Fifth Edition: the New Standard

2000 ◽  
Vol 5 (6) ◽  
pp. 1-7
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage ◽  
Leon H. Ensalada
Keyword(s):  
Musculoskeletal System ◽  
Medical Information ◽  
Objective Assessment ◽  
Scientific Data ◽  
Practical Application ◽  
Fourth Edition ◽  
Appropriate Use ◽  
Medical Evaluation ◽  
Single Set

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is available and includes numerous changes that will affect both evaluators who and systems that use the AMA Guides. The Fifth Edition is nearly twice the size of its predecessor (613 pages vs 339 pages) and contains three additional chapters (the musculoskeletal system now is split into three chapters and the cardiovascular system into two). Table 1 shows how chapters in the Fifth Edition were reorganized from the Fourth Edition. In addition, each of the chapters is presented in a consistent format, as shown in Table 2. This article and subsequent issues of The Guides Newsletter will examine these changes, and the present discussion focuses on major revisions, particularly those in the first two chapters. (See Table 3 for a summary of the revisions to the musculoskeletal and pain chapters.) Chapter 1, Philosophy, Purpose, and Appropriate Use of the AMA Guides, emphasizes objective assessment necessitating a medical evaluation. Most impairment percentages in the Fifth Edition are unchanged from the Fourth because the majority of ratings currently are accepted, there is limited scientific data to support changes, and ratings should not be changed arbitrarily. Chapter 2, Practical Application of the AMA Guides, describes how to use the AMA Guides for consistent and reliable acquisition, analysis, communication, and utilization of medical information through a single set of standards.

scholarly journals Methodological Peculiarities of the Usage of Stretching Techniques in the Process of Flexibility Development

2017 ◽  
pp. 127-130
Author(s):  
Oksana Romaniuk ◽  
Bohdan Zadvornyi
Keyword(s):  
Human Body ◽  
Physiological Mechanism ◽  
Semantic Content ◽  
Scientific Data ◽  
Physical Activities ◽  
The Body ◽  
Human Being ◽  
Practical Application ◽  
Stretching Exercises

The article is devoted to theoretical and methodological substantiations of the body flexibility development practically applying the stretching techniques. It was generalized scientific data on the organization and methodological features of stretching exercises. Semantic content and structural componential model of stretching usage in the process of flexibility development and the estimation of the changes of this characteristic according to the age were carried out. In particular, some parameters were highlighted especially which allow to recommend that methodology both for individual and group usage were analyzed. Besides, it was analyzed the diversity of physiological mechanism of the influence of stretching on human body, especially it was singled out the effect on mental and physical spheres of human being. The generalized scientific data on the theoretical and practical aspects of flexibility development with the help of stretching techniques indicate the priority of usage of this method in many types of physical activities irrespective of the scope of its practical application.

Employability

1997 ◽  
Vol 2 (6) ◽  
pp. 1-2
Author(s):  
Alan Engelberg
Keyword(s):  
Health Status ◽  
Human Resources ◽  
Health Care Providers ◽  
Medical Information ◽  
Medical Condition ◽  
Disability Evaluation ◽  
Care Providers ◽  
Fourth Edition ◽  
Basic Principles

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, provides useful definitions of employability, employability determination, and medical determinations related to employability. As the AMA Guides notes, and the term medical determination related to employability has supplanted the use of employability. Clearly, factors unrelated to health status affect both employability and its determination, but the physician's role is limited to providing useful medical information, culminating in a statement of risk to the employer. The physician's purview never includes a determination of employability, nor does it justify an opinion that an individual is or is not employable. Managers in human resources departments can clarify the basic principles of equal employment opportunity and thereby minimize the risk of intentional or inadvertent discriminatory actions. Disability evaluation covers the interplay of the injured employee, the human resources function, and the health care providers. When a worker's health status is a factor, the physician's assistance in helping an employer determine employability is crucial, but physicians must never voluntarily state that a person is or is not employable. Physicians can assist an employer in determining if a medical condition precludes travel to work, being at work for a specified time, and assignment of appropriate tasks with or without reasonable accommodation.

Performing Quality Impairment Evaluations

1998 ◽  
Vol 3 (4) ◽  
pp. 1-3
Author(s):  
Christopher R. Brigham
Keyword(s):  
Medical Condition ◽  
Data Sources ◽  
Current Status ◽  
Background Information ◽  
Fourth Edition ◽  
Step Process ◽  
Medical Evaluation ◽  
Audit Form ◽  
The Individual ◽  
Comparison Of The Results

Abstract An impairment evaluation aims to produce a report that is clear and consistent with the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, which outlines the three-step process of medical evaluation, analysis of the findings, and comparison of the results with the impairment criteria. This article reviews common errors that can occur in each of these steps. Medical evaluation is the basis for the evaluation of impairment and relies on the patient's medical history; the latter must include adequate background information, specify data sources, document pre-existing status and specifics of the injury, and document history from onset to current status. The medical evaluation should support a report that explains the effects of the medical condition on life activities; whether the medical condition is stable; whether the individual is likely to suffer incapacitation, injury, harm, or further impairment; and whether restrictions or accommodations are warranted. Common errors in this step include determinations of permanency and stability, and raters should be aware that the AMA Guides is used to assess impairment, not disability. Forms from the AMA Guides are appropriate and help mitigate errors. An audit form is included and can help physicians produce consistent, efficient reports.

Research on the Adobe Block of the System of New Compounded Adobe Walls

2012 ◽  
Vol 193-194 ◽  
pp. 553-555
Author(s):  
Guo Ping Liu ◽  
Yin Zhang
Keyword(s):  
Scientific Data ◽  
Rammed Earth ◽  
Practical Application ◽  
Soil Walls

Through the introduction of the Structure of compounded raw soil walls , this paper has a deep research on the adobe block which is the main innovative components of the wall. With the help of the traditional Rammed earth theory and large quantities of practical data, we have gained some scientific data and specific sizes of the adobe block in practical production to further improve the construction art of the ecological walls, providing the reference for the Structure of compounded raw soil walls in practical application.

The medical evaluation of the internationally adopted child

2021 ◽  
Vol 45 (2) ◽  
pp. 228-234
Author(s):  
Randi Sperling ◽  
Danielle Steinberg ◽  
Zachary Belnavis
Keyword(s):  
Medical Information ◽  
Community Support ◽  
Anticipatory Guidance ◽  
Health Issues ◽  
Developmental Assessment ◽  
Adopted Child ◽  
Medical Evaluation ◽  
Behavioural Surveillance ◽  
Internationally Adopted

Children who have been internationally adopted often have complex health issues and unique challenges. 1 The paediatric office provides a medical home by offering continuity of care, links to community support, and appropriate evaluation and treatment. During the pre-adoption evaluation, biographical and medical information provided by the child’s country of origin is reviewed. Additionally, soon after the child’s adoption, a complete medical history and physical examination should be completed. Although laboratory work may have been performed previously, studies should be repeated to ensure reliability. Developmental assessment and review of vaccinations should be completed as well. Anticipatory guidance should be provided regarding medical concerns, effects of institutionalisation and the possibility of attachment issues. Follow-up care ensures optimal medical, developmental and behavioural surveillance in this patient population.

Question and Answer

2004 ◽  
Vol 9 (4) ◽  
pp. 5-9
Keyword(s):  
Reproducibility Of Results ◽  
Medical Information ◽  
Repeated Measurements ◽  
Question And Answer ◽  
Impairment Ratings ◽  
Normal Fluctuations ◽  
Trained Observers ◽  
Single Set

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) aims to provide “consistent and reliable acquisition, analysis, communication, and utilization of medical information through a single set of standards. Two physicians, following the methods of the [AMA] Guides to evaluate the same patient, should report similar results and reach similar conclusions.” In addition, the AMA Guides emphasizes that “[c]onsistency tests are designed to ensure reproducibility and greater accuracy.” If findings are inconsistent, the examiner may choose not to base an impairment rating on them, but, as with any biological measurements, some variability and normal fluctuations are inherent in permanent impairment ratings. Specifically, two measurements by the same examiner on two separate occasions or by two trained observers using the AMA Guides are consistent if they fall within 10% of each other. Repeated measurements may decrease error, and examiners should observe for consistencies in both behavior and findings. The musculoskeletal chapters of the AMA Guides provide specific directions in terms of consistency of measurements (eg, the number of measurements that should be taken using each test), allowable variations in measurements taken at different times, reproducibility of results on different occasions or by two or more trained observers, and the validity of these measurements. Inconsistent findings cannot be used to rate impairment.

High prevalence of sexually transmitted infections among women screened for a contraceptive intravaginal ring study, Kisumu, Kenya, 2014

2018 ◽  
Vol 29 (14) ◽  
pp. 1390-1399 ◽  
Author(s):  
Vincent O Oliver ◽  
George Otieno ◽  
Roman Gvetadze ◽  
Mitesh A Desai ◽  
Mumbi Makanga ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Medical Information ◽  
Prevalence Ratio ◽  
Combination Prevention ◽  
Exchange Sex ◽  
Sexually Transmitted ◽  
Medical Evaluation ◽  
Kenyan Women ◽  
Intravaginal Ring ◽  
Simplex Virus

We assessed prevalence and correlates of bacterial vaginosis (BV) and sexually transmitted infections (STIs) including herpes simplex virus type 2 (HSV-2), gonorrhoea (GC), syphilis (SYP), Chlamydia (CT) and HIV among Kenyan women aged 18–34 years who were screened for a contraceptive intravaginal ring study. Women provided demographic, behavioural and medical information, and underwent medical evaluation, including a pelvic exam. We computed crude and adjusted prevalence ratio (aPR) and 95% confidence interval (CI) using log-binomial regression. Of 463 women screened, 457 provided laboratory specimens and were included in the analysis. The median age was 25 years, interquartile range (21–28), and 68.5% had completed primary or lower education. Overall, 72.2% tested positive for any STI or BV. Point prevalence was 55.6, 38.5, 3.9, 2.0, 4.6, and 14.7% for HSV-2, BV, GC, SYP, CT, and HIV, respectively. Co-infection with HSV-2, BV, and HIV occurred in 28 (6.1%) participants. Having ≥1 STI/BV was associated with younger age at first sex (≤13 versus 17–19 years, aPR=1.27, 95% CI 1.07–1.51), history of exchange sex (aPR = 2.05, 95% CI 1.07–3.92), sexual intercourse in the past seven days (aPR = 1.17, 95% CI 1.01–1.36), and older age (30–34 versus 18–24 years, aPR = 1.26, 95% CI 1.06–1.48). STI/BV diagnosis was less likely for women reporting one lifetime sexual partner compared to women with ≥4 lifetime sexual partners (aPR = 0.70, 95% CI 0.54–0.92). Combination prevention approaches (biomedical, behavioural, social, and structural) tailored to women with diverse risk profiles may help mitigate STI/BV prevalence in this setting.

Spatial visualisation and quantification of expression of cell specific markers — an application for chronic parathyroiditis cases

Open Medicine ◽  
2006 ◽  
Vol 1 (1) ◽  
pp. 46-57
Author(s):  
Elżbieta Kaczmarek ◽  
Rafał Strzelczyk ◽  
Agnieszka Górna ◽  
Przemysław Majewski
Keyword(s):  
Spatial Representation ◽  
Objective Assessment ◽  
Sampling Techniques ◽  
Digital Microscopy ◽  
Practical Application ◽  
Colour Intensity ◽  
Image Brightness ◽  
Tissue Sections ◽  
Third Dimension ◽  
Microscopy Images

AbstractThe aim of this work was to develop a simple and fast technique for spatial visualisation of colour cell specific markers in digital microscopy. Colour light microscopy images were transformed into their spatial representation by introducing image brightness as the third dimension. Based on spatial representation, the expression of selected colour specific markers was assessed by their surface, volume, area fraction and colour intensity. This technique was implemented for quantitative analysis of expression of PCNA, Ki67 and bcl-2 in chronic parathyroiditis cases. Comparing to standard, colour sampling techniques, the presented method based on spatial visualisation of the expression of markers in tissue sections, seems an effective and practical application in objective assessment of their distribution in the investigated material.

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