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w/ Til Luchau & Whitney Lowe
Episode 17: Who Charts Our Path?
Jun 24, 2020 | Transcript | Subscribe | Comments | ⭑⭑⭑⭑⭑
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17: Manual therapy and massage practitioners are voracious consumers of professional continuing education. Who should be deciding what they learn?
In this episode,
What implications does the "medically necessary" discussion have on massage and bodywork education, CE, and credentialing?
Why don't Rolfers™ think they're doing massage, anyway?
What is the post-COVID roadmap for professional continuing education?
In the Thinking Practitioner series, join two of the leading educators in manual therapy, bodywork, and massage therapy, as they delve into the most intriguing issues, questions, research, and client conditions that hands-on practitioners face. Stimulate your thinking with imaginative conversations, tips, and interviews related to the somatic arts and sciences, with Whitney Lowe and Til Luchau.
Resources discussed in this episode:
Kiva.org
Join the Hands-OnTherapists' Lenders Team
Or borrow, interest-free
Whitney Lowe's site: AcademyOfClinicalMassage.com
Til Luchau's site: Advanced-Trainings.com
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Books of Discovery: save 15% by entering "thinking" at checkout on booksofdiscovery.com
ABMP: save $24 on new membership at abmp.com/thinking.
Handspring Publishing: enter "TTP" at checkout for a discount at handspringpublishing.com
Your Hosts:
Til Luchau Whitney Lowe
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Til Luchau
Whitney Lowe
(The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)
Full Transcript:
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The Thinking Practitioner Podcast:
Broadcast date: 6/24/2020
©Copyright The Thinking Practitioner Podcast, Til Luchau & Whitney Lowe
Whitney Lowe:
Welcome to The Thinking Practitioner Podcast.
Til Luchau:
A podcast where we dig into the fascinating issues, conditions, and quandaries in the massage and manual therapy world today.
I'm Whitney Lowe.
And I'm Til Luchau. Welcome to The Thinking Practitioner.
Welcome to The Thinking Practitioner.
Hey, this is Til Luchau and today's episode is sponsored by Handspring Publishing. When I was looking for a publisher for the books that I wanted to write, the Advanced Myofascial Technique series, I was lucky enough to have had a couple offers. One was from a big company, the other was from a little company in Scotland run by four great people, Handspring Publishing. And in the end I went with them. I went with my gut and chose Handspring because not only did they help me make the books that I wanted to write, but their catalog has emerged as one of the leading collections of professional level books written especially for body workers, movement teachers, and all professionals who use movement or touch to help patients achieve wellness.
And Handspring does have a new instructional webinar series called Moved To learn. It's a regular series of each 45 minute segments featuring some of their amazing authors and it really is a very impressive group of authors working at Handspring there. So head on over to their website at handspringpublishing.com to check those out and have a look at their excellent catalog while you're at it. And be sure to use the code TTP when you find any of those gems that you need to have at checkout. Again, the code is TTP. And we thank Handspring very much for supporting the podcast.
Thank you Whitney. Yeah. That code gives you a discount on your purchases at Handspring. Whitney, how are you doing there?
I'm doing okay. We are in mid May that we're recording this. I think this will be released sometime around mid June. We are sort of on the brink of that period of everybody trying to figure out how to get back into some sense of normalcy and it's been a very challenging time across the board for the entire field as well as for so many individuals and it's just ... I was talking with somebody the other day. Actually, I was talking with my sister the other day. She is a grant writer for a crafts school in North Carolina. The school has had to of course close all of their summer programs and fall programs and we were just saying ... She was talking to me about my business and said, "You know, I've watched you in your business over these years do all kinds of things and deal with all kinds of troubles and challenges. It's been really great to see how you've done this." I said, "Yeah, well part of that is that all those kinds of challenges and things in the business, there are things that you read about and you figure out alternative plans for how to deal with them. But global pandemic that wiped out the entire economy didn't really make it on to my radar screen of things to prepare for."
So like everybody else I think we were really caught quite off guard by this situation trying to figure out what we do with it here.
Well yeah, you and everybody else and getting back to normal. We don't even know what that means. This new normal, what is that? We'll know more like you said, in a few weeks when this airs. But it's an evolving question. All of us having to adjust and deal with the changes as they come forward.
Yeah. Yeah. Yeah. And you've got both classes I imagine that were canceled as well as clinical practice things too that all got put on pause for a while.
Yeah, that's right. The in person classes are just completely on hold for now. Maybe the fall, we'll see. But the online stuff is interesting. That's really boomed and I know that's been keeping you busy too. We've been having such a strong response to the online offerings that it's faced us with the choice of how do we not overwork in this time which is a worthy inquiry as well.
Tell me a little bit about what you are doing with your online classes and things because I've seen some stuff across the social media landscape of ... You even seem to get a good bit of engagement with your community and things like that as well.
That's the challenge is how do we stay engaged, how do we stay connected and most people are either trickling back in or can't do their work still. So the question we're dealing with is how do you stay engaged as a body worker with your skills and your learning and your own body when our connection is virtual? When our connection is just through Zoom calls or offline study and things like that. So yeah, we've been experimenting with different ways of doing that, a few courses. But the most exciting one is a course where I give the lectures I would give at an in person training about a particular part of the body and then people go off and practice those in terms of movement practices with themselves. Yeah, or watching videos and then we have a small group with an instructor where they meet and discuss those things in a repeating cycle of those elements that turns out to be really gratifying for all of us involved. So we're learning a lot and going forward with that plan.
Nice. When they go off to do this practice thing they do that just for a certain designated period of time where they come back and a certain time later to meet up with the person who's going over these things with them, is that-
Yeah. It's a two week cycle. You listen to the lecture. About 90 minutes. Ask questions and such, it's live. Then you go watch a video of me doing a demonstration. Then you take some of those techniques you saw and turn them into self care for yourself or movement. For the people that are practicing they can go ahead and practice that. But otherwise you're mocking them up on yourself so you get an embodied sense of that. And then the other element is you meet in a small group with an instructor on Zoom to debrief and discuss and share your learning. And then that cycle repeats every two weeks.
These are wonderful examples of some things that personally for me as a person who's obsessed with education and looking at educational strategies and methods, it's been fascinating to watch this process of educators becoming incredibly innovative in very short periods of time with having to do things because there is a significant difference between designated and well planned out and well developed online education curriculum as opposed to emergency remote teaching, which is really a lot more of what's having to happen right now. And it's been really fascinating to watch what a lot of the educators and teachers have done coming up with creative ideas for how to do some things like this. And I think it's been very impressive.
Tell me about what you're up to or what are the highlights there on your side?
Well, for us it's been a little bit different because we were in the midst before this hit of a major course overhaul on all of our online programs and what this has really done is just sort of accelerated the need to get that done and it really hasn't impacted or changed a lot of what goes on with our students in our online programs because they're already all asynchronous. Meaning they weren't necessarily doing anything at one particular time. There's been a great influx of people moving back into their courses to do things now that they're out of practice and they've got some time to work on it. So that's been very significant. But I haven't ventured back out into any sort of synchronous delivery things like what you're doing there. Because we're really trying to actually use this time as much as we can for getting all these program revisions done.
And that's probably plenty. That's probably keeping you busy.
Yeah. It's been very, very busy and we're still a long way from getting everything done because the iterations of this. You see things that you want to have done differently and then you do a little tweak on this and like no, I don't like that, I want to do this differently, I want to change that thing, I want to change this activity this way. It's a whole lot of activities across seven different courses involving hundreds of video clips and interactive exercises and every little piece of technology. One little blip on there and some button's not working and somebody goes launched off into another place. It's a lot of moving parts to get it working correctly.
You've been renovating your whole school and cleaning out the closets and fluffing up the pillows and all that kind of stuff at the same time it sounds like.
That's right. Yeah. Yeah. All that project was planned before all this calamity of collapse happened of everything. So it's all being done on top of that as well. It is challenging. But it's fascinating at the same time.
And so what do you want to talk about today?
Well, I've been thinking about this a little bit with some of the things that had come up during the Covid-19 situation. And it made me think about this. It was interesting. It made me think about this topic and this issue in a light that I hadn't really given a lot of thought to before. And so wanted to kind of ... I wanted to bounce some things off of you and just sort of chat about this a little bit. There's been a big question mark that's come up for a lot of people when they were making decisions with their state legislators, et cetera about who would close, who would stay open, about whether or not massage therapy was medically necessarily. Or was it really a practice that was critically important for people to stay in practice. And there is a lot of debate on both sides of that question about whether or not it is or not. I have opinions about that but that's not really where I wanted to go with this. What really came to mind for me in looking at this is, we don't have any guidelines or definitions about this at all within our field of-
About what's necessary?
Yeah. What the topic of medically necessary means or how do we define that? And it got me thinking about well, we do have this issue we've talked about before here on the podcast of at least the massage therapy world being sort of a split personality between whether or not we are a personal care service trying to just work on general overall wellness with people or if we are a healthcare profession. And that question mark still exists out there about how we actually define what we are and we're clearly some of both in a lot of different situations. The thing that made me begin thinking about this some more is that in many of our other sister and brother allied health professions, occupational therapy, physical therapy, chiropractic, whatever those other fields are, there are designated curricula that identify the things that you really need to know to be working as a healthcare professional. And in massage therapy, in body work for example, we have basic entry level training requirements that establish a base level of training that an individual needs to get in order to be considered a safe practitioner and get their license.
But that really doesn't get into the level of determining or developing skills for them for the more challenging things that they would do with advanced practice. And that's why they go to all these CE courses and do all these kinds of things. But there really isn't a designated curriculum of advanced training. So what you choose to do with your advanced practice and your advanced training, which direction you go in is completely up to you. And it's an interesting model because it certainly gives people a lot of individual flexibility and individuality with creating their education which I'm all for that. I think that's a great model. But at the same time, there are some really important things that people really should be paying greater attention to and should be part of, let's say, a more formalized curriculum that doesn't happen when that is the situation. So it poses an interesting questions so we sort of talked about this topic of, who charts our path? It is mainly something that we do ourselves but should there be some other kinds of guidelines about the kinds of things that are necessary? Skills, knowledge, abilities for working in some of these other different challenging environments.
Okay. So that's the question then. How do we chart the path? Who charts it? It isn't so much what makes something medically necessarily if I get your drift. It's more like, how do we decide what to study and who's deciding what that as we go into the advanced levels of this work? Is that right?
Yeah. Right. Yeah. For sure.
There's a whole passel of people out there doing some phenomenal work in the education world of teaching soft tissue manual therapists all kinds of really great stuff. But again, there is no sort of guidance, guidelines, or standardization on what we need to know to work in some of these more challenging environments. That poses some challenging questions for us in terms of looking at ourselves from a regulatory standpoint and having to make some decisions in a time like this. In like the Covid-19 situation of when should we go back to work based on how necessary and important this is and what kind of things do we need to be knowing to do that?
Yeah. Okay so there's so many places I could go with this. I mean, what is the necessary piece? But it sounds like we're steering more toward the standards piece or to the how do we chart our path? Who's charting our path? So if I put the blinders on for a second, because the medically necessary one is kind of pulling at me a little bit. I got to say, your focus on charting the path and what are the standards is interesting. You say you're all for flexibility and creativity. Are you saying that you think it would be helpful if there were more standards in place coming from either government entities, professional entities, that would help us in our advanced level trainings?
I think this gets back to some fundamental questions that many of us in the profession have been trying to grapple with for years about what is this sort of distinction? I mean there is this sort of distinction between these two pathways of ... I don't have a great way to call this, so we end up calling it like personal care service stuff. And again, acknowledging that there are health benefits to what everybody does, so please don't assume that I'm saying just because something's not called healthcare massage, there's not health benefits. We all know there's great health benefits with general relaxation, massage, et cetera. But the individuals who practice in that model don't necessarily see themselves as working on some type of compromised heath condition let's say. So they're saying, I'm just mainly working for people to reduce stress, help them feel better, enhance their wellbeing, that kind of thing.
I got the just in there. I'm just working on that. I heard the just by the way.
Ah yeah. Shouldn't of said just. That's a good point. I am focusing on this but I am not necessarily seeing myself as a healthcare provider who has to learn all of this other stuff about HIPPA and contrary indications related to complex medical conditions. Making clinical decisions about should I do this refer or that kind of thing. Again, there's gray area obviously, because there's a blend over. It's not a clear black and white distinction. So yeah, that sort of separation exists there but we never have really established ... This is something I think I said in the podcast earlier in one of the earlier episodes that I think we do a good job of training requirements for the sort of focus on soft tissue manual therapy in the personal care service realm. At whatever is that training level. The 500 hours. Sort of the average timeframe. I think we do a pretty good job of-
For a massage therapist in the US, yeah. I think you're right.
Yeah. And I agree with a lot of the people who like to practice in that environment saying like, I don't want to have to go to a 3,000 hour program to do this particular type of work that I want to do which is just mainly around stress reduction, wellness enhancement, and all that kind of thing. I think there's a valid point to that. But then, for those individuals that do want to work with people who have compromised health problems and conditions and things like that, we are way, way under educated for grappling with those kinds of things. The question comes up, who sets those standards? Who develops those kinds of bars that we have to jump over? And credentialing issues. That's the sticky wicket.
That is sticky. I'm following your lead here. I'm deferring to your overview here because this is something you've been working with for quite a while and puzzling out and working with different collaborations and alliances around this question. How do we actually set standards and what needs to happen both at the entry level but perhaps at the advanced level? I know for myself I think of myself as focusing on wellness rather than disease. In other words, I wouldn't make the case that my own work as valuable as it is, would be medically necessary. Because just by the nature of what I do, I'm not dealing with issues of survival. Surviving a life threatening illness say. I'm interested and I'm better at helping people go beyond the absence of disease into a level of wellness that's an enhancement factor.
Yeah. And this kind of gets into my personal opinion. I don't think we really can say any aspect of what we do is medically necessary from the standpoint of life threatening treatments that somebody needs to have. I think we fall in that can, all of us do, of not being medically necessary. But I would also call what you do and the students who come to your work to come to training for your work, as mainly focusing on the individuals who are working with people who have more compromised health issues that they may be grappling with. Because you do some pretty advanced level training work with people on both the advanced level of what they're doing with their hands, the palpatory specificity with what you're doing as well as the things that you're teaching them about the way that they're working with people. It's definitely at that level.
So you're saying hey, Til, you're doing advanced work, you're putting it out there as that even, and so the patients or clients, that are going to be coming in to your practitioner's practices are dealing with some serious issues. And maybe there's some things that they need to know about that. Is that what you're saying?
Yeah. Absolutely.
I'm with you. I'm with you.
And so the problem is this is part of our whole guru education model that has been in sort of our practice field for so many years. These methods started mainly because there were some dynamic charismatic individuals who started doing some type of thing and they taught a group of people and those people taught a group of people and those people taught a group of people and that sort of was the way a lot of the education got passed down. As opposed to curriculum being identified by some external body of subject matter specialists that all got together and said, these things are important for us to know and so we're going to designate this as the curriculum for whatever it is. Whatever that field is. Manual therapy, massage, structural integration, whatever your field of choice is. Those kind of things don't exist.
That's right. And there's probably even diversity of opinion about what the unified field is and whether there is a unified field. I know that that's a big issue within the structural integration community that we are massage we say. And we want to distinguish ourselves from massage therapy. And I know there's those kind of distinctions that are important to different sub groups with our larger field of hands on work as well. So that probably inhibits our ability to talk about what are the standardized things that should be there to keep people safe. Because I think that's what you're talking about. You're talking about what keeps the recipients of our work safe. Especially if they're dealing with serious medical or musculoskeletal issues.
Yeah. If I can I would like to pick your brain a moment to tell me a little bit about that from ... Because I have heard this a number of times and this would be great to have somebody knowledgeable in this particular area from the perspective of structural integration saying that they're not massage.
Okay. How did I get to be elected to the spokesman for that? But I'll go there. I'm with you.
Because you said it.
I did. I brought it in. So you are saying, so what's that about? Why do people say that or what's the rationale?
What's the argument of saying that they're not massage? And I've heard that lots of times over the years. Many times. So what is essentially the argument?
Wow. Okay. Let me see if I can go there-
If you can kind of give me a-
No. Honestly, I can't say it's my position. Having taught at the Rolf Institute for 20 years and trained Rolfers and I chose that path rather than massage for myself for various reasons. I also want to be really clear and careful that for my own values and my own perspective, it's not about positioning ourselves in relationship to each other. So that's why I'm probably hesitating or reluctant to even dive into it. And it's not like structural integration is good and massage is bad. But let me just take the point of view of the people that are saying the ones doing structural integration are not massage. Maybe the argument is when I'm doing structure integration my goals are different perhaps. Ida Rolf was very clear that we are not fixing symptoms. We are raising the functioning of the organism, the individual to a higher level in an integrated fashion. And that by getting caught up in specific say musculoskeletal issues or any kind of other issues, we're actually missing the whole.
By stepping back and keeping in her mind, the functioning of the organism within the field of gravity as our goal, we're going to probably benefit those symptoms but we're not even going to try to address those in a direct or linear or reductionist fashion. We're going to keep our sights on the big picture. And that means the big picture of the way the body is connected in a structural whole, in her model, in a factual viewpoint and as a integrated feeling, living, breathing, energetic entity within a larger field of gravity which she saw as the connecting matrix around us.
So I hope I did that okay. I mean that's maybe the philosophical background. I think for sure ... Now we're getting into Til's opinion here. For sure there's an interest in distinguishing ourselves from each other professionally. And she was dedicated to exceptionalism. Let's just put it that way. She was from an exceptionally motivated family background. She as a woman in the 1920s who went and earned her doctorate at Columbia was exceptionally driven and interested in being exceptional and she was. And she wanted to start a work that was exceptional. And when you do that you by definition exclude. In order to be exceptional you exclude other things and so she was saying no, we are not all these other things, we are going to do this and we're going to do it really well. So I think there's some of that heritage there too of being exceptional in some ways.
Yeah. Right. And again, I think we find ourselves even with those sort of coming at this thing from various different perspectives we find ourselves looking through a similar lens at this particular situation now. Again, my limited perception and understanding of the structural integration is that the training program is pretty lengthy and pretty significant compared to many massage therapy training programs. So there is-
Objectively-
Is that true? Yes? No?
I think there's that ... No. I think that I believed that when I had only been in that world. Sorry. And then when I broadened my horizons a little bit I realized ... Especially when I got involved in the curriculum design and the accreditation and then this was during the time the NCB was forming and those kinds of things. Because the Rolf Institute was in those discussions and I was very active in those discussions within the organization. Realizing that hey, actually the number of hours that we train people in that model wasn't significantly different. Maybe even less than some thorough massage schools. Something less than a thousand hours. And so from an objective standpoint the number of hours involved isn't more.
And yet, I got to say, this is where my loyalty comes into my heritage and my tribe and my buddies there to say, there is some exceptional level work going on. Exceptionally good teachers, exceptionally good practitioners, and an exceptionally effective narrative that has done a good job I'd say of evolving over time too.
Sure. That gets us off into a whole different soap box thing about hours and time versus competencies in what you're actually accomplishing in that period of time and those things are not necessarily correlated. Number of hours does not necessarily mean better. Longer programs are not necessarily better. What makes it better is really the outcomes and the instructional processes, designs, the educators and all the other educational elements in there.
Yep. Yep. I mean there's two jokes ... Just to go back to the Rolfing thing. Two jokes. One is like how many Rolfers does it take to change a light bulb? Just one but it's 10 sessions.
Mm-hmm (affirmative). I've heard that one before.
And the other one was, how many Rolfers does it take to change a light bulb? One to do it and another one to say, I could do that better. Because there is this kind of ... The shallow side of exceptionalism could be perceived from the outside as a kind of arrogance or superiority and I'll raise my hand yeah, I have been there and maybe I'm a hopefully recovering person with a superiority complex.
Right. It doesn't show through so you must be fully recovered-
Maybe I'm overly compensated. Who knows? But any case, yeah, I think that's some of the things in the background of us coming together to shared visions or shared standards as you said or even to talk about what are the things that we need to be aware of as educators in this field? So that's one of the barriers for sure is these divisions within our field.
I think maybe this one you talked about too about is it are we medically oriented or are we ... You said personal services. I said wellness. Are we oriented toward disease care? Are we oriented toward health enhancement? Are we fixing symptoms and helping people with musculoskeletal issues or are we in Ida Rolf's view, elevating ourselves above that to a bigger broader picture that includes those things but actually is interested in taking people to the next level of functioning?
Yeah. And again like I said earlier, these lines are so blurry because you could take individuals who might be working let's say, in a work environment that would appear to be one basically focused on wellness enhancement pretty exclusively like let's say a spa or a franchise operation for massage therapy. And I asked this question a number of years ago. I was in an event with one of the large franchise organizations and some of the top massage therapists in each one of their states had come to this event. And I asked them, what do you see the most of? Who's coming to see you? And they said like 75 to 80% of the people who come to see them are coming to see them for some type of pain complaint. So there goes our bias and perception about people who work in franchises aren't doing healthcare oriented massage. It just isn't true.
Pain specific work or symptom specific work.
Just not true.
No. I think it's huge. I think honestly I see this in my own practice. I see it in the people that come to our trainings. They want to know how to help. I see it in the Rolfers honestly. In the structural integration people. They want to know how to help people with problems, specific problems because that's what motivating the clients and patients to come to us. And so then yeah, you're right. We got to think not only ... Which has been my inquiry. Is like how can we be really effective at helping people and creating the right expectations around that so that we can have these miracles that happen where people feel amazingly better? And when that doesn't happen, how we can still be useful and realistic with people and help people feel empowered by what we provide. So how can we do that? But at the same time, be clear about our scope of training and the scope of ability and not overreach or over promise or supplant other things that people might need to do to take care of themselves. All those questions too.
Yeah. Yeah. So I've got a couple of other things that I wanted to look at along these lines here and we'll come back and circle back around to a couple of those things after we hear from our halftime sponsor today.
Wow. That's great. Ready for them already?
I think we are here. We're at about that place here. So today's halftime sponsor is ABMP. And we want to thank them very much for their support of The Thinking Practitioner Podcast and ABMP membership does include over 50 plus member discounts on everything from massage tables and supplies to cellphone service and all members can access over 200 continuing education courses with free CE hours. You can read ABMPs award winning member magazine, Massage and Body Work at massageandbodyworkdigital.com. Both Til and I are frequent contributors on that magazine and it is an award winning publication there. And listeners who join ABMP as new members can save $24 at abmp.com/thinking. So with ABMP you can expect more. And we again appreciate their support of the podcast here.
Yeah. And the support they're peddling hard, working hard to offer to the field. I know some of the people there, they're working so hard to try to get out accurate useful clear information in this time so many people are looking for guidance.
Absolutely. A quick little plug. They just launched a new podcast too with some really good interviews of things going on currently with the Covid-19 situation so check that out as well. The ABMP podcast. There's some good stuff coming on there as well.
It takes some courage to stand up and say things that are definite because we don't know and yet you see you become a target of so much ... Well, appreciation on the good side but certainly frustration of wanting to know more. They're not the only ones, but they're one standing up that says okay, we're going to say some things.
Yeah. Yeah. And that is so needed because people feel ... I think part of what's going on is just a great deal of fear around uncertainty and lack of knowledge around things. It's clear that nobody has a monopoly on the answers right now, but certainly any good strong guidance with evidence informed things is certainly helpful and we can use more of that for sure.
There you go. What else do you want to make sure we have time for?
Well, I wanted to circle back around to one of the other things about this. Kind of getting back to this issue of looking at how we chart our past and the fact that this sort of advanced training component that we talked about is really up to everybody else to choose what they're doing.
Up to the individual, you're saying. Yeah.
Yeah. Up to the individual. I was thinking back and reflecting about this a little bit with myself and my sort of educational path which has been sort of a checkered combination of traditional education and school and radical independent pushing away of traditional education methods as well. And I remembered there was a time, and you may be familiar with this with your background in psychology as well, there was a book I read when I was an undergraduate in college. It was by the psychologist Carl Rogers and the book was called Freedom to Learn. I don't know that it's still in press any longer, but it was really a wonderful ... It was one of those things that was life changing for me because it was the first time I had read something that really said to me, you are in charge of your own education. And I realized and recognized that a lot of things were up to me in terms of what I was really choosing to do with that. I did take some of the messages out of that book and distorted them to my benefit the way a 19 year old college student will do by saying things like, "Hey, I don't really care if I study before this test or after this test as long as I learn this stuff. That's what's really important." Arguing that that was a reason not to have to study a whole lot immediately.
So anyway, that didn't have great results but it was an interesting idea-
I'm sorry. How old were you?
Let me think. I probably was 19. Probably 20. Probably 20, 21. Something like that.
I'm laughing as a former 19, 20 year old myself and as the father of one now. So yeah, go right ahead.
That you're watching, that's right. Doing those things again. But anyway, back to this whole thing, this whole idea of us charting our own education and saying, how do we determine what are the things that we want to learn and what do we want to focus on? I'm thinking about what I see in our field with people making these choices about what to take for CE course offerings and they ask other people for example, on social media, "Hey, what class should I take? What's a good thing for me to do?" The course of your education, if you want to think about it this way, is often charted by where you live geographically and who comes around your neighborhood on the CE circuit. So that ends up being a big factor to determine those kinds of things. But a lot of times it's also stuff like, well, who do people talk about a lot as being a good class to take and what does that really mean? Because sometimes a good class is one that you enjoyed because it was really entertaining or some kind of fascinating sort of mind blowing things were presented but was this really a good educational experience that you can say met particular criteria that gave you established skills and abilities that you can walk away with?
And those are some interesting questions that I think are important for us all to look at when we're trying to evaluate what makes a good course offering, a good thing that you should invest your time and money and effort into.
The division there ... I'm almost reluctant to bring it up because it's so big. The division there you're talking about or the paradox or the distinction there is, should we be free to follow our freedom to learn in that Rogerian sense of whatever's unfolding and the learner is the most important, most vital and most motivating thing? Or, are there things that if we step back with some perspective that we should be regulating or standardizing to make sure that everybody knows? Like it or not.
Yeah. And I think what we see as ... At least I'll speak for myself. What I see now as a more seasoned educator is that there is you kind of temper those perspectives and saying, as a young student who doesn't know a lot about the field, if you leave it 100% up to that person to designate their own path, they'll choose the things that seem either most interesting or easiest to go through. And that's not necessarily the things they need to really focus their attention on because sometimes you need to study the stuff that's hard. Like nobody would probably say, "Oh, I can't wait to start memorizing 200 muscles in the body because this is just going to be fun." But it is important that they know where these things are. That's just a natural part of that training program that they have to do. So, that's the challenge with the self selected, self identified training path is that you might miss some really important things that are crucial somewhere down the line. Like just as an example, the vast majority of people I think who find themselves working in more challenging healthcare environments, let's say in a clinic situation or a hospital or places like that, will probably admit that they're training on HIPPA guidelines and healthcare communications and working within healthcare teams was either grossly inefficient or nonexistent in their entry level training.
And these are skillsets or knowledge about many of these things that ... Now of course, this may differ nowadays since people are trying to pay more attention to some of these things. Some of these curriculums are doing a much better job of it. But there's a lot of training programs out there that just don't go into that kind of stuff and I know of a lot of massage schools that teach massage therapists for example and do a really good job of training massage therapists but they haven't learned some of the complexities of how health care teams work and how to communicate appropriately inside those environments.
All right. So do you see that as an important thing to include in entry level education? How to interface with the medical world. Or do you see that as a specialty that someone would focus on after entry level?
Well ideally, I really think it should be taught at our entry level training programs because as we said before, you can't always assume that you're not going to see people who have some of these challenges and you'll find yourself in situations where you need to communicate with other health professionals more thoroughly or in the ways in which they're used to dealing with health records and things like that just because that's the nature of what we're doing sometimes.
All right. So you're saying that me, whether I'm working in a franchise where you said the stereotype is we assume people are coming for a spa experience and relaxation, or I'm working as a structural integration person where I'm interested let's say in an Ida Rolf's vision of integration and wholism more than symptom fixing. You're saying that maybe I do need to know about HIPPA and interfacing with medical people?
Yeah. I'm saying that those are skills that I think would be beneficial for everybody to be learning just because it has to do with record keeping. It has to with methods of communication and appropriate communication with other health professionals we might be referring to and that sort of thing. So yeah, I do think that's important at that level.
Okay. Well, do you have more specifics? What's most important to talk about? These specific things, like is HIPPA high on your list or is it medium? Are the other things higher on the list?
I think there's probably other things that are higher on the list in terms of good decision making about what I shouldn't be doing. Who should I be referring certain types of things to? I think that kind of thing is important. But you know, people may have a good understanding of those kinds of things. Sometimes it really is more of I think a gradient scale of how well we know some of these kinds of things as opposed to just a black and white, we know this or we don't know this kind of thing. It kind of gets into where we draw that dividing line between our entry level training and what happens on some of those advanced training levels.
Yeah. I'm just thinking ... You're making me reflect and I think I do it instinctually is ... In my trainings I'm constantly thinking about where is the limit that I want to go with this client or patient? At what point do I need to pull somebody else in, give a referral? And what is right both in expectations to create a new client but then also what are the red flags I need to be watching out for?
Yeah. And it's a particularly challenging thing for us I think in this field because we do have many students who come into this work with ... They don't have undergraduate degrees when they come to their training programs and they sometimes don't have ... If you look at the overall skillsets of many of the young people entering the workforce these days, lots of people, and I'm not just talking about in our field, I'm talking about in every field, complain about people's ability to write well, to communicate well, to interact appropriately with other professionals and things like that. There's some basic skillsets that we think ideally would be covered in let's say, a basic undergraduate level education program. But there's even now I think a lot of questions about do people really learn how to do that stuff that well in many of those kinds of environments? So that makes it even more important that we focus on how do we train some of those things if people aren't coming into these programs and even because there are no degree requirements. When you think about it, we are the only field where somebody can come in without an advanced degree of any kind or without a undergraduate degree from a university or college institution and be a direct access healthcare provider.
And that's kind of scary to me. It's quite scary in fact that we have that kind of flexibility. If you want to take it to the extreme of looking at it as like a 18 or 19 year old kid. The one that I'm talking about in college was making these poor decisions earlier. That individual can be a direct access healthcare provider and choose to treat anybody who walks in off the street with any type of complex medical condition if they want to.
I find myself wanting to take the other side, so let me go for it. What about the commonly repeated point of view that says well, actually for instance our liability insurance rates are particularly low because there isn't a whole lot of actual harm that comes from the normal practice of hands on body work? So is there evidence of this being a harmful or dangerous profession that we're engaged in?
Yeah. And that argument has come up a number of times and I think there's some valid points to look at with that such as, yeah, I think overall massage therapy is not very dangerous in a broad scale. So that's one reason we don't see a lot of those kinds of complaints. But we also do know that there are certain situations where it could have very adverse consequences in certain types of unusual circumstances. The other thing is, and this is just completely anecdotal and I'll just say this is not a data driven statement, but it's something I recognized a lot of times when I was in clinical practice. We'd have people come to me as clients saying, "Yeah, I went to see a massage therapist for this and they hurt me." And I said, "Well, did you do anything about that?" Say, "What do you mean? No, I didn't do anything about it." So one of the reasons that I think a lot of injuries and adverse effects from massage are under reported is there's no place to go to tell anybody about it.
Yeah. For a long time I taught ethics at the Rolf Institute and one of my experiences I guess from stories I heard, also my own experience was that there probably wasn't a lot of physical injury, but there's all sorts of potential psychological level kind of injury or harm as subtle as body image or the way we think about ourselves, or the narratives we tell ourselves about our symptoms. And then beyond that of course the more egregious kind of violations of our ethics involve sexual boundaries and things like that that go on.
Yeah. And all of those are very important key factors of making sure that we practice safely with individuals. And I think medical journals in general do not want to publish articles about adverse effects of massage therapy so you don't see those kinds of things making it to medical journals and that's one of the reasons that there's not a lot of stuff reported there. So I don't think we have accurate data about how frequent some of those kind of adverse events occur. And like you mentioned here, the instances of people feeling like they were inappropriately communicated with or inappropriately touched or something like that during those kinds of environments, that kind of stuff is just not well reported at all.
Okay, but those are soft skills aren't they? Aren't those more in the realm of say human interaction and understanding more about the therapeutic alliance more than say a medical type of model?
I think it crosses both lanes because there's many other instances where like a person would come into me and say, "Yeah, I had this really bad neck injury and this person worked so deeply on me it just was killing me after they were done." So I mean that's clearly an inappropriately applied manual therapy approach. But that doesn't get reported anywhere. What the person does is they say, "I'm not going back to them anymore."
Okay, so what would you like to see happen?
What would I like to see happen?
Yes. Where do we go from here?
I'd like to see it all be fixed.
Yeah. Well, you got a roadmap for us?
I got to admit I'm getting tired. I'm 30 years into this battle of trying to find some way ... Here's the thing. If this was an easy answer, we'd have done it a long time ago. Really what I endeavored to do to day or wanted to do today was to shine sort of a different light on this issue of us thinking about the fact that we do self select our educational paths along these ways. And there's a lot of challenges and problems that come along with that. I think the answers to that are far more complex and they are things that we've attempted to grapple with various forms of credentialing through certificate and certification programs and licensing issues, all these types of things. And most of them are inadequate and in many instances inelegant solutions to these challenges and they are fraught with lots of problems. But it always felt-
No. I get you. I just underlining the tired you mentioned, but I was all ready for you to propose a solution and then I was ready to pick it apart too because I don't think there are really good models we have out there.
No. I would agree. And that's why I was saying if it was easy and there was a really good solution I think we would have done that a long time ago. I've been involved with a number of failed adventures and a number of adventures that I thought were steps in the direction but flawed models of doing things that I think are at least attempts to look at some of these things and attempts to find solutions. But it's challenging. It's big and challenging. But I would advocate I think what I would leave us with today is really saying how important it is that I think we start to at least come together on establishing what we feel like are maybe some core sets of competencies and skills that we should strive for. And most of our people who are working like you and I are with education levels at the CE level and at advanced training level, really try to tackle making sure that we fold as many of these things into our training programs as we can so that we can help people have access to getting those solutions available to them.
Yeah. That's right. That's right. Let's go ahead and just brainstorm together to acknowledge at least a couple more of the bright spots out there. Because it's a difficult situation and a lot of people, yourself included, put a lot of years into trying to say raise the standard or get some agreement on these standards and institutionalize those. And me teaching in different places, I see a variance across, for sure states, but even countries in terms of the amount of work that's been done on trying to get an agreed upon level of training. And I have reluctantly, I don't think it's in my nature, but I've reluctantly got behind that saying yeah, actually I do see for sure clear differences in the quality of work being done in places where there has been some regulatory involvement say in our field.
I'll think about it too, but can you think of bright spots where there seems to have been progress or something that you can stand behind and say this is good?
Well yeah, I would say some bright spots that I see are, again, the evolution of the internet and the global communication and social media has allowed the rapid dissemination of a lot of models, of a lot of information. Current research and things like that gets out faster that way. It also allows for, at least in the constructive times, it does allow for academic debate about things that help us move ourselves forward in some of these directions. So I think there's certainly some benefit in that direction of doing some of those kinds of things. I do think there's also some benefit in us looking at issues around competencies of what do we want people to be able to do once they get out of these training programs and encouraging some of the educators who are out there doing some of this kind of stuff to focus a little bit more on educational quality in some of these kinds of programs. Which I think has happened. I do see that as also a bright spot that in former years it was pretty easy for a lot of people to go out and sort of become gurus on a particular topic area and just really get out there and promulgate their own pet ideas and theories and models and things like that.
And now there's a lot more sort of critical analysis of these kinds of programs and content.
In ways that I think helps us all get better. I see those as steps in the right direction and steps toward improvement out there. And you look at the people who are doing really good stuff out there, really good educators doing really good stuff, and people aspire to meet that standard and go farther and go past that, which is good.
Yeah. I know it keeps me on my toes looking around at what my colleagues are doing. And I'm with you on the tired and I'm with you on the limits of what we've tried. I'm also with you on the bright spots because there's something really dynamic about our profession's hunger to learn. The amount of dedication, time, and money that people just throw into their personal improvement, but their professional improvement, their learning. And it's enormously gratifying to be a part of that.
It is. And it is inspiring. And I think for me, that's one of the things that has kept me going all this time is seeing some really good things out there and like you said looking around at some of my colleagues like oh man, this is really good stuff. Try to take this another step forward or something like that.
Yeah. We used to have this kind of virtual actual division. It's getting very blurred here in the post-COVID world where it's not a clear ... Someone said to me the other day, "We're having this nice in person conversation, you and me." And we were on Zoom and I go, "Okay, so this is the new in person?" Really. That's getting deeply integrated as well as what we used to call social media, which is now just another way that we're connected. It's another social dimension. And some of the very creative and interesting uses of that for better or worse. I mean, there's certainly downsides to the addictive nature or the fragmented nature of that kind of awareness, but there's also really creative and engaging things that are coming out of say Instagram and specialized groups within the different platforms that allow a focused conversation. It's just a fascinating landscape with a lot of dynamic movement in it.
And I heard you say something the other day and I can't remember where this was. If this was on a presentation that you were doing online somewhere or some discussion. You were saying that really in many instances we haven't decreased social distancing, we've decreased physical distancing with each other. Because there has been a whole lot of emphasis toward increased communication and interaction to some respect with a lot of things that we've been doing. So that was an interesting way to look at it I thought.
And there's a lot of cost in doing more through this medium, through this virtual medium. A lot of cost. It's not the same as touching. Never will be. No way. It's hard to include the body. Always will be. And yet, I just realized yesterday I'm actually getting better at reading subtle cues. I'm getting better and more intentional as listener. And I'm actually getting better too at thinking about how learning impacts the body because I can't get away with as much. I can't just sit there and talk to people for an hour and a half and not have them squirm. I have to think as an educator and as a practitioner too, I have to think about how do I really engage people's interests on all levels and keep their body engaged and keep their emotions engaged and all those kind of things too?
Yeah. So despite our best efforts I don't know that we've solved that major world problem today in this short segment of time, but hopefully at least maybe we shined a light on it and let some people have some different things to think about and reflect on.
No, thanks for bringing it forward and proposing it. Should we do our wrap up?
Yeah. I think we'll call that a wrap for today. You wanted to mention something too for our ending I think today too, an organization that you've come across here. I wanted to have you share that.
Well, it's my featured cause of the month and who knows, maybe longer. Kiva.org. K-I-V-A.O-R-G. It's a microfinance organization. They help match lenders with borrowers on a very small scale. They started in the developing world helping somebody be able to afford a cellphone so they could provide cellphone service for their entire village. And then it's moved on to anybody can apply for a loan throughout the world. And there's people in the developed world. There's quite a strong US contingent coming forward asking for loans. And then you can loan money directly to people who need it. The repayment rate is remarkably high and you can actually apply risk filters and other kinds of filters for the type of loan people want. There's a lot of people borrowing money for healthcare expenses to get a surgery that they need or to buy inventory for a store they want to launch. What I haven't seen a lot of, and I'm just starting to trickle in, is hands on therapists taking advantage of all of the lenders out there wanting to help someone through these interest free loans. And by the way Kiva's loans are interest free. By making a simple proposal, putting it out there, and seeing what you get.
It's kind of a GoFundMe kind of platform for loans as opposed to donations.
Yeah. They're interest free and they don't count against your credit rating. So as a lender, I know I've loaned a bunch of money there over the years. I know that I may or may not get paid back, but I consider that an acceptable risk. It's a gift I'm giving in any case. Like an interest free loan is a kind of gift. So anyway, check it out. Kiva.org. I'm want to see if this actually catches on. Right now there's only one body worker, or one say massage clinic in the US right now that's listed on Kiva that's helping themselves through the Covid time. I know there've been a couple more. But if you're interested in getting some assistance or if you have even as little as 25 bucks to lend, just go check it out. Kiva.org.
Great. Thanks so much for sharing that. I think that's a good thing we like to help people have some other input of things that may help them through this difficult time here so that's great for sharing that with everybody.
And we would like to say again, thank you to our sponsors for the show and to thank you all for listening, those of you who are listeners out there. We appreciate you listening. You can stop by our site, thethinkingpractitioner.com for show notes, transcripts, and other additional information there. And Til, where can people find you on the interwebs?
Advanced-trainings.com where we also have the full transcripts, show notes, and a bunch of other stuff about what I'm up to. How about you Whitney, where do people find you?
Absolutely. People can find us over at theacademyofclinicalmassage.com as well. And reminder, we've had some nice comments come in from listeners out there. You can always email us at info@thethinkingpractitioner.com as well as finding us out there on social media.
That's right. Please do let us know your thoughts, your questions, your suggestions and how we can best be supporting you during this time. Follow us on social media or find us on Spotify, Apple Podcasts, wherever you listen to podcasts. Rate us, tell your friends, listen, and take care everybody.
That sounds good. We'll see you again in two weeks.
Thanks Whitney.
Okay, take care.
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Michael Barker Studio (CC BY-NC-ND)
UW System To Create Tribal Consultation Policy
Effort Meant To Foster Greater American Indian Enrollment And Improve Graduation Rates
Monday, April 8, 2019, 3:35pm
University of Wisconsin System officials say they're starting to craft a new policy governing consultations with Wisconsin's American Indian tribes.
UW System officials said in a news release Monday announcing the effort that they hope to foster greater American Indian enrollment and improve graduation rates.
System officials say the policy will mirror a similar plan the Arizona Board of Regents adopted in 2016 that guides interactions between Arizona's public universities and that state's tribal American Indian nations on issues such as land use, education policy and research.
A dozen American Indian nations are located within Wisconsin. In the fall of 2017, the most recent data available on the UW System website, 628 American Indian students were enrolled at system institutions. They made up 0.4 percent of the system's total enrollment.
© Copyright 2020 by The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
UW System Turning To Software To Reduce Graduation Gaps Between Students Of Color, Peers
UW-Madison: Average Graduation Time For 2018-2019 Class Less Than 4 Years
Wisconsin Legislators Push In-State Tuition For Tribes
UW System: Number Of Graduates Up 13 Percent From 10 Years Ago
GOP Might Reject Evers Cabinet Pick, Challenges For Indigenous Scholars

redpajama_set_name: RedPajamaCommonCrawl


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Shootings Reported in Bayview and Potrero Hill
Bayview potrero hill shootings by Bay City News | October 15, 2014 5:00 pm	| in Crime | 0
Police are investigating two shootings that took place in San Francisco's Bayview District and Potrero Hill neighborhood Tuesday afternoon within a few hours of each other.
At about noon on Tuesday, police responded to the scene of a collision involving two vehicles near the intersection of Ingalls Street and LaSalle Avenue in the Bayview District.
One driver and two vehicles were still at the scene when police arrived.
The driver who stayed with his vehicle told police that a vehicle was chasing another vehicle and that the pursued vehicle rear-ended his own vehicle. The pursued vehicle then crashed onto the sidewalk where it came to a stop, while the pursuing vehicle fled the scene.
The driver of the vehicle that crashed on the sidewalk got out of the car and ran from the intersection.
When officers arrived at the intersection, they found several bullet holes in the abandoned vehicle, police said.
As the officers investigated the crime scene, the driver of the vehicle on the sidewalk arrived at the San Francisco Police Department's Bayview Station and reported the incident.
He told police that he had been driving when a newer-model black sedan pulled up alongside him and someone inside that vehicle began shooting a gun at him, police said.
He then attempted to speed up to get away from the shooter, but crashed into the vehicle in front of him before his vehicle came to a stop on the sidewalk.
The driver told officers that no gunfire had hit him, police said.
Police are investigating the incident and have not yet detained any suspects.
A second shooting occurred a couple hours later on Tuesday, at about 3:45 p.m., in the city's Potrero Hill neighborhood, police said.
Officers responded to a report of shots fired in the vicinity of 22nd and Connecticut streets near the Connecticut Friendship Garden at the top of Potrero Hill.
Police located several bullet casings in the street but despite interviewing witnesses, they were not able to locate any victims, suspects, or damage.
Anyone with information about these shootings is urged to contact San Francisco police at (415) 345-7300 or the Police Department's anonymous tip line at (415) 575-4444.
Hannah Albarazi, Bay City News


Center on Budget and Public Policy: NH Medicaid Work Requirements "harsher than Arkansas"
Today, the non-partisan Center on Budget and Policy Priorities released a policy analysis of New Hampshire's recently approved Medicaid waiver allowing the implementation of a work requirement for certain people.
"With federal approval now in hand, New Hampshire appears poised to move forward with a new policy to take away Medicaid coverage from people not working or engaged in qualifying work activities for 100 hours per month — despite mounting evidence that it will lead thousands of residents to lose coverage, including working people and people with serious health needs," wrote Senior Policy Analyst Jessica Schubel.
Its 100-hour threshold exceeds the 80 hours that Arkansas and most other states proposing these policies require.
It applies to adults up to age 64, versus 49 in Arkansas; older adults are less likely to be working, in part because they're likelier to face serious health challenges.
It applies to parents of children age 6 and older, whereas Arkansas' policy excludes parents. Eliminating parents' coverage harms children because families lose financial security and parents are less able to take care of their own physical and mental health. Studies also find that children are likelier to have health coverage when their parents do, too: children's coverage and access to care both improved as states expanded Medicaid coverage for parents.
Also, the policy CMS approved goes beyond New Hampshire's revised waiver application in that, starting in May 2020, it doesn't allow beneficiaries to maintain their coverage if they need more than one month to make up missed hours from a previous month.
Since New Hampshire adopted the Affordable Care Act's Medicaid expansion, its uninsured rate has fallen by 45 percent, and the share of adults forgoing care due to costs has fallen by about a quarter. Medicaid is now an important source of coverage for over 52,000 low-income adults in New Hampshire, providing cervical, breast, and colorectal cancer screenings to over 20,000 adults and substance use disorder services — which are critical in combatting the opioid epidemic gripping the state — to 11,000 adults. And uncompensated care costs have fallen by about half as a share of hospital budgets since expansion took effect. New Hampshire should reconsider moving forward with its harmful changes or risk joining Arkansas in seeing thousands of low-income adults lose coverage, reversing the state's recent progress.
The Center also showed last month that Medicaid work requirements fail to protect people who don't work because of a disability. Click here to read that policy analysis.


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Is there rotten wood or cracked stucco on the exterior?
Is the HVAC system in good condition?
When was the home last renovated?
Yellowhammer Inspection Services can help you answer these questions and more. We'll take a close look at the property to determine if it's a worthwhile investment. Make an appointment for an investment property inspection in Mobile or Wilmer, Alabama today.


Even if a defendant committed the otherwise unlawful actions alleged by the plaintiff, the defendant can still use what's called an affirmative defense, or a set of facts that negate the alleged claims. In civil court, an affirmative defense might include assertions that the legal proceedings were initiated after the statute of limitations had already passed. Essentially, an affirmative defense introduces additional information, or a new set of facts, intended to defeat a claim, even if the facts supporting that claim are true.
Once a plaintiff files a complaint, the defendant must respond to the plaintiff's claims through what's known as an answer. This is when the defendant has the opportunity to raise all possible affirmative defenses. For example, without denying any claims, the defendant can assert the plaintiff's contributory negligence or assumption of risk.
The defendant also has the option of denying the validity of the plaintiff's allegations. Unlike a denial or negative defense, which aim to disprove allegations made by the plaintiff, an affirmative defense introduces new information which renders the original claims invalid.
Contributory Negligence: The plaintiff was responsible for his own injuries.
Consent: The plaintiff has waived any liability because they signed a consent form.
Assumption of Risk: It's assumed that by intentionally participating in certain dangerous activities, such as contact sports, the plaintiff might encounter injury, and cannot file a suit against an opposing player for a broken nose, for instance.
Defense of Property: The defendant is not liable for any loss or injury caused while acting to protect their property.
If you have had a complaint filed against you, it is important you have the right legal team on your side to build a proper defense strategy. The attorneys at the Khonsari Law Group have the necessary tools and experience to guide you through this trying time and garner the best possible outcome for your case.
To learn more about the Khonsari Law Group and our practice areas, contact us at (727) 269-5300 or schedule your free consultation online today.


Want to buy someone some shoes but uncertain if you are going to get the right ones ?
Perhaps it is for Dad, The Husband, Brother, Sister, The Wife !!!!!
Well we offer vouchers which can be redeemed in full or part payment for shoes on this site. Simply select the amount you would like. Once we get the order we will send the voucher to you or onto who ever it is for. In the checkout you can decide to ship to someone else, name address etc.
To use the voucher, select the shoes you would like and then during checkout enter the code. Dependent on the amount it will either take of the payment or be enough to buy the shoes out right.
We think it is a great way of getting some shoes for someone without the hassle of getting the right ones.


text:
Nashville works on scooter regulations for NFL Draft
Posted: Mar 29, 2019 / 12:58 PM EDT / Updated: Mar 29, 2019 / 12:58 PM EDT
NFL STATS Module
NASHVILLE, Tenn. (WKRN) — The NFL Draft means more people, more cars, and more scooters in downtown Nashville.
City officials are trying to get ahead of that influx with specific scooter regulations for the Draft.
In less than a month, the NFL Draft will stretch across Ryan Long's daily ride.
"I have some friends; we're going to try to come down — at least check it out," said Long, who plans to scooter downtown to get to the Draft.
However, Long and his friends are going to hit some barriers when it comes to Lower Broadway.
"This is absolutely the biggest event that we have ever had," explained Billy Fields, Director of Metro's Transportation Licensing Commission.
According to Fields, a plan is in the works to handle scooter traffic for the Draft.
"What we're going to be doing is working with the scooter companies, in particular, to make sure that people have access to get into the event," Fields said.
First, no scooters will be allowed inside the footprint of the Draft, which spans from the Cumberland River to 5th or 6th Avenue, as well as up and down Broadway.
Second, the nine entrances to the footprint must be kept clear of scooters at all times.
Despite the heightened regulations planned, officials say scooters remain a vital piece of transportation puzzle during the NFL Draft in Nashville.
"There are a lot of scooters — but there are going to be a whole lot of people coming in, and we're going to want as many ways for them to get in and out as possible," Fields said.
For enforcement, the initial plan is to have scooter representatives at each of the entryways to make sure they remain clear.
"We expect them on the streets because it's their responsibility," Fields said. "The way the law is set up, it's their responsibility to keep the streets clear."
If that doesn't work, Fields said there's a backup plan.
"If they have to be moved, we'll certainly be able to do that," Fields explained. "That will be our last resort."
Fields said members of the Commission are planning to meet with the scooter companies next week to go over expectations during the NFL Draft.
More NFL Stories
DeAngelo Hall talks about what to expect with Redskins in 2019
by Brian Parsons / Jul 12, 2019
HAMPTON (WAVY) -- The stars were out for the annual Hampton Roads Youth Foundation event. Steelers coach Mike Tomlin always makes time for this event in his home area and he always brings along some of his friends, including the recently retired DeAngelo Hall.
The Chesapeake native now works for the NFL Network and he joined Bruce Rader on the Sportswrap to talk about his new career, how he thinks the Redskins will do this season and who he thinks should be the Redskins starting quarterback.
Watch the complete interview on WAVY.com.
Steelers coach Mike Tomlin joins Bruce Rader on the Sportswrap
HAMPTON (WAVY) -- Pittsburgh Steelers head coach Mike Tomlin is back in his home area, once again hosting his annual Hampton Roads Youth Foundation event.
The event got underway Friday night with a Casino Night, and it concludes on Saturday with a youth football camp at Hampton University.
Tomlin sat down with Sports Director Bruce Rader to talk about the importance of giving back to his community and what to expect from the Steelers following a season that saw them miss the playoffs.
Watch the interview on WAVY.com.
Local NFL players get set for training camp
by Nathan Epstein / Jul 11, 2019
PORTSMOUTH, Va. (WAVY) - The month of July is flying by, the Major League All-Star game has come and gone, and that means it's almost time for NFL training camp.
Players from several teams will report next week, and a number of local names are gearing up for another season.


text:
Q: AlamoFire: how to get file size of downloaded image in swift? I have tried using Alamofire, and alamofireimage but can't seem to get the file size of a downloaded image consistently. Am I using the wrong approach? because surely if Alamofire has downloaded the image, it will know what the filesize is?
Here is the example code I am using
 Alamofire.request(.GET, imageUrlToShow)

        .responseImage { af_image in
            debugPrint(af_image)

            print(af_image.request) // Sometimes Content-Length is returned by other times not

            if af_image.result.isFailure {
                print("error")
                completionhandler(imageInfo: nil, error: af_image.result.description)
            }
            if af_image.result.isSuccess {

                if let serverResponse = af_image.response {
                let serverHeaders = serverResponse.allHeaderFields

                    if let imageSize = serverHeaders["Content-Length"] as? String {
print("we got an imagesize")
}

A: This is the last correct syntax for the latest version (AlamofireImage 2.4.0 with dependencies from Alamofire 3.3):
import AlamofireImage

var ext: String! = "jpeg"

self.ext = "png"
Alamofire.request(.GET, "https://httpbin.org/image/png")
         .responseImage { response in
             debugPrint(response)

             print(response.request)
             print(response.response)
             debugPrint(response.result)

             if let image = response.result.value {
                 print("image downloaded: \(image)") // example: background.png
                 var imgData: NSData!
                 switch self.ext {
                    case "png":
                      imgData = NSData(data: UIImagePNGRepresentation(image)!)
                    case "jpeg":
                      imgData = NSData(data: UIImageJPEGRepresentation((image), 1)!)
                    default:
                      break
                 }
                 if let data = imgData {
                     print("Size of Image: \(data.length) bytes")
                 }
             }
         }

You can also use the general Alamofire framework , exactly this example (download files or resume a download that was already in progress).
Alamofire.download(.GET, "https://httpbin.org/stream/100") { temporaryURL, response in
    let fileManager = NSFileManager.defaultManager()
    let directoryURL = fileManager.URLsForDirectory(.DocumentDirectory, inDomains: .UserDomainMask)[0]
    let pathComponent = response.suggestedFilename

    return directoryURL.URLByAppendingPathComponent(pathComponent!)
}

Alamofire.download(.GET, "https://httpbin.org/stream/100", destination: destination)
         .progress { bytesRead, totalBytesRead, totalBytesExpectedToRead in
             print(totalBytesRead)

             // This closure is NOT called on the main queue for performance
             // reasons. To update your ui, dispatch to the main queue.
             dispatch_async(dispatch_get_main_queue()) {
                 print("Total bytes read on main queue: \(totalBytesRead)")
             }
         }
         .response { _, _, _, error in
             if let error = error {
                 print("Failed with error: \(error)")
             } else {
                 print("Downloaded file successfully")
             }
         }

A: You can use .responseData() to get the data that was returned, and get the size from that. Unfortunately the accuracy of Content-Length depends on the server returning the correct information. As you've seen that's not always an accurate indicator and not always included in responses.

redpajama_set_name: RedPajamaStackExchange


text:
class PrescribedTest < ActiveRecord::Base
  belongs_to :prescription
  has_one :laboratory_report
  belongs_to :service

  named_scope :by_laboratory_dept, lambda { |laboratory_dept_id| {:conditions => ["department_id = ?", laboratory_dept_id]} }
  named_scope :by_other_dept, lambda { |laboratory_dept_id| {:conditions => ["department_id != ?", laboratory_dept_id]} }

  def prescribed_lab_tests

  end
end

redpajama_set_name: RedPajamaGithub


Some needy families from Rus (Salaj) received 34 Alpine goats (a goat breed known for its very good milking ability), thanks to a project implemented by Heifer Project România in partnership with Agapis Foundation. Therefore, the beneficiaries of this project will improve their nutrition and supplement their income.
One of the cornerstones of Heifer's philosophy is Passing on the Gift, which allows families who have received the goats, to donate themselves the first female offspring to a named recipient from the same village. The project from Rus was the first one when the "living gift" was offered by other communities who have already took part in this kind of project: Nemsa (Sibiu) and Dragu (Salaj).


text:
Joe Biden leads Bernie Sanders in Maine's Democratic presidential primary
by Jessica Piper March 4, 2020 March 4, 2020
Democratic presidential candidate former Vice President Joe Biden points to his doggie bag as he leaves the Buttercup Diner during a campaign stop in Oakland, Calif., Tuesday, March 3, 2020. Credit: Tony Avelar | AP
Update: The BDN and its national election results partner, Decision Desk HQ, called the race for Joe Biden on Wednesday at 9 a.m. Read the latest story here.
AUGUSTA, Maine — Maine's Democratic presidential primary was too close to call early Wednesday with former Vice President Joe Biden on the verge of an upset over Vermont Sen. Bernie Sanders in a race shaped by late dropouts in the crowded field.
Biden led with 34.1 percent of votes in Maine to Sanders' 33.2 percent as he asserted himself as the new frontrunner on Super Tuesday with nearly 86 percent of municipalities reporting.
Candidates must reach 15 percent in Maine or one of its congressional districts to win any delegates to the Democratic National Convention.
Biden, Sanders and Massachusetts Sen. Elizabeth Warren were on track to win delegates in Maine, which was among the 14 voting on Super Tuesday in the Democratic nominating race to face President Donald Trump, who was uncontested on the Republican ballot in Maine.
no result handler for source: "local"
* This race will be decided by ranked-choice voting. If no candidate wins more than 50 percent of total votes, the Maine secretary of state will conduct a second ballot tally at a later date to determine the winner.
NAN% reported
It was a stunning day for Biden, who won Texas and Massachusetts to cement front-runner status nationally. Sanders won California, the state carrying the most delegates. Biden ran no campaign in Maine and Massachusetts, while Sanders and Warren organized here for months.
Portland City Councilor Spencer Thibodeau, one of only a few public officials in Maine to endorse Biden, said he was "pleasantly surprised" by the former vice president's performance in Maine, adding that the results showed that voters found his message impactful.
"This has certainly turned into a super Tuesday for Joe Biden," Thibodeau said.
The result on Tuesday was a sharp reversal from a Colby College survey released in mid-February in which Biden polled at just 12 percent, trailing Sanders, former Mayor Pete Buttigieg of South Bend, Indiana, and former New York City Mayor Michael Bloomberg.
The primary was roiled this past weekend after Buttigieg, Minnesota Sen. Amy Klobuchar and billionaire activist Tom Steyer all dropped out of the race in a span of three days. Buttigieg and Klobuchar endorsed Biden — as did some of their prominent Maine supporters — including State Treasurer Henry Beck, who had initially backed Buttigieg.
Sanders, who won the Maine caucuses handily over Hillary Clinton in 2016, was still seen as the likely frontrunner in the state this time as he led in fundraising from Mainers. He also had organizing infrastructure in the state leftover from his previous campaign.
Sanders is likely to receive nearly as many delegates from Maine as Biden. But the result is still a significant symbolic victory for the former vice president, who won without any of the campaign infrastructure that Sanders, Bloomberg and Warren deployed in the state.
Warren had 15.9 percent of the vote early Wednesday and will likely finish with a share of delegates, while Bloomberg finished below the threshold at 11.8 percent statewide. Hawaii Rep. Tulsi Gabbard, the only other active candidate on the ballot, won less than 1 percent. Candidates who left the race combined for 4.2 percent of votes.
At a watch party at Sanders' Portland office on Tuesday night, campaign staff and volunteers mixed excitement and disappointment, cheering victories in Vermont, Colorado and California while pointing to a need to organize for progressive candidates and causes in the state.
Benjamin Collings, Sanders' state director, downplayed expectations Tuesday night, noting that the Vermont senator was not always considered a frontrunner for the Democratic nomination. He added that the "movement" Sanders' had created was bigger than candidate himself, pointing to the recent popularity of ideas like a $15 minimum wage.
"He's completely changed the Democratic Party," Collings said.
Buttigieg had been expected to win some delegates here and still came away with 2.1 percent of votes. It was likely a result of many of the 22,000 voters who submitted absentee ballots through the end of last week. The late re-allocation of Buttigieg and Klobuchar voters who voted on Election Day likely helped Biden and others.
The results were disappointing for Bloomberg, who was a wild card going into Tuesday after opting not to compete in the first four contests. He threw $400 million of his own money into TV ad spending, including more than $2 million in Maine, according to FiveThirtyEight.
Biden has not visited the state since a book tour in early 2018. Diane Sherwood, a Biden voter from Fort Fairfield, said at the polls that she saw Sanders as "a screamer," and she wanted some "a little bit more balanced."
"For me, the main thing is to beat the existing president and get him out of office," Sherwood said. "I think Joe is the one who can do it."
BDN writers Michael Shepherd and David Marino Jr. contributed to this report.
Tagged: Bernie Sanders, election 2020, Joe Biden, local news, March 2020 Primaries
Previous 6 takeaways from Super Tuesday
Next Joe Biden wins Democratic primary in Texas


Our story – we're a friendly bunch of like-minded design fanatics. We launched our first nood stores in NZ in 2007 and have continued to expand but still remain a tight, dedicated and passionate team operating out of Christchurch. our team is continuously sourcing new products from around the world that we believe will complement the New Zealand lifestyle no matter what your style or budget. We pride ourselves on offering a unique range of on trend products that span furniture, kitchen & dining, bed & bath, homewares, giftware, and much more to help coordinate and create the home you desire. We believe in new and desirable products that are accessible to everyone.
Positions available - take a look at our current opportunities - if nothing takes your fancy, feel free to email us at employment@nood.co.nz and tell us a bit about yourself. We are always keen to hear from like minded people, so don't be shy.
What's it like to work at Nood – no two days are ever the same, it's a fun and fast paced environment. We're a well-known reputable brand with 15 stores around NZ. If your passionate about customer service and beautiful home décor and furniture you'll fit right in.
Perks - working here requires a love for beautiful home decor and furniture, so we offer our staff awesome discounts so they can enjoy the beautiful items we have on offer at home.


On my summer trip through Europe, I had a few extra days to spare and knew I had to stop in Paris. I have wanted to go since I was a little girl, and even more so once I started taking French language classes in high school. I couldn't wait to see the sites and absorb all that Paris had to offer.
Arriving in Paris, I was exhausted but ready to explore! So after dropping my bags off at the hotel, I rushed down the streets to see the magnificent Eiffel Tower. Luckily I had a reservation, which saved me hours of waiting.
Very helpful tip: as soon as you know you'll be in Paris, book a reservation for the Eiffel Tower! They fill up fast, and you don't want to spend half your day waiting in line just to buy a ticket for the iconic structure.
When you're done, grab a meal at a nearby cafe. There are a lot of options in this heavily populated area, but I settled on Café Du Marché for a delicious sandwich that hit the spot.] (Contrary to popular belief, it is possible to find reasonably priced cafe meals in this area, despite it being fairly touristy).
A visit to Notre Dame is the first order of business, but even though I got there early in an effort to beat the crowds, the plaza was already quite packed. Once inside, I was in awe of the beautiful architecture and decorations covering the church.
I recommend taking the trek up the stairs to get one of the best views of Paris. It's tiring, but definitely worth it! Allow a few hours for the overall experience.
Afterwards, take a stroll along the Seine River and check out the street vendors. You can find everything from old novels to beautiful, handmade jewelry. I grabbed lunch from a local restaurant and headed to the Louvre on the right bank of the river.
Again, buy your tickets in advance to save some time. The palace is massive though, so allow at least three to four hours if you want to see everything.
I decided to take the train out of the city to check out Versailles. It's about an hour train ride west of the city, and provides time to relax. Once again, buying your ticket in advance will save you a huge headache.
Another tip: avoid Tuesdays, as the palace is closed Mondays and often brings a huge crowd the following day. Plan on spending the whole day here to really enjoy the beauty of the palace and the grounds.
Take the morning to go on a photo walk and some unstructured sightseeing. I found myself by the old Pont des Arts bridge, where lovers used to put their names on locks. (This is no longer allowed because the locks had finally begun to weigh the bridge down to an unsafe degree).
Afterwards, head down to the Champs Elysee. This is a great place to stop for a meal or coffee and people watch from one of the many outdoor restaurants. At the end of the avenue, one of the most recognizable roundabouts in the world awaits you, the Arc de Triomphe.
With twelve streets merging into it, there's always a crazy scene to be watched. Take one of the underground tunnels to go inside the Arc de Triomphe, and see the Tomb of the Unknown Soldier. Another tip: going in the evening will give you an incredible view of Paris as the sun sets!
For similiar trips, check out these tours to Paris on Stride!


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text:
Samsung becomes the top smartwatch vendor in India
by Nivedita Bangari
Samsung is one of the worlds leading smart devices and chip manufacturers in the world and according to recent sources, the company has gained another milestone in its record. Recently, the South Korean tech giant has emerged as India's top smartwatch maker in the second quarter of 2021.
This development came as a sudden wave of an 860% year-over-year growth in shipments, and the increasing demand for high-performing smartwatches. The second quarter of 2021 has been extremely profitable for Samsung as it not only became India's top smartwatch brand but it also became the top vendor in the sales of SSD's and VRAM's.
Samsung ended the June quarter with a 41.2% volume market share driven by the popularity of Galaxy Watch Active 2 and Watch 3 Series. Samsung opened pre-bookings for Galaxy Watch4 and Galaxy Watch4 Classic in India on August 30, 2021.
The Watch4 series comes with a suite of health features including body composition tracking, sleep pattern tracking, blood oxygen measurement, pulse among others. It keeps track of the user's health parameters even when they are asleep and it has a high-resolution AMOLED display.
Galaxy Watch4 starts at Rs 23,999, while the Galaxy Watch4 Classic starts at Rs 31,999.
The devices will go on sale from September 10, 202 on Samsung.com and across online and offline retail stores.
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