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ICF Case Presentation Example

Transcript: Hip Environmental Factors Participation Restrictions Assessment Activity Limitations Inadequate hip extension in terminal stance Hip flexor length Hip capsular hypomobility Inadequate hip extension in terminal stance Hip flexor length Hip capsular hypomobility Gait (insert video for movement analysis) Squat Diagnosis Classification Common Conditions Achilles Tendinopathy Subjective Exam Functional Tasks Condition 2 Motor Control Deficits Gait (insert video for movement analysis) Squat Health Condition Subjective Exam Joint Hypomobility Muscular flexibility deficits Neural mobility deficits Fascial mobility deficits Inadequate ankle dorsiflexion TCJ hypomobility Gastroc/soleus flexibility Distal Tib-Fib hypomobility Calf weakness Edema Common Features Body Function & Structure Impairments Hip Special tests Distinctive factors Inflammatory Process Initial occurrence Patient demographics DOI MOI Location of symptoms Activity Limitations SINS Severity Irritability Nature Stage Categorization Tendinitis vs Tendinosis Aggravating factors Easing factors "I have pain in the back of my ankle with walking" Personal Factors Mobility Deficits Differential Diagnosis Ankle Inadequate ankle dorsiflexion TCJ hypomobility Gastroc/soleus flexibility Distal Tib-Fib hypomobility Calf weakness Edema Treatment Timing & sequencing of muscle activation Abberant movements Condition 3 Location of symptoms Occupation / Hobbies High load to plantarflexors Ankle Occupation Social history Muscle Performance Deficits Age Gender Recreation for general health Work (walking around office) Father (3 year old daughter) Joint Hypomobility Muscular flexibility deficits Neural mobility deficits Fascial mobility deficits Functional Tasks Degenerative Process Recurrent injury Patient demographics Body Function & Structure Impairments High Copay Single parent with 2 children (4yo & 6yo)

Case background

Transcript: Case Background Pro Forma Sessions began to be used in the Senate in 2007 to block recess appointments Constitutional Accountability Center Define the definition of what is considered a recess Coalition for a Democratic Workplace President Obama NLRB, U.N. Representatives, Federal Bureau of Consumer Protection "3 members of the board shall, at all times, constitute a quorum of the board" Left the issue open Congressional session where no formal business is discussed Our prediction "The President shall have the power to fill up vacancies that may happen during the recess of the Senate..." William Steele was nominated by President Bush to fill that vacancy U.S. Senate New Process Steel v. NLRB (2010) Intersession vs. Intrasession As of June 4, 2013 President Obama - 32 African American groups protested against Steele for his ruling in Evans Does NLRB have authority to rule without a Quorum of at least 3 members? Constant gridlock has made appointments difficult 1. Can the President make recess appointments during intrasessions? Involvement of NLRB Used to block recess appointments and pocket vetoes Issue: Canning refused offer from Teamsters Union over benefits Struggle for Constitutional power between Executive and Legislative branch Framer's Decision and Modern Conception Since FDR, Presidents have used recess appointments strategically January 4, 2012, President Obama appointed 3 members to the NLRB and the Director of the Consumer Financial Protection Bureau Only time intrasession appointments were made until 1940s Senate cannot always be in session Andrew Johnson Episode Reagan - 240 Clinton - 139 Bush - 171 Immediate impact on Canning? During this period, Johnson made several government appointments 11th Circuit Court Judge Emmett Cox left office due to senior status Nuclear Option President Obama Threshold now 51 instead of 60 for Judicial and Executive nominees (Supreme Court nominees still need 60) Should Pro Forma Sessions be used to block recess appointments? Law Reviews Cont. The Constitution was drafted to give Federal Government more power Respondent Stakeholders Supreme Court will overturn lower courts decision Noel Canning owns a soft drink distribution company in Northwest USA Court ruled with Canning vs. NLRB lacked authority with 2 members Article 2, Section 2, Clause 3 1868 Congress took first intrasession recess Weakens power of the filibuster Government vacancies need to be filled Questions of the Case Can take weeks to convene without recesses Case Decision Evans v. Stephens (2003) 3. Can the President make recess appointments during Pro Forma sessions? 2. Can the President make recess appointments to existing vacancies or only vacancies that arise during recess? What we learned Arguments made "Neither Chamber can adjourn for 3 days without consent of other" 600 member organizations 1940s - Bush Noel Canning v. National Labor Relations Board Checks and Balances Law Reviews Federalist Paper 67 Canning's Defense Constitutional Background Petitioner Stakeholders Pro Forma Session

Case Background

Transcript: Physical Examination What Do You Think ? Our Conclusions Case Background A 59-year-old woman was admitted to the hospital because of back pain and a mass in the lung. She had been well until 17 days before admission, when she bent down and felt a sudden snap in her back, followed by pain that was associated with profuse diaphoresis (sweating) and muscle spasms that extended from the left shoulder to the buttocks but did not radiate to the legs. She was unable to stand up straight and had difficulty breathing and sleeping because of the pain. Five days before admission, an orthopedist prescribed steroids and pain medications for symptomatic relief. Magnetic resonance imaging (MRI) of the spine revealed a pathologic fracture of the ninth thoracic vertebra with involvement of the adjacent soft tissue A large pleural effusion was noted on the left side. The patient was admitted for further evaluation. Decreased range of motion Back flexion while walking Diminished, crackled breath sounds heard from left lung Uncomfortable-looking demeanor Bone Disorders LUNG CANCER !!!! Diagnosis of Human Disease: Our Differential Diagnoses Max Goldberg Matt Margol Jayson Samaan Investigations and Lab Results Previously well Lumbar vertebra fracture 9 years ago Healthy brother and father Mother history of gallstones Sister with mitral valve prolapse Aunts / Uncles with cancer NOT a smoker Serum electrolytes, glucose and other enzyme tests of renal function normal Blood count normal CT scan reveals remarkable mass and pleural effusion Destructive lesion discovered Drained effusion and found presence of malignant cells Osteomyelitis Pulmonary Fibrosis Tuberculosis Community-Acquired Pneumonia Lung Cancer Pulmonary Disorders Patient History Differential Diagnosis Case Presentation 9

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