative days 3 and 4 for each participant and data was collected during weekly chart audits. The mean day 3 pain scores were (M = 5.769, SD = 1.945; M = 5.692, SD = 1.954; M = 5.692, SD = 2.112) compared with day 4 scores with corresponding time (M = 5.115, SD = 2.268, p = .000; M = 4.846, SD = 2.110, p = .000; M = 4.846, SD = 2.344, p \u3c .004). Medication amounts were compared in the same manner resulting in day 3 (M = 37.673, SD = 45.008; M = 35.682, SD = 33.506; M = 35.798, SD = 37.313) and day 4 (M = 37.172, SD = 47.161, p = .000; M = 29.961, SD = 35.748, p \u3c .019; M = 31.451, SD = 37.437, p = .000). The results demonstrate a significant difference in decreases in pain scores and milligrams of morphine when therapeutic music is used in combination with opioid pain medication

Do People Make Strategic Moves? Experimental Evidence on Strategic Information Avoidance

The strategic commitment moves that game theory predicts players make may sometimes seem counter-intuitive. We therefore conducted an experiment to see if people make the predicted strategic move. The experiment uses a simple bargaining situation. A player can make a strategic move of committing to not seeing what another player will demand. Our data show that subjects do, but only after substantial time, learn to make the predicted strategic move. We find only weak evidence of physical timing effects.strategic moves; commitment; bargaining; strategic value of information; physical timing effects; endogenous timing; experiment

Boilerplate in International Economic Law

Boilerplate treaty provisions are identical or nearly identical terms that reflect settled legal language in treaties with different states parties. They are often taken from model treaties or templates and reflect non-negotiated “default rules” or rules that emerged in international practice, rather than individually tailored provisions adapted to the circumstances of the specific contracting parties. Although widespread in international economic law, boilerplate provisions have not been subject to much scrutiny, unlike their distant cousins in contract law. This essay highlights drivers and functions of boilerplate in international economic law along with core expectations from rationalist and behavioral approaches. Boilerplate can provide efficient solutions to international economic problems, for instance by reducing contracting costs, and provide bargaining leverage in asymmetric negotiations. Yet boilerplate can also result in unintended and unwanted consequences, such as when drafters fail to carefully consider “default” provisions or have an excessive preference for the status quo