AMA Guides® Newsletter - Issue Archive

Articles

1. Practical Individual Resilience: A Neuroplastic Approach

   Robert Aurbach

   Pages 3–11

   DOI: 10.1001/amaguidesnewsletters.2015.MarApr01

   Abstract

   Resilience has been a disappointment in the context of understanding why some people bounce back from injury, illness, or other challenges, but others do not. Researchers have identified characteristics that are found in people they deem to be resilient, but these characteristics are too general to be used effectively and do not demonstrate how to build or reinforce resilience. Humans form habits of thought, feelings associated with particular stimuli, and behaviors in response to stimuli, a process known as neuroplasticity. Injured or ill individuals often are presented with additional stimuli that maintain the associations and expand the scope of illness. In the privacy of their own minds, individuals may repeat self-negating thoughts about economic pressure, loss of work identity, psychosocial issues, and others that lead to anger, frustration, worry, catastrophic thinking, and grief—creating a web of disability. In this context, resilience can be reframed as the ability of a person to change, quiet, or moderate self-talk in order to minimize their long-term reaction to stressors. To foster resilience, individual interventions can be undertaken as general life training, specific inoculation against anticipated situations, or in a remedial role to help those whose experience of challenges has been exacerbated by an inner voice that is out of control. Workplaces that enhance rather than diminish individual resilience allow productivity and wellness to coexist and reinforce one another.
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2. Q&A: Rating Multiple Pelvic Fractures

   James B. Talmage

   Pages 11–11

   DOI: 10.1001/amaguidesnewsletters.2015.MarApr02

   Abstract

   Part 1 of this series examined many of the rules in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, regarding rating nerve entrapment or focal neuropathies; the current article, part 2, examines how to read and match the findings in an electrodiagnostic report to the criteria in Appendix 15-B, Electrodiagnostic Evaluation of Entrapment, as explained in Section 15.4f, and determine the severity of the test findings as listed in Table 15-23. Physicians who perform nerve conduction studies often use their own definitions of mild, moderate, and severe; these definitions are not standardized and frequently differ from the electrophysiologic definitions used in the AMA Guides, Sixth Edition. When examiners rate focal entrapment neuropathy, they must match data from the electrodiagnostic report to the criteria in Appendix 15-B, and a figure shows a hypothetical motor nerve conduction report for a case that shows both mild neuropathy (conduction delay) of the median nerve at the wrist (carpal tunnel syndrome) and severe neuropathy (axon loss) of the ulnar nerve at the elbow (cubital tunnel syndrome). If both fibrillations and positive waves are seen in the same muscle, the reviewer can be more confident that other electromyographic potentials were not misinterpreted as fibrillations. Prepared with the results of electrodiagnostic studies, the evaluator can work through the steps of history, physical findings, and functional scale to determine the final upper limb impairment according to the AMA Guides.
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3. Peripheral Nerve Entrapment Impairments: Part II, Electrodiagnosis

   James B. Talmage, Jeffrey Hazlewood, J. Mark Melhorn, Charles N. Brooks

   Pages 12–14

   DOI: 10.1001/amaguidesnewsletters.2015.MarApr03

4. Book Review: Living Abled and Healthy: Your Guide to Injury & Illness Recovery

   Christopher R. Brigham, Henry Bennett, David Torrey

   Pages 15–15

   DOI: 10.1001/amaguidesnewsletters.2015.MarApr04