Connecticut Naturopathic Physician Continuing Education

• Describe the profile of suicide in the US, noting psychosocial and cultural factors that effect risk
• Identify 3 common precipitating events for suicide attempts
• Describe risk factors for suicide including co-existing psychiatric disorders
• Name the most frequent co-existing psychiatric disorders
• Use the sad person scale to assess suicide risk
• Give examples of primary, secondary, and tertiary interventions
• Describe basic level interventions that take place in the hospital or community
• Identify key elements of suicide precautions and environmental safety factors in the hospital
• Describe the problem on non-suicidal self-injury
• Explain the range of self-protective behavioral responses
• Discuss 3 myths about suicidal behaviors
• Identify 2 cultural or social factors that relate to suicide
• Examine 4 categories of motivation for attempting suicide
• Explain how suicide affects family members and friends
• Describe 3 theories that attempt to explain the causes of suicide
• Discuss the occurrence of suicide throughout each life cycle
• Outline the process for assessing the suicidal potential of a client
• Choose 3 therapeutic goals and interventions for clients with suicidal behaviors

• Indicate the manifestations of military sexual trauma
• Cite the rate of disability amongst living veterans
• Describe the incidence and distribution of mental illness in the veteran population
• Define PTSD
• Recognize the DSM-5 criteria for the diagnosis of PTSD
• Explain the risk factors to developing PTSD
• Summarize the association between PTSD and Chronic Pain
• Describe the Primary Care PTSD Screen (PC-PTSD)
• Recognize the effects of PTSD on the family of sufferers
• Summarize the psychological and pharmacological treatment for PTSD
• Define depression
• List the DMS-5 Criteria for depression
• Recognize the signs and symptoms of depression
• Define survivor guilt
• Explain suicide prevention and the VA Risk Assessment Guide
• Outline the use of the SAD PERSONS instrument
• List the risk factors to suicidal behavior
• Outline the long and short term goals in suicide prevention, interventions and their rationale
• Define the characteristics of hopelessness
• List the outcome criteria for intervention for patients with hopelessness
• Explain the factors related to ineffective coping mechanisms
• List long and short term goals of the management of ineffective coping mechanisms
• Describe interventions and their rationale for the patient with ineffective coping
• Identify medications used to treat anxiety
• Recognize medications used to treat psychotic diseases
• Identify principal signs of depression and drugs used as treatment
• Recognize agents used as antimanics and medications for bipolar disorder
• Describe behavioral disorders found in adults and children and drugs indicated in treatment
• Explain the role of medications in treating Alzheimer’s disease
• Provide patient education for compliance with medications used to treat conditions and diseases of mental health and behavioral disorders

• Determine the epidemiology, etiology and background on obesity
• Assess the theories of obesity development and pathophysiology
• Outline the risks and morbidities related to obesity

• Outline the management of obesity
• Summarize the assessment of obesity for the busy clinician
• Synthesize the literature on the dietary management of obesity
• Discuss the role of exercise and physical fitness in the management of obesity and overweight

• Outline the principles of body composition assessment
• Review the anthropometic measures of body composition
• Discuss the circumference measurements of body composition
• Assess the laboratory and field assessments of body composition

• Outline the definition and components of health and wellness
• Review the dimensions of wellness
• Discuss various models of health and the need for wellness lifestyles
• Outline the publication and goals of Healthy People

• Identify the differences between the holistic and allopathic models for health and wellness
• Show how the Web of Well-Being can be used to assess and educate clients about the various factors impacting their wellness.
• Describe the conclusions of research into the benefits of meditation for human health.
• Explain the basic principles and practice of a simple mindfulness meditation technique.

• Emphasize the unique anatomy of the cervical spine as related to spinal trauma.
• Point put the importance of the uncinate process joints as related do disc herniation, the nerve root, the vertebral artery, and the spinal cord.
• Explain how cervical spine injury may manifest clinically as low back and leg pain.
• Explain the role for sleep and sleep’s influence on the ability to safely operate a motor vehicle.
• Summarize the influence of sleep on brain neurochemistry.
• Explain the influence of awareness on an impending collision and the muscles ability to protect joints.
• Explain how being “caught by surprise” by a collision is related to a poor prognosis for full recovery.
• Summarize the history of whiplash injuries, including mechanical mechanisms, biological mechanisms, pathology, diagnostics and management.
• Define the issues that the early whiplash literature got wrong.
• Emphasize the issues that early whiplash literature got correct.
• Summarize recent advances in the understanding of whiplash injuries, emphasizing anatomy, diagnostics, pain production and pain suppression.
• Integrate whiplash trauma, chronic pain, and chiropractic care.
• Point out the mathematics of how a low speed vehicle to vehicle collision can result in passenger injury.
• Explain why vehicle damage should not be used as a proxy for passenger injury.
• Integrate the concepts of awareness, rotation, and pre-accident spondylosis in injury magnitude and prognosis.
• Define the three phases of soft tissue healing and point out the time sequence for each phase.
• Justify the clinical interventions that have a positive therapeutic influence on each phase of soft tissue injury healing.
• Emphasize the concept of motion in the healing of injured soft tissues, especially spinal adjusting (specific manipulation) motion.
• Quantify acute injury and ultimate recovery(prognosis) by using measurement outcomes.
• Summarize the biology and published data on treatment frequency and duration for whiplash spinal trauma.
• Point out published studies relating to recovery and prognosis.
• Reference the incidence of acceleration of spondylosis in long-term studies following a whiplash injury.

Hour 1:    Anatomy Review 

• Emphasize the unique anatomy of the cervical spine as related to spinal trauma.
• Point out the importance of the uncinate process joints as related to disc herniation, the nerve root, the vertebral artery, and the spinal cord.
• Explain how cervical spine injury may manifest clinically as low back and leg pain.

Hour 2:    Define Sleep Hygiene

• Explain the role for sleep and sleep’s influence on the ability to safely operate a motor vehicle.
• Summarize the influence of sleep on brain neurochemistry.

Hour 3:    Awareness and Soft Tissue Injury

• Explain the influence of awareness on an impending collision and the muscles ability to protect joints.
• Explain how being “caught by surprise” by a collision is related to a poor prognosis for full recovery.

Hour 4:    Whiplash History

• Summarize the history of whiplash injuries, including mechanical mechanisms, biological mechanisms, pathology, diagnostics and management.
• Define the issues that the early whiplash literature got wrong.
• Emphasize the issues that early whiplash literature got correct.

Hour 5:    Whiplash Today

• Summarize recent advances in the understanding of whiplash injuries, emphasizing anatomy, diagnostics, pain production and pain suppression.
• Integrate whiplash trauma, chronic pain, and chiropractic care.

Hour 6:    Low Speed Collisions and Minor Vehicle Damage

• Point out the mathematics of how a low speed vehicle to vehicle collision can result in passenger injury.
• Explain why vehicle damage should not be used as a proxy for passenger injury.
• Integrate the concepts of awareness, rotation, and pre-accident spondylosis in injury magnitude and prognosis.

Hour 7:    Soft Tissue Injury and Repair

• Define the three phases of soft tissue healing and point out the time sequence for each phase.
• Justify the clinical interventions that have a positive therapeutic influence on each phase of soft tissue injury healing.
• Emphasize the concept of motion in the healing of injured soft tissues, especially spinal adjusting (specific manipulation) motion.
• Quantify acute injury and ultimate recovery(prognosis) by using measurement outcomes.

Hour 8:    Treatment Duration, Frequency, and Prognosis

• Summarize the biology and published data on treatment frequency and duration for whiplash spinal trauma.
• Point out published studies relating to recovery and prognosis.
• Reference the incidence of acceleration of spondylosis in long-term studies following a whiplash injury.

Hour 1:     Low Back and Leg Pain Following Whiplash Injury

• Point out the probable mechanisms for direct injury to the lower back during motor vehicle collisions.
• Distinguish between radiculopathy, neuropathy, and sclerogenic referral of extremity pain.

Hour 2:     Whiplash Injury and the Vertebral Artery

• Review the anatomy of the vertebral-basilar vascular systems.
• Distinguish between the anterior and posterior circulation.
• Summarize the signs and symptoms of a cervical spine vascular injury.
• Solidify the knowledge as to when the suspected vascular injury patient should be referred to diagnostic imaging or emergency services.

Hour 3:     Whiplash Injury and Traumatic Brain Injury

• Explain the differences between a blow brain injury and an inertial brain injury.
• Define the pathoanatomic and patho-biochemistry of traumatic brain injury.
• Justify clinical interventions that have a positive therapeutic influence on traumatic brain injury.

Hour 4:     Cervical Disc Herniation

• Point out the anatomical differences between lumbar and cervical discs.
• Explore the pathoanatomical and therapeutic differences between lumbar and cervical discs lesions.

Hour 5:     Examinations and Evaluations

• Explain the minimum examinations that should be performed.
• Explain the minimum requirements for charting the daily patient contact.

Hour 6:     Informed Consent

• Define the legal requirements for informed consent for chiropractic care.
• Review common entities for an informed consent and the rational for each.

Hour 7:     Reports

• Make recommendations for re-evaluations.
• Make recommendations for interim reports contents.
• Explore common academic terminology and concepts in effective report writing.

Hour 8:     Testimony

• Distinguish between a percipient witness and an expert witness.
• Explain what a subpoena is and what it means to the treating chiropractor.
• Explain what a deposition is for the treating chiropractor. Summarize the basic rules of a treating expert deposition.
• Summarize the mechanics of a personal injury trial from the perspective of the treating chiropractor.

Hour 1 

• Point out the probable mechanisms for direct injury to the lower back during motor vehicle collisions.
• Distinguish between radiculopathy, neuropathy, and sclerogenic referral of extremity pain.

Hour 2 

• Define the parameters for cervical and lumber spine central canal stenosis.
• Utilize both the Torg/Pavlov and the ratio radiographic methods for assessing cervical spine central canal stenosis.
• Explain the critical relationship between central canal stenosis and hyperextension spinal injuries.
• Demonstrate a practical method for the clinical assessment of cervical spine central canal stenosis.

Hour 3

• Identify differences seen between a blow brain injury and an inertial brain injury.
• Define the pathoanatomic and patho-biochemistry of injury.
• Explore the relationship between cervical spine injury and TBI

Hour 4

• Discuss the concept of how the systemic inflammatory profile affects local injury.
• List 8 systemic inflammatory factors that should be considered and co-managed on whiplash-injured patients.

Hour 5 

• Discuss the anatomy of the thoracic outlet.
• Demonstrate a management protocol for thoracic outlet syndrome.
• Define cervical angina.
• Demonstrate the single most important test to distinguish cervical angina

Hour 6

• Draw the anatomical basis for cervicogenic headache.
• Integrate cervicogenic headache and the temporomandibular joint (TMJ).
• Define inertial injury and the TMJ articulation.
• Demonstrate a practical assessment and management of TMJ injury.

Hour 7

• Distinguish between a percipient witness and an expert witness.
• Explain what a subpoena is and what it means to the treating chiropractor.
• Explain what a deposition is for the treating chiropractor. Summarize the basic rules of a treating expert deposition.
• Summarize the mechanics of a personal injury trial from the perspective of the treating chiropractor.

Hour 8 

• Demonstrate a typical soft tissue direct examination.
• Show the two most common drawings to support chiropractic care for soft tissue injuries.

• Recite exercise guidelines and recommendations by the ACSPPSE, HHS and ACOG
• Outline and describe 6 benefits of exercise during pregnancy
• Describe 4 maternal physiologic changes that occur during pregnancy
• Describe 3 physiologic changes associated with exercise during pregnancy
• List 5 relative and 5 absolute contraindications to exercise during pregnancy
• Describe 2 fetal outcomes associated with maternal exercise during pregnancy

• Review anatomy and physiology of the female patient
• Perform Physical Examination procedures unique to the female patient
• Identify conditions unique to the female patient that require referral to a Medical Doctor
• Discuss the presentation, evaluation, and management of conditions affecting women’s health within the scope of Chiropractic practice
• Discuss risk factors, screening and prevention recommendations with female patients
• Review nutritional supplementations that can augment conditions affecting women’s health within the scope of Chiropractic practice

Hour 1

• Illustrate the patterns behind disordered eating in female athletes.
• Distinguish differences in the hormonal cycle, and menstrual disturbances in different kinds of female athletes.
• Contrast the differences of evaluation and management of female athletes.
• Compare and contrast the chemically and structural differences between male and female athletes.

.Hour 2:

• List common female athletic injuries.
• Explain how to evaluate knee and lower leg injuries.
• Apply knowledge of muscle strength and hormonal differences to provide suitable training recommendations for a strength athlete.
• Explain nutritional deficiencies in female athletes.

 Hour 3:

• List the detriments in health and/or sports performance from lack of proper nutrition.
• Provide recommendations for appropriate nutritional guidelines for female athletes.
• Consider body composition, increase muscle mass, and improve overall sports performance of female athletes.

• This contains all courses with the educational objectives listed from Xray 103 through Xray 118

• Discuss a common origin of lumbar disc pain
• Describe the orientation of lumbar facet joints
• Identify the effect of lordosis on the position of the nucleus pulposis
• Establish how injuries of the annulus fibrosus can cause nerve root changes
• Identify the dynamic stenosis of the lumbar spine

• Identify anatomical structures of the knee involved with anterior knee pain
• Diagnose fat pad and bursitis syndromes
• Establish pathologies of the patellar tendon in adults and children
• Differentiate different causes of patellofemoral pain
• Match clinical syndromes of knee pain with radiological appearances

• Identify the general anatomy of the knee joint
• Develop an intimate knowledge of the anatomy of the menisci and ligaments of the knee using gross dissection and cross-sectional imaging
• Understand the functional anatomy of the menisci of the knee and define the type and grade of meniscal tears
• Establish the conditions discoid lateral meniscus and meniscal cyst and understand the spectrum of treatment available
• Identify what type treatment is available for meniscal injuries and when it would be prudent to reevaluate a post-op patient with new knee pain

• Outline the physical basis of magnetic resonance imaging
• Identify patients that are candidates for an MRI
• Recognize categories of pathology in the spine that are imaged well with MRI
• Recognize cases that require contrast
• List contraindications for an MRI

• Identify and classify injuries to the anterior cruciate ligament
• Diagnose and develop treatment for injuries to the posterior cruciate ligament
• Diagnose and develop treatment for injuries to the medial collateral ligament
• Diagnose and develop treatment for injuries to the lateral collateral ligament
• Describe and classify ostochondritis dissecans of the knee

• Differentiate ossification from calcification
• Identify the categories of ossification
• Differentiate myositis ossificans progressiva from myositis ossificans traumatica
• Discuss imaging utilization with regards to ossification
• Review common and uncommon entities predisposed to ossification or calcification

• Recognize and identify important key factors for interpreting plain film x-rays of the spine and pelvis
• Recognize important medical/legal issues regarding interpreting plain films of the spine and pelvis and be able to apply appropriate radiographic documentation requirements when charting x-ray findings in the medical record
• Identify, analyze and interpret normal and abnormal anatomical osseous structures, common congenital and acquired pathologies, common normal radiographic variants and soft tissue calcifications/structures of the cervical, thoracic, lumbar, lumbosacral spine and pelvis

• Alert your clinical consciousness to prevent complacency
• Explain ways to identify the most common aneurysms clinically and on x-ray in the abdominal aorta, thoracic aorta, and splenic artery
• Differentiate aneurysm from dissection and pseudoaneurysm

• Identify the source of metastatic lesions
• Determine an advanced imaging protocol once a metastatic lesion is found
• Discuss how to identify on radiographs the two most common primary malignancies of bone - multiple myeloma and osteosarcoma

• Discuss the fundamental role of trauma in musculoskeletal disease and the various diagnostic imaging techniques used to evaluate it
• Identify, describe, and classify fractures by both direct & indirect radiographic signs
• Review fractures of specific etiologies based upon imaging findings
• Evaluate fracture alignment issues, complications, and healing
• Identify non-accidental injury of childhood, as well as normal structures that mimic fractures

• Understand Osteoporosis - (risk factors, incidence, prevalence, morbidity, etc.)
• Understand the fundamentals of DEXA (dual-energy x-ray absorptiometry), the gold standard in bone density testing
• Explain how to interpret the results
• Investigate the advantages and limitations of DEXA
• Investigate the indications and contraindications for utilization of DEXA

• This contains all courses with the educational objectives listed in Xray 119, and, Xray 123 through 127

• Use plain film to identify imaging findings of common diabetic foot fractures
• Discuss foot ulcers and using diagnostic imaging to rule out secondary osteomyelitis
• Identify diagnostic imaging findings of neuropathic osteoarthropathy (Charcot foot)

• Explain the clinical presentation, physical examination findings, orthopedic tests, laboratory findings, and radiographic findings associated with ankylosing spondylitis
• Discuss the extraskeletal manifestations of ankylosing spondylitis
• Explain the similarities and differences between the spondyloarthropathies
• Discuss the surgical and pharmacological management
• Discuss treatment that promotes spine mobility including the chiropractic adjustment

• This contains all courses with the educational objectives listed from Xray 124 through 146