Chronic Pain Treatment Guideline

This clinical guideline has been created to consistently improve health care services for injured workers by outlining the appropriate evaluation and treatment processes for the management of chronic pain which has been determined to be work related. The guideline should be used as a tool to guide health care providers of different professional disciplines to provide quality care to injured workers. The guideline is not intended to be a substitute for appropriate medical judgment, and is written to be broad enough to allow for a wide range of diagnostic and treatment modalities, and to purposely allow for philosophical and practice differences among professional disciplines of health care practitioners who provide care to injured workers with chronic pain. It is expected that approximately 10% of cases may fall outside of this guideline and may be reviewed and approved on a case by case basis. If objective clinical improvement is delayed or slower than expected, the treating provider must justify the necessity of continued care with a valid clinical rationale, with supporting, objective clinical findings. Timeframes for specific interventions commence once treatments have been initiated, not on the date of injury

Dispersive charge density wave excitations and temperature dependent commensuration in Bi2Sr2CaCu2O8+{\delta}

Experimental evidence on high-Tc cuprates reveals ubiquitous charge density wave (CDW) modulations, which coexist with superconductivity. Although the CDW had been predicted by theory, important questions remain about the extent to which the CDW influences lattice and charge degrees of freedom and its characteristics as functions of doping and temperature. These questions are intimately connected to the origin of the CDW and its relation to the mysterious cuprate pseudogap. Here, we use ultrahigh resolution resonant inelastic x-ray scattering (RIXS) to reveal new CDW character in underdoped Bi2Sr2CaCu2O8+{\delta} (Bi2212). At low temperature, we observe dispersive excitations from an incommensurate CDW that induces anomalously enhanced phonon intensity, unseen using other techniques. Near the pseudogap temperature T*, the CDW persists, but the associated excitations significantly weaken and the CDW wavevector shifts, becoming nearly commensurate with a periodicity of four lattice constants. The dispersive CDW excitations, phonon anomaly, and temperature dependent commensuration provide a comprehensive momentum space picture of complex CDW behavior and point to a closer relationship with the pseudogap state

Hubble Space Telescope NICMOS Polarization Observations of Three Edge-on Massive YSOs

Massive young stellar objects (YSOs), like low-mass YSOs, appear to be surrounded by optically thick envelopes and/or disks and have regions, often bipolar, that are seen in polarized scattered light at near-infrared wavelengths. We are using the 0.2'' spatial resolution of NICMOS on Hubble Space Telescope to examine the structure of the disks and outflow regions of massive YSOs in star-forming regions within a few kpc of the Sun. Here we report on 2 micron polarimetry of NGC 6334 V and S255 IRS1. NGC 6334 V consists of a double-lobed bright reflection nebula seen against a dark region, probably an optically thick molecular cloud. Our polarization measurements show that the illuminating star lies ~ 2'' south of the line connecting the two lobes; we do not detect this star at 2 micron, but there are a small radio source and a mid-infrared source at this location. S255 IRS1 consists of two YSOs (NIRS1 and NIRS3) with overlapping scattered light lobes and luminosities corresponding to early B stars. Included in IRS1 is a cluster of stars from whose polarization we determine the local magnetic field direction. Neither YSO has its scattered light lobes aligned with this magnetic field. The line connecting the scattered light lobes of NIRS1 is twisted symmetrically around the star; the best explanation is that the star is part of a close binary and the outflow axis of NIRS1 is precessing as a result of non-coplanar disk and orbit. The star NIRS3 is also offset from the line connecting its two scattered light lobes. We suggest that all three YSOs show evidence of episodic ejection of material as they accrete from dense, optically thick envelopes.Comment: 39 pages, 7 figures, 4 tables To be published in The Astrophysical Journa